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: A sudden increase in aggression, hiding, or vocalization is often the first sign of underlying pain, such as arthritis, dental disease, or internal discomfort.

A change in behavior is often the very first sign of sickness. For example, a normally affectionate cat that suddenly hides may be experiencing underlying kidney pain or arthritis.

The "grimace scale" in horses utilizes facial muscle tension, ear position, and nostril dilation to quantify pain levels before clinical bio-markers change. Pathological Behavior vs. Psychological Distress