Why, Yes We Can Help Cats with Arthritis
Arthritic Cats hesitate before jumping down from the bed, avoid steps, no longer groom very well, or perhaps have started having BMs outside the litter box. They may be grumpy or may be quiet about their pain, but either way, we can help them.
Cats typically develop arthritis in the elbows and shoulders, but the spine, hips, and knees can also be afflicted. Old injuries and obesity are risk factors, but most cats over the age of 12 have some evidence of Degenerative Joint Disease (DJD) on x-rays. During an exam we may find less range-of-motion in a joint, some grinding that we call crepitis, and the cat may pull away, breathe harder, or become tense as we handle that area. Depending on the signs and severity, we may or may not need x-rays to fully evaluate the situation. There are several avenues of treatment for these cats. All of them are focused on function and quality of life.
First we evaluate the cat’s body composition. Too much fat puts extra load and strain on the joints. Not enough muscle means not enough support or strength for proper movement. We will identify the calorie and protein needs for your cat, which may change over time. As far as nutritional supplements go, there is medical evidence supporting the use of two types in cats. The way these products are studied is measuring how hard animals push off with each leg as they walk across a force-plate in the floor before and after treatment. There is some evidence that glucosamine and chondroitin help cats. Two good quality products are Cosequin and Glycoflex. There is even stronger evidence for the use of fish oil. We like Wellactin and also Hill’s Prescription Diet j/d, a food that incorporates the fish oil. These approaches actually change conditions inside the joint, leading to improvement in function as well as pain relief. Nutritional approaches take 4-6 weeks to see results. Another “joint modifying agent” is Adequan. It is given by intramuscular injection weekly for a series of 4, and then every 1 to 6 months depending on the severity. Cats given Adequan often show great improvement in range of motion.
Pain Relievers help in the short-term while we are starting long-term management or for the most severe cases. Narcotics such as tramadol (made into a skin cream) and Buprenex (liquid) are both well tolerated. While constipation and physical dependency are drawbacks to long-term use in people, these are not an issue in cats at the doses we prescribe. Anti-inflammatories are also useful and great painkillers, although we must be cautious. They can damage the liver or kidneys, especially in a cat who already has internal organ compromise, and they can contribute to stomach and intestinal bleeding and ulcers. Meloxicam and Onsior are the best known drugs for cats in this class.
Therapy laser uses specific wavelengths of light to penetrate into the tissue, causing release of endorphins for immediate pain relief and calming the nerve cells to downplay the changes from chronic pain. It is anti-inflammatory and promotes healing of the supportive soft-tissue structures around the joint. The typical treatment regime starts with a 10 minute session every other day for 2 weeks, then 1-2 times a week until stable pain-control is achieved. Long-term treatment is based on the severity. Even cats with serious health problems such as kidney failure, diabetes, and heart disease can be safely treated with the laser.
Comfort: Additional home management includes heated cat beds, shallow litter boxes on every level of the home, and keeping nails trimmed.
Our Pain Management Pledge
• We will ask about signs of pain during every visit.
• We will be alert for signs of pain during every exam.
• We will rate pain and record it in the patient’s medical record.
• We will anticipate conditions that may cause pain and take steps to prevent it.
• Every member of the staff will be trained to recognize pain and monitor cats in the hospital for signs.
• We will teach our clients to recognize pain in their cats and give them tools to help.
• We will follow-up on our pain control measures and make sure they are working.
• We will tailor paincontrol to the specific needs of each patient.