Rachel thinks she has not been getting enough blog time, so I thought I'd write a bit about something we unfortunately know too well: dealing with arthritis in the cat.
Degenerative joint disease is common in ageing cats. You may notice small changes: an unwillingness to jump up to, or down from, previously favourite perches;an altered gait; stiffness - esp when first waking; and reduced grooming behaviour. Or you may notice nothing - cats are brilliant at hiding their illness.
Rachel has arthritis in her spine just behind the shoulders, and in the shoulders themselves. Rachel has lived with us for 12 years & she was between 1 & 3 when we got her (she was a FTGH in the classifieds) so she's somewhere between 13 & 15. She started showing symptoms of joint problems about 4 years ago.
#1 - vet visit
If you observe stiffness or lameness, or a change in behaviour, a vet check is in order. Don't assume it's arthritis, it could be something else. You vet will perform a thorough examination, manipulate the joints and may order x-rays and blood tests to arrive at a diagnosis.
Elderly cats who are not showing symptoms should also be checked by a vet regularly & you may wish to start supplements to prevent joint degenaration.
So, on to......
#2 - supplements
If you have confirmed that your cat is suffering from arthritis, even if it's in the early stages, or even if you have an older cat who is not showing any joint problems yet, you may want to start using supplements which are known to help with joint health. There are a variety of supplements which you will want to consider, and discuss with your vet. Some options include blue lipped mussel, Cosequin, Recovery, Duralactin, & many more. As the supplements have different biochemical mechanisms, you may need to experiment to see which supplement works best for your cat's specific condition.
#3 - pain meds
Pain medication for cats, especially pain management of a chronic condition, is a very tricky problem, not the least because there are few medications which are tested and approved for use in the feline population. One standby has been the NSAID meloxicam. Recently, the US FDA has put a black box warning on this medication regarding long term use in cats. In Europe and Canada, some vets still use this medication successfully for chronic pain in cats. You will want to make sure your vet is experienced and knowledgeable about management of chronic pain in cats, and considers pain management as an important part of a treatment plan. If your cat is in pain & the pain cannot be managed in other ways, you may need to be quite persistent to find the right medication for your cat. If you own vet is not able to offer options, consider a second opinion from a feline specialist, especially one used to dealing with geriatric population.
If you are considering going down this route, check out the AAFP's Guidelines on Long Term USE of NSAID's in Cats.
Disclosure - Rachel has been on meloxicam for a couple years now. She also has renal problems, which complicates things, but nevertheless this medicine has given her a greatly improved quality of life.
#4 - massage
Massage has been shown to help with the pain and stiffness which accompanies arthritis. There are therapeutic animal massage practitioners who can help your cat. You can also learn some basic TTouch & other massage techniques from books and dvd's and treat your cat at home. Remember that you cat is in pain so start slow & gentle.
#5 - accupuncture
Veterinary accupuncturists are worth seeking out if you have a cat with chronic pain. Check out this abstract from the 2003 World Small Animal Veterinary Congress about Feline Acupuncture to read more about all the conditions which can be helped by acupuncture treatment.
#6 - ramps & stairs; accessibility to bed & litter box
Your cat may have problems jumping up and down. Ramps and stairs will make life easier for your cat. There are options at your pet supply store, or you can make some easy ramps and stairs from stuff you have at home. A simple ramp is a 2x6 piece of wood from the lumber store. In the early days you can leave the board bare, but for a cat with moderate mobility problems you should cover the wood with carpet scraps, or a large beach towel, stapled with a heavy duty stapler to the back. The fabric allows the cat to get a good grip on the ramp. Secure the entire ramp so that it doesn't shift under the cat.
An easy way to make some steps is using a stacked set of under-bed boxes. Rachel wanted to be able to get up and down from our bed and we made it easy for her by pulling the boxes out from under the bed and stacking the boxes in a group of three, two, and one. Presto, an easy set of nice, wide, stairs to the bed.
Think about whether the cat's litter box is appropriate for his needs. When Rachel started getting increasingly stiff, we removed the lid off her box because turning around in a tight space was hard for her. By essentially removing the walls of the box, it gave her lots more space for turning around. Some cats may also need ramps or a litter box with lower sides to be able to get in & out of the box without hurting themselves.
#7- heat
Heat is like magic for arthritic joints. Here are some options.
-knit your cat a sweater. Rachel did not like it.
Take this off me. Now.
-buy your cat a fleece coat. I thought perhaps the sweater was too tight and in lieu of knitting another one, I bought her a fleecy coat. Alas, Rachel hated the coat as well. So much so that I never managed to get a photo of her sulking in it.
-renovate your bathroom & install a heated floor under the tile. Keep it set at 36.5C (essentially the temperature of a human lap) and your cat will never leave the bathroom. Just remember to warn your guests to step around the cat.
I don't care if you want to close the door. I'm not moving.
-buy a special pet heating pad. Rachel likes her pad from Cozy Winters.These pads are set to a safe maximum temperature, and are pressure sensitive. They turn on when the cat lies down on the bed, and turn off when the cat leaves. This is the third winter for our pad and it's still working well. I notice the dogs sneaking on it too.
-do not use human heating pads as they can be much too hot. Also be very careful using heat pads with pets who are mobility impaired - a pet who is unable to move themselves off the pad when they get too hot could be at risk of overheating.
-make sure your cat gets lots of lap time so the warmth of your body can soothe her joints
#8 - careful handling
Sometimes people take a cat's graceful anatomy for granted, knocking a cat off a lap and expecting him to land with 4 feet on the floor. Another common maneuver involves picking a cat up off a chair with one hand & depositing him on the floor (or just letting go a few feet above the ground ; - grrrrrr.) We can argue about whether healthy cats deserve such rough handling, but there's no argument that cats with joint problems definitely do not. Always pick up your arthritic cat with two hands, be especially careful of your cat's afflicted joints and do not let your cat's spine to be unnaturally stretched by being dangled in mid air.
#9 - extra comfort and attention
Your cat may be cranky because she's in pain. She may appreciate a bit of attention, fussing, or a gentle game to distract her a bit from her discomfort. Your comforting presence and words may help soothe your cat.
Rachel enjoys being carried around and shown things.
#10 - maintain healthy weight
A cat with arthritis needs to maintain an optimal body weight. Even a small amount of excess weight adds stress to the joints and causes pain and faster degeneration of the bone. Keep your cat at a healthy weight by feeding an appropriate food in appropriate amounts. See whether there are some physical games that your cat still enjoys - perhaps she can't run and leap, but she may still be interested in chasing a string on some soft carpet flooring, or playing with a catnip mouse. Some daily exercise is critical in maintaining muscle mass and a healthy cardio vascular system.
here is Rachel in the summer, enjoying a wrestle with a sprig of catmint
For further readingSpecial Needs of the Senior Cat and AAFP's Senior Care Guidelines (revised Jan 2011)
Do you have any other tips for helping cats suffering from degenerative joint disease? Let us know.
9 comments:
We've got Kira - who is 14 and has fairly advanced arthritis in her hips and one side of her shoulders - on the Royal Canin "Mobility Support" food. I know you feed your cats other stuff but it might be an option for someone who finds this (very informative & thorough) blog post. We had to take her off meloxicam recently because it was making her kidneys worse but it helped tremendously while she was on it. She's also taking gabapentin twice a day. We can always tell when she misses a dose because the limping gets much more pronounced.
Do you feed Rachel raw? Not that I'm saying it would make any difference, I'm just wondering. We don't feed our cat raw, well she might get the odd bit now and again if she is around when I'm feeding the dogs, and since she is inside/outside, she does catch some of her own.
Smudge is at least 14 or 15. I'm not noticing any changes, but Meredith thought she was not as easily jumping up onto her desk and then her window sill when we had to move the location of her food when Pippin was here. It could have just been the change in location though, as Smudge has got to be one of the most easily freaked out cats...
Vicki - thanks for commenting! Yes, gabapentin brings comfort to many cats & I'm glad to hear he food is helping Kira.
Karen - Rachel is a generally the most easy going cat, but on the subject of raw she out stubborned me. She's now on Nature's Variety Instinct Canned. I really wanted her on raw because in addition to all her other probs, she's got crap teeth & I've seen first hand the benefits of raw for the dogs. But there's no convincing her.... I guess I started too late. :-)
Wow, Smudge is doing very well for a cat of that age!
Thanks hornblower! I wish we could consider acupuncture but she's one of those cats who has a full-out temper tantrum whenever we bring her to the vet - she actually has to be sedated for her checkups.
Hi, I ended up here from your WEIT link on Kamik's and do want to take issue with one of your suggestions.
Where do you get your information that acupuncture is good for your cats?
Hi Jolo & welcome - the section about acupuncuture includes a link to the abstract from the World Small Animal Veterinary Congress.
Searches on pubmed for feline acupuncture do yield a # of studies.
And schools such as Cornvell offer acupuncture as part of their treatment plans for pain management. http://www.vet.cornell.edu/pain/options.htm
I am aware that on certain sites (pharyngula for instance) acupuncture is dismissed as thoroughly as amulets and crystals. I thoroughly disagree with this lumping of acupuncture among quackery.
cheers ~
I am a Pharyngulite but he is not a vet, instead PZ is a biologist. What I do read is Science Based Medicine (http://www.sciencebasedmedicine.org/?p=519) regarding this. The sticking point for me is the huge range of results in acupuncture in humans. After all, how do you tell if the pet is getting better?
It is also beneficial to remove all eastern reports as they are typically more positive (less sceptical) towards acupuncture than Western studies.
I am not trying to convince you to not give your cat acupuncture, I will ask you, or anyone else to look critically at all the evidence. I could not give my pets acupuncture being sceptical of the science behind it.
Hi Jolo - thanks for the rational & informative comment. I really do appreciate it.
Where I stand is this:
-despite me managing to eke out 10 for this post, there are actually very few things we can do for our feline friends with joint pain. The drug issue is huge. Feline metabolism is such that there are very few pain medications that actually work in cats. If you have an older cat &/or a cat with liver or kidney issues, that list of avail drugs trickles down to zero.
So we're left scrambling to give the animal some relief from their pain. My take on human acupuncture is that it's either a wash with the placebo or somewhat better (but with low confidence due to study design etc). So here's one thing to try & see. Certainly nobody seems to be suggesting it would be harmful (except to the pocketbook). It's not a case of using this unproven/possible useles treatment in lieu of giving a proven appropriate treatment to alleviate pain. It's often a case of do this, or do nothing.
As far as how we can tell: an attuned cat owner can tell - esp.when it's an indoor cat.
Signs include
-measurable levels of mobility ie. will kitty jump onto table? If a pet owner reports that for months the cat has avoided their favourite sunning perch which is high up & then after treatments, the cat is again happily ensconced there - I think we have to consider that the cat is in less pain & has greater mobility.
-vocalization. Cats in pain often talk about it. Rachel complains & fusses when she's not feeling well.
-aggression. Cats in pain can have very low tolerance for people touching them.
-avoidance. Cats in pain may choose to hide & no longer be as social as they used to be.
-litter accidents. Cats in pain may eliminate inappropriately.
I suspect that if one chatted with a veterinary accupuncturist they'd admit that many clients come in, do a series & never return - presumably because they didn't notice any improvement. But others do return because they do notice an improvement.
Or perhaps they just want to feel they're doing something. That admittedly, is not a scientifically defensible action, but it is part of our human nature. :-)
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