Tuesdays with Shlomo

How can degenerative joint disease affect your cat?

Dr. Shlomo Freiman
August 29, 2023

While people are perhaps more aware of how degenerative joint disease (DJD) affects dogs, as it was notorious with certain breeds and is also just a hazard of the typical lifestyle of dogs, cats can also be affected by it. Following up on last month’s installment in the series, “Understanding Degenerative Joint Disease in Dogs,” Dr. Shlomo Freiman holds forth on how the disease plays out in cats, covering a bit of the same ground — how to spot it, how to prevent it, and how to treat it — but also some things that are specific to cats.

This episode will be especially relevant for anyone with an aging cat, but even pet parents of younger cats will benefit from knowing how to handle DJD when and if the time comes. Spoiler alert: if your cat isn’t violently opposed to it, Dr. Shlomo does see the benefit of getting a kitty harness and getting outdoors together. More importantly, cats can benefit greatly both mentally and physically from having safe access to the outdoors.

Alright, so we’re talking DJD again, but for cats. Let’s start with kind of the same first question, which was what is it and what causes it?

A lot of it is the same. The big one here is still the wear and tear of aging. In cats, we see fewer congenital issues like hip dysplasia and things like that. Trauma, as we talked about with dogs, can happen for cats, although they tend to be a little less injury-prone. However, a lot of them are overweight. It’s still possible to injure themselves on a jump or fall or something like that, especially if they’re overweight. But I think the biggest category is just basically wear and tear. You still do get immune mediated issues, infectious causes and a whole list of things, but these are not very common causes.

If you did a pie chart, though, it sounds like the biggest slice would be wear and tear.

Wear and tear. Especially with cats, getting older is what does it.

How do you tell when your cat is suffering from this? Is it similar to dogs, where you really want to be keeping an eye on their mobility and any changes to their mobility? Like if they aren’t jumping up on as high of stuff as before or are just moving more slowly in general?

Yes, but I think with cats you need to be even more vigilant than with dogs, really, because you don’t take them for a walk. It’s harder to say, “Oh, we used to go for a hike and now they don’t want to do it.” But yes, you want to keep an eye on jumping, the way they go up and down stairs, things like that. Also, with cats there is the added difficulty of cats just being lazy to begin with. One of their evolutionary advantages is that they just conserve energy. If they don’t need to spend energy for some reason, they’re not super active. So yes they do become less active and maybe more reluctant to jump up or down from things, but often what happens with cats is they become kind of cranky. Both with family members and often other cats if there are other cats.

I can see how it would still be hard to tell because some cats are just naturally cranky.

Yeah, they’re aloof, they’re cranky. That’s part of the charm, right? But a lot of times people say, “Well, they’re just old and cranky.” Kind of like, what else would you expect in a cat? But actually the cat is acting that way because it’s very uncomfortable.

You said maintaining a healthy weight was the number one way to combat DJD in dogs. Is that the same for cats?

Cats are even more prone to obesity than dogs because they love to eat and they’re really effective in metabolizing food and storing it as fat. That gives them great advantages from an evolutionary standpoint, but in a modern, domesticated setting it means a lot of them are overweight. It is a huge problem in cats, and I would say that a lot of people, relatively speaking, are more aware of dogs having issues with arthritis. People might have a very obese cat with very low mobility and not think anything is wrong.

I have to admit I’m feeling a little bit guilty here because I’m realizing my childhood cat definitely fits the bill. It’s funny, because she would still jump up on the washing machine to get her food right up until maybe a year or so before she died, because she was so food motivated, but she was so overweight she could barely do it. I think she got up to like 25 pounds.

That’s pretty big.

Yeah and she was not a naturally big cat, it was all fat. We moved houses and she had to become an indoor cat and just did not take well to it. She became incredibly obese in about a year. I’m putting it all together and realizing that she almost certainly had kitty arthritis and, at that point, we had no idea that was even a possibility.

Yeah, it’s definitely an underdiagnosed issue in cats. But the good news, again, getting the cat to slim down will help a lot. Lowering the weight is extremely important with cats. Extremely important, extremely difficult, but absolutely essential. You can do it with diet, of course, but it also helps to keep them active. That’s also not easy, but it just takes getting them moving as much as you can, providing them with opportunities to get on things that are maybe a little bit higher.

Once they are older and have compromised mobility, maybe that doesn’t mean putting their food all the way on top of a cat tree or something like that, but you would still want to provide a place for them that’s off the ground and that they’re able and motivated to get to. It is hard. And you may have to make adjustments over time as the DJD progresses, especially with very old cats, like making it easier to get into the litter box. They may need a ramp or one with no lip.

Besides controlling your cat’s weight, what can you do to help them with DJD? Especially with these older cats where maybe they’re already in too much pain to stay active.

We’ve had very limited options for cats as far as medication, but the good news is that there are new amazing therapeutic technologies for cats with a different approach altogether than traditional medication. There’s one now, for example, called Solensia .

It’s a cat specific medicine?

It is cat specific, although they’re also going to make something similar for dogs. I think it’s already out in Europe. Anyway, the beautiful thing about it is that it’s really a cutting edge medication. It uses the immune system to fight arthritis, via monoclonal antibodies. So like I was saying in the dog interview, these types of medications are not actually a typical drug. They don’t introduce any chemicals into the cat’s system, instead they use antibodies to bind to specific types of receptors to interfere with the pathway that leads to chronic pain. Unlike many of the other drugs we used to use off-label for cats this therapy is even safe for cats with kidney or liver problems.

So it’s more about stopping the pain than numbing it?

Yes, stopping it before it even starts. Before it becomes a chronic issue. Because pain has this vicious cycle and the brain can become primed to it, where the pathways that lead to the brain and interpret sensory input as pain can become primed to constantly sense pain. If you get there the pain gets worse and worse, so if you can be proactive and act as soon as your cat starts to show symptoms that are associated with arthritis, you can prevent a lot of that.

So this medicine also can kind of act as a prophylactic medicine, it sounds like?

It’s very exciting. It’s an amazing medication. It’s really the cutting edge of technology because essentially you don’t actually take anything you would typically associate with medication, like a chemical. It’s antibodies, it’s protein. And that’s why you don’t see similar side effects to the various medications that impact the kidney. Solensia doesn’t need to be metabolized and be taken apart by the liver or the kidneys, so it’s extremely safe for cats. It’s very specific and very effective. It’s also an injection done once a month, so you don’t have to medicate your cat orally every day, which nobody likes.

Anyone who has ever tried to give a cat medicine knows how much of a pain that would be. For the injections, is it the type of thing where you can even have a nurse come out?Absolutely.Well that all sounds like great news for people who are worried about whether to give their cat medication for DJD. That said, are there other non-medical things that people can do to slow down or stop DJD? Stuff like supplements, as you mentioned with dogs.

Weight loss is still number one. Changing the environment, making that environment more suitable for their cat. But really, weight, weight, weight, weight and weight. Supplements can help early on in the disease process though.

How do you get cats to exercise? Any tips?

I mean, cats are motivated by the laser pointer. Cats that are motivated by food, you can kind of make them work for the food. We can’t put them on a treadmill, that’s for sure. I’ve had, over the years, a handful of clients that actually put their cats on the treadmill.

I cannot imagine that ended well.

No. Cats and treadmills don’t mix. But cats can walk! Some of them, at least. Funny story: I was at our property in eastern Washington, and we have a trail on it. It’s pretty rural there. We let our neighbors hike on the trail and I have this picture; the weather was really nice and these two young women were out walking with two dogs and two cats. The funny part is that the cats were not walking. The cats refused. They were on leashes but these girls were just carrying them.

That definitely did not go the way they planned it! But you’re right, some cats actually do love going for walks.

Yeah, just maybe not down a hiking trail.

One night during the pandemic, when I was doing one of those “I just need to go outside” walks, Catticus followed me on what I later found out from Google was a 1.2 mile walk. I was living on Vashon Island at the time, which is so sleepy and rural that there’s not a lot of traffic at night, but I was still kind of blown away that he just decided to tag along.

Some cats just do it. I’ve had cats that, when we go for a walk around Mercer Island, where we live, they’ll just follow us like that. There’s a lot more traffic on Mercer Island but they’re just not scared. With most cats, though, you have to worry about them taking off. You need a leash. And sometimes it’s just hard. They just won’t want to walk.

In that case, what else can you do to keep them active?

Like I said earlier, get them going up and down the stairs, get them jumping on little things, get out the laser pointer. Again, stay within reason as much as you can, don’t make an old cat do something it just can’t do. But do try. I’ll admit, though, that it is challenging with cats.

They kind of march to the beat of their own drum.

Absolutely. But again, that’s the charm of cats! But it doesn’t mean they have to be in pain, if you pay a little bit of attention, put in a little bit of effort, and — when it’s appropriate — try medication to see if it helps. I know we talk about telemedicine in every one of these interviews, but that can also really make a difference. It makes it so easy to ask your vet what’s going on if you’re worried, and it just makes it way faster in general to go from seeing something off with your cat to potentially getting a diagnosis.

We talked about your dog Mondo, who had DJD towards the end of his life. Have you personally had any cats who developed DJD?

Actually yes, and it’s kind of a funny story. My old cat Nile, who passed away some time ago but lived to a very, very old age, had DJD. He was an amazing and very large adult tomcat I got from animal control. When I got him he was already so used to spending time outdoors that there was no way to make him a strictly indoor cat. He was also an amazing hunter and he made a point of making sure we knew it, so almost every morning we used to find a display of dead rodents on our front porch.

However, as he got older and older and started having mobility issues, he wasn’t quick enough to catch rodents like he had before. Not to be deterred from his gift-giving habit, he switched to found objects like leaves or even stolen gardening gloves and other objects purloined from the neighbors. Nile’s creative “offerings” included our neighbors’ mail, which actually ended up getting his exploits written up in the local paper, as it led to some funny situations. And some new friends, when we had to return the mail. So, in this case, I suppose there was a bit of a silver lining to his DJD.

Well it certainly didn’t stop him from becoming a local legend. Long live Nile!

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