A cat receives an injection of polysulfonated glycosaminoglycans.

It is thought that almost 40% of all cats have clinical signs of arthritis and 90% of cats over age 12 have damage to the joints that you can see on x-rays. Cats are such masters at hiding pain that we are now thinking that arthritis is there earlier, pain is happening and we may not be able to see it on x-rays yet.

What if we could be proactive and start some kind of treatment before our cats even seem painful? Could we slow the deterioration of the joints? What arthritis supplements for cats are available and do they work?

The motivation behind writing this post was to help my youngest cat,  5 year old Gus, who showed some indications of spinal arthritis in his x-rays. Should I begin a supplement with him? I was astounded by the sheer numbers of arthritis supplements for cats on the market and the astounding claims they made.

arthritis supplements for cats – do they work?


Arthritis supplements for cats on the market now range from supplements used by humans to homeopathic remedies. Clinical trials are rare to non-existent on many of these products. This post addresses the more common products and ones that have had some double-blinded clinical studies done.

  • glucosamine/chondroitin,
  • omega fatty acids/ green lipped mussel extract
  • polysulfated glycosaminoglycans

Glucosamine/chondroitin


Glucosamine occurs naturally in cartilage, the flexible connective tissue found throughout the body – for example, in the external ears and the surfaces of joints. The supplement can be made synthetically in the lab or harvested from the shells of shellfish.

Some human studies have shown oral glucosamine may help with pain relief and slowing of joint degeneration in people suffering from osteoarthritis. However, in general, the results from these studies are not conclusive.

Dasuquin is a commercially available formulation of glucosamine/chondroitin for cats. It is a dietary supplement in a capsule that is sprinkled on food. The product has been evaluated for safety.

A recent double-blinded study of Dasuquin enrolled 59 cats with Degenerative Joint Disease.

  • All 59 cats were given a placebo for 2 weeks.
  • Then 29 cats received the supplement for 6 weeks while another 30 continued to receive the placebo.
  • The cats were evaluated by using an at-home accelerometer (like a kitty “fit bit”), owner observations and vet exams through out the study.
  • The study showed a strong placebo effect – 78% of the cats were more active while on the placebo.
  • Cats on the supplement did not show any statistically significant improvement over cats on the placebo.

However, the study did raise some questions:

  • The “kitty fit-bits” showed that the least active cats at the start of the study became more active on the supplement. Were these cat more painful to begin with?
  • The placebo was given in the first two weeks of the study when owner enthusiasm would have understandably been highest and owners would have been looking for improvement.

More research is needed – perhaps a different study design?

Omega Fatty acids (fish oils)


Supplementation with fish oils has shown some benefit for arthritic cats. A double-blinded study showed that cats supplemented with fish oil for 10 weeks were more active, going up and down the stairs more, jumping higher, not walking as stiffly and were more interactive with their people. This study used owner evaluation to assess the cats’ improvement.

Fish oil can be given as a dietary supplement (Welactin) or fed as a therapeutic diet, such as  Hill’s j/d.

Side effects of fatty acid supplementation include GI upset and reduced blood clotting. There is some controversy over how much fish oil is enough. Additionally, fish oil can add quite a bit of calories to your cat’s diet and could result in weight gain, taxing your cat’s joints further.

Merial’s Antinol for Cats supplement is based on fatty acids from green-lipped mussel extract. There are a number of case studies where the supplement has been given to cats with good results for cardiac and dermatological issues, in addition to joint and mobility problems.

Polysulfated Glycosaminoglycans (PSGAGs)


This product is available under the brand name Adequan.  It is the veterinary version of Arteparon, used in humans.

  • Decreases the breakdown in cartilage. The PSGAG’s allows the cartilage to hold more water, making it resistant to degradation.
  • Adequan has been extensively studied in dogs and horses for over 20 years and is FDA-approved for these species
  • Available by prescription.
  • Given by subcutaneous injection in cats with generally good results.

The jury is still out on most of the arthritis supplements for cats. Given at the manufacturer’s recommended dose, these products are safe and may be effective. Considering the individual nature of pain, some cats may respond favorably while others do not. Once again supplements are basically unapproved drugs so there is not the rigorous evaluation that accompanies FDA approval.

Your vet is your best resource on arthritis supplements for cats. He or she will be able to recommend a supplement or diet that is appropriate for your cat and is compatible with other medications or medical conditions your cat may have. In particular, combining supplements should be done with care – glucosamine, fatty acids and Adequan all effect how your cat’s blood clots.

So, what will I do for Gus?


My vets recommended the Adequan injection, citing the robustness of the canine studies and the fact that it is an injection – there is a greater confidence that the cat will get the supplement. We are not depending on him to eat something.

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HDO BP cat
A cat relaxes in his basket during a blood pressure reading at home using an HDO unit. The cuff is on his tail. The blood pressure wave is on the computer screen.

You’ve brought your senior cat in for her regular checkup and the technician asks you if you would like to have her blood pressure checked. Although your blood pressure is routinely checked when you go to the doctor, it has not occurred to you to ask to have your cat’s blood pressure checked. Should you have your cat’s blood pressure measured? How is it done – will it be uncomfortable? Frightening?

Why measure your cat’s blood pressure


As cats age, many develop hyperthyroidism and kidney disease. Other cats may develop diabetes. All of these conditions can result in the heart pumping harder to compensate for the changes. As the heart pumps harder, blood pressure increases and arteries, the eyes, the kidneys, the brain and heart can be damaged.

Left untreated, high blood pressure can result in:

  • blindness
  • increasing loss of protein through the kidneys >> shortened life span
  • disorientation, lack of balance, seizures, altered mentation or behavior, or weakness in the limbs

The best way to avoid these consequences is to monitor your cat’s blood pressure and start treatment if his blood pressure is high.

So how do we measure your cat’s blood pressure?


When measuring blood pressure in humans, we typically place a pressure cuff on the upper arm, inflate the cuff until the flow of blood to the artery is shut off . The cuff is then released, and a wave of blood fills the artery, turbulent at first, then subsiding to a smooth flow.

The human practitioner can use a stethoscope to listen to the sounds made as the blood rushes back into the artery.

  • The first sound is heard at the systolic blood pressure (the higher number in 120/80)
  • The final sound is heard at the diastolic pressure (the lower number in 120/80).

We will also use a blood pressure cuff to measure your cat’s blood pressure. This cuff can be put:

  • on the front leg
  • on the hind limb, above or below the hock (ankle)
  • on the tail

Cats’ arteries are much smaller than humans’ and it is difficult to hear the sounds of the blood flow using a stethoscope, so we turn to other methods: Doppler and oscillometric.

Doppler


 

Doppler blood pressure cat
A cat has her blood pressure measured using a doppler unit. The cuff is on the hind leg and the sensor is held right above the paw pad.

A Doppler unit measures blood flow.

  • After placing the cuff on your cat, the Doppler sensor is placed over the target artery.
  • Piezoelectric crystals in the sensor detect changes in the flow of blood in the arteries and convert these to sound.
  • Acoustic gel on the sensor ensures good contact so that the practitioner can hear the heartbeat.
  • The cuff is inflated until the heartbeat is no longer heard.
  • The cuff is then released and the pressure at which the heartbeat can be heard again is the systolic blood pressure.
  • Headphones are usually used when measuring blood pressure with a Doppler.

 

Doppler units give us a measurement of the systolic blood pressure, the larger number in the 120/80.

Oscillometric


Only a cuff needs to be placed to measure your cat’s blood pressure with an oscillometric unit.

  • A sensor in the cuff detects the pressure pulses in the artery.
  • As the cuff is inflated, the pulses decrease as flow to the artery is cut off.
  • The cuff is then deflated and the pressure wave that results as the blood rushes back into the artery is analyzed.

Oscillometric units typically only measure the peak of this wave, the average blood pressure, and calculate the systolic and diastolic pressures.

A High Definition Oscillometric unit records the entire pressure wave, directly measuring the systolic and diastolic pressures. An HDO unit is usually connected to a computer to view the pressure wave and determine if the measurement was accurate.

How accurate is a blood pressure if my cat is nervous at the vet clinic?


Just like people, cats get anxious and nervous when visiting the vet clinic. Blood pressure is sensitive to this and it can be a challenge to measure your cat’s blood pressure.

Putting the odds in our favor:

  • Most of the time, you should be with your cat during a blood pressure measurement. Your cat knows you and trusts you. Your presence is reassuring and calming.
  • Allow your cat to settle in for 5-10 minutes – the measurement should be done in a quiet room.
  • If your cat likes to snuggle in your lap, see if the measurement can be done there. If your cat prefers to sit on his stomach, perhaps a tail measurement is best. If he is comfortable laying on his side, a hind leg may be better.
  • Using the front leg to measure blood pressure puts the practitioner in front of the cat; curious cats may want to take a nibble at the blood pressure cuff. I prefer that your cat be facing you, her person, who can reassure her. I feel the tail and hind leg work better.
  • The artery being measured, tail or hind leg, should be at the same level as the heart – so kitty should not be sitting up, but laying comfortably on his stomach or side.

What do the numbers mean?


  • Again, like people, the systolic pressure is ideally around 120.
  • Pressures 150 and over can indicate the need for medication.
  • Your vet may also do an eye exam, looking at the eye with an ophthalmoscope or lens. In some instances of high blood pressure, the vessels in the eye dilate and become twisted; sometimes the retina may be detached, resulting in blindness. If high blood pressure is caught early enough, blindness may resolve with treatment.

My cat’s blood pressure is high but her eyes looked OK. What next?


High blood pressure can be treated with drugs – the most common drug used is oral amlodipine. Amlodipine takes effect fairly quickly and a blood pressure can be repeated in about 10 days and the dose adjusted if needed.
Other medications such as benazepril or telmisartan may be used alongside or in place of amlodipine.

I don’t think the reading was accurate – my cat was too nervous


It is worth investing in a home blood pressure visit. A practitioner can come to your home and get a measurement where your cat feels safe and secure.

 

Measuring your cat’s blood pressure especially as she gets older will help keep her healthy and comfortable. Without treatment, high blood pressure can have serious side effects, including blindness, seizures, and cardiac damage.

Have your cat examined regularly by your veterinarian, as changes to the eyes or a heart murmur might warrant a blood pressure check.

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About a week ago, we had invited family members to the traditional Thanksgiving dinner. Appetizers had been set out to snack on prior to the main meal. There was a cheese and cracker plate, with an open box of crackers on it, where folks could serve themselves, taking a cracker and a slice of cheese.

As we were eating dinner, I happened to look over to the counter with the cheese plate. Gus had gotten up on the counter, and was helping himself to a cracker. He very carefully selected a single cracker with his mouth without disturbing the other crackers, the plate or the box. He then carefully backed away to nibble on his prize.

What struck me was that he only took one cracker, he did not paw at the box or knock it on the floor. Had he been watching us? Can cats learn from us?

Trial and Error Learning


A cat presented with a treat ball containing treats for the first time will examine and smell the ball thoroughly, then perhaps nudge it with her nose while continuing to smell the ball. If some treats come out, the cat may then try nudging the ball again or try pawing at it. With each trial, the cat will refine her method of obtaining treats.

Social Learning – Can cats learn from us?


Cats can also learn by watching other cats do things – kittens watch their mother attentively as she manipulates prey and chooses things to eat. Their later success as hunters and the food preferences they develop reflects this instruction.

For the cat, other species are worth watching too – for example, humans, dogs and raccoons may give some invaluable lessons in manipulating doors to reach food or desirable places.

A cat will learn to use a microchip feeder or food puzzle faster if a patient owner sits by with treats and demonstrates the feeder or puzzle operation, speeding up the trial and error process.

“Do As I Do”


“Do As I Do” is a fairly new training method for dogs developed by Claudia Fugazza at Eötvös Loránd University in Budapest. In the “Do As I Do” method, an owner will demonstrate a behavior to her dog and then ask him to repeat it.

Can a cat “Do As I Do”?


In 2019, Dr. Fugazza decided to test this kind social learning in a cat. Her subject was an 11-year-old female cat, called Ebisu. Ebisu lived with her owner, Fumi Higaki, in Ichinomia, Japan. Fumi Higaki is a professional dog trainer, experienced in the “Do As I Do” method for training dogs.

Training Ebisu was a two-step process:

  1. First, Ebisu learned that the “Do It!” command meant that she should copy what her owner had done. The owner used three behaviors that Ebisu already knew to train the “Do It” command. For example, the owner would twirl around, then give Ebisu the “Do it!” command and also give Ebisu the verbal cure to twirl around.
  2. Next, the owner demonstrated three other behaviors that Ebisu was familiar with and gave her the “Do It!” command without the verbal cues. Once Ebisu successfully imitated her owner, she was ready to learn some new behaviors by copying her owner.

Ebisu successfully learned two new behaviors through imitating her owner:

  1. Sliding a lid on a container to open it – Ebisu succeeded on the first try!
  2. Placing her forearms on a book.

At this point, Ebisu was judged ready to be tested and two new behaviors were assessed in 18 test trials:

  1. Placing her paw on a box
  2. Rubbing her face on a box

During these trials, Ebisu mimicked her owner 80% of the time.  Fumi would put her hand on the box (or rub her face on the box).  She would then tell Ebisu to “Do It!”, and Ebisu would put her paw on the box (or rub her face on the box).

So what do we learn from this?

  • Cats are able to mimic the actions of a human.
  • They are able to adapt human actions to their own bodies – for example, the human touches a box with her hand and the cat touches the box with a front paw.

So, it is worthwhile for us to demonstrate the operation of food puzzles, automatic feeders, cat doors…to help our cats learn how to use these devices.  It should speed up the learning process!

Back to “cracker snatcher” Gus…can cats learn from us?


I really don’t know if Gus learned to pick out a single cracker by watching people but it’s fun to think that he did. And, not having opposable thumbs, he was not able to pick out the cracker with a paw but instead extracted it with his mouth, adapting the action so that he could perform it successfully!

Here is Gus with the box of crackers. Enjoy the video!

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