The following is a real scenario that occurred while out on a recent house call:
“My 15 year-old senior cat is starting to look a lot like me in the morning; slower than ever before to rise and get out of bed. I’ve noticed she seems worse since the weather in Los Angeles has suddenly become cold, rainy and windy.
Cleo is spry as ever when it’s time to jump on to my warm bed at night. But when the alarm goes off in the morning, she sits on the edge of the bed and stares at the floor for a full minute before jumping down. It’s as if she knows the jump to the floor will cause pain. She also limps from time to time, especially when she first wakes up from a nap. She holds her right rear paw off the floor for a few steps after a jump. Lately, I notice that Cleo stares up at the kitchen counter for a while before she jumps up to lick her favorite morning treat, the leftover milk in my cereal bowl. Her back seems arched when she walks and her tail hangs lower than it used to. When I pet her lower back, she hisses and growls, which she never used to do.”
As Cleo’s doctor, I can assess this history and discern the subtle signs of arthritis pain including hesitancy or reluctance to jump, lameness, changes in posture and aggressive responses when painful areas are touched. During the exam, I can get a painful response when I touch Cleo’s lower back, just where the tail starts. The right hind paw has some slow reflexes too.
In a hospital setting, I would take x-rays of Cleo’s lumbar spine and hips, the most common areas to have calcium deposits (arthritis or spondylosis), causing inflammation of nerves leading to pain in the back legs.
There are several levels of therapy/management for arthritis pain, depending upon the severity of the signs.On a home visit, I generally will use the first level of pain management, even without x-rays, which includes joint support supplements like glucosamine and omega fatty acids or diets that include these supplements. X –ray are generally required before starting pain management levels 2 and 3. More severe cases, including ongoing lameness or severe stiffness with loss of muscle mass, often require injections and oral medications such as corticosteroids, non-steroidal anti-inflammatory medications and hyaluronic acid injections. In order to achieve a sense of comfort, cats with severe pain may need pain medications such as gabapentin or tramadol along with the second level medications.
Other helpful actions include purchasing a heated pet bed that provides radiant heat under the body, constructing steps leading to the bed and furniture that the kitty enjoys spending time on and replacing a standard litter box with a plastic tray with shorter sides that is easier to get in and out of.
As a house call veterinarian, I understand that arthritis can be manageable with a few medical and environmental changes. I will provide an evaluation of the environment and suggest changes, along with providing medical care and pain control for your aging cat with arthritis. I will discuss the pain scale for animals with you and together we will assign a number at the outset that describes the current state of pain. We’ll then choose a target number that’s achievable with the medications, supplements and environmental enhancements I’ve recommended. A follow-up consultation by phone or email will be scheduled to confirm we are getting positive results.