Arthritis (DJD)

Arthritis, also known as degenerative joint disease (DJD), is a chronic degenerative condition of the joints, just like in people.  This affects primarily older cats, but in some cases can affect younger cats as a result of disease or obesity.  DJD can be uncomfortable and even painful for your cat, but while we cannot reverse it, there are things we can do to slow it down, and to increase your cat's quality of life.

Pathophysiology:

DJD occurs as an age related change when the cartilage that covers the surface of the bones in the joints first softens, then begins to wear, and eventually sloughs off into the joint capsule.  This results in exposure of bone to the joint capsule, resulting in pain and discomfort.  In addition, the bits of cartilage and in some cases bone that are sloughed into the joint capsule can be quite painful, like having pebbles in your cat's joints.

No one knows for sure what causes DJD in people or in animals, but it is definitely related to age, and occurs in joints that are most commonly used - in cats these are the knee joints, the elbow joints, and the hip joints, but we can see it in other joints as well.

Early DJD cannot be seen on an x-ray, but in later stages it is visible.

There is another type of DJD found commonly in cats called spondylosis.  That is DJD of the joints of the spinal column, and it is visible on x-rays.  In severe cases, spondylosis can act in such a way as to fuse an area of your cat's spinal column, making movement difficult, and in rare cases, affecting your cat's ability to urinate and defecate.

50% of cats 10 and older have evidence of DJD on x-rays.  70% of cats 15 and older have evidence of DJD on x-rays.  There is no diagnostic test for DJD, rather, we will usually just go off of symptoms, physical exam findings, and x-ray findings.

Symptoms:

Jumping.  One of the first things you might notice is a decrease in your cat's jumping ability, or a hesitation before they jump.  They may start finding alternative ways up to higher places instead of jumping up to them.

Grooming.  You might notice that your cat is no longer grooming as well.  This can also be caused by various diseases, but DJD is definitely the most common.

Movement.  You might notice a decrease in your cat's overall movement around the house, stiffness, or a reluctance to get up after a nap.

Walking.  In more severe stages you might see your cat start to walk lower on their feet or hocks, or you may see your cat start to have a hard time keeping their balance, especially on hard surfaces.  They may appear to waver or even fall over.

Treatment:

With DJD, the sooner we initiate treatment, the sooner we can slow down the progression of DJD.  There are several treatments which include nutraceuticals, glycosaminoglycan (GAG) analogs, and anti-inflammatories.  Both nutraceuticals and GAG analogs tend to slow down the progression of DJD along with increasing lubrication in the joints, and mild anti-inflammatory properties.  Anti-inflammatories do just that, they reduce inflammation on a stronger scale in the joints, and also help prevent pain.

Cosequin and/or Dasuquin.  These are combination GAG analogs, which are similar to the fluid found in your joint capsules, and nutraceuticals, which are nutrients that have been shown to have a beneficial medical effect.  These are available in capsules that can be taken apart and the powder inside, which is tuna flavored, can be mixed in moist food.  These are probably the commonly used DJD supplement, and have little to no side effects.

• Cosequin contains glucosamine chondroiton sulfate, which is bovine cartilage that has been shown to be beneficial in people and animals.  Cosequin is available over the counter.
• Dasuquin is glucosamine chondroiton sulfate plus avocado soybean unsaponifiables (ASUs) which are used commonly in Europe for DJD in people and animals.  Dasuquin has been shown to be slightly more effective than Cosequin, and is only available through veterinarians.

Prescription Diets.  There are a couple of prescription diets that use nutraceuticals to help slow down and treat your cat's DJD.  They are only available through veterinarians, but are safe to feed to other cats in the home of any age.  They are:

• Science Diet J/D
• Purina JM

Adequan.  This is a GAG analog that is given as an injection to your cat twice weekly for a month, then just once every 3 months.  Adequan is probably the most effective of the treatments, but is also the most costly up front.

Metacam.  This is a non-steroidal anti-inflammatory drug (NSAID), similar in function to ibuprofen.  Metacam is probably the most effective treatment for cats with more advanced DJD.  However, it can potentially be hard on the kidneys, so the benefits of it must be weighed with the potential side effects. 

Therapy Laser.  This has been shown to have fairly good benefit in cats.  The laser therapy reduces inflammation associated with the DJD, and does not generally require sedation or anesthesia for most cats.  We do not have this available at All Feline, but if you are interested we can refer you to clinics in town who do offer this.

For all of these treatments the sooner they are started, the better the prognosis.  So if you start to notice any symptoms of DJD at all, we recommend starting treatments.

If you have any questions or concerns over any of the above, please contact us at All Feline Hospital at info@allfelinehospital.com.

This handout was written by Dr. Shelley Knudsen, DVM

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