Treating feline arthritis with spectrum of care

What is arthritis?

Arthritis is common in cats over 10 years of age. Arthritis, also known as Degenerative Joint Disease (DJD), usually refers to the wear-and-tear injury to joints that occurs over time. Less common kinds of arthritis are septic arthritis caused by infections and immune-mediated arthritis caused by diseases such as rheumatoid and rare reactions to drugs or vaccines.

At home, arthritic cats limit their activity to avoid things that hurt such as steps or jumping off high beds. They may seem “crabby” towards children or other pets, and they may be perceived as “lazy” for lying around a lot. During a physical exam, there is muscle loss across the shoulders and thighs. They show less range of motion in their elbows, hips, and knees and react painfully when lowered onto affected legs. On X-rays, different kinds of arthritis have distinct appearances. Risk factors for arthritis include declawing, obesity, and previous injuries.

Treatments

Treatment goals: We have 3 major goals with treatment: control pain, restore joint function, and slow progression of joint degeneration. The pain in arthritis come from micro-tears in the joint capsule and joint cartilage. Nerve growth factor is a chemical messenger in the body that triggers the pain message in nerves.

• Feeding to optimize weight and body composition: Extra fat is a burden on arthritic joints, so we can see tremendous improvement in quality of life when cats are fed to be slightly lean. Nutrition can also support improved muscle mass to support weaker joints.
• Nutritional supplements: There is strong evidence that Omega-3 fatty acids slow the progression of arthritis, improve function, and decrease pain. There is some evidence that glucosamine and chondroitin help slow the progression, but on their own they do not help the pain or function of existing joint disease. Options include Wellactin, Antinol, Dasuquin, and mobility diets.
• Injectables: Adequan is a product that improves joint function in several ways. It helps the cat produce more, thicker joint fluid, helps scar over ragged cartilage, and repairs small, painful tears in the joint capsule. It is given weekly the first month, then every 30 to 90 days. Solensiauses the immune system to block nerve growth factor, a big player in joint pain. It is given monthly in the office and typically shows dramatic results by the second month.
• Physical rehabilitation: Cats with arthritis love warmth and heated beds. Arthritic cats have trouble grooming their claws, so trimming them every 8-12 weeks is important to prevent overgrowth into paw pads. The therapy laser is a medical device that uses light energy to relieve pain and improve joint function. It is very safe even for frail cats with liver or kidney disease.
• Oral and transdermal medication: Non-steroidal anti-inflammatories (NSAIDs) are fast-acting medication that relieve pain. Ideally, they are reserved for rescue on more painful days. NSAIDS can cause liver or kidney damage or stomach bleeding, especially if over-dosed. Paradoxically, some studies show that carefully dosed NSAIDs improve survival time in stage 1 and 2 renal disease. Tramadol and buprenorphineare mild narcotic pain relievers. They are safe for cats who take prednisolone, are prone to gastrointestinal bleeding, or have pain from multiple health problems.