Treatment of osteoarthritis in cats

Osteoarthritis or osteoarthrosis (OA) is a progressive and chronic degenerative joint disease and a regular cause of limping1. The occurrence of this disease increases with age. 

Primary articular OA is more common in cats than in dogs. Various studies have observed that 92% of patients of all ages present at least one joint affected with radiological signs2, while other studies show that 61% of patients show signs of degenerative joint disease in one joint and 48% in at least two3.

Pathogenesis of inflammatory processes in feline osteoarthritis

Pro-inflammatory mediators are released, causing synovitis, which leads to the release of such mediators as prostaglandins and cytokines (IL-1b and TNF-a), growth factors related to the formation of osteophytes and the nerve growth factor4. The release of all these mediators leads to destruction of the matrix followed by alterations in the cartilage repair systems.

Changes in the subchondral bone and the synovial alterations are considered key at the start and during progression of OA. Cartilage wear, changes in the synovial membrane, the subchondral bone and the muscles involved in the affected joint, nerves and ligaments occur. 

Articular cartilage has no nerve innervation, meaning that symptoms do not manifest and only appear when other structures are affected. The cartilage loses elasticity and the subchondral bone is exposed. Alteration also occurs in the articular matrix, worsening injury to the tissues involved5.

Certain underlying and aggravating factors exist, such as obesity. This is considered a complicating factor owing to the overload on affected patients and the endocrine disorder it causes, a resistance to insulin, the release of TNF-a and pro-inflammatory cytokines that aggravate the situation of the patient6.

Symptoms and diagnosis

The differing nature between feline and canine patients must be understood in order to comprehend the symptomatology that may present. It is more difficult to notice the changes that occur in cats due to their character. Despite experiencing pain, it is difficult to interpret the symptoms they present. In these patients, the most important change occurs in lifestyle habits, so anamnesis by the owner themselves is essential. Besides the associated habits, various scales and models have been created based on facial expressions, body postures7 and changes in personality.

Imaging tests are also necessary for diagnosis, possibly requiring advanced imaging techniques.

The importance of a multimodal approach in the treatment of osteoarthritis

In many cases, treatment represents quite a challenge due to the presence of accompanying diseases. The identification of various pathologies is essential for establishing the best therapeutic options. In terms of OA, it is important to improve the environmental factors (easy access to resources, assistance based on ramps and steps, etc.)8.

Thanks to its three general effects (analgesia, inflammation control and a biostimulant effect), laser therapy is highly useful in the treatment of osteoarthritis, both in human and veterinary medicine9.10. Laser therapy has an analgesic effect in various ways, potentially helping to alleviate the pain caused by articular degeneration11,12. It has been observed that laser therapy reduces and regulates certain cytokines, such as IL-1b and TNF-a13. Furthermore, its biostimulant effect can help to stimulate the regeneration of cartilage14.

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DoctorVet as an aid in the treatment of feline osteoarthritis

DoctorVet has specific protocols for feline medicine based on the different joints and their specific characteristics. 

The five stages present in the DoctorVet protocols consider the various tissues affected in the joint. Furthermore, these protocols can be combined with general pain and/or inflammation depending on the symptoms in the patient. We recommend the massage treatment head in contact mode. If the patient is unable to tolerate contact mode, we recommend using the scan treatment head in non-contact mode. The scan application technique should be used in both cases. 

The treatment schedule requires an initial stage in which these patients are treated 2-3 times/week until the photobiomodulation effects are observed. Subsequently, the sessions can be gradually spread apart until reaching the maintenance stage, in which patients can be treated every 3-6 weeks depending on the individual response of each patient and the severity.

  1. Damià E et al. Osteoartritis. Capítulo 4, Edit. Servet, 2020.
  2. Lascelles D. et al. Cross-sectional study on the prevalence of radiographic degenerative joint disease in domesticated cats. Vet Surg (39), 85, 2010.
  3. Slingerland L. et al. Cross-sectional study of the prevalence and clinical features of osteoarthritis in 100 cats. Vet J (3), 187: 304-309, 2011.
  4. Isola M. et al. Nerve growth factor concentrations in the synovial fluid from healthy dogs and dogs with secondary osteoarthritis. Vet Comp Orthop Traumatol. 24(4): 279-284.
  5. Carrillo Poveda JM. et al. Osteoartritis en pequeños animales visión actualizada de un viejo conocido. Canis et Felis, 176 (3), 2022.
  6. Vallejo López F. Claves para el diagnóstico y manejo del propietario en la OA felina. Abstract SEVC, 2021.
  7. Evangelista M. et al. Clinical applicability of feline grimace scale: real- time versus image scoring and influence of sedation and surgery. Peer J, 2020.
  8. Scherk M. Cómo trato…un gato viejo con múltiples problemas. Abstract, 2019.
  9. Staulsholm MB. et al. Efficacy of low-level laser therapy on pain and disability in knee osteoarthritis: systematic review and meta-analysis of randomized placebo-controlled trials. BMJ Open 9:e031142, 2019.
  10. Looney AL. et al. A randomized blind placebo-controlled trial investigating the effects of photobiomodulation therapy (PBMT) on canine elbow osteoarthritis. Can vet J, 59: 959-966, 2018.
  11. Der-Sheng et al. Involvement of substance P in the analgesic effect of low-level laser therapy in a mouse model of chronic widespread muscle pain. Pain medicna 0, 1-8. 2019
  12. Wakabayashi et al. Effect of irradiation by semiconductor laser on responses evoked in trigeminal caudal neurons by tooth pulp stimulation. Lasers in surg.and medicine, 13: 605-610. 1993.
  13. Fernandes et al. Effect of photobiomodulation on expression of IL-1beta in skeletal muscle following acute injury. Lasers Med. Sci. 28(3), 1043–1046 (2013).
  14. Felizatti AL. et al. Effects of low-level laser therapy on the organization of articular cartilage in an experimental microcrystalline arthritis model. Lasers in Medic Science: 1-12, 2019

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