Arthritis Management

Arthritis management for cats

Cats are masters at hiding illness & pain because they are guided by instinct to always pretend like they are perfectly fine in case there is a predator around who will choose the sick/weak-looking prey. So, that means we often do not know when our kitty is painful. Arthritis is incredibly common in cats as they age, though they rarely limp or show overt signs of pain. They often simply "slow down" or sleep more or avoid jumping up/down or use intermediate objects (for example, jumping on a chair then table rather than straight from floor to table).

Here are 2 great sites for helping you determine if your kitty may be exhibiting subtle signs of arthritis:

https://www.zoetispetcare.com/checklist/osteoarthritis-checklist-cat

‍https://catswitharthritis.com/

There are several arthritis/pain management options for cats. Arthritis is a condition that we often manage with multi-modal therapy using combinations of non-pharmaceuticals, supplements, and prescription medication.

Non-Pharmaceutical Treatment Options:

K Laser therapy:

Protocol for chronic arthritis typically 3 times first week, 2 times 2nd week, once 3rd week then monthly thereafter; takes 2-3 minutes each time; nurse appointments; $25 each session. The K Laser is a class IV therapeutic laser that can help manage pain and decrease inflammation. The energy produced by the laser increases circulation which helps to decrease inflammation, swelling, stiffness, and pain.

Electromagnetic therapy:

At home treatment using the Assisi Loop. See website: Assisi Animal Health :: For Pet Owners The Assisi Loop is around $275 and includes ~150 treatment sessions. It is suggested to start at 1 (15 minute) session 2-4 times a day the first week then 1-2 times a day thereafter. You place the loop on, under, or around the cat's problem area for each session.

Massage and passive range of motion:

You can try massaging the sore areas at home or try exercises like gentle bicycle motion of the back legs.

Exercise:

Try to promote increased exercise/activity through play sessions at home.

Weight control:

Maintaining a healthy weight helps the joints tremendously. Fat tissue actively secretes inflammatory chemicals, so decreasing fat tissue greatly decreases inflammation. Fat loss is by far one of the best ways to decrease arthritis pain.

Acupuncture:

Dr. Loupe can perform acupuncture, and you would be surprised that many cats cooperate nicely (she first stimulates a relaxing point then proceeds once kitty is calm); we would set up an initial exam/consultation (and likely x-rays) with her to determine the actual treatment plan based on which joints are most affected.

Environmental changes:

Incremental elevation (stairs/steps to help getting up on higher surfaces). Low-walled (or cut-out wall) litter box so it is easier to get in and out of the box. Raised food and water dishes so your cat does not have to bend down as much to access the bowls. Lots of padded bedding and heating pads or heated pet beds. It is also important to regularly trim nails to prevent any ingrown nails or the nails from getting caught on things. Cats with arthritis also often have a harder time grooming themselves so regular brushing is important.

Stem Cell Therapy:

Involves removing fat from your kitty and injecting the extracted stem cells back into your kitty (either IV or directly into a joint or region) to decrease inflammation and pain. For more information, see our website: catsmeowvets.com/news/stem-cell-therapy

Pharmaceutical Treatment Options:

Adequan injections:

(polysulfated glycosaminoglycan) This is a medication given as an injection under the skin at home or in clinic. The medication helps to inhibit enzymes in the joints that break down/damage cartilage. It also helps to increase/thin out the joint fluid to keep the joint better lubricated. There is an initial loading period where this medication is given more frequently to increase the presence of the medication in the body. You start out giving 1-2 times per week, then a long term maintenance dose is used for chronic control. Most cats' maintenance dose is one injection under the skin every 3-4 weeks.

solensia:

A once monthly injectable feline anti Nerve Growth Factor monoclonal antibody used to decrease pain caused by osteoarthritis in cats. In easy terms: treatment for arthritis pain in cats.  Solensia may be combined with other arthritis and pain treatments such as Adequan, Gabapentin, glucosamine, NSAIDs, CBD, etc.

Glucosamine / chondroitin supplements:

There are many supplement forms such as Cosequin or Flexadin Plus which contain formulas to support joint health and function. These products typically come in treat forms or as capsules that can be opened and powder mixed into food.

Flexadin Advanced:

This is a chewy treat that contains UC-II cartilage. It is designed to decrease the body's reaction to cartilage fragments. It also contains omega-3 fatty acids (fish oil).  It works well given along with glucosamine & chondroitin.

Fish oil capsules:

(~600 mg of fish oil/day) This is a great source of omega-3 fatty acids which can reduce inflammation. The capsules can be given orally or mixed into food at home. It also comes as a pump of liquid.

CBD:

(cannabidiol) This is an ingredient derived from the hemp plant. It does not cause a high or dependency but can decrease pain and has the potential for being very useful for chronic pain such as in arthritis. CBD is readily obtainable in most parts of the United States, though its exact legal status is in flux and products vary widely among manufacturers. Veterinary universities have conducted pet studies establishing doses, efficacy, and safety using the products from the company Elle Vet.

Gabapentin:

(a neuropathic pain medication) This is medication that can be given orally as a capsule/tablet/liquid or the capsule can be opened and mixed into food. It is used to help manage signs of pain/discomfort at home. The main side effect is sedation/drowsiness. It is recommended to slowly build this medication up to an effective pain control dose that does not cause excessive sedation. Most cats tend to use the medication every 12 hours. If the medication is started and the cat is using it long term then it should not be stopped abruptly as rebound pain can occur.

NSAIDs:

(non-steroidal anti-inflammatory medication) This class of medication decreases joint inflammation/damage and helps manage pain. It is typically given every 24-48 hours as a liquid or pill or can be used as needed for flare-ups/bad days at home. It cannot be given if your cat is on steroids such as prednisolone (or receiving depomedrol injections). Side effects of this type of medication can include tummy upset and potentially kidney damage (usually only if using high doses). If your cat is not eating or drinking well on this medication or starts having vomiting or abnormal bowel movements then stop right away and call the office. It is also recommended that we check the kidney values prior to starting the medication chronically and then monitor the kidney blood values on a regular basis (every 6-12 months) when a cat is on this medication long term to make sure the kidneys are tolerating the medication and not having side effects. Overdoses of this medication can be very damaging to the kidneys so always make sure you are giving the accurate amount at home.

amantadine:

Amantadine is an antiviral medication that helps reset the spinal cord and decrease pain (only if used in conjunction with pain medications). It is generally given as a once or twice a day liquid for at least a few weeks. It can be very helpful to decrease chronic, severe pain.

We can send home some free samples of some of these to try. Please only give 1 at a time in case any of them cause stomach upset. Ok to separate by a few hours each. We can fill prescriptions for whichever one(s) your kitty likes!