Wednesday, September 22, 2010

Senior Feline Care - Arthritis

One of the more common ailments to afflict senior cats is arthritis. Clinical studies have shown that 22-64% of all cats and 90% of cats older than twelve years old have radiographic (x-ray) signs of arthritis. Cats most commonly develop arthritis in their hips, elbows, knees, ankles, and spine.

Arthritis causes pain and loss of movement of the joints. The word arthritis literally means joint inflammation (arth=joint, ritis=inflammation). Inflammation is a reaction of the body that causes swelling, redness, pain, and loss of motion in an affected area. Normally, inflammation is the way the body responds to an injury or to the presence of disease agents, such as viruses or bacteria. During this reaction, many cells of the body's defense system - called the immune system - rush to the injured area to wipe out the cause of the problem, clean up damaged cells, and repair tissues that have been hurt. Once the battle is won, the inflammation normally goes away and the area becomes healthy again.

In many forms of arthritis, the inflammation does not go away as it should. Instead, it becomes part of the problem, damaging healthy tissues of the body. This may result in more inflammation and more damage - a continuing cycle. The damage that occurs can change the bones and other tissues of the joints, sometimes affecting their shape and making movement hard and painful.

As with most illnesses and injuries in cats, the symptoms of arthritis can bey very subtle and easily missed especially if they are gradual in onset. Many of them are dismissed as simply being signs of "old age" and not necessarily indicative of an actual, treatable (or at least manageable) ailment. Symptoms can include:
unusual sleep patterns;
eliminating outside the litter box;
avoiding interaction with people or other pets in the home;
dislike of being stroked or brushed;
decreased grooming, reluctance or inability to jump as high as they once could or to go up stairs;
reluctance to jump down or landing ungracefully/with difficulty;
decrease or change in play;
stiff gait or lameness.

Diagnosing arthritis involves a thorough exam that may reveal pain, crepitus, and/or swelling in the joints. Pain can be difficult to interpret in cats during an exam because they are not in their familiar environment. To help with this, we rely on your observations of the cat's behavior at home as well as diagnostic tools as radiographs (x-rays). Radiographs can show changes in the bony structures of the joints, which do indicate developing arthritis. However, there can be cartilage changes that cannot be seen on radiographs.

Although treatment may not turn your senior cat into an agile and active kitten, it will relieve pain and distress and enable your cat to do normal activities. Treating arthritis is tackled with a three-pronged approach: nutrition, medication and environmental changes.

Nutrition: Just as with humans, being overweight can exacerbate symptoms and pain associated with arthritis. If your cat is on the heavier side, we will work with you to help her lose some of those extra ounces. We can calculate calories needed and monitor weight loss with regular progress exams. Additionally, there are prescription diet formulas specifically designed to help with mobility issues in older cats. Finally, we may recommend fatty acid supplements that many help reduce inflammation.

Medications: Most medications used for arthritis in cats are not approved for use in cats by the FDA and are "off-label". This is due to the cost of the research to prove the safety and efficacy in cats. The medications, however, have been used extensively in cats by veterinarians and can be used safely if used at proper doses and with proper monitoring, including regular medical progress exams, blood panels, and communication with your veterinarian.

There are a variety of medication types available to help your cat:
Glucosamine/condroitin promotes the health of the cartilage and joint fluid. Adquean, delivered by subcutaneous injection, is a polysulfate gylcosaminoglycan which also helps cartilage and joint fluid. Stronger medications include NSAIDS (Non-steroidal Anti-inflammatory Drugs), which control inflammation in the joints providing pain relief. NSAIDS can cause gastrointestinal upset and damage to the kidneys, although the side effects are rare with low doses. Analgesics or steroids might also be part of your cat's arthritis therapy depending on various factors.

Many cats with arthritis benefit from multiple medications and supplements. By using various types of medications, we can keep the doses of each lower to minimize side effects. All medication treatments require regular monitoring by your veterinarian through progress exams.

Environmental modifications: In order to improve your arthritic cat's quality of life around the home, here a few suggestions for easy modifications to accommodate her. There are many litter boxes out on the market now that have lower sides, or a least a low entry side, making it easier for her to get into the box and reducing the risks of eliminating outside of it. You can also mound the litter to one side to help her position herself more comfortably when defecating. You might also consider adding additional litter boxes around the house, especially if you live in a multi-story house, so she doesn't have to walk as far to reach one.

Because access to heights is important to most cats, consider adding ramps or steps to help her get to her favorite places. There are many manufacturers of such products, specifically for older cats, or you can do a simple rearrangement of the furniture for her. Make sure she has easy access to food and water. If you feed her on a counter, add steps for her, or start feeding her on a lower plane, or on the floor.

Arthritis is a lifelong disease, and one that is likely to progress over time. The sooner it can be diagnosed and treatment begun, the more comfortable your cat will be.

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