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Arthritis in cats is often something that is overlooked and not diagnosed due to the lack of recognition of the condition by owners and veterinary surgeons. Cats have a natural survival instinct to hide signs of pain and so the traditional symptoms recognised in other pets such as dogs are often not apparent in cats.

Incidence of osteoarthritis in cats

Due to the challenges of diagnosing arthritis in cats, it can be difficult to tell how many cats are affected with arthritis. However, recent studies looking at radiographs of older cats showed 90% of cats over 12 years had evidence of osteoarthritis. (Hardie et al, 2002). This study and others suggest that it is very common in older cats and is being under-diagnosed.

What causes osteoarthritis?

Osteoarthritis is a type of arthritis in which the normal cartilage that cushions the joint is worn away, exposing the bone and resulting in discomfort. There are some factors that can contribute to the development of osteoarthritis.  These include:

• Genetics: certain breeds appear to be predisposed to developing arthritis due to various underlying joint problems, for example hip dysplasia in Maine Coons and patella luxation in Abyssinians. Scottish Folds are particularly prone to OA affecting multiple joints and Burmese cats show a higher incidence of elbow arthritis than other breeds.
• Injures that cause abnormal joint loading such as fractures, dislocations and ligament damage can cause the joint to be used differently and result in secondary osteoarthritis of the affected joint.
• Obesity increases the weight loading on the cat’s arthritic joints which leads to worsening of pain and exacerbation of their symptoms.
• Acromegaly is an unusual hormonal disease that leads to diabetes mellitus and some cats also develop arthritic joints.

What are the signs of osteoarthritis?

The most obvious sign of arthritis is joint pain, with the most commonly affected joints being the elbows, stifles (knees) and hips. However, this is where the problem arises; cats are the masters of hiding discomfort and and the majority of arthritic cats do not demonstrate the obvious signs of pain. They are not taken for walks like dogs and restrict their own activity to minimise the use of the sore joints. They also tend not to show the same obvious signs of pain as other species such as vocalising, and will exhibit more ‘passive’ behaviour to disguise pain.

Signs that your cat may have arthritis:

• Reduced mobility
  • Changes in their ability to jump – this is the most important sign to look for
  • Reduced height of jumping e.g. no longer getting up on kitchen bench
  • Reluctance or hesitation before jumping up or down from furniture, appear to think carefully before jumping
  • Reduced frequency of jumping up to usual places
  • Difficulty or slow when using stairs or getting through the cat flap
  • Pulling themselves up with front legs to get onto the couch or the bed
  • Litter tray accidents, urinating and/or defecating outside the litter tray, reluctance to climb into high sided tray
  • Reduced agility e.g. will jump on chair before jumping on table
  • Lameness or stiff/stilted gait is relatively uncommon in cats with arthritis
• Reduced activity
  • Increased time sleeping or resting
  • Not hunting or exploring the outdoor environment as frequently
  • Reduced interaction e.g. lack of response to petting
  • Reduced interest in playing with toys, people or other animals
• Changes in grooming behaviour
  • Matted and scurfy coat, difficulty grooming themselves
  • Some cats will over-groom themselves over painful joints causing hair loss
  • Overgrown claws due to lack of activity
• Temperament or behaviour changes
  • Sleeping in different, easier to access sites
  • Lack of tolerance of handling, children, other pets
  • More irritable or grumpy when handled or stroked
  • More irritable with people and other animals
  • Withdrawal and avoidance of interaction with household

On examination, affected cats may demonstrate discomfort and resist palpation and movement of the affected joints. The joints may feel firm and swollen. Orthopaedic examination can be challenging in cats, as they are often reluctant to walk normally in a consulting room. Being gentle and not rushing will help the cat relax and behave more normally, facilitating a more rewarding examination. The next step in the diagnosis involves radiography. Ideally at least two views are taken of the affected joints and changes seen include the formation of new bone around the joint margins (the body’s attempt to ‘stabilise’ the joint).

Sclerosis (thickening) of the underlying bone and narrowing of the joint space are also observed. Further laboratory tests are not usually required to diagnose osteoarthritis, however as affected cats tend to be older they may have more than one disease. As a minimum it is recommended to assess a complete blood count, serum biochemistry blood panel and a urinalysis before prescribing medication to screen for other illnesses. 

Management of the arthritic cat

Treating arthritis in cats doesn’t start and finish with a pill or potion. Home comforts and management adjustments are vital to the improving the cats’ quality of life and can be just as important as medications.

Easy home and management adjustments for the arthritic cat:

• Provide soft beds for sore joints in easily accessible, quiet places
• Place beds in quiet, draft free areas of the house
• Igloo beds or cardboard boxes can make an older cat feel warm and secure
• Provide ‘steps’ up to higher sites, e.g. the sofa, the cat flap
• Tie the cat flap open so the cat doesn’t need to push through
• Always have a litter tray inside and use a low sided version or cut out the sides to make it easy for arthritic cats to climb in
• Use different types of litter that are softer for sore feet
• Make sure food and water are easily accessible, at floor level or with steps up to higher levels
• Put food, water and litter trays on one level to avoid the cat having to go up and down stairs
• Radiator beds are popular but again arthritic cats will need help to get into them, other warming devices such as wheat bags can help but electrical devices should be used only when the cat is monitored
• Arthritic cats may need extra grooming and help cleaning eyes and perineal region
• Overgrown claws need regular cutting

Nutritional management and nutraceuticals

Obesity will exacerbate osteoarthritis and so should be avoided. Obese cats need careful diet changes supervised by a veterinary surgeon. Overweight cats need to lose weight slowly and changes may take several months.  Rapid weight loss can result in metabolic problems such as hepatic lipidosis which is a serious condition that can lead to liver failure.

Several dietary supplements and diets are available for cats with osteoarthritis containing combinations of essential fatty acids (EFAs) to reduce inflammation, natural glycosaminoglycans and marine supplements such as Green Lipped mussel extract. We stock both the Paws Osteosupport for Cats and 4Cyte granules. For the finicky cat that will not take a supplement, there are some prescription foods available for cats that contain joint supplements.

Chondroitin and glucosamine supplements are available for cats. The effects are unproven but they have been shown to be effective in dogs, horses and people and so may be beneficial. They may help in early or mild cases but are not likely to be enough alone in more severe cases.

Medical treatment

Medications can be very effective at controlling pain but should only be used once the cat has been fully assessed for their general health and screened for the presence of other diseases. Most cats with arthritis are geriatric and therefore commonly suffer concurrent disease. Ideally cats should have a full blood test and urinalysis prior to commencement of medication.

The most common medication used and the only medication to have a license for the treatment of chronic pain caused by osteoarthritis in cats is Meloxicam. This drug is very effective for treating pain but should be used with extreme caution in cats with kidney problems and liver problems. It is important to avoid giving this medication to your cat if they have vomiting, diarrhoea, are dehydrated or have low blood pressure (hypotension). The lowest effective dose should be used and the drug must always be given with food. Maximising water intake is important in all older cats to prevent dehydration and urinary problems and this is especially true of cats receiving Meloxicam. Ensure you have multiple water sources easily accessible around the house and increase the amount of wet food in your cat’s diet. For more information about NSAIDS and cats refer to our information page here.

Other pain relief medications that are used to treat arthritis in cat include opioids such as buprenorphine which can be given sublingually, tramadol and gabapentin. These drugs are not licensed for use in cats with osteoarthritis and so have not been closely studied. Anecdotal reports suggest they may be useful in cases where Meloxicam is not appropriate or tolerated. Corticosteroids are not recommended as they cause side effects and result in long term health problems such as diabetes.

In conclusion, osteoarthritis is a common condition in older cats and can be challenging to identify. Diagnosis relies on an observant owner who knows what to watch out for as their cat grows older, being mindful that the signs of arthritis in cats are very subtle. Medications can be very effective and can improve a cat’s quality of life significantly. Concurrent geriatric disease should be always be considered before such drugs are prescribed. Finally, the importance of non-medical management changes cannot be over-estimated.

Disclaimer: Please note that the information provided on this page does not replace the advice of your veterinarian. If you are concerned about your cat’s health in any way, we strongly recommend you seek veterinary advice.