Osteoarthritis in older cats: The 6 most important treatment options for a better quality of life

Written from a veterinary perspective by Susanne Arndt, veterinarian, medical director and owner, with support from AI

Arthritis in older cats is often mistaken for normal aging.

Arthritis in older cats Osteoarthritis is far more common than many cat owners realize. In a study of geriatric cats, radiologically detectable degenerative changes were found in 90 percent of the animals. Another study found radiological signs of degenerative joint disease in 92 percent of the cats included in the study. These figures should not be interpreted to mean that every older cat is necessarily in severe pain. Radiographic changes and the actual intensity of pain do not always correlate. However, they do demonstrate the importance of considering osteoarthritis in older cats early on.

The typical image of a noticeably limping animal is seen much less frequently in cats than in dogs. Cats are masters at hiding pain and adapting their daily lives to physical limitations. Instead of limping, a cat might only jump onto the sofa after a brief stop. It sleeps longer, moves more cautiously, plays less, or no longer grooms certain areas thoroughly. Some cats become irritable when picked up. Others withdraw or suddenly urinate next to the litter box because the high step has become painful. Therefore, arthritis in older cats often first manifests as a change in behavior.

In my daily work, I regularly encounter cat owners who initially describe changes in their cat's life with the phrase, "She's just getting old." It's precisely at this point that a closer examination is worthwhile. Age alone doesn't automatically cause pain. If a cat jumps less, avoids the stairs, or can no longer reach its previously favorite window seat, arthritis in older cats could be the cause. Appropriate treatment can often restore significantly more quality of life than the owner previously expected.

The following article addresses the six key treatment areas of a peer-reviewed overview published by Kate Barnes in March 2025 and categorizes them for cat owners in Germany, taking into account more recent safety information. Crucially, the multimodal approach is essential: osteoarthritis in older cats is generally not optimally treated with a single measure. Medication, weight management, home modifications, controlled exercise, appropriate nutrition, and, if necessary, surgery must be individually tailored.

How can you recognize arthritis in older cats?

Cat owners should pay particular attention to changes that have developed gradually. These include a reduced willingness to jump, shorter jumps, difficulty climbing stairs, stiff movements after sleeping, and a cautious or hesitant gait. In older cats with arthritis, descending from elevated surfaces may be more impaired than jumping up.

Other possible clues include:

• longer sleep times and less activity,
• Reduced grooming, especially on the back and hindquarters,
• matted or flaky fur,
• Difficulty getting into the litter box,
• Urination or defecation next to the toilet,
• Defensive reactions when petting or picking up,
• less contact with people or other animals,
• less interest in play and hunting movements,
• Unusually long claws because scratching boards are used less frequently,
• a change in sitting or lying position.

None of these signs alone proves osteoarthritis. Similar changes can occur with kidney disease, hyperthyroidism, high blood pressure, toothache, neurological disorders, muscle atrophy, or cognitive changes. This is precisely why osteoarthritis in older cats should not be diagnosed solely based on an internet article or video. The veterinarian's role is to differentiate between possible causes while also considering that an older cat may have multiple health conditions simultaneously.

How is osteoarthritis diagnosed in older cats?

The diagnosis begins with as precise a description of the cat's daily routine as possible. Videos from the familiar environment are particularly helpful for me. A cat often moves differently in the clinic than at home. Fear and tension can mask pain, while some cats simply refuse to move at all in the examination room.

The owner can record several short videos before the appointment:

• Getting up after a rest period,
• Walking on level ground,
• Climb stairs,
• Entering the litter box,
• Jumping to a familiar place,
• Cleaning the back and hind legs.

The examination assesses gait, posture, muscle mass, joint mobility, and any pain responses. A neurological examination is also advisable, as diseases of the spine, nerves, or spinal cord can cause similar symptoms.

X-rays can reveal degenerative changes, bone spurs, misalignments, old injuries, or joint alterations. However, it's important to remember that an abnormal X-ray doesn't automatically prove that the affected joint is causing the current pain. Conversely, a cat can experience significant discomfort even though the radiological changes appear minor. Therefore, diagnosing osteoarthritis in older cats is a combination of factors: history, examination, observation of movement, imaging, and response to controlled treatment.

Before starting long-term drug therapy, blood tests, urine tests, weight checks, and, if necessary, blood pressure measurements are often advisable for senior cats. These tests can help detect kidney problems, liver changes, diabetes, or thyroid disorders, among other things. These findings influence which treatment is suitable for osteoarthritis in older cats and how frequently the cat should be monitored. Senior care guidelines emphasize that older cats should be examined more frequently because diseases often go undetected for a long time and changes can develop more rapidly.

The 6 most important treatments for osteoarthritis in older cats

1. Individual pain therapy

Effective pain management is the foundation of any therapy. A cat that anticipates pain with every movement will move less. This leads to muscle atrophy, joint stabilization, and further mobility loss. Therefore, when treating arthritis in older cats, one should not wait until the cat is noticeably limping or can barely stand.

Nonsteroidal anti-inflammatory drugs

Nonsteroidal anti-inflammatory drugs, often referred to as NSAIDs, can reduce joint pain and inflammation. In cats, depending on the country, approval, product information, and individual situation, medications such as meloxicam or robenacoxib are used. The duration of approval and the permitted uses vary between countries and medications. Therefore, information from American articles should not be applied to Germany without verification.

The consensus guidelines published in 2024 by the International Society of Feline Medicine and the American Association of Feline Practitioners confirm the important role of NSAIDs in chronic pain management. At the same time, they emphasize the importance of selecting suitable patients, conducting an examination before starting treatment, individualizing the dosage, and conducting regular check-ups. The dosage should be determined exclusively by a veterinarian.

Chronic kidney disease does not automatically mean that NSAIDs should never be used. However, it significantly increases the requirements for drug selection, dosage, fluid management, and monitoring. A dehydrated, vomiting, or refusing-to-eat cat should not simply be treated according to the previous protocol. The treating veterinarian must reassess the benefit-risk ratio for each individual patient.

Warning signs during NSAID treatment include loss of appetite, vomiting, diarrhea, black stools, marked fatigue, sudden increase in thirst, changes in urination, or a deterioration in the animal's overall condition. In such a situation, the medication should not be given, increased, or combined with another pain reliever without consulting a veterinarian. The veterinarian should be contacted promptly.

NSAIDs should never be combined with a second NSAID or a cortisone preparation without explicit veterinary advice. Medications left over from a previous treatment should also not be included in the current treatment plan without consultation.

Frunevetmab as a monoclonal antibody

Frunevetmab is a felinized monoclonal antibody that targets nerve growth factor (NGF). NGF is involved in the transmission and amplification of certain pain signals. The drug is administered subcutaneously at regular intervals and is approved in the European Union for the relief of pain associated with osteoarthritis in cats. Controlled studies have shown improvements in owner-based assessments and veterinary examinations in some treated cats. However, not every cat responds equally well.

Frunevetmab may be particularly interesting if the daily administration of a tablet or liquid at home causes significant stress. However, it is not an automatically risk-free treatment. Before each continuation, it should be assessed whether the individually defined daily activities have actually improved.

In the European Union, the product information was updated in 2026. In addition to previously known skin reactions, ataxia, increased urination, and increased thirst were added as very rare adverse events. Hypersensitivity reactions must also be considered. A temporal relationship in an individual patient does not automatically prove that the medication was the cause. However, any new changes should be documented and reported to the treating veterinarian.

Other pain-relieving medications

Gabapentin, tramadol, certain opioids, or other complementary medications may be part of a multimodal treatment plan in selected cases. For example, gabapentin can be helpful for certain chronic or neuropathic pain components, but it can cause fatigue or an unsteady gait in some cats. Tramadol improved activity in geriatric cats with osteoarthritis in a small controlled study, but its taste, dosage, and potential side effects make it impractical for every patient.

The choice of treatment is not based solely on the severity of the pain. Kidney and liver function, other medications, stress during administration, pre-existing conditions, and the owner's ability to reliably administer the treatment are also crucial factors.

Do not administer any human medications.

Paracetamol should never be given to cats. Cats cannot safely metabolize the active ingredient; even a seemingly small amount can cause life-threatening blood disorders and severe organ damage. Ibuprofen, diclofenac, and other human painkillers can also cause severe poisoning, gastrointestinal damage, or kidney failure in cats. In cases of arthritis in older cats, all pain medication should be administered under veterinary supervision.

2. Adapting the apartment

Rearranging the living space is one of the most effective and yet most frequently underestimated measures. When dealing with arthritis in older cats, it's not enough to simply look at the extent of the changes shown in the X-ray. Equally important is how easily the cat can access food, water, the litter box, sleeping areas, and familiar people.

A stable, non-slip step in front of the sofa can halve the required jumping height. A shallow ramp can be helpful if the cat struggles with stairs. The surface must provide good grip. Smooth wood, metal, or slippery fabric increase insecurity and may lead to the cat refusing assistance.

The following adjustments are particularly helpful for a cat with arthritis:

• Low entry into at least one large litter box,
• sufficient space to turn and scrape,
• Non-slip mats in front of the toilet, bowls and favorite spots,
• several easily accessible water sources,
• Feeding areas without the need for jumps,
• stable intermediate steps to sofa, bed or window sill,
• well-padded, warm sleeping places,
• easily accessible retreats,
• Scratching options in a horizontal or only slightly inclined position.

For a litter box with a low entrance, the other sides can be higher. Some cats in pain can no longer squat deeply. Higher sides then protect against urine overflowing the rim. The litter box should not be in the basement if a steep staircase has to be climbed to reach it daily.

Environmental guidelines for cats emphasize that water, food, litter box, safe resting places, and social contact must be reliably accessible. For arthritis in older cats, this accessibility is an essential part of medical treatment and not merely a matter of comfort.

The claws also deserve attention. Cats with limited mobility sometimes use scratching posts less frequently. Claws that are too long alter the pressure on the paws and can grow inwards. The fur on the back or hindquarters may need gentle grooming. Avoid pulling forcefully on painful joints.

3. Gentle weight management

Excess weight increases the mechanical stress on the joints and makes every movement more difficult. A cat that is already in pain moves less, uses less energy, and may gain even more weight. This creates a cycle of pain, lack of exercise, muscle loss, and additional strain.

Weight management for arthritis in older cats doesn't mean drastically reducing their food intake. Maintaining muscle mass is crucial for senior cats. An older cat may appear robust but still have lost significant muscle mass in its back and hind legs. Therefore, body weight, body condition score, and muscle condition should be assessed together.

A suitable plan takes the following into account:

• current weight and target weight,
• actual calories consumed,
• Main food, treats and supplementary food,
• Kidney, thyroid or intestinal diseases,
• Acceptance and tolerability of the food,
• Eating habits in a multi-cat household,
• Changes in weight and muscle mass.

Portions should be weighed rather than poured by eye. In multi-cat households, separate feeding is often essential, otherwise it remains unclear which cat has eaten how much. Food games can encourage exercise, but for older cats with arthritis, they shouldn't be so difficult that the cat gives up in frustration or has to assume painful postures.

The senior care guidelines explicitly mention weight management as part of a holistic osteoarthritis treatment. The goal is not the fastest possible weight loss, but a controlled reduction of excess body fat while preserving muscle mass as much as possible.

4. Adapted exercise and physiotherapy

Complete rest is usually not advisable for cats with chronic osteoarthritis. Without regular exercise, muscle mass continues to atrophy, joints become stiffer, and the cat loses stability. At the same time, a cat in pain should not be overexerted with strenuous exercises or high jumps.

For older cats with arthritis, short, frequent, and voluntary exercise sessions are usually more suitable than infrequent, intense activity. Even two to five minutes of quiet play can be beneficial. Good options include slow-motion hunting games at ground level, short trips to small portions of food, or controlled climbing over very low, non-slip obstacles.

The toy shouldn't be constantly tossed high in the air. The goal isn't to elicit spectacular jumps. A better approach is for the cat to take a few steps, turn gently, and shift its weight in a controlled manner. If it stops abruptly, lies down, swishes its tail, or loses interest, the session may have been too long or too challenging.

Veterinary rehabilitation can help select appropriate exercises. Depending on the diagnosis and temperament, controlled movement exercises, targeted muscle building, massage, heat applications, or other physiotherapeutic methods may be considered. For some methods, the scientific evidence for cats is still limited. Therefore, the benefits should be assessed based on concrete, everyday goals. The 2025 review of geriatric cat care identifies exercise and rehabilitation as an important component of multimodal management.

Pain management and exercise go hand in hand. A cat cannot build muscle if every step is painful. Conversely, even a good painkiller cannot completely prevent muscle loss if the cat continues to move very little.

5. Joint diets and dietary supplements

Dietary supplements are frequently used to treat osteoarthritis in older cats. However, the effectiveness of all ingredients is not equally well-documented. Furthermore, products can vary considerably in quality, concentration, and composition.

For omega-3 fatty acids, especially EPA and DHA, there is some evidence of a possible supportive benefit. In a controlled study, a diet with higher levels of EPA and DHA, as well as green-lipped mussel extract, glucosamine, and chondroitin, led to an improvement in objectively measured activity in cats with degenerative joint disease. However, this does not mean that every over-the-counter product, regardless of dosage, will have the same effect.

The research on glucosamine and chondroitin alone is less consistent. A systematic review of fortified feeds and nutraceuticals for dogs and cats shows that the evidence strongly depends on the specific product and its composition. Therefore, a dietary supplement should not be considered a substitute for necessary pain management.

The following questions should be clarified before administering the medication:

• Is the exact amount of active ingredients specified?
• Does the product fit into the rest of the diet?
• Does it contain extra calories?
• Does the patient have kidney disease or another metabolic disorder?
• Could there be any interactions with medications?
• Can a concrete improvement be observed after a few weeks?

For osteoarthritis in older cats, a clear observation period is recommended. Before starting, three to five activities should be defined, such as getting into the litter box, going to the windowsill, or the duration of grooming. If these activities remain unchanged, it should be questioned whether continued administration of the medication is advisable.

6. Surgery for treatable orthopedic causes

Osteoarthritis is not always just an age-related, diffuse joint disease. It can also develop as a consequence of a treatable orthopedic condition. These include, for example, hip dislocations, hip dysplasia, poorly healed fractures, unstable joints, or certain ligament injuries.

In such patients, surgery can reduce the mechanical cause and significantly improve function. Depending on the condition, options include stabilization, correction of malalignment, removal of the femoral head, or, in specialized centers, an artificial hip joint. The most suitable treatment depends on the joint, the underlying cause, body weight, muscle condition, and any accompanying illnesses. Cats with hip dysplasia and resulting osteoarthritis can develop significant pain and require individually tailored conservative or surgical treatment.

Chronological age alone does not determine whether surgery is possible. More important are cardiovascular stability, kidney function, thyroid status, blood pressure, and the expected improvement. A 15-year-old patient with well-controlled comorbidities may, in some cases, be a better candidate for surgery than a significantly younger cat with a severe systemic disease.

In cases of widespread primary osteoarthritis without a correctable cause, surgery is usually not the first choice. Here, pain management, environmental modifications, weight management, and controlled exercise are the primary focus.

This results in a practical treatment plan.

The treatment of osteoarthritis in older cats shouldn't be based solely on lab results and x-rays. It has to work in everyday life. A theoretically effective pill is of little use if every administration leads to a daily struggle and strains the human-animal relationship.

At the beginning, three to five concrete goals should be noted down. Examples include:

• The cat is now using the toilet on its own again.
• She reaches the sofa via a step.
• She is cleaning her hindquarters more frequently again.
• She plays for a few minutes every day.
• She runs up the stairs without long breaks.
• She no longer reacts aggressively when picked up.

These goals are easier to assess than the general question of whether the cat seems "somehow fitter." Short videos in consistent situations are particularly useful. A weekly log of appetite, activity, litter box habits, medication administration, and any unusual behavior can also be helpful.

In my practice, I prefer a structured approach to monitoring the progress of complex senior cats. This involves more than just checking whether medication has been administered. Crucially, it's about observing whether the cat exhibits increased voluntary activity in its daily life and whether any undesirable changes have occurred. Osteoarthritis in older cats is a chronic condition. Therefore, the treatment plan must be continually adapted to the cat's current life situation and any new co-existing conditions.

When is a prompt veterinary examination necessary?

A slowly increasing limitation of mobility is consistent with osteoarthritis. However, a sudden, severe deterioration should not be hastily attributed to osteoarthritis in older cats. A timely or immediate examination is particularly important if the cat:

• suddenly one or more legs are no longer bearing weight.,
• drags its hind legs behind it,
• has cold paws or bluish pads,
• screams or pants loudly,
• It no longer runs normally after a fall.,
• does not eat and vomits at the same time,
• becomes noticeably weak or unsteady after taking medication.,
• suddenly drinks or urinates a lot,
• Consciousness appears to be altered.

Such symptoms could be caused by a blood clot, a fracture, a neurological disorder, a severe drug reaction, or another acute illness. Pre-existing osteoarthritis does not preclude the possibility of an additional emergency.

International specialist sources and further reading

The underlying academic article by Kate Barnes is available at Clinician's Brief available.

The international recommendations for long-term NSAID use are available in the freely accessible [sources/documents/etc.]. 2024 ISFM and AAFP Consensus Guidelines.

The study on the high frequency of radiological joint changes in geriatric cats was conducted in Journal of the American Veterinary Medical Association published.

The controlled study of Frunevetmab is over PubMed reachable.

Current European marketing authorization information for Frunevetmab can be found in Union Register of the European Commission and in the version updated in June 2026 European product information.

The study on a joint diet enriched with EPA, DHA and other components is about PubMed available.

Frequently Asked Questions

Detailed summary

Osteoarthritis in older cats is a common, yet still underestimated, cause of chronic pain. Osteoarthritis in older cats rarely manifests as the noticeable limping many owners expect. Instead, the cat may change its habits, jumping less, sleeping longer, or avoiding the litter box. Osteoarthritis in older cats should therefore always be considered if mobility, grooming, social behavior, or litter box use gradually changes. Radiographic examinations show that degenerative joint changes are very common in senior cats, although not every visible change is equally painful.

Osteoarthritis in older cats should not be diagnosed solely based on an X-ray. For a proper diagnosis, the owner's observations, videos from the home, an orthopedic examination, and an assessment of any accompanying illnesses are crucial. Osteoarthritis in older cats often occurs alongside kidney problems, thyroid disorders, high blood pressure, or muscle atrophy. Therefore, a comprehensive treatment plan considers the entire patient, not just a single joint. Blood and urine tests help in selecting the most appropriate medications and monitoring changes over time.

Osteoarthritis in older cats often requires individually tailored pain management. Depending on their overall health, treatment options for osteoarthritis in older cats include nonsteroidal anti-inflammatory drugs (NSAIDs), frunevetmab, and selected complementary medications. The choice of medication for osteoarthritis in older cats must always be made by a veterinarian. A careful benefit-risk assessment is particularly important in cases of kidney disease, dehydration, loss of appetite, or when the cat is already taking other medications. Human medications such as paracetamol or ibuprofen should never be given to a cat without consulting a veterinarian.

Osteoarthritis in older cats can be significantly alleviated with frunevetmab in some patients. However, with osteoarthritis in older cats, it is crucial to assess treatment success based on specific activities and not rely solely on a vague overall impression. For example, jumping height, litter box access, stair use, and grooming can be documented for osteoarthritis in older cats. Skin reactions are known potential side effects. The European product information was updated in 2026 to include ataxia, increased thirst, and increased urination as very rare adverse events. Therefore, any new symptoms should be consistently reported.

Arthritis in older cats becomes significantly more manageable when the home is adapted to their limited mobility. Arthritis in older cats makes high litter boxes, smooth floors, and large jumps daily obstacles. For older cats with arthritis, low litter boxes, non-slip walkways, stable intermediate steps, gentle ramps, and warm sleeping areas are helpful. These changes not only reduce pain but also preserve independence. A cat should still have access to its favorite elevated spots despite its limitations. The solution is not to eliminate all heights, but to create safe pathways to them.

Osteoarthritis in older cats is further exacerbated by excess weight and muscle loss. Therefore, weight management in older cats with osteoarthritis should always include maintaining muscle mass. An uncontrolled crash diet is unsuitable for older cats with osteoarthritis. Food quantity, treats, any co-existing conditions, and previous weight trends must be assessed together. Portions should be weighed, and cats in multi-cat households should be fed separately if necessary. Regular weight checks will show whether the plan is working. A leaner body condition makes movement easier but does not replace necessary pain management.

Arthritis in older cats does not require constant, complete rest. In fact, older cats often benefit from short, controlled, and voluntary exercise sessions. For older cats with arthritis, gentle games of chase at ground level, short trips to food, and simple physiotherapy exercises are more suitable than forced jumps. Exercise maintains muscle mass, mobility, and coordination. However, it should not lead to significant exhaustion or a worsening of symptoms after exercise. Only adequate pain control allows for meaningful muscle building. The intensity of exercise must be adjusted to the cat's temperament, joint condition, and daily state of health.

Osteoarthritis in older cats can be supported with appropriate joint-specific diets or selected supplements. There is some evidence suggesting a benefit from EPA and DHA in suitable combinations for osteoarthritis in older cats. The evidence for glucosamine and chondroitin alone is less consistent for osteoarthritis in older cats. Product quality, actual amount of active ingredients, additional calories, and any co-existing conditions must be considered. Supplements should only be given if a demonstrable benefit is evident after an appropriate observation period. They should not replace necessary pain management.

Osteoarthritis in older cats can, in certain cases, be specifically addressed through surgery. Surgery should be considered for older cats with osteoarthritis, particularly when a treatable cause such as instability, dislocation, malalignment, or a poorly healed fracture is present. Age alone does not determine the suitability of surgery for osteoarthritis in older cats. General health, organ function, expected benefit, and aftercare are crucial factors. In cases of diffuse osteoarthritis affecting multiple joints without a correctable cause, conservative, multimodal treatment usually remains the most important approach. An orthopedic referral can offer additional options in cases of unclear or severe findings.

Arthritis in older cats is a chronic condition that requires regular review of treatment. Arthritis in older cats can change, and new illnesses can affect the existing treatment plan. Owners of older cats with arthritis should use specific goals, short videos, and a simple weekly log. It's not just about whether medication has been administered, but also whether the cat is walking, jumping, playing, grooming itself, and using its litter box more willingly. With a well-coordinated combination of pain management, home modifications, weight management, exercise, nutrition, and, if necessary, surgery, the quality of life for many older cats can be significantly improved.

About the author:

Susanne Arndt studied at the Faculty of Veterinary Medicine at the University of Leipzig. She then worked for six years as an assistant veterinarian at the small animal clinic of Dr. Thomas Graf in Cologne and spent a year developing and expanding the small animal department at the Lahr Animal Health Center. Since 2013, she has owned small animal practices in Karlsbad-Ittersbach and Karlsbad-Langensteinbach. She is currently pursuing a Master's degree in Small Animal Science at the Free University of Berlin and continuously expands her knowledge in the field of osteosynthesis. She is a member of the German Veterinary Medical Society, the Feline Medicine Working Group of the German Society for Veterinary Medicine and Veterinary Surgery (DGK-DVG), and the Laser Medicine Working Group of the DGK-DVG.

Important NOTE: This article is not a substitute for a veterinary examination. Pain medication, nutritional supplements, and changes to existing treatment should always be discussed with your veterinarian when administering treatment to an older cat.