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Arthritis In Cats

               Cats get arthritis. There are many products on the market to treat pain in humans and dogs, but unfortunately cats cannot take the medications. Most Non-Steroidal Anti-Inflammatory Derivative, or NSAIDS, will harm your cat if given. Human medications like Motrin, Aleve, and Tylenol and canine medication like Carprofen (Rimadyl) and Previcox are toxic to cats. So what is arthritis and what can we do to help arthritic cats?

Overview

                Many cat owners may not know arthritis is not just a disease for dogs. They don’t necessarily know to look for the signs. In fact, by the time cat owners notice something wrong, they have a hard time believing that the loss of muscle and function is the result of arthritis. That is why so many cat owners tend to get a late start on the disease.

                Arthritis is a joint disease that can reduce mobility and elicit pain. It can be caused by injury, infection, the body’s own immune system, or developmental problems involving the joints. However, the most common form of arthritis in cats is osteoarthritis or a degenerative joint disease.

                Normally joints form smooth connections between bones, but in the case of osteoarthritis that smooth, glistening surface on the end of a bone is transformed into a roughened, poorly gliding surface. Osteoarthritis involves the thinning of joint cartilage (a protective cushioning between bones), the buildup of fluid within the joint, and ultimately the formation of bony growths within the joint. Over time, the roughness created by these bony growths can lead to reduced joint mobility and pain, even in cats.

Symptoms and Identification

                Think about a dog with arthritis. They may be lame, there is an obvious change in activity level, stiffness, or trouble with stairs. At Bayside, we may see dogs that will not walk or hike as far as they used to, that tire more easily when playing fetch, that do not leap to their feet when the doorbell rings, and limp after playing with the dog next door. During physical examinations, these patients may appear relaxed until we try to manipulate the painful joint, which may elicit a yelp, struggle, or growl.

                But what about cats? They do not go out for walks, play fetch, or leap to their feet when someone is at the door (well most don’t). Cats are tricky because they don’t display classic signs of pain, and an orthopedic examination may yield few results because of their stoic nature. Also, cats often resist handling at the veterinarian and may be tense, struggling, and growling before the joint manipulation. Therefore, these behaviors may not be reliable indicators of discomfort.

                Then there is our own human bias. A behavior change in a dog, like no longer jumping onto the bed or struggling to go up steps, may immediately raise suspicion for joint disease. When we see a similar behavior change in a cat, we may attribute it to the cat’s whim; “Fluffy is moody” or “Fluffy now prefers to sleep on the couch downstairs”. It may also go unnoticed because cats vary their routines more than dogs. Dogs may come to bed at “bedtime” every night while cats may jump on and off of the bed throughout the night.

Signs of arthritis in cats

  • Stiffness after exercise or laying for long periods of time
  • Wasting away of muscle in front or hind limbs
  • Limited movement
  • Reluctance to jump up or avoid high places
  • Difficulty or reluctance jumping down from things
  • Joint swelling
  • Trouble getting up, lying down, walking, climbing stairs, or jumping
  • Noticeable sounds or a “grating” noise coming from joints
  • Other changes in activity level or behavior

                Recognizing arthritis in cats can be difficult because the condition progresses slowly and cats are great at hiding illness and not complaining about their joints aching. Some owners also assume that signs of arthritis are “normal” in older animals.

                Taking a cat in for regular checkups can help a veterinarian identify clinical signs early. Radiographs (X-rays) can reveal bony growths and abnormalities.

Affected breeds

                Any cat breed can develop arthritis

Treatment

                These approaches are commonly recommended for the treatment of arthritis in cats:

  • Pain medication, including NSAIDS, may help relieve the signs of arthritis. There are only a few of these types of drugs approved for use in cats, and they must be used with caution. They can lead to kidney or liver failure. Just one Tylenol or Motrin can kill a cat, so always check with your vet before giving your cat anything!
  1. Meloxicam: Because of Meloxicam’s potential for causing kidney damage, the drug is recommended only or one-time use  making long term use off label for cats
  2. Robenacoxib (Onisar) is an NSAID for short term use in cats, but it has only recently become available in the United States.
  • Other oral prescription options for degenerative joint disease related chronic pain in cats include opioids, buprenorphine and the synthetic opioid tramadol. Long-term use of opioids can have significant adverse effects, such as constipation, can create dependence, and require increasing doses to achieve the same effect. There is also the possibility of diversion, the use of a drug by a human family member
  • Glucocorticoids (steroids) such as prednisolone can be used for their anti-inflammatory effect. They are not analgesics but may provide analgesia through their powerful anti-inflammatory action. Systemic steroid use in cats is associated with many adverse effects, the most serious of which may be diabetes mellitus and congestive heart failure. Therefore, systemic steroid use cannot be considered a first-line therapy for DJD.
  • Amantadine and gabapentin (Neurontin) are gaining a foothold for managing chronic pain in dogs and cats. Although detailing the use of these drugs is beyond the scope of this article, they may prove helpful in treating cats with severe DJD. Neither drug is recommended as a sole therapeutic agent. The two drugs are meant to be part of a multimodal program to address chronic pain.
  • Drugs that slow the course of the disease, called disease-modifying osteoarthritis drugs (DMOADs) can be an important part of managing osteoarthritis. Adequan (polysulfated glycosaminoglycan) and Cartophen Vet (sodium pentosane polysulfate) are given as an intramuscular injection to target joint cartilage. By keeping the cartilage healthy and intact, further joint destruction is delayed. Both medications are given on a strict schedule. Initial, frequent dosing is eventually replaced with once-monthly injections. There is no peer reviewed research on the use of either drug in cats, but anecdotal reports are promising. Some veterinarians prescribe the drugs for subcutaneous (or under the skin)use in cats, allowing owners to administer them at home and avoiding the stress of frequent veterinary visits. Both drugs are heparin analogues, so their use in conjunction with anticoagulants requires veterinary supervision.
  • Various oral joint supplement may contain glucosamine, chondroitin, perna (green lipped) mussel, methylsulfonylmethane, hyaluronic acid, and/or avocado and soy unsaponifibles. All of these substances claim to lessen joint pain. Most supplements claim to improve joint health by strengthening cartilage and decreasing inflammation. For some supplements, there has been a significant amount of research. For others, there has been little or no research. These products are rarely contraindicated. Some veterinarians recommend the animal-specific formulations for use in patients with or at risk of DJD.
  • Getting or keeping cats slim can help be decreasing the stress load on their joints. Feeding cats the right amount of a high-quality food should help with weight control.
  • Carefully monitored exercise on soft surfaces can help affected cats. Because arthritis is aggravated by cold and dampness, affected cats should be kept warm and dry. Padded cat beds can help. There are heated cat beds available.
  • Warm compresses can soothe affected joints.
  • Massage can increase a cat’s flexibility, circulation, and sense of well-being. Professional animal massage therapists are available.
  • Acupuncture can be very beneficial to pets with arthritis. Many pets respond positively to acupuncture and aquapuncture treatment.  Make sure to visit a Certified Veterinary Acupuncturist for your pet’s treatment.
  • Surgery may be a good choice for advanced cases of feline arthritis.

Prevention

                As pets age, osteoarthritis can appear gradually with very subtle signs. Regular veterinary visits provide a great opportunity to assess your cat’s joint health, get a diagnosis early during the course of the disease, and start instituting changes to make your cat comfortable and improve their quality of life.

                With many pet cats living into their late teens and even early twenties, most cases of osteoarthritis in cats are probably not preventable. But regular, moderate exercise and a high quality diet can help manage body weight and keep a cat’s musculoskeletal system in excellent shape.

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