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Cat health

Arthritis and chronic pain in cats

Osteoarthritis (also called degenerative joint disease) is a progressive deterioration within joints. There is degeneration of cartilage (the smooth material which lines the ends of bones), changes to the underlying bone, and changes to the joint capsule that secretes joint fluid. These changes are seen in many older cats. But can also be seen in young cats secondary to inherited disorders or trauma (e.g. fracture, ligament injury).

SIGNS OF OSTEOARTHRITIS

Arthritis can be very difficult to recognise in cats. We are often asked how to assess pain because cats don't outwardly complain and realistically "choose not to suffer pain".  Signs of arthritis in cats can include:

  • Decreased activity: sleeping more, not moving around as much, playing or
  • hunting less.
  • Decreased mobility: reduced willingness to jump, not jumping as high, executing several smaller jumps to reach the desired height, stiffness, and sometimes obvious lameness
  • Decreased grooming: reduced time or difficulty grooming, a poor coat,
  • overgrown claws
  • Altered personality: less keen to interact with people or other pets, seeking solitude, aggression or vocalisation when touched, ʻgrumpierʼ
  • Other signs may include decreased appetite & difficulty using the litter tray.

As these signs develop gradually, it is often easy to accept them as signs of old age, rather than as signs that your cat suffering from pain associated with osteoarthritis. Sometimes we will trial pain relief medication if we are suspicious of arthritis, as the response to treatment in most cases is excellent; many owners are often surprised at how much more active and mobile their pet becomes.

DIAGNOSIS

Arthritis can be difficult to diagnose by physical examination. Owners’ observations at home are very important in making a diagnosis of osteoarthritis in cats.  X-rays are sometimes taken to confirm the diagnosis and to rule out other causes.

You can complete the following client outcome measurement suvery via the following lik. It can help determine the level of pain and treatment success - there is a wealth of information on the website

Pain Free Cats - FMPI tool (Feline muscoluskeletal pain index)

TREATMENT OF OSTEOARTHRITIS

Treatment of osteoarthritis is palliative i.e. designed to relieve the clinical signs, and in some cases slow the progression of osteoarthritis, but the degeneration within the joint is permanent and will continue. Different types of medical treatments for arthritis are available including:

Metacam: an anti-inflammatory pain killer which is given on food once per day. As arthritis in an inflammatory process, this medication yields very good results, but it does have potential side effects. For this reason we often recommend doing blood & urine tests before starting this medication to check for pre-existing kidney or liver problems. In cats on this medication long-term, we may repeat these blood tests every 3-6 months.

Solensia: is a NEW treatment option based on Feline monoclonal antibody therapy targeting Nerve growth factor (NGF). By targeting the transimssion of of pain & inflammation, reduced pain and improved mobility & quality of life is seen by over 75% of cats owners. Solensia can be sued in conjunction with other treatment modailities and is given as a injection initially ONCE monthly - subsequent treatment intervals could be extended.

Cartrophen: a product containing glycosaminoglycans, which may help cells in the joint produce more fluid to lubricate the joint, and prevent or slow ongoing cartilage degradation. It is given as an initial course of 4 injections, each 7 days apart. The response to this medication in cats is variable. However if there is a favourable response,  it has the additional benefit of having minimal side effects.

Weight loss in overweight cats: Being overweight puts added pressure on joints, increasing pain and degeneration. It is very easy for an arthritic patient to become overweight as their activity levels decrease due to their pain and ageing. If your cat is overweight, weight loss can make a tremendous difference.  Please talk to us for specific advice about achieving and maintaining an ideal body weight in your cat.

Environmental Modification: Ensure your cat has a soft area to sleep in an easily accessible & safe area.  Be particularly mindful that the area is warm and cozy in the winter months as symptoms of arthritis are always worse in the cold.  Provide steps to facilitate easier access to and from their favorite hang-outs, sleeping areas, etc.

Glucosamine / chondroitin supplements: There are many different products available (e.g. PAWS osteosupport, Joint Guard, Seaflex treats). Glucosamine and chondroitin sulphate are substances present in normal cartilage, and the theory is that supplementing them may help damaged cartilage to heal. Many cats respond favourably to these products and they can be used long-term. They are slow acting, and need to be given for at least 4 - 6 weeks to assess if there is an improvement.

Tramadol +/- Gabapentin. Thes medications are opiate type derivatives and nerve pain killers. They have wide safety margins and are used in patients unsuitable or non responsive to widely used NSAIDS. They can cause drowsiness and constipation, but can be very well tolerated in our older patients.

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