The former Wigan Athletic and Middlesbrough midfielder has struggled with injuries to both knees this season and has been able to feature in just ten Premier League games as a result.
With eight matches of the season left, Sunderland are just four points above the drop-zone and are currently 4.00 to be relegated from the Premier League while Southampton are 8.50 to go down, Wigan 2.00 and Norwich City 21.00.
O'Neill admits his side has missed captain Cattermole's influence, saying: "We hope for the best but, to me, if he comes back this season, then that would be a bonus - and an unexpected bonus.
"We may have to cope without him and, even if he does successfully come back from the injury, he will still be nowhere near match fit.
"We have had to do without him pretty much all season. He has definitely been a loss to us, no question about that. We have missed that drive, the things that he would give us, but we have had to make do without it."
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