Arthritis in cats

Content by Dr Nicole Olewinski – BVSc MRCVS

Arthritis is inflammation and degeneration of one or more joints. And while it is uncomfortable, pain levels vary with severity and during flare-ups. Cat owners may only notice subtle changes in behaviour and activity levels.

It’s also not just the joint that’s affected. Ligaments, muscles and other supporting tissues can also be damaged or placed under strain.

• Arthritis is common in older cats
• Cats may not show pain or limp
• Common signs include grooming or jumping less
• Arthritis can be managed, but it can’t be cured

Anything that causes inflammation, abnormal friction or uneven wear in a joint can lead to arthritis. This includes things like:

• Developmental problems like hip dysplasia
• Injuries 
• Joint infections
• Obesity and nutrition
• Wear and tear over time
• Cancer, though very rarely

Any cat can develop arthritis, but some breeds are more prone to conditions that can cause it at a younger age.

Maine Coons have a higher risk of hip dysplasia, while Abyssinians and Devon Rex cats are more prone to patellar problems. Munchkin cats can develop joint and bone problems related to their short-legged conformation. The genetic mutation that gives Scottish Folds their characteristic ears can also cause faulty cartilage development, known as osteochondrodysplasia.

Arthritis reduces the frequency and force with which cats use an affected joint. While this can mean obvious limping, some cats compensate for mild arthritis, and their symptoms can be quite subtle. Common signs of arthritis in cats include: 

• Limping and stiffness
• Pain which may show as vocalisation, sensitivity to touch or licking a sore area
• Loss of muscle
• Reluctance to jump or play 
• Grumpiness when touched
• Going outside less or not venturing as far
• Grooming less
• Difficulty using a litter tray

Typically, cats with arthritic elbows may find jumping down more uncomfortable, whereas cats with lumbosacral or hip problems may find jumping up more difficult. However, cats can have arthritis in several areas at once, so these patterns aren’t always obvious. Some cats cope very well with arthritis for long periods, then have a flare-up when their pain and stiffness become more noticeable.

A good clinical examination can often pick up on swollen and stiff joints, but identifying specific causes and severity requires additional testing:

• X-rays 
• Advanced imaging such as CT or MRI for complex joints
• Joint fluid samples
• Blood samples don’t necessarily identify underlying causes but help assess whether certain medications are safe to use 

While x-rays are a routine way of diagnosing arthritis, it takes time for bony changes to develop (in other words, changes to the bones becoming visible on an x-ray), and the amount of change does not always directly translate into the level of discomfort a cat feels. Lots of radiographic change doesn’t always mean high levels of pain, but monitoring bony change over time can give a clue into the speed of progression or stability of the arthritis.

It’s not currently possible to stop the progress of arthritis or reverse it, although researchers are hopeful. Many treatments claim to be chondroprotective or disease-modifying. But even when drugs should theoretically work, what happens in the working joint of a running, jumping, hunting and often elderly cat is very different. This means that medical treatment is essentially aimed at achieving one thing: comfort and quality of life. 

Medical treatment

Medical treatments include:

• NSAIDs (non-steroidal anti-inflammatory drugs), which work by reducing inflammation and pain. 
• Other pain relief such as opioids and gabapentin may be used alongside NSAIDs when additional pain relief is needed.   
• Additional analgesic drugs are available, although individual responses can vary significantly. 
• Steroids are powerful anti-inflammatories and – although they can have significant side effects – they are appropriate in some cases. 
• Solensia is a relatively new treatment for osteoarthritis that blocks nerve growth factor, which plays an important role in pain signalling.
• Cartrophen, which is licensed for dogs, is occasionally used in cats as an additional treatment for arthritis.   

Regular blood tests are advisable to monitor how the liver and kidneys are coping with long-term medication.

A small number of arthritis cases benefit from surgery – for example joint fusion, femoral head excisions or hip replacements. Some cats also experience a temporary reduction in pain after injections into the affected joint. 

CBD may become another addition to the pain-management arsenal. But in the UK, there are no licensed CBD products for cats, and the purity and safety of products sourced online can’t be guaranteed. 

Other therapies include:

• Hydrotherapy
• Physiotherapy
• Massage and/or acupuncture
• Laser or infrared therapy
• Support dressings 

Minimising ongoing wear and tear and supporting your cat’s overall health can have a much bigger impact than many people realise:

• Weight loss
• Joint supplements
• Good-quality, life-stage appropriate diet
• Warm sleeping spots
• Low-sided litter trays
• Anti-slip mats

With the right management, many older cats live long, contented lives with arthritis. Problems tend to occur when other health issues, common in old age, make management more difficult. When there has been a specific trigger for the arthritis, like a developmental condition, rapidly progressing or earlier-onset arthritis does have the potential to impact quality of life more significantly. 

“For most cats, a little arthritis in old age is inevitable, but it’s important not to dismiss it as ‘just old age’. I’ve made several changes to help my own elderly cat. He’s never been a clean cat, preferring to sleep anywhere the sun shines, including compost heaps, but he now needs help grooming and removing dead hair before it becomes matted. He’s sensitive over his back and hips, so I’ve swapped our usual comb for a softer silicone brush.

“Despite his love of the outdoors, I no longer let him out at night. He can’t run away or defend himself if confronted by a cat, fox or badger, and the cold can make his stiffness worse. He’s also losing weight, so I feed him smaller meals more often and have changed his litter tray to a low-sided one, with a piddle mat underneath for the inevitable accidents. I’ve also provided more low-level, padded beds.

“I’ve provided more low-level, padded beds, but he’s still determined to get on the sofa for a cuddle, usually while I’m having my morning coffee, so I’m training him to wait to be picked up. I gently massage and move his back legs when he’s comfortable with it. This winter I’m also looking into a heated cat bed, as my dogs won’t always sit still long enough when he wants to cuddle for warmth. None of this is mind-blowingly complex, but it makes a difference to him and the extra attention sets off his crazily loud purr.”

Dr Nicole Olewinski – BVSc MRCVS

If you’re thinking about buying a Petgevity Lifetime Plus policy, we’ll consider all pre-existing conditions when offering cover for your cat* – including arthritis.

When you apply for cat insurance, you need to let us know: 

• Which medical conditions they’ve had in the last two years 
• Their health status now

Find out more about Petgevity’s cat insurance for pre-existing conditions.