Arthritis in Cats

Last month’s article discussed osteoarthritis in dogs. It is important that cats are discussed separately, not because their arthritis is much different, but because their signs can be different and the treatment options are bit more limited.

As with dogs, arthritis is a degenerative condition of the joints. It is chronic, progressive, and can affect any joint space, including the cartilage, joint capsule and associated bones. In cats, it typically affects the spine, elbow, hips and knees. Arthritis can be primary – associated with aging and “wear and tear”, or secondary – the consequence of some initiating factor such as a trauma or a congenital malformation such as hip dysplasia. Primary arthritis is more commonly diagnosed in cats, whereas secondary arthritis is more commonly diagnosed in dogs.

Cats are very good at hiding their pain, making arthritis a drastically underdiagnosed condition. There are signs at home that can indicate there may be a problem. Cats may no longer jump or seek out higher locations. They may avoid the litter box, especially if it’s in a “far away” location such as down in the basement – or if the sides of the box are relatively high requiring them to take big steps to get in/out. They may also have a personality change – they could be more withdrawn/less social or start growling/biting/scratching more. Cats who stop grooming (greasy coats, matted fur, dirty back ends) may have arthritis as the cause as they cannot contort their bodies to reach their entire coats.

A diagnosis can often be made on physical exam by palpating thickened joints, decreased range of motion, muscle loss, and sometimes painful reactions. However, radiographs are also very helpful. They can uncover more cases and assess the severity of arthritis. Studies have found that 90% of cats over 12 years old had radiographic evidence of arthritis, whether or not they had signs noted at home or on exam.

There are options to help alleviate discomfort, slow the progression, and improve overall quality of life. A big help is weight management as overweight cats are more prone to arthritis due to the added pressure on their joints and less active lifestyle. Supplements aimed to protect the joint cartilage are not always as effective as we’d like them to be and the efficacy studies are lacking, however some owners report improvement on supplements that contain glucosamine and chondroitin or polysulfated glycosaminoglycans. Omega 3 fatty acids (mainly EPA and DHA) are helpful as they reduce pro-inflammatory factors. Just as with dogs, flaxseed oil containing alpha-linolenic-acid, is not helpful. Humans are able to convert ALA to DHA and EPA, however cats are not able to perform this conversion, making flaxseed an ineffective source.

A difference between dogs and cats is the use of nonsteroidal anti-inflammatorties (NSAIDs). These are used often in dogs to provide anti-inflammatory and pain relieving effects. However, these are not as well tolerated in cats. There are few NSAIDs approved for use in cats and only one licensed for long term use outside of the United States. Using NSAIDs in cats is not completely off the table, but it must be approached cautiously with serious discussion with your veterinarian first.  Corticosteroids are also controversial for treating arthritis, as they haven’t been shown to relieve pain in cats.

Because of the limited availability of using NSAIDs and steroids, pain medications (analgesics) are commonly used. There are several analgesics that can be considered, both oral and injectable.  

Modifying the home by using ramps/steps, moving the litter box and providing one with lower sides or an opening to walk in, and offering soft bedding in multiple locations may also help. In dogs, physical therapy (including LASER and acupuncture) and surgical techniques are relatively common, but in cats these areas are just beginning to be explored.

Our pets cannot verbally tell us that they are not well, so it is up to us to look for cues and have them evaluated at least annually. If arthritis is suspected, it should be addressed as soon as possible – the earlier the above treatments and modifications are implemented, the more rewarding the results. Every kitty is unique, and their treatment plan should be tailored to them.