VN June 2021

Vetnuus | Junie 2021 12 Osteoarthritis (OA), a form of degenerative joint disease (DJD), is the most common cause of chronic pain in mammals, including cats. More than 90% of adult cats may have radiographic evidence of OA, with the presence/severity of disease expected to increase by >10% each year. Pain can be classified as either adaptive (physiologic) or maladaptive (pathologic). Adaptive pain facilitates tissue protection and healing, whereas maladaptive pain negatively impacts health, quality of life (QOL), and behaviour, which can impact the human–animal bond, potentially leading to surrender or euthanasia of the pet. OA is a non-healing disease, with OA-associated pain having no protective benefit; thus, OA causes maladaptive pain that, without treatment, progressively worsens as peripheral and central sensitisation and neuropathic pain develop. Although OA is not curable, if identified and treated early, the progression of the intensity of OA pain can be slowed, providing a prolonged period of controllable pain and good QOL (likely a normal lifespan). Because OA is more common in geriatric cats,OA screening should begin when cats reach 7 to 10 years of age. Key Points • Owners should be educated that cats experience pain from OA, which impacts health, QOL, and behaviour. Behavioural and QOL scores and mobility animations can be useful tools on educating owners how to recognize OA-associated pain (see Education&Diagnostic Tools ). • Using pain-specific questionnaires and performing feline-friendly, OA pain- specific examinations can help expedite a diagnosis of pain (see Education &Diagnostic Tools ). • FelineOApatientsshouldbetreatedwiththedrugsandtechniquescurrently available, but clinicians should stay abreast of futuredata andnewtreatment options as they emerge. RecognisingOA-Associated Pain OA-associated pain may not be obvious—to owners and to veterinary teams. Because cats are evolutionarily both predators and prey, their natural instinct is to hide any vulnerability that could increase predation, including pain. Tools such as checklists, animations, and videos can help owners and veterinary teams accurately recognise and assess pain associatedwith OA in cats. Tools for Owners Although the expected prevalence of OA is similar between dogs and cats, cat owners may be less likely than dog owners to identify pain in their pet. However, educating owners on the prevalence of OA-associated pain and available treatment options maymake owners more likely to bring their cat to the clinic. Owner education starts with an understanding of feline behaviour and mobility. Owners should understand that the clinical signs of OA-associated pain are rarely what is expectedbut the impact of pain (i.e., pain-mediated changes inbehaviour, activity, and mobility) can still be identified. Behaviour and activity changes related to urination/defecation, grooming, and social interactions (with humans and/or other pets) are often indicators of pain and, if not due topain, couldbe due to other conditions that may requiremedical attention. Cats are largely sedentary, making pain-relatedmobility changes challenging to observe. Cats are also often semi-nocturnal, so owners may be sleeping when cats exhibit mobility changes. Feline OA is often idiopathic and bilateral as compared with canine OA, which is primarily secondary and unilateral. Thus, classic limping as exhibited by dogs is unlikely to be exhibited by cats. In addition, cats also spend more time moving vertically (e.g., jumping, climbing) as compared with dogs. Vertical mobility changes, which most owners do not know how to identify, are important indicators of OA-associated pain. Checklists can be useful in a variety of settings, including medical diagnostics. Using checklists with specific pain-related behaviour/activity questions can educate the owner on the potential presence of pain and expedite diagnosis by alerting the clinician to pain-related concerns (see Education&Diagnostic Tools ). Questions on a checklist should focus on the cat’s behaviour and activity. Mobility discussions should centre on the cat’s ability to jump and climb. Videos and animationsmay helpowners understandmobility inpatientswithOA, as the ownermaymore readily identifywith observing the cat inmotion. Detailed animations are available and can be effective diagnostic tools, comparing the movement of a cat with healthy, non-painful joints with a cat with painful osteoarthritic joints as the cats climb up and down stairs, jump up and down, and jump to/from elevated surfaces, among others (see Education &Diagnostic Tools ). Providing mobility animations on the clinic website and/or social media can alsobebeneficial; they can alsobedisplayedonTVor computer screens in the lobby or examination rooms. Infographics describing changes in behaviour-related pain are also available (see Education & Diagnostic Tools ). Clinicians should strive to be a preeminent resource for animal health information. Thus, infographics and questionnaires should be shared on the clinicwebsite and/or social media and hard-copiesmade available in the clinic. Information regarding this material can also be included by audio in the clinic’s on-hold phone recording. Tools for Clinicians I n a study of 90 geriatric cats with radiographic changes of DJD, only 4 had DJD or arthritis mentioned in their medical records. Although radiographic changes do not consistently predict the presence of pain, there is some correlation, and it could therefore be assumed that >4 of these 90 cats were painful.. Identifying feline pain canbe difficult for the clinician if not specifically investigated. Clinicians rarely observe a cat walking at the clinic as commonly occurs with dogs; thus, gait analysis is not typically a normal part of a non-pain–related examination. Feline Osteoarthritis Pain: Tools for Clinicians & Pet Owners Tamara Grubb, DVM, PhD, DACVAA, Washington State University (First published in Clinician’s Brief, September 2020. Reprinted with permission) Article