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A black cat is cuddled in a soft bed with a purple towel over her and a Plague Doctor Sqiushable next to her. The image is attached to a post on arthritis in cats.

Last summer I noticed some odd things about Bella’s behavior that got me concerned. Photo by JaneA Kelley

It was a remarkably cool day for a Seattle summer, and I was relaxing with a video game while Tara looked out the window and chattered at the bird family that had built a nest nearby. Then I heard scrabbling claws and a thump. It was Bella. She’d missed the jump from the floor to the counter for the third time in less than a week. When I looked in her eyes, I got the feeling that something was wrong, that she was in pain.

A week later, Bella and I were at the vet’s office waiting to be seen. As she curled up next to me and tried to hide, I was worried, too. I was at least as worried about finding out nothing was wrong and it was just me suffering from “hypochondria by proxy” (this isn’t a real thing, it’s just my term for being worried and anxious about illnesses in my cats that aren’t there) as I was about finding out something was wrong.

When the vet came in, I told her what I’d noticed: the lack of jumping, the lack of zoomies, and just the sense that something was off. She did some range-of-motion exercises to see how Bella felt about having her legs flexed and extended, and there were definitely a couple of moments where Bella shot the vet a “do that again and your reward will be a fist full of claws” expression. Because Bella had reacted painfully to some of the things the vet had done, I consented to X-rays to see if there were any worrying signs.

It turned out that Bella was suffering from arthritis. Pretty mild arthritis at this time, but definitely something that could benefit from pain management. I agreed to start her on Dasuquin, a joint supplement. And thus began our arthritis journey.

Arthritis in cats has very subtle symptoms

Unlike dogs, who are really good at demonstrating lameness and other signs of pain, cats are instinctively driven to hide signs of illness or injury. That’s what happens when you’re a predator but also a prey animal: weakness means death. Thus, often the only signs you’ll see are behavior changes, like I did with Bella: reluctance to jump, a change in activity levels, and maybe a sort of depressed vibe in your cat. Other signs include a change in mood like becoming grumpier, weight loss, and elimination outside the litter box.

A 2023 article in Today’s Veterinary Practice on managing arthritis in cats shares one study that showed 90 percent of cats older than 12 years of age have arthritis in one or more joints, according to X-rays, while owners and even veterinarians sometimes miss the signs because they’re so subtle.

In cats, arthritis appears most commonly in the shoulders, elbows, spine, hip joints, and the cat equivalent of the ankles.

Two X-rays of an arthritic cat's legs and knees. The knee joint has a lot of degeneration and scarring, The X-ray showing both legs provides a clear picture of bone deformity.

Kissy was only two years old, but she had major arthritic changes in her left leg due to congenital bone deformity.

Risk factors for feline arthritis

The most common risk factor for arthritis is simply age. Cats are living longer than ever, so we’re starting to see an uptick in “old kitty diseases” such as arthritis or kidney disease.

Another risk factor for arthritis is obesity. The extra pressure on the joints leads to extra wear and tear, so obese cats can develop arthritis younger than cats of a more appropriate weight. That said, Bella has never been obese, and she was 11 when she was diagnosed with arthritis, so don’t think your slender cat will never get arthritis. Today’s Veterinary Practice also says that while obesity is an important risk factor, it has been reported that only 14 percent of arthritic cats were obese.

Congenital (present at birth) bone and joint deformity also provides fertile ground for the development of arthritis. This was the case with my cat, Kissy. She was only two years old and suffering from severe pain in one of her rear legs. I took her to the vet and had them do X-rays (those are Kissy’s X-rays above), and the vet noted some serious arthritic changes in her left knee, and the X-rays, which showed that her lower leg bones in her left leg were deformed, led my vet to believe this was a congenital issue. Hip dysplasia is another joint deformity that can lead to arthritis. While hip dysplasia is not common in cats, it is more common in very large breeds such as the Maine Coon and the Siberian.

Declawing is a big risk factor for arthritis in cats. According to The Paw Project, researchers have shown that immediately after the surgery, newly declawed cats shift their body weight backward onto the large central pad (the three-lobed pad on the palm). This altered gait persists over time and can cause stress on the leg joints and the spine, which could lead to arthritic changes in multiple joints.

Other risk factors for arthritis in cats include a history of injury (past fracture, ligament damage, muscle injury, joint infection, or damage/erosion of cartilage), tick-borne illnesses such as Lyme disease, and some autoimmune diseases.

Treatment of arthritis in cats

Treating pain conditions in cats can be tricky due to their well-known sensitivity to NSAIDs (like aspirin, ibuprofen, and naproxen sodium) and acetaminophen (Tylenol, which could kill them). Here are some common treatments for our creaky kitty friends.

  • Nutraceuticals. Nutraceuticals are dietary supplements that have a medicinal effect. Two nutraceuticals commonly used in treating arthritis pain are Cosequin and Dasuquin. These medications help to slow down the breakdown of cartilage, promote healthy cartilage cell production, and reduce inflammation. I found that Dasuquin did not agree with Bella’s poor little tummy, so we had to switch her to another medication.
  • Prescription medications. Some prescription drugs are safe to use long-term in cats.
    • Gabapentin is a medication that helps sedate cats prior to travel and also relieves pain.
    • Amantidine is generally used to control tremors in people with Parkinson’s Disease and can also relieve pain in cats.
    • Adequan is an injectable prescription medication that supports joint health by stopping destructive enzymes within the joint. It is, however, used off label in cats, so make sure to discus it with your vet. Adequan is the medication I’m now using with Bella.
    • Buprenorphine (or other opioids) are generally used in cats with severe arthritis. Siouxsie was getting buprenorphine for the last year or so of her life.
  • CBD or hemp supplements. According to PetMD, CBD is short for cannabidiol. Unlike marijuana, which contains THC, CBD won’t get your cat high. CBD is derived from cannabis (hemp) plants with low THC content. I personally prefer a broad-spectrum hemp supplement, and when Siouxsie’s arthritis pain was moderate I used a product called Canna Companion, which was very effective for her. Canna Companion was created by my former veterinarian and her husband, who is also a veterinarian, and I highly recommend it for anyone seeking CBD or hemp supplements for their cat’s arthritis. Canna Companion can be shipped anywhere in the U.S.–except Idaho. Because of course Idaho.
  • Solensia. Known by the generic name frunevetmab, Solensia is a felinized immunoglobulin monoclonal antibody: an antibody designed to target nerve growth factor (NGF), thereby reducing pain and inflammation. “Felinized” means it’s made specifically for cats and can’t be used in other species. I talked to my vet about Solensia for Bella, but we agreed that her arthritis is still mild and there aren’t a lot of studies about long-term use in cats, so we’d hold off on it for a while.
  • Non-drug treatments. These include weight loss, hydrotherapy and other physical therapy treatments. Acupuncture is an option for pain relief, but it’s not a cure because it does not heal the damage to the joints that causes arthritis.
  • Very specific NSAID pain relievers. There are two NSAIDs that have been approved by the U.S. Food and Drug Administration for very short-term use in cats. These are meloxicam (brand name Metacam, only approved for one injection) and robenacoxib (Onsior, only approved for three days’ use). There are very serious safety concerns about using meloxicam off-label for cats, though, and kidney failure and death are among them. (See the FDA’s page on the boxed warning for use of meloxicam in cats for more information.)
A black cat with a purple harness and lead rests in a heated cat bed.

Siouxsie loved her heated cat bed and used it all the time. It made her creaky hips feel better. Photo by JaneA Kelley

Making life easier for cats with arthritis

If you have an arthritic cat, there are some things you can do that will immediately make her life better. All of these things revolve around changing the environment so your cat can still enjoy the things she loved before her joints started hurting.

A clear, lidded storage tote

Use a clear storage tote like this, with a deep-cut entry, if your arthritic cat is a vertical pee-er.

  • Low-sided litter boxes. It can be hard for an arthritic cat to get in and out of a litter box if it has high sides. If you have vertical pee-ers in your house, try  using a large, high-sided storage tote and cutting an opening no more than 3-4 inches off the floor in one end.
  • Lots of pit stops. Make sure you have at least one litter box per floor of your home, and make sure at least one of those litter boxes is near where your arthritic cat likes to hang out.
  • Ramps and steps. Your cat still wants to be able to watch Bird TV from her favorite window sill or get to high-value locations like the bed and the sofa. If you give her ways to get up to and down from these locations without pain, she’ll be delighted!
  • A heated cat bed. There are lots of heated cat beds available for sale. The one I used with Siouxsie, which you can see in the photo above, had a soft cushion and only got warm when she was sitting in it. Another option is getting a nice, soft cat bed and putting a heating disk under the cushion. A heating disk is a thing you microwave and put under a cat’s bedding. A well-known brand is Snuggle Safe. Do not use a heating pad; it can get too hot and burn your cat’s skin.

Arthritis is inevitable, suffering is not

If your cat is moving more slowly than he used to, or he’s gotten a little grumpy, or he’s not making jumps like he used to, take him to the vet and have him checked out for arthritis. The range of treatment options available today is amazing, and most of them are not terribly expensive, either. There’s no reason why cats with arthritis can’t have a wonderful quality of life. Bella practically turned into a new cat once I had her on the right arthritis medications, and if you get your cat treated for arthritis, I bet you’ll see your kitty perk up pretty quickly.

 


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