Caring for cranky old cats

Cats experience chronic pain the same way dogs do – but they are much better at hiding it. So how will you know if your cat is feeling pain? We take a look.

Cats can experience chronic pain for the same reasons dogs do. Degenerative joint disease has been shown to be present in up to 90 per cent of cats over 12. Other causes include dental disease, gut pain, urinary tract pain and neuropathic or spinal pain. However, signs of pain in cats are often subtle. Cats evolved as a solitary species, and are able to conceal weakness even from observant owners. We frequently don’t see cats presenting for pain until it has advanced to a point where they can no longer cope, which means our cats may be living with significant pain much longer than they need to.

So how will you know if your cat is feeling pain? Close observation of all your cat’s behaviour can give you clues. Watch for: toiletting outside of the litter tray, decreased grooming, reduced appetite, avoidance of human touch and being less playful, or reluctance to jump up on benches. Your cat may sleep more and move less. They can be more likely to show signs of aggression like hissing or growling.

Pharmacological options

Pharmacological options to treat pain in cats are limited when compared to dogs. Non-steroidal anti-inflammatory medications such as meloxicam can cause gut, liver and kidney side effects. Since many of our older feline patients have some degree of kidney deficiency, this class of medications is not ideal in the long term.

However, a strong argument in favour of their use is that pain affects quality of life, and if cats are screened via a blood test and monitored carefully, then low doses of NSAIDS may be able to be safely used.

Opiates can be effective but can really only be used for a short time. Gabapentin, which is used as a seizure treatment, can be used for mild to moderate pain and neuropathic pain, but can cause drowsiness, and dosing needs to be three times daily. Paracetamol is used for adjunctive treatment of pain in dogs but must never be used in cats due to a deficiency of an enzyme in the breakdown pathway.

Where possible we try to limit long-term use of conventional pharmaceuticals in cats, and look at alternative strategies, using supplements, herbs and physical modalities.

Alternative strategies

Green-lipped mussels contain omega-3 essential fatty acids, glucosamine, chondroitin and antioxidants, and have been shown to reduce symptoms of arthritis in cats. Omega-3 essential fatty acids can help reduce inflammation and microthrombi formation. The two supplements complement each other, and cats usually like the fishy taste, making dosing easy. Both should be stopped seven days before any surgery.

No discussion on pain relief options is complete these days without mentioning CBD oil. Products used in dogs and cats must have less than 3 per cent TCH. Potential benefits in dogs and cats include reduced pain and inflammation, reduced anxiety and neuroprotective effects.

Currently the legality of using such products in veterinary medicine in Australia is a grey area, but they may be able to be obtained via a veterinary compounding pharmacy. Online products vary in effectiveness and constituents. The potential benefits and any risk for your cat should be discussed with your vet. There are also some herb–drug interactions, so always tell your vet if you intend to use this for your cat. Another available phytocannabinoid is palmitoylethanolamine (PEA), which can also help reduce neuropathic pain and anxiety.

Application of heat increases blood flow and helps reduce muscle soreness and relieve pain. Heat must be applied safely, because it is possible to burn cats, especially older cats, despite their fur coats. Avoid electrical or wheat bags. You can use microwave portable packs but wait 60 seconds, check the temperature on the inside of your wrist and wrap in a flannel. Make sure your cat can move away if it wants. Heat can be applied for 10to 20 minutes once or twice daily. I recommend you discuss with your vet any specific contraindications for your cat.

Weight management is critical to managing pain associated with arthritis or back problems. Excessive weight increases the workload for already stressed joints and increases the risk of injury. Fatty tissue also releases pro-inflammatory cytokines which will increase joint inflammation.

Cats with mobility restrictions find it difficult to manage day-to-day activities such as grooming and toileting. See if you can purchase litter trays that are wider with a low lip, which may be easier to use. You can assist your cat with grooming by daily use of a soft brush or a wipe over with a damp flannel. If you can, trim your cat’s nails every two weeks.

Massage has positive effects on mobility and also enhances the human animal bond. Massage improves circulation and lymph drainage, relaxes muscles, may improve joint range of motion, and reduces stress hormones while releasing endorphins. Patting is an instinctive form of massage. You can also use your thumbs to make small circles along each side of the spine, moving the skin to massage the myofascial tissue. Always work within your cat’s comfort and stop if massage is too painful. Avoid massaging areas that are acutely painful, infected or recent surgery wounds. Specific massage techniques, acupressure or TTouch can be learned via a holistic vet or via Linda Tellington-Jones’ website.