Managing arthritis is the cat requires thinking beyond a magic pill or potion to take away the pain. The greatest success occurs with a multi-modal approach that includes environmental modification, nutrition, medication and physical approaches.
Environmental management is actually fairly easy although it may require some creativity on occasion. The goal is to make everything as accessible, and as comfortable, as possible for the arthritic feline. There are many aspects to consider in altering the environment including:
- Soft, thick, comfortable beds should be placed in easily accessible, quiet areas that are free of drafts and noisy traffic. Several companies manufacture electric warming beds and pet heating pads (made to work at low, safe temperatures) to improve the comfort for those aching joints.
- Many cats enjoy high spots on sofas, window sills or furniture that may be harder to reach as arthritis sets in. Providing ramps or steps to these areas may allow them to continue to continue to enjoy their favorite spots.
- In multi-storied homes, it is ideal to have litterboxes, food and water on every floor.
- Many litterboxes have fairly high sides that can be hard to negotiate with arthritis. Either purchase a litterbox with a low entry opening or modify your existing box so there is an opening that is only 2 to 3 inches high and 6 or so inches wide. You can place a litter catch mat or washable bathmat by that side of the box to catch any escaped litter debris.
- Check the cat door – if the flap is heavy, tie it open for easy access. If the opening is high, try to create a step on each side to make it more readily accessible.
- Confirm that the food and water bowls are low enough to be easily accessible or provide steps to their usual location.
- Gentle brushing can help with grooming. Many arthritic cats find it difficult to groom their back and flanks and tight mats may occur even in short-haired kitties. A gentle, soft brushing for a few minutes each day can help prevent this matting, which will make them feel better.
- Check your cat’s claws every few weeks – they may need extra trimming if they are less active and not stretching to “sharpen” their claws.
Diet and Nutritional Supplements are another area worthy of attention. Obesity, or even simply being overweight, can contribute to the problems associated with arthritis. It’s not even as simple as excess load bearing caused by obesity – fat as a tissue actually releases inflammatory mediators that can exacerbate the inflammation and pain associated with degenerative joint disease (this occurs in humans too!). Gradual, controlled weight loss can be a huge benefit in managing arthritis and mobility. There are several prescription veterinary diets that have been proven to accelerate weight loss safely in felines, so ask your vet about their favorite (Hill’s Prescription Metabolic Diet is very popular).
Of the nutritional supplements, there are several that can prove useful with arthritis. These do take some time to see the actual benefit, but they can provide substantial benefits with little or no risk of side effects. They are best used along with multi-modal management.
Some useful supplements include:
- Essential fatty acids – the dose used for arthritis is higher than for allergy, so ask your vet for a specific dose (and brand) recommendation.
- Joint supplements – a term that covers a wide array of products, but typically includes chondroitin sulfate, glucosamine and other nutritional supplements. These are not terribly well-regulated in animals (or people, for that matter), so select a brand reputed to be properly analyzed. Dasuquin® for cats is very popular and well regarded among vets.
- Duralactin® for cats is a supplement that works via a very different mechanism from the others and can also be helpful – it is not appropriate for milk-intolerant cats as it is a milk derivative.
Medications can be very useful in managing the pain and inflammation caused by osteoarthritis in the cat, but need to be used with care. Cats are not small humans or even small dogs as they have their own unique quirks in the metabolism of some drugs. Tylenol is extremely toxic to cats and even one tablet can potentially kill an adult cat. There are a few non-steroidal anti-inflammatory drugs (NSAID) that are licensed for use in cats in different countries with different dosing protocols. Used carefully, these medications can be tremendous tools in managing pain and discomfort. There are several other medications that can be used as alternatives or to supplement the analgesic effects of an NSAID. Some adjunctive medications include Gabapentin, Amantadine, Buprenorphine and Tramadol.
Solensia ™ is a monoclonal antibody (mAb), which is a highly specific protein targeting molecules involved in disease. It functions like naturally occurring antibodies, and is eliminated via normal protein degradation pathways, with minimal involvement of the liver or kidneys. Solensia binds to Nerve Growth Factor (NGF), and its action helps to control pain and limit the release of proinflammatory mediators that increase inflammation and can lower neurogenic inflammation also. These combined actions can reduce the pain caused by osteoarthritis in cats.
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Other Therapies can be used that are free of the potential side effects of pharmaceuticals. These can be used alone with milder levels of discomfort or combined with other treatments with more persistent pain. One is Adequan®, an injectable medication used in horses and dogs for decades to help with joint disease.
Adequan can actually help modify the disease process in those species and there is early evidence to suggest the same in cats. It has not gone through FDA approval for use in the cat, but has been used for several years with good results. Another option is therapeutic laser, also called cold laser or low level laser therapy.
Laser therapy can reduce inflammation and improve comfort when applied to arthritic joints and there is much evidence to support its effectiveness with osteoarthritis patients.
Physical therapy, known as animal rehabilitation in the veterinary world, can help with many arthritic cats, but does require a trained veterinary rehabilitation therapist. Acupuncture has a great deal of evidence for its usefulness in pain control in humans, horses and dogs. Again, someone certified in veterinary acupuncture is essential for this mode of therapy. We are still gathering information in cats and other species, but since the neurology is nearly identical in all mammals, we would expect, and anecdotally do see, improvement with acupuncture therapy in most cats.
The Future: There are some very exciting new medications in the pipeline right now that may provide additional options for pain management in cats as soon as the end of this year. By attacking their pain from many directions, we can provide a good quality of life for arthritic kitties for a much longer period than was possible even just a decade or two ago and we expect to have even better treatment options in the coming years.
Elizabeth F. Baird, DVM, CVPP, CCRT, cVMA
Steele Pain Management & Rehabilitation Center
