Osteoarthritis In Cats

Written by Shula Berg BVSc CertAVP(GSAS) GPAdvCert(SASTS) MRCVS
Clinically reviewed by Elizabeth McLennan-Green BVM&S CertAVP(SAM) MRCVS

Table of Contents

 - Overview
 - Symptoms
 - Diagnosis
 - Treatment
 - Outlook

What is Osteoarthritis?

Arthritis is a condition causing pain, inflammation and stiffness of the joints. When people talk about Arthritis they are usually referring to Osteoarthritis, the most common type. Other types of Arthritis can occur less commonly in our pets, such as Septic Arthritis due to infection or Immune-Mediated Arthritis.

Often referred to as OA, or Degenerative Joint Disease (DJD), Osteoarthritis is a progressive condition and the most common cause of chronic pain in our pets. Any pet can be affected by Arthritis, including cats, dogs and rabbits. Any age pet can be affected, though it is more common in older animals. It is estimated that 60-90% of older cats are suffering from Arthritis in one or more joints.

Underlying causes include poorly formed joints (such as in Hip Dysplasia), trauma (such as previous fractures), instability or other joint conditions. Once OA develops, cartilage that lines the joints becomes damaged and is not repaired or replaced. Damaged cartilage can no longer create thick, viscous joint fluid that helps to provide shock absorption. The entire joint becomes inflamed, and lack of cushioning from joint fluid and cartilage makes everything weaker and less stable. In response, scar tissue may form that makes the joint stiff and unable to move normally. Eventually, new bone is deposited around the joint, which is visible on x-rays.

During this degenerative process, inflammation triggers nerve receptors in the joint to send regular signals to the brain to say something hurts. As Arthritis progresses, more nerve receptors are created, and they send signals more often. This phenomenon is called “wind up” and means the brain will receive a disproportionate amount of pain signals in chronic conditions than would be caused by a short-term inflammation of a similar level. A key part of management of OA is trying to prevent or reduce “wind up”.  

What are the symptoms of Osteoarthritis in Cats?

Arthritis is one of the most over-looked conditions in our pets, with symptoms commonly attributed to “slowing down” or “getting older”.  Changes often happen gradually, and affect more than one joint, so it is common that animals continue walking on all four limbs despite increasing pain and discomfort.  In cats especially, Arthritis often causes changes in behaviour rather than overt limping on one limb.  Symptoms of Arthritis can include:

• Lameness/stiffness
• Hesitating before jumping up, using the front legs to complete the jump
• Reluctant to jump down, takes an easier route or steps rather than leaps
• Slow to climb up or down stairs, taking one step at a time or taking a break part-way
• Reduced play, especially jumping and chasing
• Reduced or absent grooming, especially over the back end
• Toileting outside of the litter tray, especially if high-sided
• Less willing to interact, hiding away more, grumpy behaviour

Which tests are used to diagnose Osteoarthritis in Cats? 

Arthritis can be considered very likely based on a history of compatible symptoms and a clinical examination by a vet. Your vet will ask for relevant history, such as previous accidents or injuries, and a description of any changes you have noticed.  Cats are often unwilling to move around the clinic, so videos of observed behaviour at home can be very useful. 

Imaging, such as radiography (x-rays) or CT, is the ideal method of diagnosis as this allows changes in the joint to be directly assessed. Occasionally, a sample of fluid is removed from the joints for analysis (called a “joint tap”). Sometimes anaesthesia is not advisable due to other health problems, so an assumed diagnosis is made based on consistent symptoms. In these cases, a positive response to treatment can also help confirm the diagnosis.

Clinical Metrology Scoring is a validated system to grade a pet’s lameness in an objective and repeatable way. It can be used in an initial assessment to determine the degree of lameness present and therefore the most appropriate treatment plan, or to monitor response to treatment. The Feline Osteoarthritis Checklist is a reliable and repeatable way to identify if a cat has signs of joint disease and consists of some simple questions you can answer at home.

Older pets are prone to many other problems that can cause them to “slow down”, so it is important to rule these out before assuming a diagnosis of OA, especially where symptoms are more vague or non-specific.

How is Osteoarthritis in Cats treated? 

There are many aspects to successfully treating Osteoarthritis. As a progressive disease it can only be managed, rather than cured, but good management aims to keep pets comfortable and mobile as well as slowing down progression. Generally, several management options are required to see an effective difference; while some treatments must be prescribed by a vet, you can also make many changes at home to help.

Management at home

Weight management

It is well demonstrated in both people and animals that obesity has a negative effect on Arthritis. Not only does carrying extra weight increase pressure on the joints, but fat tissue releases inflammatory chemicals that increase joint inflammation. Altering your cat's diet may help them to lose some of their excess weight and therefore put less stress on their joints.

Home adaptations

Simple changes such as offering low-sided litter trays, steps to access higher areas, draft free comfortable beds, multiple resources (e.g. beds, water stations, litter trays) to ensure they are close by and easy to open cat flaps can make a surprising difference to your pet’s ability to manage day to day life comfortably. Some cats may benefit from regular grooming and nail trimming.

Encouraging movement

Although we do not want to push cats to complete activities they find uncomfortable, small amounts of regular movement are good to keep joints mobile and maintain muscle tone. Short periods of gentle play, or use of feeding puzzles can help reduce stiffness.

Complementary therapies

These include physiotherapy, acupuncture, osteopathy, and laser therapy, amongst others. They can be a great accompaniment to other therapies, however there is poor regulation of many of these practices, so always speak to your vet about whether they recommend a specific practitioner. Complementary therapy should never be administered without signed permission from your vet, as they are not all suitable for every pet.

Nutraceuticals

Supplements can be given as tablets or capsules, or are already included in a joint diet. There are many conflicting reports about their effectivity, but on the whole there is insufficient evidence to be certain of a benefit in veterinary patients. They are harmless if used properly but shouldn’t be relied upon as a sole therapy.

Medical management

Most pets with Arthritis will benefit from some degree of medical management. This may include pain relief, anti-inflammatories, joint modulation or even surgery.

For some pets, a short course of medication may be suitable to reduce “wind-up" and allow the benefits to be felt from other changes such as weight loss or physiotherapy. For other pets, medical management is likely to be required long-term. It is likely that your vet will want to review your pet at regular intervals to ensure any medications are still necessary and suitable.

It is important to remember that no medication is entirely without side effects. Our goal is to balance the impact of drug use against the benefits to the pet, especially in alleviating their discomfort and the impact this has on their welfare.

Commonly used medical treatments include:

Non-steroidal anti-inflammatory drugs (NSAIDs)

E.g. Meloxicam (Meloxaid, Metacam®), Robenacoxib (Onsior®)

These drugs are highly effective at controlling pain and inflammation and are usually the first medication prescribed for OA. NSAIDs can be used as a short- or long-term treatment and are suitable to be used after surgery. They come in different formats, such as tablets or liquid, and usually need to be given daily. Most NSAIDs can be easily adjusted to trial a lower dose if your vet feels this is appropriate.

The most common side-effect from NSAIDs is gastrointestinal upset (vomiting or diarrhoea) which stops when medication is withheld. Rarely, this can progress to gastrointestinal ulceration, bloody diarrhoea, or kidney damage. NSAIDs are metabolised by the liver or kidneys, so pets needing long-term NSAID therapy should have blood tests performed every 6-12 months to ensure there are no underlying problems that mean the drugs are no longer suitable.

Other Anti-inflammatories

E.g. Gabapentin, Amantadine

If a patient doesn’t suit NSAIDs, or these drugs alone are not sufficient to manage symptoms of OA, other drugs can be used instead or as well. Most of these drugs are human medications, not licensed for pets, and are prescribed under the veterinary cascade. The law states that your vet should recommend licensed medications first; for this reason, in most cases your vet will recommend trying NSAIDs first.

Monoclonal Antibody Therapy (mAb)

E.g. Frunevetmab (Solensia®)

These drugs work by targeting nerve growth factor (NGF), which has the effect of reducing pain and inflammation in arthritic joints. They work specifically in Arthritis so are not used for pain elsewhere in the body, or for conditions such as Cruciate Rupture (prior to surgery) where Arthritis is not the primary problem.

MAb drugs are given by injection, and last for approximately a month, so are a good option for pets that do not take oral medication well. They are typically more expensive than NSAIDs, and pets will have to attend the practice monthly to receive the injection.

MAb therapy has some recognised side effects. Some cats (up to 10 out of every 100 treated) will develop a side-effect known as Pruritis (itchiness) which can be severe and cause the cat to intensely scratch the head and neck. This usually resolves if treatment is stopped but will recurr if further doses of mAb are given. Other less common side effects include soreness at the site of injection, scabs on the skin, and, very rarely, allergic reaction.

For many cats living with Arthritis, mAbs offer a significant improvement in quality of life. It is recommended that mAb therapy is used following the manufacturer’s guidance, specifically it should only be used for pets with primary OA and should not be given at the same time as NSAIDs, or in cats with kidney disease. Due to their effect on growth factors, mAbs should only be used in cats over a year or age and must not be given to cats used for breeding.

Surgery

Most cases of Arthritis don’t benefit from surgery. Occasionally, salvage procedures are used to manage very severe Arthritis. These may include hip replacements or joint fusion, known as Arthrodesis.

In summary, there are a wide variety of treatment options available for OA, ultimately the choice of treatment should be based on what is best for you and your pet and guided by your vet. It is important to remember that what is right for one patient is not right for every patient.

For patients taking some medications long term, a written prescription can be requested from your vet enabling you to purchase medication from an online pharmacy.

What is the outlook for cats with Osteoarthritis?

Osteoarthritis is a progressive disease, meaning once it is present it will never go away and will gradually get worse. If management techniques are followed as described, many cats will live comfortably with Arthritis for several years. Medication can make a significant difference to activity levels. If changes are not implemented until disease is severe, or not implemented at all, quality of life will be affected much more rapidly.

Regular check-ups are important to monitor progress. Change can be gradual, so more formal methods of monitoring changes can be useful. By identifying 3-5 activities that your cat struggles with at the start of treatment and rating the difficulty with which these are performed at regular intervals, response to treatment can be measured and subtle improvements noted.

Disclaimer

Please note that the content made available on this webpage is for general information purposes only. Whilst we try to ensure that at the time of writing all material is up to date and reflects industry standards, we make no representation, warranties or guarantees that the information made available is up to date, accurate or complete. Any reliance placed by yourselves is done so at your own risk.

Last review date: 23^rd July 2025

Next review date: 23^rd July 2027