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This study aimed to develop and validate the Feline Grimace Scale (FGS) to detect naturally-occurring acute pain. Thirty-five client-owned and twenty control cats were video-recorded undisturbed in their cages in a prospective, case-control study. Painful cats received analgesic treatment and videos were repeated one hour later. Five action units (AU) were identified: ear position, orbital tightening, muzzle tension, whiskers change and head position. Four observers independently scored (0\u20132 for each AU) 110 images of control and painful cats. The FGS scores were higher in painful than in control cats; a very strong correlation with another validated instrument for pain assessment in cats was observed (rho\u2009=\u20090.86, p\u2009&lt;\u20090.001) as well as good overall inter-rater reliability [ICC\u2009=\u20090.89 (95% CI: 0.85\u20130.92)], excellent intra-rater reliability (ICC\u2009&gt;\u20090.91), and excellent internal consistency (Cronbach\u2019s alpha\u2009=\u20090.89). The FGS detected response to analgesic treatment (scores after analgesia were lower than before) and a cut-off score was determined (total pain score &gt; 0.39 out of 1.0). The FGS is a valid and reliable tool for acute pain assessment in cats.<\/jats:p>","DOI":"10.1038\/s41598-019-55693-8","type":"journal-article","created":{"date-parts":[[2019,12,13]],"date-time":"2019-12-13T06:04:00Z","timestamp":1576217040000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":214,"title":["Facial expressions of pain in cats: the development and validation of a Feline Grimace Scale"],"prefix":"10.1038","volume":"9","author":[{"given":"Marina C.","family":"Evangelista","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryota","family":"Watanabe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian S. 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