Arthritis in Cats

By Ryan Llera, BSc, DVM; Robin Downing, DVM, DAAPM, DACVSMR, CVPP, CRPP

Osteoarthritis (OA) is a complex condition involving inflammation and degeneration of one or more joints. It is sometimes referred to as degenerative joint disease (DJD). Cats with OA experience pain and inflammation in various joints that interfere with daily activities.

OA is diagnosed through a thorough physical examination, palpation (feeling with the fingers to localize pain and determine its intensity), and additional diagnostics, including radiographs (X-rays) or other imaging technology. About 90% of cats over the age of 10 years experience OA in at least one joint.

What causes OA?

There is no single cause of OA. Many factors influence its initiation and development, including:

  • Body conformation (how a cat is built)
  • Body condition and weight (excess weight and obesity are highly correlated with OA)
  • Abnormal joint development (such as hip or elbow dysplasia and luxating patellas)
  • Injury history (past fracture, ligament damage, muscle injury, joint infection, or damage/erosion of cartilage)
  • Orthopedic surgery
  • Nutritional history

Most cats with OA experience a combination of these factors as their OA develops and progresses. We now know that just ‘getting old’ is NOT a cause of OA.

"We now know that just ‘getting old’ is NOT a cause of OA."

What are the clinical signs of arthritis?

Cats can exhibit many different signs when they have OA, and they do not necessarily demonstrate all the same signs all the time. The most common signs cat owners may notice include:

  • Difficulty getting up and down
  • Walking stiffly
  • Lameness in one or more legs
  • Reluctance to go up or down steps
  • Reluctance to jump up or down
  • Reluctance to play
  • Stiff, swollen, or sore joints
  • Reluctance to be touched on some parts of the body
  • Unexpected aggression toward other cats or humans
  • Hiding more than usual
  • House soiling (if a cat has difficulty getting in and out of the litter box)
  • Poor coat condition (because self-grooming becomes difficult)

How is arthritis treated?

Unfortunately, there is no magic bullet for treating OA. Once OA is in place, the goal is to manage rather than treat it because OA cannot be cured. OA is a very complex disease, so managing it is complex because the best results come from combining multiple modalities. Typical multimodal management of arthritis generally includes the following:

Normalizing body condition is critical, so your veterinarian may prescribe a specific diet to accomplish this goal. There is now a nutrient profile that can support the joints while helping to normalize body weight and condition. It is important to stick strictly to the prescribed nutritional program.

Pain medication
Non-steroidal anti-inflammatory drugs (NSAIDs) are generally used as the first line of defense against the pain of OA. Commonly used drugs in this class for cats are robenacoxib (Onsior®) and meloxicam (several trade names). Your veterinarian will determine if your cat is a good candidate for this class of medication.

"Non-steroidal anti-inflammatory drugs (NSAIDs) are generally used as the first line of defense against the pain of OA."

In extremely rare circumstances, a corticosteroid anti-inflammatory drug will be prescribed instead of an NSAID. The two classes of medication CAN NOT be used together.

Gabapentin is a pain medication that addresses chronic pain differently from NSAIDs or corticosteroids and complements those medications. It provides a way to address the chronic nature of OA pain and is especially helpful when the patient is older and unable to take NSAIDs.

Other less commonly used drugs include tramadol and amantadine, but they are less effective unless paired with other drugs mentioned above. A newer drug called frunevetmab (Solensia®) is an injection that lasts for a full month. While its use in cats is considered off-label, polysulfated glycosaminoglycan (Adequan®) may sometimes be prescribed.

It is important to never reach into your own medicine cabinet when your cat limps or has been diagnosed with OA.

When a nutritional supplement has medicinal effects, it is called a nutraceutical. There are many of these products on the market, many labeled for use with joint disease. Common products include glucosamine, chondroitin, and omega-3 fatty acids. Ask your veterinarian about the scientific data that supports any nutraceuticals prescribed.

Physical therapy
Medical acupuncture can provide excellent pain relief for many cats with OA. Likewise, other physical medicine disciplines like chiropractic and medical massage may be helpful.

Physical rehabilitation is a discipline that translates physical therapy techniques from human medicine to animal patients. These techniques include (but are not limited to) therapeutic lasers, therapeutic exercises, joint mobilization, and hydrotherapy using an underwater treadmill. Your veterinarian can refer you to a rehabilitation specialist.

For the most extreme of cases, surgical procedures can alleviate the pain associated with OA. Femoral head ostectomy (FHO) can be done for severe hip dysplasia with good results, as well as joint arthrodesis (fusion) of the carpus (wrist).

Can I do anything else to help my cat be more comfortable?

There are simple ways you can help your cat with comfort and mobility, including:

  • Provide soft, padded bedding
  • Raise food and water dishes (elbow height)
  • Provide non-skid floor surfaces
  • Have a ramp or stool/step for getting onto higher surfaces
  • Adhere to prescribed feeding and medication recommendations

See the handout “Helping Your Cat with Osteoarthritis” for more ideas.

What is the prognosis for my cat?

With appropriate management, cats with OA can live a normal life expectancy. Your veterinarian can provide specific guidance about lifestyle adjustments.

Can feline OA be prevented?

Allowing a cat to grow slowly as a kitten, maintaining a lean body condition throughout growth and into adulthood, is the most effective way to prevent OA. Growth abnormalities and injuries cannot always be predicted, so even our best efforts may not be enough to ward off OA in an older cat. With slow growth, proper nutrition, optimal body condition, and regular exercise, the odds of preventing or at least delaying OA are excellent. Your veterinarian will partner with you to create the best plan for your cat.

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