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Arthritis is very often under-diagnosed in cats due to their innate ability to hide signs of disease as well as the lack of recognition of this condition by both owners and veterinarians. Most cat owners know that cats are masters of disguise. In the wild, cats can fall prey to many predators which is why their natural survival instinct is to hide signs of illness or discomfort. Owners may sometimes notice their cats “slowing down” or sleeping more and think this is normal for their age. In reality, this could be your cat’s way of telling you that they are in pain and need some help. 

Did you know that osteoarthritis exists in 40% of all cats and more than 90% of cats over the age of 12 will have evidence of osteoarthritis on radiographs? Arthritis is often mistaken as a disease of older cats exclusively. However, research has shown that even cats as young as 2 years of age can suffer from this disease. 

There are many types of arthritis but in this month’s blog, we will be discussing osteoarthritis. Osteoarthritis is a specific type of arthritis where cartilage that normally cushions the joint is worn away, exposing the bone which results in discomfort. Later on in this blog, we will go into a little bit more detail on the vicious cycle of inflammation and pain in arthritic joints. Arthritis can occur in any joint, but the most commonly affected areas include the elbows, hips, knees, shoulders and spine. 

There are some factors that can contribute or predispose a cat to the development of arthritis. These include: 

• Breed genetics: Maine Coons (hip dysplasia), Abyssinians (patella luxation), Scottish Folds (osteoarthritis affecting multiple joints due to a cartilage abnormality), Burmese (higher incidence of elbow arthritis).
• Injuries: previous fractures, dislocations, ligament damage 
• Obesity
• Acromegaly: this is an unusual hormonal disease that leads to diabetes mellitus, but some cats also develop arthritic joints.  

Although it can be difficult to spot obvious signs of pain and discomfort in cats, there are some very subtle signs you can look out for: 

• Reduced mobility (“bunny-hopping” with both back legs when climbing stairs/stopping for a break, angling their body when climbing down stairs, descending one step at a time, hesitating before jumping, not clearing jumps in one leap, pulling themselves up with front legs, making small jumps instead of one big jump, inappropriate toileting (missing the litter tray))
• Reduced activity (sleeping more, reduced interest in toys, not playing as much, reduced interaction with you or other cats, muscle loss around thighs)
• Changes in grooming behaviour (matted/scruffy/greasy coats especially in the lower half of their body, some cats will over-groom joints that are painful resulting in hair loss, overgrown claws due to inactivity)
• Temperament or behaviour changes (sleeping in different, easier to access areas, irritability when being handled or when interacting with children or other pets, withdrawal and avoidance of interaction with the household)

When you bring your cat to the vet for an check over, we will begin by getting a full history to see if we might be able to identify any other subtle changes that may suggest that your cat has arthritis. When performing a physical exam, your vet may gently palpate down the spine and manipulate their limbs to assess for any tenderness. Watching your cat walk around the consult room may also be helpful, though some cats may alter their gait when nervous. As a minimum, your vet may recommend a full blood test and urine test to screen for other underlying illnesses before prescribing certain medications but there are also many ways to manage arthritis at home. 

Ways to manage arthritis: 

• Easy home management (soft beds, warm spots to rest, easily accessible resources such as low sided litter trays with softer litter for sore feet and more water and food bowls on floor level for easier access, brushing and grooming areas your cat can’t reach, providing steps or ramps to reach higher areas, trimming their nails)
• Weight management, diets to reduce weight and pressure on joints
• Nutritional supplements (essential fatty acids, Green Lipped mussel extract, natural glycosaminoglycans. We stock a variety of supplements at our hospital such as Paws Osteosupport for cats, Paws Fish oil and 4Cyte)
• Medical treatment: Pain relief such as Gabapentin, Meloxicam, Buprenorphine, and a new therapy called Solensia.

Above, we have talked briefly about what causes pain in arthritic joints, but let’s go into a bit more detail on what affects this and how Solensia works to manage arthritic pain. 

When cartilage in a joint becomes damaged, the damaged cells (chondrocytes) release certain proteins and inflammatory mediators such as nerve growth factor (NGF). These inflammatory mediators stimulate pain by causing inflammation within the joint which results in the release of even more inflammatory mediators. Nerves in and around the joint become activated as these inflammatory mediators bind to pain receptors and begin carrying these signals to the brain where pain is perceived. NGF also causes the nerve endings in the joint to produce other molecules that result in a process called neurogenic inflammation. Neurogenic inflammation works together with NGF to grow new blood vessels and nerves which increases the joint’s sensitivity to painful stimuli.

So what is Solensia and how does it work? 

Solensia is the first and only “monoclonal antibody” specifically designed for cats with osteoarthritic pain. It works by targeting NGF which plays a key role in the vicious cycle of inflammation and pain in an arthritic joint. It is administered as a single monthly injection just under the skin and it helps to alleviate pain for 1 month. It has shown to be highly effective in managing osteoarthritic pain in cats, improving their quality of life. 

As it is an antibody, this fascinating new therapy is metabolised and eliminated with minimal involvement of the liver, kidneys and gastrointestinal tract, just like regular antibodies. Studies on the use of Solensia in cats with stage 1 and 2 chronic kidney disease have shown to be well-tolerated and just as effective as in healthy cats. Solensia can also be used in conjunction with other commonly used products such as vaccines, flea and worming products, antibiotics and nutritional supplements. 

We know it can be very difficult to pick up on the subtle signs of osteoarthritis in your cat if you aren’t sure what to look out for. A checklist is available to help you identify these symptoms, so that you can promptly seek management of this debilitating disease. If you want your cat assessed for arthritis, or if you would like to talk to us more about Solensia, please feel free to speak to one of our friendly staff or reception to book an appointment. You can also book your appointment online. 

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