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Treatment of Arthritis in Cats
Veterinary & Aquatic Services Department, Drs. Foster & Smith
Muscle & Nervous System Diseases
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Cat in cat tree It is never easy to see a beloved pet and friend in pain. Medical treatment of degenerative joint disease (commonly called arthritis or osteoarthritis) has greatly improved in the last several years thanks to the introduction and approval of several new drugs and supplements. And while there is not yet a cure for this debilitating disease, there is much you can do to control the pain, make your cat comfortable, and perhaps slow down the progression of the symptoms.

Weight management

Weight management is the first thing that must be addressed in cats with arthritis. All surgical and medical treatment and management procedures will work much better if the cat is not overweight. Considering that up to half of the pets in the U.S. are overweight, there is a fair chance that many of the cats with arthritis are also overweight. Getting the cat down to his recommended weight and keeping it there may be the most important thing owners can do for their cats. This may be the hardest part of the treatment, but it is worth it. Very few cats can drive to McDonalds, work a can opener, or open the refrigerator, so you, the owner, are controlling what your cat eats.

Because overweight cats, especially those in pain, are not active, their caloric requirement is very low, so it may be difficult to get them to lose weight. It may be necessary to feed a 'light' food and/or feed multiple very small meals during the day to prevent begging. It is very important that overweight cats not have their food restricted too much or lose weight too fast. This can cause a serious liver condition. Consult with your veterinarian to design a weight control program for your cat.

Some arthritic older cats may be too thin, and because of the difficulty in moving about, and the pain, may eat less than they need. There are other medical conditions, however, such as kidney disease and hyperthyroidism, which may cause cats to lose weight. Have your cat examined by your veterinarian to determine the cause of the cat being too thin. If the cause is arthritis, feeding a high calorie food, placing several food dishes around the house in areas easily accessible by the cat, and varying flavors of foods may be of benefit.

Exercise

Exercise is the next important step. It is difficult to get cats to exercise, although many have been taught (or submitted) to walk on a leash. New toys and catnip may be helpful in getting your cat to move more.

Provide warmth and good sleeping areas

Cats tend to like it warm, but warmth can be especially important to some cats with arthritis. Signs of arthritis tend to worsen in cold, damp weather. You may want to consider keeping the temperature in your home a little warmer, too. Place comfortable places for your cat to sleep in sunny areas or near heat registers.

Massage and physical therapy

Cats may not be too keen on physical therapy, however, ask your veterinarian or the veterinary staff about how to perform physical therapy on your cat to help relax stiff muscles and promote a good range of motion in the joints.

Some cats may like a massage, others may not want that much human touch. If your cat accepts massage, remember, your cat is in pain so start slow and build trust. Start by petting the area and work up to gently kneading the muscles around the joint with your fingertips using a small, circular motion. Gradually work your way out to the surrounding muscles. Warm towels on the area may help relax the muscles. Again, have your veterinarian show you what to do.

Make daily activities less painful

Place litter boxes and food and water dishes where your cat can reach them easily. You may need to find litter boxes with lower sides.

Going up and down stairs is often difficult for arthritic cats. Many people build ramps to help the cat get to different areas of the house. For my arthritic cat, I made a set of 'stairs' from cushions so he could get up on the couch to his favorite spot to watch the birds. Use your ingenuity to design ways to decrease jumping but increase movement.

Many cats may have difficulty grooming, so gently brushing your cat and/or cleaning the rectal area may help him in this important daily activity.

Glucosamine and chondroitin

Glucosamine and Chondroitin: Glucosamine and chondroitin are two compounds that have been widely used to help manage osteoarthritis in both animals and humans.

Glucosamine is the major sugar found in glycosaminoglycans and hyaluronate, which are important building blocks in the synthesis and maintenance of joint cartilage in the joint. Chondroitin enhances the synthesis of glycosaminoglycans and inhibits damaging enzymes within the joint.

When a cat has degenerative joint disease, the joint wears abnormally and the protective cartilage on the surface of the joint gets worn away and the resultant bone-to-bone contact creates pain. Glucosamine and chondroitin give the cartilage-forming cells (chondrocytes) the building blocks they need to synthesize new cartilage and to repair the existing damaged cartilage. These products are not painkillers; they work by actually healing the damage that has been done. These products generally take at least six weeks to begin to help heal the cartilage and most animals need to be maintained on these products the rest of their lives. These products are safe and show very few side effects. There are many different glucosamine/chondroitin products on the market, but they are not all created equal. Drs. Foster and Smith's line of Joint Care products or Cosequin are recommended.

Perna Mussels: Perna canaliculus, or green-lipped mussel, is an edible shellfish found off the shores of New Zealand. The soft tissue is separated from the shell, washed several times, frozen, and freeze-dried. It is then processed into a fine powder and added to joint care products. It is made up of 61% protein, 13% carbohydrates, 12% glycosaminoglycans (GAGs-an important component of connective tissue), 5% lipids, 5% minerals, and 4% water. It also contains glucosamine, a GAG precursor and one of the building blocks of cartilage. Glucosamine and GAGs are the compounds in the mussel believed to contribute to its beneficial effects.

Omega-3 Fatty Acids: Omega-3 fatty acids are often used for the management of the signs of allergies in pets. Because of their anti-inflammatory properties, some have advocated their use in cats with osteoarthritis.

Avocado/Soybean Unsaponifiables (ASUs): ASU's are an extract of avocados and soybeans. There is some very promising research that indicates that ASU's can help protect cartilage, support cartilage repair, and decrease the discomfort associated with osteoarthritis. ASU's are thought to enhance the action of glucosamine and chondroitin. ASU's are found in Doctors Foster and Smith Premium Joint Care 3.

Anti-inflammatories and pain relievers

Buffered aspirin, or aspirin of any kind, should not be used in cats, unless prescribed by your veterinarian.

Buffered Aspirin: Aspirin must be used with great care in cats and should not be used except under direct supervision by your veterinarian. Cats are very sensitive to aspirin and the dose is generally limited to every other day.

Butorphanol: Butorphanol is a pain reliever used in cats. It comes in both an injectable and tablet form, and is available through your veterinarian. It can cause sedation in cats, which in most cases is undesirable since we want the cat to move about.

Corticosteroids: Corticosteroids have been used for many years to treat the pain and inflammation associated with osteoarthritis, although their use now is controversial. Corticosteroids act as a potent anti-inflammatory, but unfortunately, have many undesirable short- and long-term side effects. Because of these side effects and the advent of newer, more specific drugs, corticosteroids are generally only used in older animals where all other pain control products have failed, or in acute flare-ups. Corticosteroids are a prescription product and come in both a pill and injectable form.

Surgical treatment

Because of their size, surgical treatment and/or joint replacement is generally not performed on cats. In rare cases, surgery may be performed on the hip to remove the end of the femur (thighbone) that is part of the hip joint. This procedure is called a 'femoral head excision.' The cat would then develop a 'false joint' and have less pain.

Summary

Each cat with arthritis will need to have a management program specifically designed for his needs. What helps one cat with arthritis, may not help another. Work with your veterinarian and watch your cat carefully so that between you, your cat, and your veterinarian it can be determined what is best for your cat. Realize, too, the program may need to be changed as your pet ages, or if symptoms improve.

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