Interview with Dr. Elizabeth Colleran: How to Recognize and Treat Feline Arthritis

This post is sponsored by Assisi Animal Health

Arthritis, a condition that affects as many as 1 in 3 adults, also affects cats. Feline arthritis is a degenerative joint disease. The cartilage within the joint is worn down, leading to inflammation, pain and decreased quality of life. As the condition progresses, the friction can wear down to the point where it damages the bones themselves. This kind of arthritis is most common and causes the most pain in the weight-bearing joints like the shoulders, hips, elbows, knees, and ankles.

Signs of osteoarthritis can be subtle, and since cats are such masters at masking pain, it often remains untreated. As many as 3 in 10 cats suffer from this debilitating condition, but only 7% of cats with arthritis receive treatment.

Dr. Elizabeth Colleran is the owner of Chico Hospital for Cats in Chico, CA. She is a 1990 graduate of Tufts University School of Veterinary Medicine and holds a  Masters of Science Degree in Animals and Public Policy, Tufts University School of Veterinary Medicine. A former President of the American Association of Feline Practitioners (AAFP,) Dr. Colleran is the spokesperson for the AAFP Cat Friendly Practice initiative and speaks at major conferences around the world.

I had a chance to ask Dr. Colleran about why osteoarthritis is so often not diagnosed, and learn more about how she approaches working with her clients to design treatment plans that work for each individual cat.

Osteoarthritis is often not diagnosed in cats because it is difficult to recognize. What do you tell your clients to look for, and at what age do you suggest they start being aware of the possibility of arthritis?

Radiologists tell us that osteoarthritis (OA) can be recognized in cats usually starting around 9 years old. We talk as much as we can about signs of pain, but it is really tough to get the “subtle signs” to come alive for people without help.

The resources we love are http://www.painfreecats.org and https://www.zoetispetcare.com/checklist/osteoarthritis-checklist-cat.

The first is  the Feline Musculoskeletal Pain Index (FMPI), the only clinically validated tool for diagnosing and monitoring feline chronic pain arising from degenerative joint disorders. It is designed to help people at home to evaluate their cat’s behavior and track changes over time. It is written in an easy to understand language. Cats, unlike dogs, are very hard to evaluate for gait changes in the exam room. Much better to see how they act at home.

The second website is brand new, and I just love what it contains. There are ultra-short cartoons that show normal and abnormal movement behaviors in cats who do and don’t have OA. It’s a terrific visual aid and one I will be using every day going forward.

The third resource is the thing everyone has in their pocket: a smart phone with a camera. Short videos can be easily evaluated at a visit or even emailed. I use them all the time for pain evaluations and behavior challenges.

Cats can’t look into the future and know the pain will go away. In a way, they “are” their pain.

Arthritis pain in humans can be debilitating. Do you feel that it would be helpful to draw a comparison between human and feline arthritis?

In reality, for cats it’s worse. They live and are “the moment”. If I have (and I do) an episode of arthritis pain beyond the usual “background noise,” I take an ibuprofen and get out my neck massage ring and plug it in, knowing that soon I will feel better. Cats can’t look into the future and know the pain will go away. In a way, they “are” their pain. That’s one of the reasons it is so crucial for us to make sure cat caregivers learn to recognize pain. It is so different than they way dogs and people manifest pain, so it largely goes unseen.

How do you diagnose arthritis in your clinic?

We use the tools I mentioned, as well as careful palpation. Muscle condition scoring is also important for recognizing differences between limbs and other manifestations of muscle loss.

Click on the image below for a detailed explanation by veterinary nutritionist Lisa M. Freeman, DVM, PhD, DACVN.

Image via Clinical Nutrition Service, Cummings School of Veterinary Medicine at Tufts University

What treatments do you offer for OA?

There are an array of therapies that we tailor to each patient and their family. The categories are:

• Pharmacy interventions: buprenorphine, gabapentin, onsior, methadone, adequan
• Supplements: Omega-3 fatty acids have documented anti-inflammatory properties. I am a fan of 1TDC right now because cats will take it willingly in food. There are others, depending upon palatability, the cat and the owner’s willingness. Any diet supplemented with Omega-3 could be helpful, too.
• Non-Pharma Anti-Inflammatory Devices (NPAID): The Assisi Loop and Assisi Therapy Pad. Every one of our surgery and dentistry patients recovers on an Assisi Therapy Pad. Others are therapeutic laser, physical therapy, warmth (heat is great for arthritis pain so I encourage people to get heated beds or pads.)
• Home modification: Steps up to resting places, raised food bowls, ramps, cat trees with low access and not a lot of distance between levels, etc.

The most important thing is to try to develop a plan that people can comply with, and then go back over and over to make sure it gets modified until the cat is more comfortable, and then to revisit regularly to modify as needed. Arthritis is a progressive condition, so what works today may need to be modified in three months. That’s why exams at least every six months are so important for older cats.

Which of these treatments have you found to be the most effective for early and for advanced stages of arthritis?

I don’t know that we are good enough at early recognition to say yet. Even veterinarians don’t know how to “see” OA well yet. I want every vet to see and share the cartoons in the link above and get themselves competent at assessing arthritis in their physical exams. We have a lot of work to do!

What good is it to create a pain management plan when it ruins the loving relationship they have?

As veterinarians we are responsible not only for recognizing and treating OA pain but to do so in a way that preserves the relationship between the cat and caregiver. That balance has to be central to how we plan our care. What good is it to create a pain management plan when it ruins the loving relationship they have?

That’s why non-aversive therapies are at the center of what we are focused on. Interventions that the cat doesn’t mind, like the Assisi Loop, Therapy Lounge and Pad are wonderful additions to a pain management plan just for that reason. Giving medications by mouth that are not palatable can be really hard on cats and their people, so we like 1TDC, and buprenorphine and compounded formulas that are yummy. A medication that was effective but could be given as infrequently as every 4-6 weeks would be another way to balance comfort with relationships (stay tuned!)

We have two sometimes competing priorities: to cure or treat disease and to preserve relationships. We need to focus on both to do our jobs with compassion.

How the Assisi Loop Works

The Assisi Loop, created by Assisi Animal Health, is a non-pharmaceutical, non-invasive device provides targeted pulsed electromagnetic field therapy (tPEMF™). tPEMF, which was first studied in the 1970s and is FDA-cleared for use in humans, uses low-level pulses of electromagnetic energy to stimulate the body’s own healing mechanisms to help relieve pain and swelling. This therapy can benefits cats with pain associated with arthritis, pancreatitis, wounds, or post-surgical swelling as well as many inflammatory conditions. The Loop is well tolerated by most cats. In fact, many cats really enjoy receiving Loop treatments. Because the Loop stimulates the body’s own healing process, rather than introducing a new substance (like a medication), even a sensitive cat body can handle it easily.

The Assisi Loop Lounge Therapy Pad

Featuring the same pain control of the Loop via targeted pulsed electromagnetic field therapy (tPEMF™,) the Loop Lounge™ is the only therapeutic pet bed backed by scientific research. Click here to read more about the Assisi Loop Lounge.

For more information about how the Assisi Loop or the Assisi Loop Lounge could help your cat, visit http://www.assisianimalhealth.com or contact Assisi Animal Health at info@assisianimalhealth.com, 866-830-7342.

*FTC Disclosure: This is a sponsored post, which means that I was compensated to feature this content. Regardless of payment received, you will only see products or services featured on this site that I believe are of interest to our readers.

The post Interview with Dr. Elizabeth Colleran: How to Recognize and Treat Feline Arthritis appeared first on The Conscious Cat.