Ways to Manage Arthritis in Cats

It is estimated that by age 10 most cats are suffering from some degree of arthritis. Signs of arthritis in a cat are less obvious than in dogs. They may be less active and hiding more, or jumping up on furniture less often. Sometimes they will have litter box issues if they have trouble squatting to urinate or struggle to get in and out of the box. When cats experience pain with going to the bathroom they often associate that pain with the litter box and will stop using it.

Usually they are still walking around, but you may notice that their movements are more stiff. They also may stop grooming as regularly and will have a more unkempt hair coat.

As it rarely affects cats as dramatically as dogs, it’s not always addressed as early. And many times cats are not diagnosed at all and never receive any treatment.

Often dogs with arthritis are struggling to stand or finish their walks outside, so the owners and veterinarians are more proactive at addressing their issues.

But if the average cat lives to 15, with some living past 20, I would like for you to know how we can keep them active and comfortable during their golden years.

What is arthritis?

It is a progressive condition affecting the joints where there is loss of the articular cartilage and osteophyte formation. The articular cartilage is the cartilage found at the ends of the bones within the joints. It provides cushioning as we walk or move, and as it is lost there is pain and inflammation from the bones rubbing more directly against each other.

The osteophytes are like bone spurs that form within the joint secondary to this chronic friction in the joint. And lastly the joint will begin to form scar tissue which further reduces the range of motion and mobility of the joint.

We can see evidence of osteoarthritis on radiographs. The ends of the bones, when there is arthritis present, will lose their smooth shape and instead appear flattened and irregular. The osteophytes are also visible on x-rays.

When we examine animals with arthritis we may find that the joint is more stiff than it should be. This could mean it doesn’t flex or extend to it’s full amount. Or we may detect crepitus in the joint.

This is a crackling noise you can feel within the joint when it is flexed. As the degeneration in the joint progresses these animals will usually develop some muscle atrophy. This is a loss of muscle mass that may develop along the spine or within the muscles of the legs.

How Can we Manage Arthritis in Cats?

1. Weight Management

Obesity is a common issue in our domestic indoor cats. This weight puts increased strain on the joints which can speed the progression of arthritis. The adipose (fat) tissue also may play a role in increasing inflammation in the body. One of our goals in treating arthritis is reducing inflammation in the joints. So if reducing the amount of excess fat tissue can reduce inflammation, then we may lower the amount of damage occurring in the joints.

Weight loss in cats can be achieved by first decreasing the amount of calories ingested. This can be done with a prescription weight loss diet such as Hills r/d.

It is also important not to just free feed your cat as this can result in overeating. Use an online calculator such as at Pet Nutrition Alliance to discover how many calories your cat should be eating in order to lose weight, and then make sure to limit their daily calories to this amount.

You can also encourage weight loss by increasing their activity. This is hard if they are already suffering from pain and limited mobility. But even just using one of the slow feeder toys that are available can help.

2. Fish Oil Supplements

Studies have shown that Omega 3 fatty acids will block the development of inflammation in the joints. Since inflammation itself is damaging to the cartilage this will slow the degenerative changes occurring in the cartilage.

Some studies have shown that cats receiving higher levels of Omega 3 fatty acids have better mobility. Some senior diets are already high in Omega 3 fatty acids, but there are also supplements such as Eicosaderm which can be added to the diet.

3. Cartilage Protectants

The goal of these products are to reduce the destruction of the articular cartilage. One of the most well known ingredients are Glucosamine-Chondroitin Sulfate. These two ingredients will slow the breakdown of the cartilage and possibly promote healing. One of my favorite products for cats is Cosequin. Many cats are difficult to medicate but these capsules can be opened so you can simply mix the powder in to their canned food.

Another drug option for cartilage protection is Adequan. This medication is available in a canine version but can be used off label in cats. It is an injectable medication so may require a weekly trip to your veterinarian for administration.

The is a safe drug composed of Polysulfated glycosaminoglycan, or PSGAGs. PSGAGs inhibit the formation of enzymes which are created during inflammation. These enzymes are known to cause progressive breakdown of the cartilage so reducing their production will reduce the amount of damage endured by the cartilage cells.

4. Anti-inflammatory Medications

Corticosteroids are potent anti-inflammatory medications but also can slow healing which is not ideal. Another option are NSAIDS (non-steroidal ani-inflammatory medications). In humans these are equivalent to drugs like Motrin and Aleve.

But these human products are extremely dangerous to cats. In fact, even in the NSAIDs designed for veterinary use, very few are approved for cats. And older cats, the ones most likely to benefit from NSAIDs for arthritis, are at even greater risk from their side effects.

Chronic kidney disease is a common condition of older cats. It is a progressive degeneration of the kidney tissue, and NSAIDs can cause further damage to the kidneys.

But one NSAID, called Meloxicam, has been used successfully as a chronic treatment for arthritis even in senior cats. It is generally administered daily at a quarter of the labeled dosage. This much lower dose has been found to still provide pain relief to cats with chronic pain, without the same risk to the kidneys.

But most veterinarians will still require initial bloodwork to check kidney values, followed by regular rechecks of the kidney values before prescribing this medication for chronic use.

5. Pain Medications

In addition to protecting the joints from further damage by reducing inflammation, we can also provide pain relief with analgesics. The two most commonly used in cats are Tramadol and Gabapentin, both of which are controlled drugs in my state. This means they are strictly regulated and may require a prescription to a human pharmacy to have filled.

Both are very effective analgesics in cats with minimal long term risk. Short term you will likely see some sedation, but usually this resolves as they adjust to the medication.

Tramadol is an effective medication for pain in cats, but can be rejected due to the taste. Thankfully it can be compounded by special pharmacies in to either a flavored liquid or even a transdermal ointment which may be better tolerated by your cat.

Gabapentin is another analgesic which I have found to be a great option for cats. If your cat is not a picky eater you can also usually simply open the capsule and mix the contents in with some wet food. But if your cat is petite and needs a smaller size, it can also be compounded by an outside pharmacy. We utilize a couple of pharmacies at my clinic that will bill and ship directly to the owners so this is something you should ask your vet about.

6. Alternative Therapies

There are also other methods to help your cats mobility and reduce pain from arthritis. If there is a facility near you, you could consider taking your cat in for some rehabilitation exercises. Have you seen the Youtube videos of Cinder-block the cat on the underwater treadmill? Their goal for her was to help her lose weight, but she needed to use the underwater treadmill because it reduced the strain her weight was putting on her joints.

There are also many veterinarians who are trained in the skill of acupuncture. They are knowledgable on points of the body which can be stimulated to either provide pain relief or promote healing.

These are very small needles but you may be skeptical on how your cat will tolerate the vet placing several needle in to your cat. One reason this may make you apprehensive is if your cat becomes easily stressed in the car. Before you assume acupuncture is not an option find out if there is an acupuncture veterinarian in your area who does house calls.

Also, even if you aren’t using gabapentin daily for pain relief, you should know that is also an effective sedative for cats. Giving a higher or additional dose prior to a vet visit may allow for a stress free visit for your cat.

There are also some products to help restrain even the crankiest of kitties. A veterinarian who frequently does acupuncture on cats may already own something, but you could even look in to purchasing your own product. Many of my colleagues use this wrap from calmcozycat.com

There are also non-invasive treatments such as cold laser therapy. These units deliver low level wavelengths from a laser that can reduce inflammation in the muscles or joints. It is painless, but will require repeated treatments to maintain the effects. It also may be less accessible as a house call option as the equipment is larger and harder to transport.

Both acupuncture and cold laser will have varying degrees of effect for each patient. We usually recommend giving each method 3-4 rounds of treatment to determine if it’s helping. If you do not feel like that there has been any benefit to your cat then continued rounds of treatment are unlikely to help.

Conclusions

Symptoms of arthritis can be much more subtle in cats, but we should not assume that they are not suffering just as much as their canine siblings. If your cat has started hiding more, is less active or is starting to go to the bathroom beside their litter box, it could be due to underlying joint pain.

Keeping them comfortable and active will approve their overall quality of life and reduce the chance of secondary behavioral issues. In addition to potentially causing litter box issues, chronic pain can also make our patients crankier and more aggressive with their families.

If you have an older cat who has had behavior changes like those mentioned above then I recommend you schedule an appointment with your veterinarian. In addition to a thorough physical exam I recommend senior bloodwork. This will make sure the symptoms aren’t due to other underlying diseases, but also determine which treatments may be safest for your cat.

Let me know if you have cared for an older cat with arthritis and how you and your veterinarian chose to manage it!