Your cat used to land on the kitchen counter in one fluid motion. Now she takes the chair first, then the counter — and only sometimes. She sleeps more. Her coat looks slightly unkempt over the hips. She has started missing the litter box by an inch or two. Most owners file all of this under "she's just getting older." Most veterinarians now file it under something else: osteoarthritis. It is one of the most common and most under-diagnosed conditions in cats, and unlike old age, it is treatable.
How Common Is It Really?
Far more common than almost anyone assumes. In radiographic surveys of cats presented to veterinary hospitals, degenerative joint disease turns up with startling regularity: one retrospective study using orthogonal (two-view) radiographs found appendicular degenerative joint disease in roughly 74% of cats examined, with spinal changes in about 40%. Other work has found radiographic evidence of joint disease in more than 90% of cats over the age of 12, and in a majority of cats past six years old.
The FDA has publicly flagged feline osteoarthritis as being "more common than you think," and that framing is deliberate — the gap between how many cats have arthritis and how many are diagnosed and treated for it is enormous. It is not only an old-cat problem, either. Radiographic changes show up in young and middle-aged cats too, particularly in the elbow, which is the single most frequently affected limb joint in cats. The hips, stifles (knees), hocks, shoulders, and lumbosacral spine are also common sites, and arthritis in cats is usually bilateral — affecting the same joint on both sides.
Why Cats Hide It So Well
Dogs with arthritis limp. Cats, as a rule, do not. This is the central reason feline osteoarthritis goes unrecognized for years.
Two things conspire against detection. First, because the disease is typically symmetrical, there is no "good leg" for the cat to favor — a limp only appears when one side is clearly worse than the other. Second, cats are small, light, exceptionally good at compensating, and evolutionarily disinclined to advertise weakness. In one radiographic study, no obvious pain could be elicited on joint palpation in the cats found to have appendicular degenerative joint disease, even though the disease was clearly visible on film. A stoic cat in a stressful exam room, held by a stranger, may show a normal orthopedic exam while being genuinely uncomfortable at home.
The practical consequence: the owner, not the veterinarian, is the person best positioned to detect feline arthritis — because the signs are behavioral, and they happen at home.
The Signs Owners Actually See
Feline osteoarthritis shows up as changes in what a cat chooses to do, not as obvious lameness. Watch for:
- Reduced or altered jumping. Jumping up less, jumping down more hesitantly, "cheating" by using an intermediate step, hovering before a leap, or scrabbling on landing.
- Height loss. Favorite perches on top of the fridge or the wardrobe quietly go unused in favor of the sofa or the floor.
- Stiffness after rest, especially in the morning or after a long nap, that eases as the cat moves around.
- Grooming changes. A duller, greasier, matted or dandruffy coat over the lower back, hips, and tail base — areas an arthritic cat can no longer twist to reach. Some cats instead over-groom a single painful joint until the fur thins.
- Litter box problems. Missing the box, eliminating just outside it, or urinating and defecating elsewhere in the house. High-sided boxes and boxes reached by stairs are frequent culprits.
- Overgrown, thickened claws from reduced scratching activity.
- Personality changes. Hiding, withdrawal, reduced play, less tolerance of being picked up or brushed, and irritability or swatting when handled over the back or hindquarters.
- Difficulty with stairs, or taking them one step at a time with both hind legs together.
None of these is dramatic on its own. Two or three together in a cat over seven deserve a veterinary conversation.
How Veterinarians Diagnose It
Diagnosis rests on three legs: owner history, physical examination, and imaging — with the history carrying more weight than owners expect.
Many practices now use validated owner questionnaires, such as the Feline Musculoskeletal Pain Index or short mobility checklists, that ask specifically about jumping, stairs, grooming, and litter box use. Short phone videos of your cat moving around the house, jumping onto furniture, and using the litter box are genuinely valuable diagnostic material — take them before the appointment.
Your vet will palpate joints for thickening, reduced range of motion, crepitus, and pain responses, though a normal exam does not rule arthritis out. Radiographs can confirm degenerative changes, but there is an important caveat: radiographic severity and clinical pain correlate poorly in cats. A cat with mild-looking films can be markedly uncomfortable, and vice versa. For that reason, many vets diagnose on the combination of behavioral signs plus a positive response to a carefully monitored analgesic trial. Bloodwork is usually run as well — not to diagnose arthritis, but to screen for concurrent kidney disease, hyperthyroidism, and diabetes, all of which are common in the same age group and shape which pain medications are safe.
Treatment: What Actually Works
Osteoarthritis cannot be cured, but feline pain management has changed substantially in the last few years. Effective plans are almost always multimodal — several approaches stacked together.
Anti-NGF monoclonal antibody (frunevetmab, sold as Solensia). Approved by the FDA in January 2022, this was the first monoclonal antibody licensed for use in cats. It is a once-monthly injection given in the clinic that binds nerve growth factor, a key driver of osteoarthritis pain. In placebo-controlled trials it produced significant improvement in owner-assessed outcomes; the most common adverse effects reported were vomiting and injection-site pain. Because it is cleared by protein degradation rather than the liver or kidneys, it is often chosen for cats with concurrent kidney disease.
NSAIDs. Meloxicam and robenacoxib remain effective mainstays. The 2024 ISFM/AAFP consensus guidelines on long-term NSAID use in cats concluded that these two drugs, at the lowest effective dose, can be used long term — including in cats with stable IRIS stage 1 and 2 chronic kidney disease — provided baseline bloodwork, urinalysis, and blood pressure are checked and monitoring is repeated every three to six months. NSAIDs other than meloxicam and robenacoxib are not recommended for chronic use in cats. Licensing differs by country, so follow your own vet's guidance.
Adjunctive medications. Gabapentin is widely used for chronic pain and to reduce the fear and tension that make handling and vet visits worse; amantadine and other agents are sometimes added by veterinarians experienced in chronic pain.
Weight management. This is the single most valuable thing many owners can do. Excess body weight increases joint loading and worsens systemic inflammation, and weight loss in overweight cats reliably improves mobility. Any weight-loss plan for a cat must be gradual and vet-supervised — rapid weight loss in cats risks hepatic lipidosis.
Diet and supplements. Therapeutic joint diets enriched with omega-3 fatty acids (EPA and DHA) have the best supporting evidence among nutritional approaches. Glucosamine and chondroitin supplements are commonly used and generally safe, but the evidence in cats is weaker.
Physical and environmental therapy. Gentle, regular play maintains muscle mass; some cats benefit from veterinary physiotherapy or acupuncture.
Home Changes That Make an Immediate Difference
Environmental modification is free, fast, and underrated. For an arthritic cat:
- Get a bigger, lower litter box. A large box with at least one entry side no more than about 5 cm (2 inches) high solves a surprising number of "behavior" problems. Put one on every floor of the house.
- Build ramps and steps to favorite perches, windowsills, and beds so the cat never has to make a single big jump.
- Raise food and water bowls slightly so the cat isn't crouching down to eat, and keep food, water, litter, and resting spots on the same level.
- Provide warm, soft, well-padded beds away from drafts — warmth helps stiff joints, and a firm floor is punishing for a bony older cat.
- Lay down rugs or runners on slick laminate, tile, or wood floors to give the cat traction and confidence.
- Help with grooming and nails. Brush the areas your cat can no longer reach and trim claws regularly, since reduced scratching lets them overgrow and even curl into the pads.
One absolute rule: never give a cat human pain medication. Acetaminophen (paracetamol) is lethal to cats even in small doses, and ibuprofen, naproxen, and aspirin are highly toxic to them. Every analgesic must come from your veterinarian.
The Takeaway
Arthritis in cats is not a rare diagnosis in unlucky animals — it is close to the default state of the aging feline skeleton, and it is quietly shrinking the world of millions of otherwise healthy cats. The disease can't be reversed, but pain can be controlled, and cats treated for osteoarthritis frequently regain behaviors their owners assumed were gone for good: the high perch, the evening zoomies, the clean coat, the reliable litter box habits. If your cat has "just slowed down" in the last year or two, that is a symptom worth investigating, not a stage of life to accept.