What kinds of medication are available for cats with arthritis? My cat has arthritis of the knees and has difficulty walking. The veterinarian prescribed prednisone. Is there any other treatment to relieve her pain? And could you give me more information about arthritis?
Arthritis, which means inflammation of one or more joints, is grouped into two categories: inflammatory and non-inflammatory. The inflammatory forms of arthritis characteristically have immune system cells and biomolecules in the affected joints. Many of these forms are referred to as "polyarthritis" since several or many joints, symmetrically distributed, are affected. These include joint disease associated with systemic lupus erythematosus, rheumatoid arthritis, and other collagen-vascular diseases, and chronic infections and other disorders; these diseases are immune-mediated. Polyarthritis may or may not cause joint cartilage erosion. Chronic bacterial viral, Erhlichial, and Mycoplasma infections of one or more joints provokes a defensive inflammatory response and may result in cartilage erosion.
The non-inflammatory form of arthritis is called degenerative joint disease (DJD) or osteoarthritis -- the familiar "wear and tear arthritis" of people. Cartilage erosion and a limited, injury and reparative inflammatory response characterize DJD. "Bone spurs" are often seen about the joints on x-rays. Unlike cases of inflammatory arthritis, in which the inflammatory response is directed against an antigen, in DJD the inflammatory response is stimulated to attempt to repair damage caused by some type of injury, including trauma, inappropriate biomechanical stress, and congenital or acquired deformity. However, this response to injury also causes the loss of key building block molecules normally involved in maintaining joint cartilage integrity.
There are two different types of medications used in veterinary medicine for cats with arthritis. Nutraceuticals, like Cosequin® and Glycoflex®, constitute the first type of anti-arthritis medication. Nutraceuticals are used in cases of DJD. Chondroprotective (or joint cartilage protective) supplements containing glucosamine and chondroitin may help cartilage heal and repair itself. They act to lubricate the joint and minimize the bone-to-bone contact of affected joints, thus minimizing the arthritic pain. The use of these products is based on anecdotal reports since the safety and efficacy of oral absorption have not been thoroughly researched. These medications are not an instant "fix" for arthritis, but are often used long-term to manage the problem. This is because the medications often take a month or two to begin to work because it is necessary to get sufficient blood levels into the body.
Anti-inflammatory agents make up the other type of medication used in managing arthritis. They are employed in both inflammatory and non-inflammatory types of arthritis. However, one of the dilemmas facing veterinarians is finding a safe and effective oral anti-inflammatory medication for our feline patients. Cats are very sensitive to many different drugs, especially many of the anti-inflammatory agents used in veterinary medicine. In fact, acetaminophen, the pain reliever in Tylenol® and many other over-the-counter medications, is deadly to cats. Cats metabolize aspirin and other similar drugs very slowly; this can lead to a build-up of any of these medications within the bloodstream that can result in toxicity. Thus, these drugs are given in small doses every two to three days. Corticosteroids, such as prednisone or dexamethasone, can cause side effects such as diabetes, gastrointestinal upset, and others, but most cats are very tolerant of the potential side effects of these medications. Because of the risks associated with the use of the various anti-inflammatory drugs, it is always important to consult with your veterinarian before giving ANY medication to your cat.
Overweight animals can also benefit from weight loss, since this will reduce the amount of stress on the affected joint or joints. Consistent, controlled exercise such as walking (in the cat this may be just playing) will maintain muscle tone and flexibility.
Some veterinary practices also use alternative medicine to help with some of their patient's chronic illnesses, including arthritis. Acupuncture may be used as a replacement for pain medications, which over an extended period of time can cause side effects and even make arthritis and other diseases worse.
I would recommend that you discuss your concern about your cat's arthritis with your veterinarian and consider making an appointment for a re-examination. Your veterinarian will then be able to monitor your cat's progress and recommend further testing or treatments as needed.
12/01/03
