steoarthritis or degenerative joint disease (DJD) is an irreversible, degenerative disease of the lining of the joint. The shoulder and elbow joints are those most frequently affected in older cats followed by the spine, hips, and knees.  Cartilage is eroded from the ends of the bones making up the joint, and bony spurs (called osteophytes) and thickening occur in bones adjacent to the joint. Arthritis is a painful condition that should always be taken seriously.

How do I know if my cat has arthritis?

Most cats that are middle-aged or older have arthritis. Studies have shown that about 90% of cats over the age of 12 have x-ray evidence of arthritis in at least one joint, and most of the cats in this study did not have signs seen by the owner or veterinarian! Another study showed that of cats older than 6 years of age, 61% had x-ray evidence of arthritis in at least one joint and almost 50% had arthritis in multiple joints! All of this is to say that arthritis is incredibly common and just because your cat is not displaying arthritis signs does not mean they do not already have arthritis!

Most cats with arthritis do not have very visible clinical signs, like lameness. Cats often have arthritis in both joints (i.e., both elbows or both knees) which is why we often do not see them limping. Cats are also very good at hiding their pain. Instead, there are numerous other signs of arthritis such as:

• Difficulty climbing stairs or jumping (longer anticipation time vs swift leap)
• Decreased activity, especially play behaviors
• Decreased interaction with the family – staying in one place/room
• Decrease or changes in scratching post use, especially vertical use; arthritic cats tend to scratch horizontally as reaching up becomes challenging
• Difficulty lying down or getting up
• Favoring/laying down on one side specifically
• Elimination outside of the litter box as posturing in a loose substrate becomes increasingly difficult; stable surfaces (hard floors and carpet) are often chosen
• Increased stiffness or limping
• Inability to groom or be groomed due to pain, resulting in poor coat condition or matting, especially on back half of the body as it is difficult to twist and contort to reach the hind end, groin, and rear
• Aggression and petting intolerance, less tolerance with other pets/people and “busyness” around them due to their inability to react and move quickly
• Heat-seeking behavior, such as lying by heat vents, coffee pots, sunny locations, laptops
• Weight loss or a decreased appetite as cats will always choose to remain in a warm, comfortable bed vs walk down a flight of stairs to eat.

Many pet parents will notice that their cat prefers to jump onto a chair or stool before jumping onto or off a counter/higher surface. If there is no stool, the cat may slide their paws down the vertical surface so as to lower their center of gravity lower to the floor before making the jump. When jumping up, they may do a “rearing” motion instead of just jumping lithely up onto the counter!

If you think your cat may be showing signs of arthritis, they probably are! It’s best to schedule an appointment so we can discuss treatments. It’s very helpful if you can bring videos of your cat walking, running, using stairs, and jumping. This allows us to see how they move around at home since they are often too scared or sleepy on their pre-medications to move here! We also often recommend that all cats around 7-10 years old start on an arthritis therapy to help them be more comfortable. If your cat has had limb injuries or is handicapped in any way (declawed, three-legged, previous hit by car injury, broken pelvis, bad knees, etc.) then it is advised to start joint support earlier in life rather than waiting until they show symptoms. Prevention is the best medicine!

What treatments are available for arthritis?

There are numerous treatment options available for arthritis. Depending on how severely your cat is affected, we may recommend one or multiple of the below therapies.

• Glucosamine and chondroitin: Glucosamine is a major component of cartilage, and chondroitin aids the formation of cartilage and inhibits enzymes in the joint that tend to break down cartilage. Cosequin is a tuna/chicken flavored powder which comes in a capsule that can be given orally or sprinkled over food. Dasuquin Advanced contains glucosamine and chondroitin like Cosequin as well as additional beneficial arthritis supplements like Boswellia extract, which is a plant based anti-inflammatory.
• PSGAGs (polysulfated glycosaminoglycans): Adequan is an injectable PSGAGs that is given subcutaneously (under the skin). PSGAGs help to prevent cartilage breakdown and may help to increase the quality of the fluid within the arthritic joints.
• Omega-3 fatty acids: diets and supplements containing omega-3 fatty acids, particularly DHA & EPA, may reduce pro-inflammatory factor production. Fatty acids from cold water marine mammals are best compared to those from plants. Green-lipped mussel extracts are often used as a great source of omega-3 fatty acids and are found in Antinol Plus, one of our preferred fish oils. Another great option is Vetoquinol’s Triglyceride OMEGA, which contains fatty acids from fish oils from Atlantic sardines, mackerel, and anchovies.
• NSAIDs (non-steroidal anti-inflammatory medications): NSAIDs are anti-inflammatory and provide pain relief by blocking parts of the pain pathway. It’s similar to a human taking ibuprofen. Since cats cannot have ibuprofen, Tylenol, or some other human pain medications, there are NSAIDs that have been created specifically for cats, such as Onsior and Meloxicam. Unfortunately, in the US no NSAIDs are labeled for long-term use in cats; this does not mean we do not use NSAIDs off-label in cats long-term, because we absolutely do! However, care should be taken when choosing the medication, dose, and frequency of the medication to minimize as many side effects as possible. NSAIDs are processed through the kidneys and so monitoring kidney values is important for every cat on regular NSAID therapy. For many of our patients, receiving daily NSAIDs is what helps to preserve their quality of life and help them be pain-free in their older years.
• Monoclonal antibody therapy: a miraculous medication that has become available in the US in recent years is Solensia. This injection is given once monthly subcutaneously. Solensia actually works to block a part of the arthritis pain pathway; specifically, it inhibits something called nerve growth factor (NGF) in the pain pathway. By inhibiting NGF, pain signals are inhibited allowing the cat to feel much better and pain-free. When first starting Solensia, the injection is given once monthly for three months; this is because there is an additive effect with each subsequent injection. If after 3 months your cat does not have improvement on Solensia, it is discontinued. Some cats may develop a tolerance to the medication over time which is why we do not recommend this as a first-line therapy.
• Other pain medications: other pain medications, such as gabapentin, buprenorphine, tramadol, or amantadine, may be used. These medications do not decrease inflammation but instead focus on decreasing pain. We frequently use gabapentin early on because it has minimal side effects and we can adjust the dose easily over time.
• Alternative therapies: many other options are available for decreasing inflammation and/or minimizing arthritis pain. These options can include acupuncture, laser therapy, PEMF therapy, and CBD therapies (ElleVet). We do not offer these therapies at PWC but can direct you to other local practitioners who offer these services if we believe it may be helpful for your cat!

What else can I do to help my arthritic cat?

Excess weight can overburden already painful joints. If your cat is overweight, talk with your vet about the best way to safely reduce the cat’s weight. Exercise provides a two-fold benefit: it aids in weight loss and it helps keep arthritic joints from becoming stiff. Play with your cat!

Warmth provides comfort for stiff, painful joints. You might provide a heated or thermal pet bed (such as K&H heated pet beds) or use a Snuggle Safe disk to supply safe warmth without electricity. Don’t forget that cardboard is insulating and helps your cat maintain their “thermal neutral zone” without having to use extra energy, so a cardboard box with soft bedding in the sunshine can work wonders!

Large-breed dog beds usually provide thicker cushioning than cat beds, making them an excellent resting spot for your arthritic cat. Many cats will also love the extra cushion provided by memory foam, fleece plush blankets, or orthopedic beds.

Be mindful of your cat’s changing needs. Having a wide variety of choices for all of their environmental needs can help greatly. For example, add a litter box closer to the cat’s favorite napping spot or add a feeding station on each floor so the cat doesn’t have to climb the stairs to eat or get a drink. As a rule of thumb, there should be at least a litter box on every level of the home. If your home is very long, there should be litter boxes on either side of the house. Additionally, you may need to change the type of litter box you have, such as opting for one with a lower side/cutout entrance. Food and water should be easily accessible in all of the places your senior cat spends their time. We recommended spreading out resources when they are young and healthy; when they are senior, think efficiency apartment! Make it easy for them to access their needs.

Add chairs, stools, or pet ramps/stairs between the floor and higher surfaces of the home, such as beds, couches, or counters. If your cat used to jump on the counter to eat their food, make sure the counter is now easily accessible or transition to having the food on a lower level.

With a little special care, your arthritic cat can not only enjoy their senior years, they can thrive!