Studies have found that over 60% of cats 6 years of age and older have signs of osteoarthritis (OA), and 90% of cats over 12 have it. These are some hefty numbers! By recognizing signs that your cat may be suffering from joint discomfort, you can make changes at home and talk with your veterinarian about pain relief.
Does My Cat Have OA?
Osteoarthritis develops slowly and can be easy to miss. Much like in people, OA generally causes chronic pain that is always present. Your cat is unlikely to cry out like she might with a broken leg or a scratch on her face. Instead, she will gradually adjust her behavior and activities to relieve discomfort.
Signs that your cat may have osteoarthritis include:
- Decreased activity
- Not wanting to jump up or down from places she used to perch
- Avoiding stairs
- Less interest in playing
- Decreased socialization
- Hiding more often
- Increased clinginess
- Not wanting to be touched
- Grumpiness, bad attitude
- Urinating and/or defecating outside the litterbox
- Unusual posture when eliminating
- Standing with legs tucked under her
- Muscle loss
- Poor grooming, unkempt coat
- Changes in appetite
- Overgrooming/chewing spots
- Squinting
Specific activities that are often tracked for cats suspected of having OA include running, jumping up, jumping down, navigating stairs, and chasing objects. If your cat can perform these activities normally, she’s doing great. But if she is having a little trouble or avoiding these activities, she may have osteoarthritis or another problem and should be checked out.
Obtaining a Diagnosis
If you suspect your cat may have OA, schedule a veterinary appointment. Your cat’s veterinarian will ask questions about her activity and behavior at home and watch your cat moving on her own around the exam room.
The Montreal Instrument for Cat Arthritis Testing is a useful tool that has been validated for detecting osteoarthritis in cats in a small study. For this evaluation, your veterinarian will observe your cat from multiple angles as she moves and stands. He/she may toss toys or treats to encourage your cat to move on her own and will assess how she navigates around obstacles like furniture. Your veterinarian will then score your cat for each item and add up her overall score. Videos of what your cat does and how she moves around at home can help your veterinarian, too.
After observation, your veterinarian will perform a full physical exam, including palpation and manipulation of your cat’s legs, neck, and spine. He or she will feel for range of motion, crepitus (crunchiness), swelling, and heat, watching for any pain response from your cat, such as a skin twitch, ear flick, head turn, or growl. This part of the appointment can help pinpoint specific areas that are a source of discomfort for your cat.
Your veterinarian may also recommend X-rays on joints of concern. These can show arthritic changes in the bones, fractures, bone infections, and even soft tissue swelling that can cause discomfort. X-rays can often be taken with the cat awake, but some joints are easier to see under sedation, and feisty or painful cats usually require sedation to obtain X-rays.
If you are working with a tight budget, discuss with your veterinarian whether X-rays will change the treatment plan for your cat and ask if specific view(s) can be prioritized. Your cat’s behavior is often as diagnostically useful as imaging studies in ruling out OA, and putting money toward pain control is usually the top priority. X-rays can be done later if your cat does not respond to initial empirical treatment.
Multimodal Pain Therapy
The best way to manage osteoarthritis in cats is to address it from multiple angles with a variety of different tools and management strategies. This will maximize your cat’s benefit while reducing the risk of side effects from any one medication. Each cat will have a custom treatment plan that fits her needs and your preferences.
Remember that your cat’s treatment plan will likely evolve over time. Osteoarthritis is a progressive disease, so she may need additional support over time. On the other hand, successful implementation of home management and medical therapies may mean that you can decrease some medications and therapies as your cat becomes more comfortable.
Pain Medications
Medications may play a role in the treatment plan of cats with OA. They may include:
- Buprenorphine (opioid)
- Robenacoxib (nonsteroidal anti-inflammatory drug, brand name Onsior)
- Meloxicam (NSAID, brand name Metacam)
- Gabapentin (works on nerve pain)
- Pregabalin (GABA)
- Tramadol (opioid)
- Amantadine (dopamine agonist)
- Anti-nerve growth factor antibody (brand name Solensia)
Buprenorphine is often used for flare-ups of severe pain or after an injury or surgery that is causing additional pain. Buprenorphine and other opioids should never be given at the same time as a nonsteroidal anti-inflammatory, as combining these classes of drugs dramatically increases the risk of dangerous side effects.
Gabapentin is frequently used in cats and is generally tolerated well. It can provide some calming and sedation and is often used to help anxious and fractious cats have a positive experience at the veterinary clinic. It is available both as a capsule and as a liquid.
Robenacoxib (Onsior) and meloxicam are the only FDA-approved NSAIDs for cats. Onsior is available as an injection or a tablet, and meloxicam is available as an injection, liquid, or tablet. Both drugs are given once a day.
Solensia, an anti-nerve growth factor monoclonal antibody injection, is a relatively new product. Solensia is given once a month as an injection under the skin. It works by blocking nerve growth factor from binding to pain receptors. This option is given once a month, but it can take six to eight weeks to see improvement.
Omega-3 fatty acids, such as fish oil, are one of the best ways to support your cat’s joint health. You may opt to feed foods rich in fatty acids or add omega-3 supplements to her current food.
Note: If your cat needs to change medications, especially when transitioning from an NSAID, she will often need to do a seven-day washout. This may be a bit rough for you and your cat, but it can be critical to protect her health in the long run.
Weight Management and Rehab
Weight loss and rehabilitation therapy are things that you can work on both at home and in the veterinary office. Chunky cats put extra strain on their joints, increasing pain. Muscle loss makes movement more challenging. Always discuss a weight loss strategy with your veterinarian before instituting it, as weight loss that occurs too quickly can make your cat ill.
Encourage your cat to do low-impact exercise such as walking throughout the day. One easy way to do this is to break her meals into many small installments scattered around the house, so she must walk around to “earn” each bite.
Acupuncture can help with pain relief and improve muscle function.
An animal rehabilitation therapy practitioner can evaluate your cat and create a plan of home exercises for you to help your cat increase her range of motion and rebuild muscle gradually over time. If you have a rehab facility nearby, you may want to sign up for regular sessions. During these treatment sessions, your cat may receive therapeutic laser treatments, therapeutic ultrasound, electrical stimulation, and even underwater treadmill workouts for pain relief and to build muscle.
The key to doing any rehab therapy or exercise with your cat is to take it slow (a cat is not going to do 10 reps in two minutes) and use rewards to make it a positive experience for your cat. You will need to be creative. For example, if one of your cat’s exercises is to step over a broomstick, you may need to place the broomstick across a doorway that your cat frequently goes through to encourage her to do it.
Environmental Management
You can make changes at home to make life easier on your cat’s painful joints. These adjustments enable your cat to go about her normal routines without unnecessary discomfort:
- Use ramps or steps to give your cat access to high perches and resting spots that she likes
- Try raised bowls for food and water, so she doesn’t have to bend down
- Use litter boxes with low walls that are easy to step into
- Provide food, water, and litter boxes on each floor of the house
- Brush your cat regularly to keep her skin and coat healthy (this is also great bonding time!)
- Trim claws regularly if your cat isn’t wearing them down on her own
Monitoring Progress
Remember that your cat’s treatment plan will evolve over time to adapt to her needs. One great way to track her progress is to use the Client-Specific Outcome Measures form from North Carolina State University (available at https://cvm.ncsu.edu/research/labs/clinical-sciences/comparative-pain-research/clinical-metrology-instruments/). Start by identifying three activities that your cat struggles with due to her arthritis pain, then rate her progress in each of these each week.
If she is showing improvement and doing well, her treatment plan is working! If she is still struggling over time, talk to your veterinarian about additional pain control or environmental management strategies that might be helpful.
Your cat should also have her weight and body condition score evaluated regularly. These factors can indicate success of treatment and overall health and may impact medication doses.
