ArticleLiterature Review

Osteoarthritis in the cat: 1. How common is it and how easy to recognise?

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Abstract

Practical relevance Osteoarthritis (OA) is very common, particularly in older cats, but its clinical significance has largely gone unrecognised until recently. As in other species, OA is often painful and appropriate treatment is required to improve the animal’s quality of life. Most cases appear to be primary or idiopathic. It is important for the clinician to actively seek these cases in the practice population. Clinical challenges The recognition of chronic arthritic pain is a major challenge since most cats will not exhibit lameness. The main features of feline OA are changes in behaviour and lifestyle, which develop gradually and which owners tend to interpret as simply being the effects of old age. A meaningful physical orthopaedic examination can be difficult to achieve. A lack of familiarity with feline joint radiographs, and the fact that major cartilage pathology can be present in the absence of any bony change, mean that radiographic identification of OA in the cat can also be problematic. Client questionnaire The recognition of chronic arthritic pain in the cat is based on owner questionnaires designed to elicit information about changes in mobility, activity levels, grooming habits and general demeanour. Evidence base Several publications now report on the significance of behavioural and lifestyle changes as indicators of chronic arthritic pain in the cat. However, there is not as yet a fully validated owner-based questionnaire for recognising chronic pain in the cat. Furthermore, the aetiopathogenesis of feline OA still requires detailed investigation. Such studies are likely to make a major contribution to comparative rheumatology, since feline OA, more so than the canine disease, shows many similarities with human OA.

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... Osteoarthritis (OA) is common in cats; the radiographic prevalence of degenerative changes of the joints, including those associated with OA specifically, increases with age and is associated with pain and disability. [1][2][3][4] Clinical trials of non-steroidal anti-inflammatory drugs (NSAIDs), meloxicam and robenacoxib, an anti-nerve growth factor (NGF) antibody, a therapeutic diet and dietary supplementation with long-chain omega-3 fatty acids have yielded improvements in mobility (eg, jumping) and activity (telemetric activity monitoring [AM] or subjective assessment), lameness/stiffness, mood and grooming. [4][5][6][7][8][9][10][11][12][13][14] Subtle and non-specific osteoarthritic (OA) signs in this species may be incorrectly attributed to mere aging, contributing to under-diagnosis of feline OA. 1,3 Clinical OA detection relies heavily on owner-reported historical abnormalities. ...
... [1][2][3][4] Clinical trials of non-steroidal anti-inflammatory drugs (NSAIDs), meloxicam and robenacoxib, an anti-nerve growth factor (NGF) antibody, a therapeutic diet and dietary supplementation with long-chain omega-3 fatty acids have yielded improvements in mobility (eg, jumping) and activity (telemetric activity monitoring [AM] or subjective assessment), lameness/stiffness, mood and grooming. [4][5][6][7][8][9][10][11][12][13][14] Subtle and non-specific osteoarthritic (OA) signs in this species may be incorrectly attributed to mere aging, contributing to under-diagnosis of feline OA. 1,3 Clinical OA detection relies heavily on owner-reported historical abnormalities. 1,15 Lameness has been reported, 15,16 but appears less prominent, 1,3 for example, than in canine OA. 17 In addition, joint pain upon manipulation and palpable abnormalities may be poorly reliable, 18 and do not correlate highly either with radiographic or historical OA signs. ...
... [4][5][6][7][8][9][10][11][12][13][14] Subtle and non-specific osteoarthritic (OA) signs in this species may be incorrectly attributed to mere aging, contributing to under-diagnosis of feline OA. 1,3 Clinical OA detection relies heavily on owner-reported historical abnormalities. 1,15 Lameness has been reported, 15,16 but appears less prominent, 1,3 for example, than in canine OA. 17 In addition, joint pain upon manipulation and palpable abnormalities may be poorly reliable, 18 and do not correlate highly either with radiographic or historical OA signs. 2,11,12,15,[18][19][20] Difficulty detecting OA pain in cats impedes clinical case management, and novel drug testing. ...
Article
Full-text available
Challenges in the clinical assessment of feline osteoarthritis (OA)-related pain and disability impede diagnosis and treatment of the disease. A pain scale was developed for use by cat owners and caretakers, the Montreal Instrument for Cat Arthritis Testing - Caretaker/Owner (MI-CAT(C)). Following content validation and a pilot assessment (n=11 cats with and without OA) of MI-CAT(C)-v1 reliability and validity, a randomised, double-blinded, placebo-controlled, crossover clinical trial was conducted; meloxicam efficacy in 54 OA-affected cats was evaluated using the MI-CAT(C)-v2 and locomotor activity monitoring (AM). The intra-class correlation coefficient was 0.81 for total scale intra-rater reliability, and 0.64 for inter-rater reliability; secondary owners tended to have more trouble completing the scale than did primary owners. Internal consistency assessed by Cronbach's alpha was >0.70 for the total scale, but <0.70 for subscales and subcategories. Compared to reference level, MI-CAT(C)-v2 score decreased by 17.56% with meloxicam (P< 0.05) and increased with age (P< 0.01). Night-time AM (NAM) was lower than daytime AM (P< 0.0001). Actimetry increased by 23.83% with meloxicam treatment (P< 0.0001). MI-CAT(C)-v2 scores correlated negatively with log NAM (RhoP =-0.36, P =0.0074) and positively with age (RhoP =0.43, P =0.0011). These preliminary findings support the reliability and validity of the MI-CAT(C)-v2 when completed by the primary owners of OA cats. However, questions remain regarding item comprehension and internal scale structure/internal consistency. Further refinement and testing should include a comprehension analysis and exploratory factor analysis in a larger sample of cats, as well as evaluation of sensitivity/specificity to OA status in a sample of cats with and without OA, testing of responsiveness to other OA therapies and ability to distinguish treatment from placebo, and finally, development of guidelines for clinical use, such as determination of the minimum clinically important difference in scale score and thresholds for determining OA vs. non-OA status.
... [32][33][34][35] The affective domain of pain assessment is the emotional component of the pain. 36 Diagnosing feline musculoskeletal disease requires an understanding of what is 'normal' for that individual cat, 37,38 and this can be difficult to determine in a clinical setting. Owner questionnaires or clinical questioning are often the first step in the diagnosis of mobility issues. ...
... Owner questionnaires or clinical questioning are often the first step in the diagnosis of mobility issues. 37,38 Owner-observed abnormalities were used in the diagnosis of OA in 94% of cats in one study, with changes in gait, jumping and stair climbing being the most commonly reported mobility-associated issues. 31 Feline musculoskeletal disease CMIs are designed to determine if pain related to musculoskeletal disease is present and detect any improvement following therapy, 32 and have been shown to be clinically valuable in both research and clinical settings. ...
... In the clinic, orthopaedic assessment can be separated into visual assessment of the cat moving around the consulting room (if the cat is willing) and a detailed physical assessment of the musculoskeletal system. 37,38 Ortho paedic examinations are not always straightforward to perform in cats, 37,38 but the current authors would recommend incorporating a routine visual and physical assessment into annual health examinations to allow the clinician to determine what is normal for that individual and recognise any changes. ...
Article
Practical relevance An understanding of the process of musculoskeletal ageing – which all senior and geriatric cats will experience – is vital to maintaining the health and welfare of our ageing cat population. Clinical challenges Assessment of the feline musculoskeletal system is not always straightforward. Diagnosis of impairment relies on input from owners and veterinarians in terms of visual observation, and clinical and orthopaedic examination, in addition to diagnostic imaging Audience This review is written for the primary care veterinary team. Aims The goals are to raise awareness and improve clinical diagnosis of musculoskeletal impairment as a result of ageing. The article also reviews therapeutic options and considers the evidence available for the prevention/deceleration of musculoskeletal ageing and impairment. Evidence base There is good evidence of a high prevalence of osteoarthritis (OA) and degenerative joint disease (DJD) in older cats. There is also good evidence to indicate that functional impairment and chronic pain are sequelae of musculoskeletal disease. However, there is a paucity of information for what is best practice for the management and treatment of musculoskeletal impairment in a clinical situation. There is also a lack of evidence on how prevention of central stimulation of the nervous system caused by musculoskeletal impairment and, in turn the development of chronic pain, can be avoided.
... Osteoarthritis (OA) is common in cats; the radiographic prevalence of degenerative changes of the joints, including those associated with OA specifically, increases with age and is associated with pain and disability. [1][2][3][4] Clinical trials of non-steroidal anti-inflammatory drugs (NSAIDs), meloxicam and robenacoxib, an anti-nerve growth factor (NGF) antibody, a therapeutic diet and dietary supplementation with long-chain omega-3 fatty acids have yielded improvements in mobility (eg, jumping) and activity (telemetric activity monitoring [AM] or subjective assessment), lameness/stiffness, mood and grooming. [4][5][6][7][8][9][10][11][12][13][14] Subtle and non-specific osteoarthritic (OA) signs in this species may be incorrectly attributed to mere aging, contributing to under-diagnosis of feline OA. 1,3 Clinical OA detection relies heavily on owner-reported historical abnormalities. ...
... [1][2][3][4] Clinical trials of non-steroidal anti-inflammatory drugs (NSAIDs), meloxicam and robenacoxib, an anti-nerve growth factor (NGF) antibody, a therapeutic diet and dietary supplementation with long-chain omega-3 fatty acids have yielded improvements in mobility (eg, jumping) and activity (telemetric activity monitoring [AM] or subjective assessment), lameness/stiffness, mood and grooming. [4][5][6][7][8][9][10][11][12][13][14] Subtle and non-specific osteoarthritic (OA) signs in this species may be incorrectly attributed to mere aging, contributing to under-diagnosis of feline OA. 1,3 Clinical OA detection relies heavily on owner-reported historical abnormalities. 1,15 Lameness has been reported, 15,16 but appears less prominent, 1,3 for example, than in canine OA. 17 In addition, joint pain upon manipulation and palpable abnormalities may be poorly reliable, 18 and do not correlate highly either with radiographic or historical OA signs. ...
... [4][5][6][7][8][9][10][11][12][13][14] Subtle and non-specific osteoarthritic (OA) signs in this species may be incorrectly attributed to mere aging, contributing to under-diagnosis of feline OA. 1,3 Clinical OA detection relies heavily on owner-reported historical abnormalities. 1,15 Lameness has been reported, 15,16 but appears less prominent, 1,3 for example, than in canine OA. 17 In addition, joint pain upon manipulation and palpable abnormalities may be poorly reliable, 18 and do not correlate highly either with radiographic or historical OA signs. 2,11,12,15,[18][19][20] Difficulty detecting OA pain in cats impedes clinical case management, and novel drug testing. ...
Article
Objectives Feline osteoarthritis causes pain and disability. Detection and measurement is challenging, relying heavily on owner report. This study describes refinement of the Montreal Instrument for Cat Arthritis Testing, for Use by Veterinarians. Methods A video analysis of osteoarthritic (n = 6) and non-osteoarthritic (n = 4) cats facilitated expansion of scale items. Three successive therapeutic trials (using gabapentin, tramadol and oral transmucosal meloxicam spray) in laboratory cats with and without natural osteoarthritis (n = 12–20) permitted construct validation (assessments of disease status sensitivity and therapeutic responsiveness) and further scale refinements based on performance. Results Scale osteoarthritic sensitivity improved from phase I to phase III; phase III scale total score ( P = 0.0001) and 4/5 subcategories – body posture ( P = 0.0006), gait ( P = 0.0031), jumping (0.0824) and global distance examination ( P = 0.0001) – detected osteoarthritic cats. Total score inter-rater (intra-class correlation coefficients [ICC] = 0.64–0.75), intra-rater (ICC = 0.90–0.91) and overall internal consistency (Cronbach’s alpha = 0.85) reliability were good to excellent. von Frey anesthesiometer-induced paw withdrawal threshold increased with gabapentin in phase I, in osteoarthritic cats ( P <0.001) but not in non-osteoarthritic cats ( P = 0.075). Night-time activity increased during gabapentin treatment. Objective measures also detected tramadol and/or meloxicam treatment effects in osteoarthritic cats in phases II and III. There was some treatment responsiveness: in phase I, 3/10 subcategory scores improved ( P <0.09) in treated osteoarthritic cats; in phase II, 3/8 subcategories improved; and in phase III, 1/5 subcategories improved ( P <0.096). Conclusions and relevance The revised scale detected naturally occurring osteoarthritis, but not treatment effects, in laboratory cats, suggesting future potential for screening of at-risk cats. Further study is needed to confirm reliability, validity (disease sensitivity and treatment responsiveness) and clinical feasibility, as well as cut-off scores for osteoarthritic vs non-osteoarthritic status, in client-owned cats.
... Die Osteoarthrose (OA) ist eine Erkrankung der synovialen Gelenke, charakterisiert durch Abnutzung und Abbau des Gelenkknorpels und Formation von knöchernen Zubildungen (degenerative Gelenkerkrankung) (Acker und Tacke 2011, Bennett et al. 2012a). Konsequenzen der Zerstörung der Gelenkfl ächen sind eine zunehmende Schmerzempfi ndung, wobei Katzen und Hunde mit der Zeit eine zentrale und periphere Sensibilisierung entwickeln (Monteiro et al. 2017). ...
... Fortbildung schen Geschehens. Insgesamt wird dabei von nur 25 % der an OA erkrankten Katzen ausgegangen (Bennett et al. 2012a). Neben einem Trauma sind in der Entstehung von sekundären OA auch andere Pathologien verantwortlich, wie zum Beispiel eine Mucopolysaccharidose, mediale Patellaluxation, Akromegalie, Scotish fold Osteochondrodysplasie, kongenitale Ellbogenluxation und andere Arthropathien (Bennett et al. 2012a, Hardie et al. 2002, Lascelles et al. 2010b, Slingerland et al. 2011. ...
... Insgesamt wird dabei von nur 25 % der an OA erkrankten Katzen ausgegangen (Bennett et al. 2012a). Neben einem Trauma sind in der Entstehung von sekundären OA auch andere Pathologien verantwortlich, wie zum Beispiel eine Mucopolysaccharidose, mediale Patellaluxation, Akromegalie, Scotish fold Osteochondrodysplasie, kongenitale Ellbogenluxation und andere Arthropathien (Bennett et al. 2012a, Hardie et al. 2002, Lascelles et al. 2010b, Slingerland et al. 2011. ...
Article
Osteoarthrosis (OA) is a degenerative disease that regularly causes increased pain due to progressive destruction of articular cartilage. Cats are rarely diagnosed despite its high prevalence in this species. One of the reasons might be the different clinical and radiographic findings compared to dogs. Behavioural problems and a reduced play and brushing behaviour often provide the first indications of a painful joint disease. Conservative therapy is the first choice in many cases. A combination of drugs together with environmental adaptation should lead to an improvement in symptoms and thus quality of life. Possible surgical treatment includes, for example, the removal of irritating joint mice with arthroscopy or arthrotomy. A femoral head neck resection or, more and more frequently, a cemented hip joint prosthesis are suitable options in cases of painful, therapy-resistant coxarthroses.
... Feline osteoarthritis (OA) has a high radiographic prevalence that increases with age [1], and is increasingly recognized as an important cause of pain and loss of physical function [2,3]. Improvements have been reported in mobility (e.g., jumping) and activity [4][5][6][7][8][9][10], lameness/stiffness [5,11], mood [6,9,11], and self-grooming [6] of cats with degenerative joint disease (DJD) including OA, in response to treatment with a non-steroidal anti-inflammatory drug, meloxicam [4][5][6]8,11] or robenacoxib [9], or a therapeutic diet [7]. ...
... One study found that OA cats receiving dietary supplementation with long-chain omega-3 fatty acids showed improved mobility vs. placebo [12]. However, the rate of diagnosis of this disease in the feline population appears to be low in relation to its radiographic prevalence [13], and physical examination findings (e.g., lameness, abnormalities upon palpation) do not necessarily correlate with radiographic signs [3,4,14]. Recent studies suggest that palpable abnormalities or pain are poorly sensitive for radiographic DJD in most joints (excepting the elbow, and lumbar and lumbosacral spine) [14], and the prevalence of radiographic signs in painful joints ranges from 33% [5] in one study to 85% in another [4]. ...
Article
Full-text available
Subtle signs and conflicting physical and radiographic findings make feline osteoarthritis (OA) challenging to diagnose. A physical examination-based assessment was developed, consisting of eight items: Interaction, Exploration, Posture, Gait, Body Condition, Coat and Claws, (joint) Palpation-Findings, and Palpation-Cat Reaction. Content (experts) and face (veterinary students) validity were excellent. Construct validity, internal consistency, and intra- and inter-rater reliability were assessed via a pilot and main study, using laboratory-housed cats with and without OA. Gait distinguished OA status in the pilot ( p = 0.05) study. In the main study, no scale item achieved statistically significant OA detection. Forelimb peak vertical ground reaction force (PVF) correlated inversely with Gait (Rho s = -0.38 ( p = 0.03) to -0.41 ( p = 0.02)). Body Posture correlated with Gait, and inversely with forelimb PVF at two of three time points (Rho s = -0.38 ( p = 0.03) to -0.43 ( p = 0.01)). Palpation (Findings, Cat Reaction) did not distinguish OA from non-OA cats. Palpation-Cat Reaction (Forelimbs) correlated inversely with forelimb PVF at two time points (Rho s = -0.41 ( p = 0.02) to -0.41 ( p = 0.01)), but scores were highly variable, and poorly reliable. Gait and Posture require improved sensitivity, and Palpation should be interpreted cautiously, in diagnosing feline OA.
... In dogs, it affects approximately 20% of those over the age of 1 year [2]. OA is also very common in elderly domesticated cats, its prevalence being greater than 50% [3]. Clinical signs (i.e., lameness, stiffness, behavioral and lifestyle changes) are largely related to persistent and chronic pain [1][2][3], i.e. a mixed phenomenon involving both inflammatory and neuropathic mechanisms at the peripheral (joint) and central (spinal and supraspinal) levels [4]. ...
... OA is also very common in elderly domesticated cats, its prevalence being greater than 50% [3]. Clinical signs (i.e., lameness, stiffness, behavioral and lifestyle changes) are largely related to persistent and chronic pain [1][2][3], i.e. a mixed phenomenon involving both inflammatory and neuropathic mechanisms at the peripheral (joint) and central (spinal and supraspinal) levels [4]. Currently, the most frequently used analgesics for canine and feline OA are non-steroidal anti-inflammatory drugs (NSAIDs) [4]. ...
Article
Full-text available
Background Osteoarthritis (OA) is a common progressive joint disease in dogs and cats. The goal of OA treatment is to reduce inflammation, minimize pain, and maintain joint function. Currently, non-steroidal anti-inflammatory drugs (e.g., meloxicam) are the cornerstone of treatment for OA pain, but side effects with long-term use pose important challenges to veterinary practitioners when dealing with OA pain. Palmitoylethanolamide (PEA) is a naturally-occurring fatty acid amide, locally produced on demand by tissues in response to stress. PEA endogenous levels change during inflammatory and painful conditions, including OA, i.e., they are typically increased during acute conditions and decreased in chronic inflammation. Systemic treatment with PEA has anti-inflammatory and pain-relieving effects in several disorders, yet data are lacking in OA. Here we tested a new composite, i.e., PEA co-ultramicronized with the natural antioxidant quercetin (PEA-Q), administered orally in two different rat models of inflammatory and OA pain, namely carrageenan paw oedema and sodium monoiodoacetate (MIA)-induced OA. Oral treatment with meloxicam was used as benchmark. Results PEA-Q decreased inflammatory and hyperalgesic responses induced by carrageenan injection, as shown by: (i) paw oedema reduction, (ii) decreased severity in histological inflammatory score, (iii) reduced activity of myeloperoxidase, i.e., a marker of inflammatory cell infiltration, and (iv) decreased thermal hyperalgesia. Overall PEA-Q showed superior effects compared to meloxicam. In MIA-treated animals, PEA-Q exerted the following effects: (i) reduced mechanical allodynia and improved locomotor function, (ii) protected cartilage against MIA-induced histological damage, and (iii) counteracted the increased serum concentration of tumor necrosis factor alpha, interleukin 1 beta, metalloproteases 1, 3, 9 and nerve growth factor. The magnitude of these effects was comparable to, or even greater than, those of meloxicam. Conclusion The present findings shed new light on some of the inflammatory and nociceptive pathways and mediators targeted by PEA-Q and confirm its anti-inflammatory and pain-relieving effects in rodent OA pain models. The translatability of these observations to canine and feline OA pain is currently under investigation.
... Assessment of gait is particularly challenging in cats because they do not like to move around in unfamiliar surroundings and need time to acclimatize. Furthermore, cats often adopt a crouched position in the consulting room, making it even more difficult to evaluate gait [4,5]. Much effort has been made to establish objective outcome measurements in cats [6][7][8][9][10][11]. ...
... Historically, lameness was considered uncommon in cats and a rare reason for a visit to a veterinary hospital [4,5]. However even if pathological changes on radiographs are common in cats [16][17][18][19], it is an infrequent cause of lameness [17]. ...
Article
Full-text available
Detection of lameness in cats can be very time-consuming and frustrating. Feline studies have shown that the success of treatment can be evaluated by measurement of the ground reaction force (GRF). However, the possibility of multiple limb involvement or the presence of a compensatory mechanism has not been investigated. Furthermore, there has been no research in cats on possible differences in GRFs between those with stifle problems and those with hip problems, as reported in dogs. In this study, we compared temporospatial parameters and GRFs in 20 lame cats after femoral head and neck ostectomy (FHO) or stifle disease to those in 15 healthy cats. An orthopedic examination was performed in all cats and radiographs were obtained to confirm the disease. GRFs, including peak vertical force (PFz), vertical impulse (IFz), time to PFz, and temporospatial parameters, including step length, paw contact area, and stance phase duration, were calculated. We also calculated the symmetry index (SI) in the forelimbs and hind limbs. The GRFs were normalized to total force (% TF). We found that the IFz (% TF) and PFz (% TF) were lower in the affected limb than in the other limbs in the lame cats. When the lame cats were compared with the sound cats, this difference was only significant for IFz (% TF). The SI values for the PFz and IFz were significantly higher in the hind limbs than in the forelimbs in the lame cats group but there was no difference in the SI according to whether the problem was in the hip or stifle. There were also differences in stance phase duration and paw contact area in both the forelimbs and hind limbs between the sound group and the lame group. There was no difference in PFZ (% TF) or IFZ (% TF) in the affected limb between the lame cats with stifle and those after FHO; however, there were changes in time to PFz and step length. In conclusion, mild to moderate lameness can be detected and measured in cats using pressure plates. The compensatory mechanisms in cats at a walk appear to involve shifting the weight to the other three legs without favoring either the contralateral or the diagonal limb.
... Assessment of gait is particularly challenging in cats because they do not like to move around in unfamiliar surroundings and need time to acclimatize. Furthermore, cats often adopt a crouched position in the consulting room, making it even more difficult to evaluate gait [4,5]. Much effort has been made to establish objective outcome measurements in cats [6][7][8][9][10][11]. ...
... Historically, lameness was considered uncommon in cats and a rare reason for a visit to a veterinary hospital [4,5]. However even if pathological changes on radiographs are common in cats [16][17][18][19], it is an infrequent cause of lameness [17]. ...
Article
Detection of lameness in cats can be very time-consuming and frustrating. Feline studies have shown that the success of treatment can be evaluated by measurement of the ground reaction force (GRF). However, the possibility of multiple limb involvement or the presence of a compensatory mechanism has not been investigated. Furthermore, there has been no research in cats on possible differences in GRFs between those with stifle problems and those with hip problems, as reported in dogs. In this study, we compared temporospatial parameters and GRFs in 20 lame cats after femoral head and neck ostectomy (FHO) or stifle disease to those in 15 healthy cats. An orthopedic examination was performed in all cats and radiographs were obtained to confirm the disease. GRFs, including peak vertical force (PFz), vertical impulse (IFz), time to PFz, and temporospatial parameters, including step length, paw contact area, and stance phase duration, were calculated. We also calculated the symmetry index (SI) in the forelimbs and hind limbs. The GRFs were normalized to total force (% TF). We found that the IFz (% TF) and PFz (% TF) were lower in the affected limb than in the other limbs in the lame cats. When the lame cats were compared with the sound cats, this difference was only significant for IFz (% TF). The SI values for the PFz and IFz were significantly higher in the hind limbs than in the forelimbs in the lame cats group but there was no difference in the SI according to whether the problem was in the hip or stifle. There were also differences in stance phase duration and paw contact area in both the fore-limbs and hind limbs between the sound group and the lame group. There was no difference in PF Z (% TF) or IF Z (% TF) in the affected limb between the lame cats with stifle and those after FHO; however, there were changes in time to PFz and step length. In conclusion, mild to moderate lameness can be detected and measured in cats using pressure plates. The compensatory mechanisms in cats at a walk appear to involve shifting the weight to the other three legs without favoring either the contralateral or the diagonal limb.
... Osteoarthritis and spondylosis deformans are the two most common forms of degenerative joint disease (DJD) in cats ( Figure 4). 29 Both conditions can cause pain and painassociated behavioral changes. 29,30 Pain can be difficult to identify in cats. ...
... 29 Both conditions can cause pain and painassociated behavioral changes. 29,30 Pain can be difficult to identify in cats. With proper guidance, clients can learn to detect changes in their cat's normal mobility and behavior patterns that are indicative of pain (Table 2). ...
... Osteoarthritis and spondylosis deformans are the two most common forms of degenerative joint disease (DJD) in cats ( Figure 4). 29 Both conditions can cause pain and painassociated behavioral changes. 29,30 Pain can be difficult to identify in cats. ...
... 29 Both conditions can cause pain and painassociated behavioral changes. 29,30 Pain can be difficult to identify in cats. With proper guidance, clients can learn to detect changes in their cat's normal mobility and behavior patterns that are indicative of pain (Table 2). ...
Article
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The ‘2021 AAFP Feline Senior Care Guidelines’ are authored by a Task Force of experts in feline clinical medicine and serve as an update and extension of those published in 2009. They emphasize the individual patient evaluation and the process of aging, with references to other feline practice guidelines for a more complete discussion of specific diseases. Focusing on each cat encourages and empowers the owner to become a part of the cat’s care every step of the way. A comprehensive discussion during the physical examination and history taking allows for tailoring the approach to both the cat and the family involved in the care. Videos and analysis of serial historical measurements are brought into the assessment of each patient. These Guidelines introduce the emerging concept of frailty, with a description and methods of its incorporation into the senior cat assessment. Minimum database diagnostics are discussed, along with recommendations for additional investigative considerations. For example, blood pressure assessment is included as a minimum diagnostic procedure in both apparently healthy and ill cats. Cats age at a much faster rate than humans, so practical timelines for testing frequency are included and suggest an increased frequency of diagnostics with advancing age. The importance of nutrition, as well as senior cat nutritional needs and deficiencies, is considered. Pain is highlighted as its own syndrome, with an emphasis on consideration in every senior cat. The Task Force discusses anesthesia, along with strategies to allow aging cats to be safely anesthetized well into their senior years. The medical concept of quality of life is addressed with the latest information available in veterinary medicine. This includes end of life considerations like palliative and hospice care, as well as recommendations on the establishment of ‘budgets of care’, which greatly influence what can be done for the individual cat. Acknowledgement is given that each cat owner will be different in this regard; and establishing what is reasonable and practical for the individual owner is important. A discussion on euthanasia offers some recommendations to help the owner make a decision that reflects the best interests of the individual cat.
... Osteoarthritis and spondylosis deformans are the two most common forms of degenerative joint disease (DJD) in cats ( Figure 4). 29 Both conditions can cause pain and painassociated behavioral changes. 29,30 Pain can be difficult to identify in cats. ...
... 29 Both conditions can cause pain and painassociated behavioral changes. 29,30 Pain can be difficult to identify in cats. With proper guidance, clients can learn to detect changes in their cat's normal mobility and behavior patterns that are indicative of pain (Table 2). ...
... A simple questionnairebased tool, by which the owner assesses changes in their cat's behavior/lifestyle, has been useful for identifying chronic musculoskeletal pain in their pets (32). Although these methods may detect the possibility of morbidity of feline OA, orthopedic diagnosis and localization still depends on radiography in cats (33). ...
Article
Full-text available
Feline degenerative joint disease (DJD) has been reported worldwide. Radiographic evidence, including that from single-plane radiographs, has been used for diagnosis in these reports, though orthogonal radiographs are generally required to diagnose DJD. However, more orthogonal radiographs are required for diagnosis. In this study, we investigated how many orthogonal radiographs are necessary to diagnose feline DJD among domestic short-haired cats. We analyzed the data from 101 cats for which the owners requested screening for arthritis. Orthogonal radiographs of appendicular and intervertebral joints were taken from the chest to the caudal side. Radiographs were then reviewed and graded by severity of DJD in each joint. Radiographic evidence of appendicular DJD was detected in 74.26% of 101 cats, of which 40.59% had intervertebral DJD (typically of the lumbosacral joint). Appendicular DJD was most common in elbow joints. Lameness was recognized by an owner of two cats and was diagnosed by a veterinarian in two cats. No obvious pain was detected on palpation in any cats with appendicular osteoarthritis, but lumbosacral DJD was associated with back pain in seven cases. Aging was associated with radiographic evidence of DJD: radiographic evidence of DJD was observed in most older domestic short-haired cats. Most cases without lumbosacral DJD had no obvious symptoms. As the lifespan of cats increases due to better lifestyles, diet, and medical treatment, lumbosacral DJD, which is more likely in older cats, may become an increasingly important clinical problem. In addition, orthogonal radiograph must be taken to make diagnosis for appendicular joint DJD especially hip and stifle joint.
... In general, older cats are more likely to have osteoarthritis, which may alter mobility, activity level, grooming habits, and temperament. 12 It has been documented previously that 68.8% of cats with CKD also have degenerative joint disease as a comorbidity. 13 Although none of the cats had clinical signs of lameness, joint pain, or joint effusion on physical examination, the presence of subclinical orthopedic disease may have decreased the time that affected cats spent in cover-up activity. ...
Article
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Background: Urinary disorders in cats often require subjective caregiver quantification of clinical signs to establish a diagnosis and monitor therapeutic outcomes. Objective: To investigate use of a video recording system (VRS) to better assess and quantify urination behaviors in cats. Animals: Eleven healthy cats and 8 cats with disorders potentially associated with abnormal urination patterns. Methods: Prospective study design. Litter box urination behaviors were quantified with a VRS for 14 days and compared to daily caregiver observations. Video recordings were analyzed by a behavior analysis software program. Results: The mean number of urinations per day detected by VRS (2.5 ± 0.7) was significantly higher compared with caregiver observations (0.6 ± 0.6; P < .0001). Five cats were never observed in the litter box by their caregivers. The mean number of urinations per day detected by VRS was significantly higher for abnormal cats (2.9 ± 0.7) compared with healthy cats (2.1 ± 0.7; P = .02); there were no apparent differences in frequency between these groups reported by caregivers (0.7 ± 1.0 and 0.5 ± 1.0, respectively). There were no differences in mean urination time between healthy and abnormal cats as determined by VRS or caregivers. Mean cover-up time determined by VRS was significantly longer in healthy cats (22.7 ± 12.9 seconds/urination) compared with abnormal cats (8.7 ± 12.9 seconds/urination; P = .03); differences in cover-up time were not detected by caregivers. Conclusions and clinical importance: Caregivers commonly underestimate urination frequency in cats when compared to video-based observations. Video recording appears to facilitate objective assessment of urination behaviors and could be of value in future clinical studies of urinary disorders in cats.
... Examining the body condition can provide useful information, as changes in the body weight may indicate a severe medical condition or the presence of stress in general (13,30). Inadequate grooming behavior, malnutrition, social conflicts in the group, and chronic diseases are reflected in the coat quality, so it should also be included among the welfare indicators (31), as well as the inability of the animal to move normally due to an injury or a disease (32,33). ...
Article
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The aim of this study was to detect changes in health-oriented welfare indicators of shelter cats housed in a shelter by means of long-term monitoring of health indicators of welfare in a population of group-housed cats in a private, no-kill shelter in the Czech Republic. The cat population housed in a large group was monitored for 1 year. The data recording took place at 2-week intervals. A total of 220 cats were evaluated using a protocol containing eight health-oriented welfare indicators: body condition, third eye visibility, eye discharge, eye irritation, nose discharge, the presence of pathologically induced respiratory sounds, coat condition, and lameness and abnormal posture. The assessment was performed based on the observation by two trained evaluators. The cats' condition was rated on a 5-point scale for each indicator, where the optimal condition was represented by the score of 1 and a severe deterioration by the score of 5 for the given indicator, except for the body condition indicator, where the optimal condition was represented by the score of 3. A deterioration in the score in at least one of the indicators during the stay in the shelter was recorded in 52 (41.6%) of 125 cats that were assessed at least twice. The effect of the LOS, sex and age on the scores for each health indicator was examined via a linear mixed model analysis, as this method allows for handling of dependencies in the data of repeated measurements. The effect of predictors on the third eye visibility scores was not found. The age of cats predicted the coat condition and body condition scores. The LOS predicted scores of the abnormal posture and lameness indicator and scores of a composite index composed of indicators related to upper respiratory tract disease. The results suggest that despite the fact that some improvement of health was documented during the cats' stay in the shelter, there were a non-negligible number of animals experiencing a permanent or long-term deterioration in health. Efforts to minimize the undesirable factors contributing to the deterioration of well-being of cats during their stay in a shelter should be made.
... Osteoarthritis (OA) is a common progressive joint disease in dogs and cats (Johnston, 1997;Bennett et al., 2012). It is currently viewed as a multifactorial disorder in which chondrodegeneration and low-grade, chronic inflammation concurrently contribute to progressive cartilage loss, pain, and joint dysfunction (Robinson et al., 2016). ...
Conference Paper
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Osteoarthritis (OA) is a common multifactorial disorder, chondrodegeneration and low-grade, chronic inflammation concurrently contributing to progressive cartilage loss, pain, and joint dysfunction. Targeting just one of these processes could thus be insufficient to benefit OA patients. Aim: To investigate the effects of the aliamide palmitoyl-glucosamine, micronized alone or co-micronized with the natural antioxidant curcumin, in chondrodegeneration, inflammation and pain. Conclusion: Orally administered, the aliamide palmitoyl-glucosamine effectively and concurrently targets chondrodegeneration, inflammation and pain and even more so if co-micronized with curcumin. The micro-composite PGA-Cur has thus the potential to provide a valuable approach to the complex pathophysiology of OA.
... [1][2][3][4][5][6] Even though it is a common disease, OA is still underdiagnosed and undertreated in cats. 7 Currently the method for diagnosing OA is based on a combination of information from the cat owner, the cat's medical history, and findings from the physical and orthopaedic examination and radiography. The orthopaedic examination in a feline patient is often challenging. ...
Article
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Background Feline osteoarthritis (OA) is a common cause of long-standing pain and physical dysfunction. Performing a physical examination of a cat is often challenging. There is a need for disease-specific questionnaires or the so-called clinical metrology instruments (CMIs) to facilitate diagnosis and evaluation of treatment of feline OA. The CMI provides the owners an assessment of the cat’s behavioural and lifestyle changes in the home environment. The purpose of the study was to evaluate readability, internal consistency, reliability and discriminatory ability of four CMIs. Methods This is a prospective, cross-sectional study with 142 client-owned cats. Feline OA was diagnosed based on medical history, orthopaedic examination and radiography. Results The results indicate that all four instruments have sound readability, internal consistency, are reliable over time and have good discriminatory ability. Preliminary cut-off values with optimal sensitivity and specificity were suggested for each instrument. The osteoarthritic cats showed significant changes in behavioural response to pain during orthopaedic examination, compared with sound cats. Conclusion The results indicate that all four questionnaires make an important contribution in a clinical setting, and that the cat’s behavioural response to pain during physical examination should be a parameter to take into account as a possible indication of chronic pain.
... 1,4 However, in spite of this high prevalence, DJD in cats remains underdiagnosed and undertreated. 5,6 Several reasons for this discrepancy have been suggested, including the decrease in cat visits to the veterinarian and the difficulty of diagnosis. Another reason may be the lower prevalence of singlelimb lameness as a major clinical sign of DJD in cats. ...
Article
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Objectives The aim of this study was to develop an evidence-based, clinically expedient checklist to identify cats likely to have degenerative joint disease (DJD)-associated pain. Methods Data were compiled from previously conducted studies that employed a standardized subjective outcome measure consisting of a series of questions. These studies included a prevalence study (with DJD non-informed owners) and therapeutic trials (with DJD-informed owners). For each cat, and each question, response scores were converted to ‘impaired’ and ‘unimpaired’. Cats were categorized as ‘DJD pain’ and ‘non-DJD’ based on orthopedic pain and radiographic DJD scores. These binary data were compared between cat phenotypes (non-DJD and DJD pain) for each question. Sensitivity and specificity of each question were calculated using the binary data; based on this, potential questions for the checklist were selected. Sensitivity and specificity across this group of questions were calculated, and questions sequentially removed to optimize length, sensitivity and specificity. Finally, the proposed checklist was applied to a novel data set to evaluate its ability to identify cats with DJD pain. Results In total, 249 DJD pain cats and 53 non-DJD cats from five studies were included. Nine questions with adequate sensitivity and specificity were initially identified. Following sequential removal of questions, a checklist with six binary questions was proposed. Based on the data from the cohorts of DJD-informed and DJD non-informed owners, the sensitivity and specificity of the proposed checklist were approximately 99% and 100%, and 55% and 97%, respectively. Conclusions and relevance The proposed checklist represents a data-driven approach to construct a screening checklist for DJD pain in cats. This checklist provides a clinically expedient tool likely to increase veterinarians’ ability to screen for DJD pain in cats. The identified behaviors comprising the checklist may further provide a foundation for increasing awareness of DJD pain among cat owners.
... In cats, osteoarthritis (OA) develops with aging and causes significant chronic pain expressed as gait abnormalities, decreased activity and various behavioral changes (Bennett and Morton, 2009;Lascelles et al., 2010;Slingerland et al., 2011;Benito et al., 2012;Bennett et al., 2012;Klinck et al., 2012). ...
Article
The objective of this pilot study was to investigate central nervous system (CNS) changes related to osteoarthritis (OA)-associated chronic pain in cats using [(18)F]-fluorodeoxyglucose ((18)FDG) positron emission tomography (PET) imaging. The brains of five normal, healthy (non-OA) cats and seven cats with pain associated with naturally occurring OA were imaged using (18)FDG-PET during a standardized mild anesthesia protocol. The PET images were co-registered over a magnetic resonance image of a cat brain segmented into several regions of interest. Brain metabolism was assessed in these regions using standardized uptake values. The brain metabolism in the secondary somatosensory cortex, thalamus and periaqueductal gray matter was increased significantly (P ≤ 0.005) in OA cats compared with non-OA cats. This study indicates that (18)FDG-PET brain imaging in cats is feasible to investigate CNS changes related to chronic pain. The results also suggest that OA is associated with sustained nociceptive inputs and increased activity of the descending modulatory pathways. Copyright © 2015 Elsevier Ltd. All rights reserved.
... While the prevalence of feline osteoarthritis (OA) varies, it is possibly due to dissimilar studies that have involved varying age groups of cats [110]. The primary standard for diagnosing radiographic OA is the occurrence of osteophytes; however, radiographically typical joints can also be affected by articular cartilage pathology; thus, radiographic studies are possible to undervalue the OA prevalence [111]. Nevertheless, while the prevalence of feline OA varies between publications and is likely to be biased for numerous reasons [112][113][114], more like the recent prospective, cross-sectional studies are possible to be less biased [110,115]. ...
Article
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OA is quite common in companion animals, especially in large breed dogs and horses. Collagen, the most abundant protein of mammals, has specific connective tissue types for skin, bones, reticulate, basal lamina, bones, cell surfaces, while type II collagen (UC-II) forms the main structure of cartilage tissue. Even at the smaller dosages, UC-II has also been reported to be more effective than the glucosamine and chondroitin sulfate supplements, which are the supplements most frequently used in the market. In this review, we summarize the effects of UC-II on joint health and function in health and disease conditions in companion animals.
... Perhaps the most common cause of chronic pain in elderly cats is osteoarthritis [37], with neuropathic and cancer pain being poorly assessed [38]. Since >90% of cats aged 12 years or older have evidence of osteoarthritis [39,40], yet it had been diagnosed in only 24.3% of the cats in the current study, this was almost certainly an under-diagnosis, so it may have contributed to more vocalisation than was recognised. ...
Article
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The objectives of this study were to explore owner perception of the causes of increased vocalisation in cats diagnosed with cognitive dysfunction syndrome (CDS) and consider what impact this vocalisation may have on the cat’s household. Owners of cats diagnosed with CDS that presented with increased vocalisation were invited to complete an online survey. The survey consisted of 28 questions including the cat’s signalment, its medical history, and questions pertaining to the owner’s perception of what motivated their cat´s increased vocalisation. This was determined by looking at the cat’s behaviour when vocalising, where it was looking when it was vocalising, and if the vocalisation stopped when the owner interacted with it, e.g., petting or feeding it. The owners were also asked how stressful they found their cat’s vocalisation. There were 37 responses. The majority of owners reported that the main cause of their cat’s vocalisation appeared to be disorientation (40.5%) or attention seeking (40.5%). Seeking a resource such as food was reported in 16.2%, and pain was perceived to be the cause in only 2.7% of cats. However, the majority of owners (64.8%) believed there was >1 cause of their cat’s increased vocalisation. Importantly, when owners were asked how stressful they found their cat’s increased vocalisation, 40.5% scored ≥3 (where 1 = not stressful; 5 = significantly stressful). This study provides novel insight into owner perception of feline CDS, as well as potential causes for increased vocalisation; this will allow veterinarians to better advise owners on how to manage their cat with CDS.
... Proposed cellular mechanisms in DJD are shown in Figure 1.5. Although there is a paucity of feline-specific studies investigating the pathophysiology of DJD, studies to date support these findings (Bennett et al., 2012a, Freire et al., 2014. Cyclo-oxygenase (COX); interleukin (IL); inducible nitric oxide synthase (iNOS); matrix metalloproteinase (MMP); nitric oxide (NO); tissue inhibitor of metalloproteinase (TIMP); tumour necrosis factor α (TNF-α). ...
Thesis
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Degenerative joint disease (DJD) is one of the most common causes of chronic pain in cats. Two studies were designed to identify risk factors for DJD in 6-year-old cats by examining prospective data from a longitudinal cohort study, and compare the activity profiles and quality of life of cats with (cases) and without (controls) early owner-reported signs of impaired mobility using orthopaedic examination, accelerometry and owner-completed questionnaires (Feline Musculoskeletal Pain Index (FMPI), VetMetrica). Binomial logistic regression using backwards elimination identified four risk factors for increased owner- reported mobility impairment score in 6-year-old cats: entire neuter status at six months of age (OR=1.97, 95%CI 1.26–3.07), sustained trauma before six years of age (OR=1.85, 95%CI 1.3–2.6), outdoor access at six years of age (OR=1.67, 95%CI 0.96–2.9), and overweight/obese status at six years of age (OR=1.62, 95%CI 1.13–2.33). Case cats scored significantly lower than control cats for the FMPI (p=0.003) and the VetMetrica domain of comfort (p=0.002), but not vitality (p=0.009) or emotional wellbeing (p=0.018). Total pain (p<0.0001), crepitus (p=0.002) and thickening (p=0.003) scores were higher in case cats. Accelerometry differentiated cases from controls with a 90.9% accuracy. Risk factor analysis demonstrated that obesity, outdoor access, and a history of trauma predispose cats to developing DJD, whereas neutering appears to decrease that risk. Changes in joint health as detected by orthopaedic examination and accelerometry reflected owner-reported mobility changes, differentiating cats with early DJD-related signs from healthy cats, whilst the VetMetrica comfort domain score indicated an impaired quality of life of cats with early DJD compared to healthy cats. Being able to recognise signs of mobility impairment earlier would allow interventions aimed at slowing DJD progression, thereby improving feline health and welfare. These findings have identified that orthopaedic examination, FMPI and accelerometry are effective in identifying early DJD-related mobility changes in cats.
... However, it is important to highlight the underdiagnosis of the disease associated with the lack of signs such as lameness and a lower radiographic identification. This is in addition to its difficult physical examination by clinicians [12]. Furthermore, the treatment of OA is a major challenge in this specie, related to reduced availability of drugs as well as increased adverse effects and complications [13]. ...
Article
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Glucosamine and chondroitin sulfate have been proposed due to their physiological and functional benefits in the management of osteoarthritis in companion animals. However, the scientific evidence for their use is still controversial. The purpose of this review was to critically elucidate the efficacy of these nutraceutical therapies in delaying the progression of osteoarthritis, evaluating their impact on the synovial knee joint tissues and biochemical markers in preclinical studies by systematically reviewing the last two decades of peer-reviewed publications on experimental osteoarthritis. Three databases (PubMed, Scopus and, Web of Science) were screened for eligible studies. Twenty-two articles were included in the review. Preclinical studies showed a great heterogeneity among the experimental designs and their outcomes. Generally, the evaluated nutraceuticals, alone or in combination, did not seem to prevent the subchondral bone changes, the synovial inflammation or the osteophyte formation. However, further experimental studies may be needed to evaluate their effect at those levels. Regarding the cartilage status and biomarkers, positive responses were identified in approximately half of the evaluated articles. Furthermore, beneficial effects were associated with the pre-emptive administrations, higher doses and, multimodality approaches with some combined therapies. However, additional studies in the long term and with good quality and systematic design are required.
... A detailed musculoskeletal examination to detect signs of osteoarthritis is critical as this condition is one of the most significant and underdiagnosed diseases in cats. 23,28 A fundic examination is key to detecting signs of ophthalmic disease or hypertension. 29 Practices should employ a validated pain assessment scale or tool to diagnose, monitor, and assist in the evaluation of patients for subtle signs of pain. ...
Article
Full-text available
The guidelines, authored by a Task Force of experts in feline clinical medicine, are an update and extension of the AAFP–AAHA Feline Life Stage Guidelines published in 2010. The guidelines are published simultaneously in the Journal of Feline Medicine and Surgery (volume 23, issue 3, pages 211–233, DOI: 10.1177/1098612X21993657) and the Journal of the American Animal Hospital Association (volume 57, issue 2, pages 51–72, DOI: 10.5326/JAAHA-MS-7189). A noteworthy change from the earlier guidelines is the division of the cat’s lifespan into a five-stage grouping with four distinct age-related stages (kitten, young adult, mature adult, and senior) as well as an end-of-life stage, instead of the previous six. This simplified grouping is consistent with how pet owners generally perceive their cat’s maturation and aging process, and provides a readily understood basis for an evolving, individualized, lifelong feline healthcare strategy. The guidelines include a comprehensive table on the components of a feline wellness visit that provides a framework for systematically implementing an individualized life stage approach to feline healthcare. Included are recommendations for managing the most critical health-related factors in relation to a cat’s life stage. These recommendations are further explained in the following categories: behavior and environmental needs; elimination; life stage nutrition and weight management; oral health; parasite control; vaccination; zoonoses and human safety; and recommended diagnostics based on life stage. A discussion on overcoming barriers to veterinary visits by cat owners offers practical advice on one of the most challenging aspects of delivering regular feline healthcare.
... As in other mammals, it causes chronic pain and physical disability. It is a challenge to diagnose OA in cats since they appear to have an innate ability to disguise injury and disease, particularly in unfamiliar surroundings, such as the clinical examination room [6,7]. Furthermore, the cat demonstrates non-specific clinical signs, such as being less active [1,3,[8][9][10]. ...
Article
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Background Osteoarthritis (OA) is a common cause of chronic pain and dysfunction in older cats. The majority of cats with OA do not show signs of overt lameness, yet cats with orthopaedic disease are known to redistribute their body weight from the affected limb. OA can cause changes in the cat’s behaviour, which is often misinterpreted as signs of aging. The aim of the present study was to investigate if cats with a previous cranial cruciate ligament (CCL) injury perform differently on the pressure mat and exhibit different behaviour compared to sound cats according to the owner´s subjective assessment. Ten cats with a previous CCL injury were assessed with a pressure mat system and their owners were asked to complete an assessment questionnaire. The results were compared to those of 15 sound cats, matched to have the same weight and body condition score. ResultsThe front/hind limb index for peak vertical force (PVF) was significantly higher for CCL cats, and there was a decreased PVF and vertical impulse (VI) on the affected hindlimb compared to the unaffected one. The results indicate that cats with a previous CCL injury put less weight, on the affected hindlimb but for a longer time. There was a significantly higher owner assessment questionnaire score for the group of cats with CCL injury compared to sound cats. Conclusions Cats with a previous CCL injury have a different gait pattern compared to sound cats and a different behaviour according to owner subjective assessment. It is of great importance that further studies are performed to investigate the long term effects of CCL injury as a cause of pain and physical dysfunction, and its role in the development of OA in cats. Improved assessment tools for chronic pain caused by OA in cats are needed, both to facilitate diagnosis and to evaluate pain-relieving treatment.
... A detailed musculoskeletal examination to detect signs of osteoarthritis is critical as this condition is one of the most significant and underdiagnosed diseases in cats. 23,28 A fundic examination is key to detecting signs of ophthalmic disease or hypertension. 29 Practices should employ a validated pain assessment scale or tool to diagnose, monitor, and assist in the evaluation of patients for subtle signs of pain. ...
Article
Full-text available
The guidelines, authored by a Task Force of experts in feline clinical medicine, are an update and extension of the AAFP–AAHA Feline Life Stage Guidelines published in 2010. The guidelines are published simultaneously in the Journal of Feline Medicine and Surgery (volume 23, issue 3, pages 211–233, DOI: 10.1177/1098612X21993657) and the Journal of the American Animal Hospital Association (volume 57, issue 2, pages 51–72, DOI: 10.5326/JAAHA-MS-7189). A noteworthy change from the earlier guidelines is the division of the cat’s lifespan into a five-stage grouping with four distinct age-related stages (kitten, young adult, mature adult, and senior) as well as an end-of-life stage, instead of the previous six. This simplified grouping is consistent with how pet owners generally perceive their cat’s maturation and aging process, and provides a readily understood basis for an evolving, individualized, lifelong feline healthcare strategy. The guidelines include a comprehensive table on the components of a feline wellness visit that provides a framework for systematically implementing an individualized life stage approach to feline healthcare. Included are recommendations for managing the most critical health-related factors in relation to a cat’s life stage. These recommendations are further explained in the following categories: behavior and environmental needs; elimination; life stage nutrition and weight management; oral health; parasite control; vaccination; zoonoses and human safety; and recommended diagnostics based on life stage. A discussion on overcoming barriers to veterinary visits by cat owners offers practical advice on one of the most challenging aspects of delivering regular feline healthcare.
Conference Paper
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Introduction: Several cases report histopathologic evidence of necrosis in the adrenal parenchyma following treatment with trilostane.1 Moreover, modifications of the echotexture of adrenal parenchyma in dogs treated with trilostane have been reported.2,3 Aim: We hypothesized that contrast-enhanced ultrasonography (CEUS) can might show necrotic areas in patients treated with trilostane. Materials and Methods: Five client-owned dogs with untreated ACTH-dependent hyperadrenocorticism (ADHAC) were included in the study. CEUS of both AGs was performed according to a previously described method4 with intravenous injections of SonovueC � . Dogs were presented at the endocrinology consultation at the diagnostic time and for control of trilostane treatment over 6 to 12 months. The starting dose was between 0.5 to 1.5 mg/kg twice daily and was then adapted. At each control time, an ACTH stimulation test, Na+, K+, urea, and creatininemia dosage were performed. Ultrasonography (US) and CEUS were performed at diagnosis and after 6 to 12 months. Blood results were confronted with CEUS and US findings. Results: The height of the caudal poles of the left and right adrenal glands measured 7.7 ± 1.9 mm at diagnosis, and was 8.5 ± 2.1 mm after 6 to 12 months. Besides diffuse enlargement, no US changes were observed in adrenal echogenicity, echotexture or contours. On CEUS, there was no difference observed in enhancing pattern between diagnosis and control times in four of five dogs. In one patient, a large central band in the left adrenal gland did not show any contrast uptake during all CEUS examinations, whereas adjacent adrenal parenchyma displayed a normal enhancement. On blood work, only the former patient presented a relapse and failure to respond to trilostane treatment, as clinical signs of ADHAC were present and post-ACTH cortisol was too high. No clinically relevant abnormalities were observed in blood work of other patients. Although there is no histological evidence of adrenal necrosis in this relapsing patient, the absence of contrast uptake on CEUS is strongly suggestive of necrosis. Whether or not the adrenal necrosis is due to trilostane administration or repeated ACTH injections remains unclear. Conclusion: A larger study might assess whether CEUS is a reliable technique to monitor and screen those patients for adrenal necrosis. References: 1. Ramsey IK. Trilostane in dogs. Vet Clin Small Anim 2010;40:269–283. 2. Ruckstuhl NS, Nett CS, Reusch CE. Results of clinical examinations, laboratory tests, and ultrasonography in dogs with pituitary-dependent hyperadrenocorticism treated with trilostane. Am J Vet Res 2002;63:506–512. 3. Mantis P, Lamb CR, Witt AL, Neiger R. Changes in ultrasonographic appearance of adrenal glands in dogs with pituitary-dependent hyperadrenocorticism treatedwith trilostane. Vet Radiol Ultrasound 2003;44:682–685. 4. Pey P, Vignoli M, Haers H, Duchateau L, Rossi F, Saunders JH. Contrast-enhanced ultrasonography of the normal canine adrenal gland. Vet Radiol Ultrasound 2011;52:560– 567.
Article
Osteoarthritis (OA) is a debilitating condition affecting up to 20% of canine and 60% of feline patients. While diagnosis is fairly straightforward, the aetiology behind the disease process, and therefore the treatment strategies, is not. Multimodal management is the mainstay of controlling clinical signs and ensuring patient comfort, however this involves potentially long-term pharmacological and dietary control, and requires significant client compliance. Research into disease pathogenesis and treatment strategies is ongoing but evidence, especially relating to many therapies and nutritional supplements, is currently lacking. Genetic research continues, as does that into mesenchymal stem cell therapy and cartilage repair and regeneration, but clinical ‘cure’ remains a distant objective. This series of two articles aims to briefly cover the basic concepts relating to OA and its management, and some new treatment strategies will be discussed. The hope is that by presenting the basic facts and concepts, th...
Chapter
This chapter discusses the recognition and assessment of acute (adaptive) and chronic (maladaptive) pain in cats. Cats express their pain-induced behavior in a unique manner. In this chapter, we will address the most common causes and behavioral signs of acute and chronic pain in this species. A user-friendly, dynamic and interactive approach for assessment of pain in cats is described including the use of validated pain scoring systems. Factors that may influence recognition of pain are discussed.
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Osteoarthritis is a progressive condition that causes degeneration of the articular cartilage. Although the condition is painful, it can be difficult to diagnose in cats because of the cat's ability to hide pain. Owners can be made aware of the signs of osteoarthritis, and this could help to enable a diagnosis, which will then enable symptoms of pain to be alleviated. Meloxicam is the only NSAID licensed for long-term use in cats, and has been shown to be an effective form of pain relief for cats with osteoarthritis. The addition of glucosamine to the cat's diet may help with the re-building of cartilage. The veterinary nurse plays an important role in educating cat owners with respect to the changes in the cat's behaviour that are indicative of osteoarthritis, and through the suggestion of simple changes in the home that can improve the cat's quality of life.
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Elbow degenerative joint disease is the most common cause of non-traumatic thoracic limb lameness in the cat. Medial epicondylitis is also being diagnosed with increasing frequency. Lameness originating from the shoulder is not as common in cats as in dogs but shoulder joint dysplasia has been described. Radiographic signs can be subtle or even absent in the early stages of disease and repeat imaging or alternative forms of imaging may be required to facilitate a diagnosis. Many cases respond to non-surgical treatment but surgical options are available for those cases where discomfort persists.
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Pain is characterized by physical discomfort, and typically leads to evasive action and acute mental or emotional distress or suffering. It negatively affects quality of life, induces behavioral changes, and causes unnecessary fear, anxiety, and stress. Pain is classified as acute or chronic, localized or generalized, and adaptive or maladaptive, and an individual may experience several types of pain concurrently. Commonly used systems for assessing pain include simple descriptive scales, numeric rating scales, and visual analog scales (VAS). Recognition of pain in cats is complex. It involves learning to recognize covert as well as overt signs of pain. Humans show large individual variation in responses to pain and its treatment and the same is probably true for cats. Thus, it is important to assess each cat as an individual.
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Recent advances in pain assessment in companion animals represent a tenacious, painstaking and time-consuming dedication to improving animal welfare. Attitudes and knowledge about pain assessment, particularly in cats, have changed dramatically in the past few decades, representing a very obvious shift to prioritising analgesia, which is important from an ethical and humane standpoint. Time for training and practising pain assessment must be created in the veterinary team, to ensure consistency for intervention and improving practice. Adopting pain assessment as one of the ‘vital signs’ in the hospitalised patient evaluation is a progressive and necessary step. Discussing pain assessment with cat owners, and providing resources about pain assessment, will optimise welfare, strengthen the human-animal bond and ultimately improve the client-practice relationship and reputation.
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Elbow osteoarthritis (OA) is common in cats and radiography is typically used for diagnosis. However computed tomography (CT), with its multiplanar three-dimensional characteristics, could have significant advantages for assessment of OA compared to radiography, particularly early in the disease process. The study objectives were to compare radiography and CT to histologic OA changes, investigate the stage of OA that radiography and CT detect, and search for specific changes in CT images strongly predictive for feline elbow OA. Right elbows from 29 cats were evaluated by radiography and CT, and articular cartilage lesions graded histologically and macroscopically. Three further joints were sampled to specifically evaluate the morphology of the anconeal process. Macroscopic, radiographic and CT OA diagnosis were compared to the reference standard histologic OA that was divided into mild, moderate and severe. Osteophytic spurs on the lateral margin of the anconeal process could be reliably measured in CT images (intra-class correlation 0.79) and when ≥0.5 mm had high sensitivity for moderate/severe histologic OA, moderate sensitivity for mild histologic OA and high specificity for all stages of OA. In moderate/severe histologic OA both radiography and CT subjective OA diagnosis had moderate to very high sensitivity. However, in mild histologic OA CT grading had low sensitivity and radiography did not detect OA. In conclusion, CT of the feline elbow including measurement of osteophytes on the anconeal process lateral margin is superior to radiography for OA detection and should be considered for OA diagnosis, particularly when mild OA changes are of interest.
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The companion animal population is continuing to live longer, with approximately 40% of pet dogs and cats aged 7 years or older. Continued improvements in veterinary care and disease prevention strategies, veterinary nutrition, breeding and husbandry are just a few of the factors contributing to pet longevity, resulting in a significant population of senior small companion animals. This article considers the most common causes of weight loss in the older cat through review of the definitions and pathophysiology of muscle loss, and examining the most common concurrent metabolic and endocrine diseases associated with weight loss in the older feline patient.
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Osteoarthritis is a painful, incurable disease which can affect the mobility and quality of life of the cats suffering from it. Osteoarthritis mainly affects the hips, stifles and elbows. The presence of osteoarthritis is diagnosed by radiographs which can identify osteophytes that form around the surrounding joint. This debilitating disease is estimated to affect 90% of cats to some degree over the age of 12. The veterinary team can play a huge part on educating owners to recognise behavioural changes in their cat which will assist in identifying osteoarthritis and provide them with various treatment options to improve their mobility and quality of life.
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Chronic pain is subtle and more difficult to recognise in both dog and cat patients. As veterinary nurses, we need to recognise both signs of chronic and neuropathic pain. Low-stress handling techniques should be employed with cats to reduce pain and distress that could exacerbate a pain state. While not many validated chronic pain scales are available for cats, assessment and recognition of feline chronic pain has been well described. Feline chronic pain conditions can be degenerative joint disease (DJD), non-DJD, nonmalignant pain and cancer pain. By learning about various feline chronic pain conditions and evidence-based treatments, we can alert our veterinarians quickly about changes that occur in the patient. One of our primary jobs is to educate owners about chronic pain to improve quality of life for our feline friends.
Chapter
Laser therapy has a firm place as a primary or adjunct treatment modality in feline practice. Cats are notoriously stoic creatures. Therefore, in treating feline patients, it is our duty as veterinarians to perform conscientious pain assessments and prescribe generous analgesia. Laser therapy is a great tool for pain control, especially in such a drug-sensitive species. Cats have many disease processes that they share with other species that respond to photobiomodulation therapy (e.g., arthritis, fracture healing, post-surgical treatment, allergic dermatitis, and otitis). There are also some feline-specific conditions the treatment of which has been greatly improved with laser sessions (e.g., feline acne, hyperesthesia syndrome, eosinophilic granuloma complex, cat-bite abscesses, idiopathic cystitis).
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Feline stifle osteoarthritis (OA) is common, however little is known about the early stages of the disease. Furthermore, the importance of small articular mineralizations (AMs) in feline stifle OA is controversial. This study aimed to describe microscopic articular cartilage lesions and to investigate associations between cartilage lesions and AMs, synovitis, osteochondral junction findings and subchondral bone sclerosis. Stifles of 29 cats, aged 1–23 years and euthanized for reasons other than stifle disease, were examined. Osteochondral tissue and synovial membrane changes were histologically evaluated. Computed tomography and radiography were used for evaluation of AMs. Global cartilage scores (GCS, n = 28) were summarized and joints assigned a histologic OA grade. Minimal to mild histologic OA was seen in 24/28 joints. In 27/29 joints tibial cartilage lesions were seen, whereas femoral lesions were only seen in two joints. Articular mineralizations were detected in 13/29 joints, 11 were small and 12 were located entirely within the medial meniscus. There was no association between GCS and presence or volumes of AMs. However, higher GCS was associated with synovitis (P = 0.001) and age (P < 0.0005). Presence of subchondral bone sclerosis (P < 0.0005) and disruption of the calcified cartilage or tidemark (P < 0.0005) were associated with cartilage lesions. We conclude that the tibial articular cartilage is a common location for histologic OA lesions in cats. Synovitis and changes in the subchondral bone and calcified cartilage may be important in the pathogenesis of feline stifle OA, whereas small AMs likely represent incidental findings.
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Osteoarthritis (OA) is the most common joint disorder leading to significant disability and dysfunction seen by small animal clinicians. While OA and degenerative joint disease (DJD) are often considered as being almost synonymous in dogs, this may not be the case in cats. Current therapy focuses on palliative care, aiming to reduce pain and inflammation and maintain or improve joint function without altering the pathologic process in the tissues. This chapter lists three of the most common false assumptions made by clinicians and owners in the initiation of a management plan for chronic OA pain to emphasize the need for a realistic and scientifically sound approach to pain management. Weight control is essential when dealing with OA. The introduction of diets formulated with high omega-3 polyunsaturated fatty acids (PUFA) is adding a whole new dimension to the management of OA. Analgesic and anti-inflammatory agents are the most common final component in the management of OA.
Article
Abstract Objectives The aim of this study was to determine the presence of protease-activated receptor 2 (PAR2) and matriptase proteins and quantify PAR2 and matriptase mRNA expression in the articular cartilage and synovial membrane of cats with and without osteoarthritis (OA). Methods A total of 28 articular cartilage samples from adult cats (14 OA and 14 normal), 10 synovial membranes from adult cats (five OA and five normal) and three cartilage samples from 9-week-old fetal cats were used. The presence of PAR2 and matriptase in the cartilage and synovial membrane of the adult samples was detected by immunohistochemical (IHC) staining, while real-time PCR was used for mRNA expression analyses in all samples. Results PAR2 was detected in all OA and normal articular cartilage and synovial membrane samples but confined to only a few superficial chondrocytes in the normal samples. Matriptase was only detected in OA articular cartilage and synovial membrane samples. PAR2 and matriptase mRNA expression were, however, detected in all cartilage and synovial membrane samples. PAR2 and matriptase mRNA expression levels in OA articular cartilage were five (P <0.001) and 3.3 (P <0.001) times higher than that of the healthy group, respectively. There was no significant difference (P=0.05) in the OA synovial membrane PAR2 and matriptase mRNA expression compared with the normal samples. Conclusions and relevance Detection of PAR2 and matriptase proteins and gene expression in feline articular tissues is a novel and important finding, and supports the hypothesis that serine proteases are involved in the pathogenesis of feline OA. The consistent presence of PAR2 and matriptase protein in the cytoplasm of OA chondrocytes suggests a possible involvement of proteases in cartilage degradation. Further investigations into the PAR2 and matriptase pathobiology could enhance our understanding of the proteolytic cascades in feline OA, which might lead to the development of novel therapeutic strategies.
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Behavioral changes resulting from chronic (maladaptive) pain are not always easily detected in cats. They may include decreased and or altered mobility, altered interaction with caregivers and other animals, and altered performance of daily living activities. Chronic pain impacts negatively on quality of life and may be associated with various conditions such as degenerative joint disease, cancers, gingivitis, cystitis and persistent postsurgical pain among others. Just as in humans, chronic pain can become a disease in its own right due to plastic changes in the nervous system (neuroplasticity) which may induce central sensitization. Owner-based assessment, which relies mostly on description of the cat's behavior at home, is of utmost importance for recognition of chronic pain in this species.
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La obesidad representa una alteración muy común en la especie felina y, al igual que en la especie humana, se considera el principal factor de riesgo de la diabetes mellitus tipo 2. Los gatos también pueden presentar otros desórdenes asociados a la obesidad que comparten características con el síndrome metabólico humano. Sin embargo, en los gatos no se ha descrito la aterosclerosis, la aparición de la hipertensión no parece guardar relación con la obesidad, y el papel de la diabetes y de la obesidad en el desarrollo de la enfermedad renal crónica es incierto. La ausencia de producción de algunas citoquinas proinflamatorias en el tejido adiposo, la disminución de la enzima convertidora de angiotensina 2 en los depósitos de grasa subcutánea observada en gatos obesos y la corta esperanza de vida de esta especie pueden ser algunos de los mecanismos que contribuyen a que en los gatos no se observen dichas alteraciones. Esta revisión aborda la patogénesis de la obesidad en la especie felina, describiendo cada uno de los factores de riesgo derivados de ésta y centrándose en su comparación con la especie humana.
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Persian cats are a popular cat breed worldwide, and especially in the US, Europe and Asia. This study aimed to describe the demography, common disorders and mortality in Persians under general practice veterinary care in 2013 in the UK. The study population of 285,547 cats overall included 3235 (1.1%) Persians. Mean adult Persian bodyweight was 3.9 kg (SD 0.9) and median age was 7.0 years (IQR 3.3–11.6). At least one disorder was recorded in 2099 (64.9%) Persians. The most common specific disorders were haircoat disorders (411, 12.7%), periodontal disease (365, 11.3%), overgrown nails (234, 7.2%), and ocular discharge (188, 5.8%). The most common disorder groups were dermatological (578, 17.9%), ophthalmological (496, 15.3%) and dental (397, 12.3%). Median longevity was 13.5 years (IQR 9.9–16.0). The most common grouped causes of death were renal disease (102, 23.4%), neoplasia (37, 8.5%) and mass-associated disorder (35, 8.0%). This is the first study to use general practice data to examine the overall health of Persian cats. With haircoat, ocular and dental disorders being the predominant disorders identified, this study highlights the need for increased owner awareness to manage and prevent the typical health problems associated with this breed’s phenotype.
Chapter
This chapter discusses osteoarthritis (OA) in dogs and cats. OA is a syndrome that affects synovial or diarthrodial joints and may manifest its presence by causing pain in association with degeneration of articular cartilage and changes in periarticular soft tissues. It can occur in two forms: primary and secondary, with secondary OA being the more common form presenting clinically in veterinary medicine. Primary OA is considered a “wear and tear” phenomenon of joint degeneration occurring in older patients. Secondary OA is due to an underlying or secondary cause for the development of the disease. Diagnostics are initially directed towards orthogonal view radiographs of the affected joint and should include the contralateral joint for comparative assessment. Nonimaging modalities can be used for more detailed joint evaluation, including computed tomography and magnetic resonance imaging. Current treatment strategies used to treat OA patients are multimodal medical management, surgery or, more commonly, the integration of both treatment modalities.
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Chronic mixed pain and orthopedic dysfunction are the most frequently associated consequences of canine osteoarthritis (OA). An unmet need remains for safe and effective therapies for OA. Palmitoyl-glucosamine (PGA) and curcumin are safe and naturally occurring compounds whose use is limited by poor bioavailability. Micronization is an established technique to increase bioavailability. The aim of this study was to investigate if the dietary supplementation with PGA co-micronized with curcumin (PGA-Cur, 2:1 ratio by mass) could limit pathologic process in two well-established rat models of inflammation and OA pain, i.e., subplantar carrageenan (CAR) and knee injection of sodium monoiodoacetate (MIA), respectively. In CAR-injected animals, a single dose of PGA-cur significantly reduced paw edema and hyperalgesia, as well as tissue damage and neutrophil infiltration. The repeated administration of PGA-Cur three times per week for 21 days, starting the third day after MIA injection resulted in a significant anti-allodynic effect. Protection against cartilage damage and recovery of locomotor function by 45% were also recorded. Finally, PGA-cur significantly counteracted MIA-induced increase in serum levels of TNF-α, IL-1β, NGF, as well as metalloproteases 1, 3, and 9. All the effects of PGA-Cur were superior compared to the compounds used singly. PGA-Cur emerged as a useful dietary intervention for OA.
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To determine the items (question topics) for a subjective instrument to assess degenerative joint disease (DJD)-associated chronic pain in cats and determine the instrument design most appropriate for use by cat owners. 100 randomly selected client-owned cats from 6 months to 20 years old. Cats were evaluated to determine degree of radiographic DJD and signs of pain throughout the skeletal system. Two groups were identified: high DJD pain and low DJD pain. Owner-answered questions about activity and signs of pain were compared between the 2 groups to define items relating to chronic DJD pain. Interviews with 45 cat owners were performed to generate items. Fifty-three cat owners who had not been involved in any other part of the study, 19 veterinarians, and 2 statisticians assessed 6 preliminary instrument designs. 22 cats were selected for each group; 19 important items were identified, resulting in 12 potential items for the instrument; and 3 additional items were identified from owner interviews. Owners and veterinarians selected a 5-point descriptive instrument design over 11-point or visual analogue scale formats. Behaviors relating to activity were substantially different between healthy cats and cats with signs of DJD-associated pain. Fifteen items were identified as being potentially useful, and the preferred instrument design was identified. This information could be used to construct an owner-based questionnaire to assess feline DJD-associated pain. Once validated, such a questionnaire would assist in evaluating potential analgesic treatments for these patients.
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To determine the relationship between degenerative joint disease (DJD) and passive laxity of the hip joint in a group of cats. Prospective study. A select (nonrandomized) group of 78 cats. Standard hip-extended radiographic views and compression and distraction views of the pelvis were obtained from cats during sedation. Radiographs were evaluated, using an Orthopedic Foundation for Animals (OFA)-like scoring system for dogs. Passive joint laxity was measured, using Norberg angle (NA) and distraction index (DI). Hip laxity in cats with DJD was compared with hip laxity in cats without DJD. Hip dysplasia (HD) was subjectively diagnosed radiographically in 25 of 78 (32%) cats using the OFA-like scoring system. Nineteen cats had mild HD 4 had moderate HD, and 2 had severe HD. Fifteen of the 25 cats with HD had DJD. The NA ranged from 56 to 105. The mean NA in cats with DJD was (84 degrees) significantly lower than in cats without DJD (95 degrees). The DI ranged from 0.2 to 0.84. The mean DI for cats with DJD was (0.6) significantly higher than that for cats without DJD (0.49). Cats with a DI < 0.4 did not have DJD. Cats had an increased likelihood of having DJD with increased laxity in the coxofemoral joint, as measured by NA or DI. The mean NA for radiographically normal cats (92.4 degrees) was lower than that in radiographically normal dogs (103 degrees). The overall mean DI for cats in this group (0.51) is similar to dogs of breeds with high joint laxity, such as the Labrador Retriever (0.5). As in dogs, there is a relationship between DJD and laxity in the hip joint of cats.
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To better characterise the bone and joint problems which can develop in Scottish Fold cats. Retrospective study of cases seen in five veterinary clinics and radiographic survey of cats in a cattery. Six Scottish Fold cats (four castrated males, two spayed females) aged between 5 months and 6 years were presented for signs of skeletal disease including lameness, reluctance to jump, a stiff stilted gait, short misshapen distal limbs, swelling of plantar tarsometatarsal regions and short thick inflexible tails. A further four cases (one male, three females, 15 months to 11 years) were identified by radiographic screening of a cattery. A diagnosis of osteochondrodysplasia was based on characteristic radiological findings including irregularity in the size and shape of tarsal, carpal, metatarsal and metacarpal bones, phalanges and caudal vertebrae, narrowed joint spaces, and progressive new bone formation around joints of distal limbs with diffuse osteopenia of adjacent bone. A plantar exostosis caudal to the calcaneus was present in advanced cases. In all nine cases where pedigree information was available, affected cats allegedly originated from the mating of a Scottish Fold to a cat with normal ears. The severity and time of onset of physical signs, and rate of progression and extent of radiographic abnormalities, varied from case to case. Limited histological observations suggested the underlying problem may be an osteochondrodysplasia, related to inadequate cartilage maturation. Clinical signs were ameliorated by administration of pentosan subcutaneously in two of three cats in which it was trailed, and one of these also benefited from an oral glycosaminoglycan preparation. Clinical and radiological findings were ascribed to defective maturation and function of cartilage, particularly in the distal limbs, ears and tail. As all Scottish Fold cats suffered from osteochondrodysplasia of some degree, the best solution would be to avoid using fold-eared cats for breeding and instead use Scottish shorthairs.
Article
The radiographic skeletal form and structure of all cats with mucopolysaccharidosis VI is described. Common manifestations included epiphyseal dysplasia, generalized osteoporosis, abnormal nasal turbinate development, his subluxation, impaired development of skeletal growth, pectus excavatum, hyoid hypoplasia, aplasia, hypoplasia and fragmentation or abnormal ossification of the dens, and aplasia or hypoplasia of frontal and sphenoid sinuses. The skeletal measurements of two affected cats were compared with those of normal, sex-matched littermates, and the measurements of two affected female cats were compared with those of a normal male littermate.
Article
Acromegaly was diagnosed in 14 middle-aged to old cats of mixed breeding. Thirteen (93%) of the cats were male and one was female. The earliest clinical signs in the 14 cats included polyuria, polydipsia, polyphagia, all of which were associated with untreated diabetes mellitus. All developed severe insulin resistance within a few months; peak insulin dosages required to control severe hyperglycemia ranged from 20 to 130 U per day. Other clinical findings weeks to months after diagnosis included enlargement of one or more organs (e.g., liver, heart, kidneys, and tongue) (n = 14), cardiomyopathy (n = 13), increase in body size and weight gain (n = 8), nephropathy associated with azotemia and clinical signs of renal failure (n = 7), degenerative arthropathy (n = 6), and central nervous system signs (i.e., circling and seizures) caused by enlargement of the pituitary tumor (n = 2). The diagnosis of acromegaly was confirmed by demonstration of extremely high basal serum growth hormone concentrations (22 to 131 μg/1) in all cats. Computerized tomography disclosed a mass in the region of the pituitary gland and hypothalamus in five of the six cats in which it was performed. Two cats were treated by cobalt radiotherapy followed by administration of a somatostatin analogue (octreotide), whereas two cats were treated with octreotide alone. Treatment had little to no effect in decreasing serum GH concentrations in any of the cats. Eleven of the 14 cats were euthanized or died four to 42 months (median survival time, 20.5 months) after the onset of acromegaly because of renal failure (n = 2), congestive heart failure (n = 1), concomitant renal failure and congestive heart failure (n = 3), progressive neurologic signs (n = 2), persistent anorexia and lethargy of unknown cause (n - 1), the owner's unwillingness to treat the diabetes mellitus (n = 1), or unknown causes (n = 1). Results of necropsy examination in ten cats revealed a large pituitary acidophil adenoma (n = 10), marked left ventricular and septal hypertrophy (n = 7), dilated cardiomyopathy (n = 1), arthropathy affecting the shoulder, elbow, or stifle (n = 5), and glomerulopathy characterized by expansion of the mesangial matrix and variable periglomerular fi-brosis (n = 10). (Journal of Veterinary Internal Medicine 1990; 4:192–201)
Article
Objective: To determine the prevalence of radiographic signs of degenerative joint disease (DJD) in a randomly selected sample of domestic cats. Study Design: Prospective observational study. Animals: Client-owned cats. Methods: Cats (n=100) from a single practice and equally distributed across 4 age groups (0–5; 5–10; 10–15, and 15–20 years old) were randomly selected (regardless of heath status) and sedated for orthogonal radiographic projections of all joints and the spine. Quasi-Poisson regression analysis was used to investigate the relationship between patient demographics, blood biochemistry, hematologic and urine analysis variables, and DJD severity. Results: Most (92%) cats had radiographic evidence of DJD; 91% had at least 1 site of appendicular DJD and 55% had ≥1 site of axial column DJD. Affected joints in descending order of frequency were hip, stifle, tarsus, and elbow. The thoracic segment of the spine was more frequently affected than the lumbosacral segment. Although many variables were significantly associated with DJD, when variables were combined, only the association between age and DJD was significant (P<.0001). For each 1-year increase in cat age, the expected total DJD score increases by an estimated 13.6% (95% confidence interval: 10.6%, 16.8%). Conclusion: Radiographically visible DJD is very common in domesticated cats, even in young animals and is strongly associated with age. Clinical Relevance: DJD is a common disease of domesticated cats that requires further investigation of its associated clinical signs.
Article
Obesity is characterised by an expansion of white adipose tissue mass that can lead to adverse health effects, such as decreased longevity, diabetes mellitus, orthopaedic and respiratory disease and neoplasia. Once thought a passive fuel depot, adipose tissue is now recognised as an active endocrine organ that communicates with the brain and peripheral tissues by secreting a wide range of hormones and protein factors, collectively termed adipokines. Examples include leptin, adiponectin, cytokines (tumour necrosis factor-alpha, interleukin-6), chemokines, acute phase proteins, haemostatic and haemodynamic factors and neurotrophins. Adipokines can influence various body systems, and perturbation of normal endocrine function is thought central to the development of many associated conditions. This review focuses on the medical consequences of obesity in companion animals, assesses the endocrine function of adipose tissue in disease pathogenesis, and highlights the potential role of adipokines as biomarkers of obesity-associated disease.
Article
To (1) determine prevalence of radiographically detectable meniscal mineralization in domestic cats and (2) to evaluate the association between meniscal mineralization and degenerative joint disease (DJD). Prospective study. Animals: Client-owned cats (n=100) and 30 feline cadavers. Randomly selected client-owned cats were used to determine the prevalence of meniscal mineralization. Stifles from feline cadavers were used to evaluate the relationship between meniscal mineralization (using high-resolution X-ray), radiographic DJD, and cartilage damage. Menisci were evaluated histologically. Forty-six percent of the client-owned cats had meniscal mineralization detected in 1 or both stifles. Pain scores were not significantly different between stifles with meniscal mineralization and those with no radiographic pathology (P=.38). Thirty-four of 57 cadaver stifles had meniscal mineralization, which was always located in the cranial horn of the medial meniscus. Percentage mineralization of the menisci was significantly correlated with the cartilage damage score of the medial femoral (r(2)=0.6; P<.0001) and tibial (r(2)=0.5; P<.0001) condyles as well as with the total joint cartilage damage (r(2)=0.36; P<.0001) score and DJD score (r(2)=0.8; P<.0001). Meniscal mineralization is a common condition in domestic cats and seems to indicate medial compartment DJD. Clinical significance of meniscal mineralization is uncertain. Further work is needed to determine if the meniscal mineralization is a cause, or a consequence of joint degeneration.
Article
To critically review and collate published information on feline degenerative joint disease (DJD) and identify areas in which information is lacking. Critical literature review. Literature search through Pub Med, Commonwealth Agricultural Bureau Abstracts published in the English Language, or translated into English (January 1940-August 2008). Although there are no prospective studies, the prevalence of radiographic DJD appears to be high and can be associated with clinical signs of decreased mobility. There appears to be a mismatch between radiographic and clinical examination findings (pain response). There is little information on the cause of DJD in different joints. There are no fully validated subjective or objective assessment systems for the measurement of chronic DJD-associated pain in the cat. Development of a feline model of chronic DJD-associated pain may speed the development and evaluation of candidate pain-alleviating compounds and treatments. The high prevalence of feline DJD and lack of information about it, suggests further investigation is needed. Feline DJD occurs with high frequency, and yet there is little to guide the clinician on prevention or treatment.
Article
To assess clinical signs and relevance of osteoarthritis (OA) in cats, the radiographic prevalence of OA in the appendicular skeleton of 100 client-owned cats (≥ 6 years old) was assessed. Possible associations between radiographic OA, clinical locomotor system examination, and owner-perceived behavioural changes were evaluated. OA was most prevalent in the shoulders, elbows, hips and tarsal joints with 61% of cats having OA in at least one joint and 48% in more than one joint. Overall, clinical examination of the larger peripheral joints had the highest sensitivity and specificity for radiographic OA. Regression analysis showed age to be related to OA (P = 0.002), as were decreased mobility and grooming (P = 0.008), although there was a correlation with age. Finally, increased inappropriate elimination was associated with OA (P = 0.046). It was concluded that the prevalence of OA in cats is strikingly high and increases with age. OA in cats seems to be associated with behavioural changes.
Article
This study describes the use of a simple questionnaire-based tool to identify behavioural/lifestyle changes that are associated with chronic pain in the cat. These changes were grouped into four behavioural domains (mobility, activity, grooming and temperament). Twenty-three cats with chronic musculoskeletal pain as determined by clinical examination were included. The owners of these cats were asked to complete a questionnaire before and 28 days after the start of analgesic treatment (meloxicam). This included a global assessment of changes in behaviour and assessment of the degree of behavioural change observed within each of the defined domains. The attending veterinary surgeon was independently asked to provide a global score before and after treatment. Both owners and veterinary surgeons reported significant changes in behaviour/lifestyle after analgesic therapy. There was no difference between the owners and veterinary surgeons global assessments at baseline but there was at day 28 (P=0.02). The owners' scores decreased from a median of 5 at baseline to 3 at 28 days (P=0.0004) while the median veterinary surgeon scores decreased from 5 to 2 at 28 days (P<0.0001). There was a statistically significant reduction in the owners' scores for each of the four domains with the greatest reduction occurring in the activity category (P=0.0001). This study shows that owner assessment of changes in their cat's behaviour/lifestyle is an important method of identifying chronic pain in their pets.
Article
An investigation of the aetiology and pathology of deforming cervical spondylosis was carried out in 19 normal, newly-weaned kittens divided into 6 groups. Four groups were fed lean beef and milk. One group served as a control and the remainder were supplemented with vitamin A daily at the rate of 15, 30 and 150 μg./g. body weight, respectively. Two other groups were fed raw liver and milk providing average daily intakes of vitamin A of 17 and 35 μg./g. body weight, respectively. After 24 to 41 weeks, primary lesions developed mainly about the first three diarthrodial joints of the cervical vertebrae in all except the controls and the lowest vitamin A supplemented groups. These consisted of an extensive osseocartilagenous hyperplasia, mainly at the margins of the joints. The trauma resulting from normal head and neck movements of coat licking was regarded as the basis of this predilection site for the lesions. There was marked lipid infiltration involving mainly the reticulohistiocytic cells of the liver, lungs, spleen and hepatic lymph node and of the tubular epithelium of the renal cortex in all cats in the experimental groups. Prominent fading, pale green fluorescence attributable to vitamin A was observed in these organs. Plasma levels and liver and kidney concentrations and reserves of vitamin A were very high. The percentage of the vitamin A stored was highest in the groups fed liver. The vitamin A intake of cats fed raw liver was comparable to that reported to produce chronic hypervitaminosis A in laboratory animals. It is concluded that hypervitaminosis A is the cause of naturally-occurring, deforming cervical spondylosis of the cat.
Article
Results of radiologic and anatomic studies of each cubital articulation (elbow) of a group of 50 adult cat cadavers indicated that a sesamoid bone may be located in a constantly present sesamoid cartilage associated with the tendon of origin of the supinator muscle. Radiography revealed a sesamoid bone in 40 of the 100 tendons of origin of the supinator muscles dissected from the elbows. The sesamoid bone articulated with the craniolateral aspect of the head of the radius, and the larger sesamoid cartilage, which contained the bone, articulated with the head of the radius and the capitulum of the humerus. Of several possible functions of the sesamoid cartilage (bone), it was considered that protection of the craniolateral part of the humeroradial articulation and maintenance of the complex anatomic system during joint movement were important. In radiographic views of the elbows of lame cats, the sesamoid bone should not be mistaken for a chip fracture or an osteocartilaginous loose body.
Article
Long-term changes in the three-dimensional external loading, hind limb kinematics and knee stability were assessed in an anterior cruciate ligament (ACL)-transected cat model of osteoarthritis (OA). Seven skeletally mature cats (mean mass 4.6+/-1.4 kg) were studied before ACL transection (ACLT) and at 1 and 3 weeks, and at 3, 6, 9 and 12 months following ACLT. One week following ACLT, significant changes from the normal locomotion pattern were observed: peak vertical and anterior posterior ground reaction forces were decreased, particularly the peak posterior forces in the early phase of stance. Furthermore, knee angles were reduced by about 15 degrees throughout the whole gait cycle, while ankle and hip angles were reduced at paw off in the experimental compared to the contralateral hind limbs. Ground reaction forces and hind limb kinematics recovered to near pre-surgical patterns over the one year period assessed. ACLT was also associated with an increased knee instability which improved over time. X-rays suggested that there was a continued degeneration in the experimental knee over the one year period; there was osteophyte formation at the joint margins and an increase in cartilage thickness throughout the joint. It was speculated that the more flexed knee angles and the reduced anterior-posterior ground reaction forces in the ACL-transected compared to the intact hind limb represent an adaptive strategy aimed at avoiding excessive anterior displacement of the tibia in the early phase of stance. The recovery of the locomotion pattern with time might be related to the corresponding improvement of knee stability.
Article
The study population consisted of cats presented to the University of Missouri-Columbia Veterinary Medical Teaching Hospital from January 1, 1991 through December 31, 1995. Ventrodorsal radiographs including the pelvic region were evaluated for radiographic evidence of hip dysplasia. Each radiograph was evaluated independently by three board-certified veterinary radiologists and a consensus normal of dysplastic evaluation was determined. There were 684 cats from 12 breeds. The data derived from this study indicate the frequency of feline hip dysplasia in this population to be about 6.6% (45/684) and that the incidence appears to be breed dependent. Also, the radiographic appearance of hip dysplasia in cats is different than in dogs. A shallow acetabulum with remodeling and proliferation involving the cranio-dorsal acetabular margin were the most common radiographic signs. Minimal remodeling of the femoral neck was seen.
Article
To determine prevalence of radiographic evidence of degenerative joint disease (DJD) in geriatric cats. Retrospective study. 100 cats > 12 years of age. One investigator reviewed radiographs and for each articulation (or group of articulations) that was visible assigned a grade of severity (0, 1, 2, 3) for DJD. Another investigator reviewed medical records and recorded signalment, environment, previous disease, diseases evident at time of radiography, FeLV vaccination and infection status, feline immunodeficiency virus serologic status, serum creatinine concentration, serum globulin concentration, and any other important findings. Associations between DJD of grade 2 or 3 and variables recorded from the medical record were determined. Radiographic evidence of DJD was evident in 90% of cats. Neurologic disease was associated with lesions in the lumbosacral portion of the vertebral column. Severe lesions were found in 17% of the elbow joints, but an underlying cause was not determined. Degenerative joint disease was detected radiographically in most geriatric cats and may be an overlooked cause of clinical disease. Clinicians should be alert to the possibility that DJD is associated with neurologic signs.
Article
To study, in vitro, the effect of leptin (OB), alone or in combination with interferon-gamma (IFNgamma), on inducible nitric oxide synthase (iNOS) and NO production in human primary chondrocytes and in mouse embryonic chondrogenic ATDC5 cells. Leptin receptor expression and iNOS messenger RNA expression were evaluated by reverse transcriptase-polymerase chain reaction. Then, iNOS activity was indirectly studied by measuring nitrite accumulation, using the Griess colorimetric reaction, in culture medium of human primary chondrocytes and ATDC5 cells. ATDC5 mouse embryonic cells expressed functional OB receptor. Alone, neither OB nor IFNgamma produced nitrite accumulation in culture medium. However, costimulation with OB and IFNgamma resulted in dose-dependent up-regulation of the expression of iNOS and NO production in human primary chondrocytes and ATDC5 cells. Production of NO was blunted by the iNOS-specific inhibitors L-N(G)-nitroarginine methyl ester and aminoguanidine. In addition, the janus-activated kinase 2 (JAK2)-specific inhibitor Tyrphostin AG 490 completely blocked OB + IFNgamma-driven up-regulation of iNOS and NO production. Our data show for the first time a putative proinflammatory role of OB via iNOS induction and NO production. This occurs via activation of JAK2.
Article
Before recommending a diet for a senior pet, a thorough nutritional evaluation should be completed. Although many middle-aged and older pets are overweight, a large percentage of geriatric cats and dogs have a low BCS. Approximately one third of cats older than 12 years of age may have a decreased ability to digest fat, whereas one in five may have a compromised ability to digest protein. Thus, appropriate diets for these two age groups may differ considerably. Mature (middle-aged) cats would likely benefit from a lower calorie food, whereas geriatric cats (>12 years of age) may need a highly digestible nutrient-dense diet. More than 40% of dogs between the ages of 5 and 10 years are overweight or obese. Such dogs may benefit from diets with lower fat and calories. Senior dogs also have an increased need for dietary protein, however. Therefore, healthy older dogs may benefit from diets with an increased protein-to-calorie ratio, providing a minimum of 25% of calories from protein. Common obesity-related conditions in dogs or cats include DM and OA. Diabetes differs between dogs and cats. Type I diabetes, common in dogs, seems to respond to fiber-enriched diets, whereas type II diabetes, common in cats, seems to benefit from high-protein and low-carbohydrate diets. OA, an inflammatory condition that occurs in approximately 20% of dogs, may benefit from weight management and nutrients that reduce the inflammatory responses, such as long-chain n-3 fatty acids.
Article
To provide basic information about natural feline osteoarthritis (OA) as part of more extensive studies. A retrospective study of cats (greater than one year of age) radiographed for any reason at a first opinion and referral veterinary practice was performed. Cats were classified as either having or not having radiographic OA. Computerised histories were searched for records of potential causes and clinical signs of OA. The genders and ages of the affected cats were compared with a control population using chi-squared tests. Of 491 cats, 292 (59 per cent) had undergone a diagnostic radiograph of at least one synovial joint. Sixty-three of 292 cats (22 per cent) showed evidence of radiographic OA; 21 (33 per cent) of which also had clinically evident OA. A potential cause of OA had been recorded in only seven of 63 cats (11 per cent). The population of cats with radiographic evidence of OA was older than the control population (P<0.001). Radiographic OA was found in 22 per cent of the test population. In many cases there was no clinical evidence of OA recorded in the history, suggesting that either there is little correlation between clinical and radiographic OA or that clinical signs of OA in cats may not have been observed or recorded. Idiopathic/primary OA was common.
Article
The prevalence of radiographic signs of degenerative joint disease (including appendicular osteoarthritis) among a hospital population of 218 cats was 33.9 per cent (74 cats), and the prevalence of signs of appendicular joint osteoarthritis was 16.5 per cent (36 cats). Half of the cases of appendicular joint osteoarthritis had no apparent radiographic or historical cause, and clinical signs of lameness were recorded in only six of them, all of which had an apparent radiographic cause. The 74 cats with radiographic signs of degenerative joint disease were on average significantly older than the 144 cats in which there were no radiographic signs of the disease.
Article
To analyze the distribution of leptin, adiponectin and resistin between paired serum and synovial fluid (SF) samples of patients with osteoarthritis (OA) and to determine the potential sources of these adipokines in the joint. The active free form of leptin was also examined by evaluating the level of the soluble leptin receptor (sOb-R). Levels of adipokines and sOb-R were measured by a sandwich enzyme-linked immunosorbent assay in serum and SF collected from OA patients. The levels of adipokines were also determined in conditioned media from cultured joint tissues (synovium, infrapatellar fat pad, meniscus, osteophyte, cartilage and bone). The adipokines exhibited different patterns of distribution between the joint and the circulating compartment. Serum levels of resistin and adiponectin exceeded those in the paired SF. Conversely, leptin SF concentrations were similar or higher than those measured in serum counterparts. Leptin and adiponectin in SF may derive from each joint tissue examined, whereas resistin was not detected in conditioned media of cultured explants. Synovium and infrapatellar fat pad were the major sources of adipokines, but osteophytes released also large amounts of leptin. The sOb-R deficiency found in SF further increased the difference in the bioactive leptin levels between serum and SF. A gender-specific difference was observed with women exhibiting the highest level of free leptin in the joint. These data demonstrated that adipokines serum levels are not predictive values for SF determination. The joint cavity is a special space where each adipokine undergoes specific regulatory pathways, strengthening the hypothesis that adipokines may have local effects in the joint and may account for the high prevalence of OA in women.
Article
Seventeen cases of feline cranial cruciate ligament rupture are presented. The cases are divided into two groups: those with traumatic multiligamentous damage, and those with isolated cranial cruciate ligament rupture without a history of trauma. The cats that had suffered cruciate ligament rupture were heavier than the general population of cats and there is evidence reported that this injury parallels the degenerative cranial cruciate ruptures seen in overweight small breed dogs. The limited literature on this subject is reviewed including approaches to treatment.
Article
To describe clinical signs and results of treatment in cats with patellar luxation. Retrospective case series. 42 cats in which patellar luxation had been diagnosed on the basis of results of palpation of the stifle joints. Degree of luxation was graded on a scale from 1 to 4, and severity of lameness was graded on a scale from 0 to 5. Radiographs of stifle joints were evaluated for signs of osteoarthritis. Long-term function was classified as poor, fair, good, or excellent. 34 cats had bilateral luxation and 8 had unilateral luxation. Only 7 (17%) cats had a history of trauma. Mean age of the cats was 3.3 years, and mean weight was 4.26 kg (9.4 lb); 26 (62%) were domestic shorthairs. Seventy-three of the 76 (95%) affected joints had medial patellar luxation. Luxation grades could be assigned to 65 joints, with grade 2 (30 joints) and 3 (22 joints) luxation being most common. Lameness grades could be assigned to 73 joints, with grade 1 lameness (27 joints) most common. Outcome was excellent for 8 of 17 joints treated without surgery and for 23 of 35 joints treated surgically. Complications attributable to surgery were reported in 8 cats. Patellar luxation should be considered as a cause of hind limb lameness in cats. Low-grade luxation can be associated with lameness of the same severity as high-grade luxation. Surgical correction of patellar luxation in cats with grade 2 or 3 lameness can result in a favorable outcome.
Article
To identify a cohort of cats with clinical osteoarthritis and to report on the clinical signs, the frequency of joints affected and the possible aetiopathogenesis within this population. Inclusion criteria for this prospective study were presence of historical evidence and/or clinical signs of osteoarthritis, together with radiographic evidence of osteoarthritis. Patients showed clinical improvement within four weeks of analgesic administration and were free from other disease processes, which might explain the clinical signs and/or their response to analgesia. Twenty-eight cases were included in the cohort. The elbow (45 per cent) and the hip (38 per cent) were the most frequently affected joints. Seventy-one per cent of cases had primary/idiopathic aetiology. Alterations in both the ability to jump (71 per cent) and the height (67 per cent) of jump (lifestyle changes) were the most frequent signs of disease. Sixty-one per cent of owners felt that their pet had made a marked improvement following administration of an analgesic/anti-inflammatory drug. There were statistically significant improvements in the ability to jump (P < 0.001), the height of jump (P < 0.001), lameness (P = 0.03), stiff gait (P = 0.04) and the activity level (P = 0.02) when compared with the start and the end of the study period. Osteoarthritis is a clinical problem in cats, but overt lameness is not the most common clinical feature.
Article
There are no validated systems for measuring pain from osteoarthritis in cats. Owner subjective assessments and an activity monitor (AM) can be used to detect pain in cats with osteoarthritis and to assess efficacy of treatments. Thirteen cats older than 10 years old, with owner-assessed decreases in activity, painful arthritic joints, and clinically normal blood work were included and evaluated for 3 weeks. A collar-mounted AM measured activity and a client-specific outcome measure (CSOM) questionnaire characterized the severity of impairment. Overall global quality of life was also evaluated for each treatment. In weeks 2 and 3, meloxicam (0.1 mg/kg, day 1; 0.05 mg/kg, days 2-5) or a placebo was administered in a blinded, randomized, cross-over manner to test the assessment systems. The cats had a median of 4 arthritic appendicular joints. Activity counts for the week when cats (complete data on activity; n=9) were administered meloxicam were significantly higher than at baseline (P = .02) but not after placebo (P = .06). Baseline activity counts were not significantly different from placebo (P = .6). The CSOM data (n=13) showed that owners considered their cats to be more active on meloxicam compared with baseline (P = .001) and placebo (P < .004), and more active on placebo than at baseline (P < .01). Global quality of life improved significantly with meloxicam (P < .042). Both an AM and a CSOM system can detect behavior associated with pain relief in cats that are arthritic. Objective activity data might allow subjective assessment systems to be validated for use in clinical studies.
Article
To evaluate the contribution of leptin (an adipose tissue-derived hormone) to the pathophysiology of osteoarthritis (OA), by determining the level of leptin in both synovial fluid (SF) and cartilage specimens obtained from human joints. We also investigated the effect of leptin on cartilage, using intraarticular injections of leptin in rats. Leptin levels in SF samples obtained from OA patients undergoing either knee replacement surgery or knee arthroscopy were measured by enzyme-linked immunosorbent assay. In addition, histologic sections of articular cartilage and osteophytes obtained during surgery for total knee replacement were graded using the Mankin score, and were immunostained using antibodies to leptin, transforming growth factor beta (TGFbeta), and insulin-like growth factor 1 (IGF-1). For experimental studies, various doses of leptin (10, 30, 100, and 300 microg) were injected into the knee joints of rats. Tibial plateaus were collected and processed for proteoglycan synthesis by radiolabeled sulfate incorporation, and for expression of leptin, its receptor (Ob-Rb), and growth factors by reverse transcriptase-polymerase chain reaction and immunohistochemical analysis. Leptin was observed in SF obtained from human OA-affected joints, and leptin concentrations correlated with the body mass index. Marked expression of the protein was observed in OA cartilage and in osteophytes, while in normal cartilage, few chondrocytes produced leptin. Furthermore, the pattern and level of leptin expression were related to the grade of cartilage destruction and paralleled those of growth factors (IGF-1 and TGFbeta1). Animal studies showed that leptin strongly stimulated anabolic functions of chondrocytes and induced the synthesis of IGF-1 and TGFbeta1 in cartilage at both the messenger RNA and the protein levels. These findings suggest a new peripheral function of leptin as a key regulator of chondrocyte metabolism, and indicate that leptin may play an important role in the pathophysiology of OA.
Textbook of veterinary internal medicine
  • D Bennett
  • Canine
Studies of osteoarthritis in domestic cats (
  • D Godfrey