Underreported and underdiagnosed osteoarthritis in domestic cats?

My research indicates to me that osteoarthritis is underreported and underdiagnosed in domestic cats in America. That assessment probably applies to other countries because it is difficult to assess. It’s hard to assess in the consulting room because cats are frightened anyway, and they don’t behave normally so it is difficult to assess a cat for joint pain. It is said that in “performing a physical examination of a cat is often challenging” in respect of diagnosing feline osteoarthritis (OA) (source: FDA).

90% of elderly cats have OA
90% of elderly cats have OA. Image: in public domain.
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There are questionnaires provided to cat care givers which help to assess whether their cats are in pain. The point is that a veterinarian might be dependent upon the client/cat caregiver to make an accurate preliminary assessment as to osteoarthritis in domestic cats. This points to the need to make the questionnaires very readable, reliable and consistent.

Feline OA is diagnosed on medical history, orthopaedic examination and radiography. Feline OA is a common cause of long-standing pain and physical dysfunction. It appears to be more prevalent than people think.

In one study by DR Godfrey entitled “Osteoarthritis in cats: a retrospective radiological study”, the conclusion as to prevalence was that “radiographic OA was found in 22% of the test population”. That means that 22% of the participating cats had osteoarthritis as seen on x-rays. In only 11% of these cats was there a potential cause of OA recorded. This indicates that idiopathic OA is common.

In other words, veterinarians often don’t know the cause of osteoarthritis in their patients. The study referred to concerns cats of various ages. However, osteoarthritis is a common radiographic finding in older cats with a prevalence of up to 90% in “appendicular joints”. These are joints associated with the cat’s appendages i.e., their legs.

As expected, it causes impaired mobility. But cats can tolerate bone and joint problems firstly, and secondly, they generally dislike being physically handled in veterinary clinics and therefore it is difficult for the veterinarian to get to the bottom of the problem.

The FDA say that “your veterinarian may have a hard time deciding whether your cat is pulling its foot away because of pain or simply because it doesn’t want to be touched”.

And because of this difficulty in the consulting room, “a cat owner’s observations about his cat’s decreased activity becomes very important if the veterinarian suspects the cat may have osteoarthritis”.

If a veterinarian suspects that a patient has osteoarthritis, they may treat their patient for the disease to see whether there is an improvement. It’s a sort of reverse analysis in which they use drugs to detect problems working backwards.

The clinical signs of osteoarthritis in cats include the usual: inability to jump on and off objects, urination or defecation outside the litter tray, poor grooming habits, a general change in the cat’s attitude, loss of appetite, depression, weight loss and general lameness although this is not commonly reported as a clinical sign by owners (due to a cat’s ability to compensate and hide pain).

The most commonly affected joints are the elbows and hips and sometimes shoulders and hocks (ankles). It affects the backbone and sternum much less commonly.

In a further study published in the Journal of Veterinary Internal Medicine, the researchers examined cats’ joints for evidence of pain and changes in the joint as seen in radiographs. They concluded that half of the cats’ joints had osteoarthritis. However, in only 10% of the joints was there both pain and osteoarthritis.

They decided that not all cases where x-rays showed up osteoarthritic changes in the joint resulted in pain.

This post simply highlights from a layperson’s point of view the difficulties of diagnosing and dealing with osteoarthritis in domestic cats. It appears to be somewhat under the radar certainly from the perspective of the cat caregiver. I hope that the article helps some cat caregivers to understand that there is a distinct possibility that their elderly cat (certainly) is suffering from OA, and they should take the necessary steps to make their life as comfortable as possible.

Do senior cats have special needs? Living with elderly cats.

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