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Review
. 2012 Jan;14(1):65-75.
doi: 10.1177/1098612X11432828.

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

David Bennett  1 , Siti Mariam bt Zainal Ariffin, Pamela Johnston
Affiliations
Review

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

David Bennett et al. J Feline Med Surg. 2012 Jan.

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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Conflict of interest statement

The authors declare that there is no conflict of interest.

Figures

Figure 1
Figure 1
Change in mean scores for each of four behavioural domains in cats with OA between baseline and following 28 days of treatment with an analgesic (meloxicam) (Bennett and Morton).28 The higher the score, the more change there has been in the parameters listed in Table 1 as compared with the situation when the cat was a young adult; the lower score after 4 weeks of analgesic therapy means less change and thus the cat is behaving more like its old self. Owners can easily identify these changes and assess/score the degree of alteration
Figure 2
Figure 2
Mediolateral radiograph of the left shoulder of a cat with OA. There is sclerosis of the glenoid and the glenohumeral joint space appears reduced at its caudal aspect. Osteophytes are seen on the caudal aspect of the humerus. The apparent separate mineralised body at the caudal edge of the glenoid could be an osteophyte not completely remodelled or could represent a ‘free’ osseocartilaginous body (osteochondroma), as seen in Figure 3. Note the clavicle
Figure 3
Figure 3
(a) Photograph of a feline shoulder showing advanced OA. There is an extensive area of total cartilage loss on the humeral head with eburnation of the underlying subchondral bone. Several discrete osseocartilaginous bodies (osteochondromas) are seen on the surface of the synovium; some of these are totally free and mobile; others are ‘adherent’ to the synovium. The forceps have lifted an ‘ossicle’ from a fossa within the synovial surface in which it was embedded. (b) Photomicrograph of an osteochondroma originally embedded within the synovial membrane of the elbow joint. Note the presence of trabecular bone despite no obvious blood supply being present, and the cartilaginous (‘articular’) surface which contacted the distal humerus
Figure 4
Figure 4
Mediolateral radiographs of the left (a) and right (b) elbow. There is osteophyte formation on the distal humerus of the right elbow. Apparent sclerosis beneath the ulnar notch is present in both elbows. The supinator sesamoid bone is easily seen in the left elbow (arrow) but is less apparent in the right. The arrow on the right elbow shows soft tissue calcification within the joint capsule
Figure 5
Figure 5
Pathological specimens of the elbow joints seen in Figure 4. Cartilage loss and prominent ridges and grooves (‘wear lines’) (arrows) are observed on the articular surface of the humeral condyle of the left (a) and right (b) elbow. Total loss of articular cartilage and bone eburnation is seen in the left elbow. (c) There is osteophyte formation on the medial coronoid process and along the margins of the ulnar trochlear notch (arrows) of the left ulna; there is severe cartilage loss from the trochlear notch. Pathological changes are always more severe in the medial compartment of the elbow joint
Figure 6
Figure 6
Mediolateral radiographs of the left (a) and right (b) elbow joint. There is a mild degree of increased radiopacity beneath the ulnar trochlear notch, particularly in the right
Figure 7
Figure 7
Pathological specimens of the elbow joints seen in Figure 6. Prominent ridges, grooves and roughening of all articular surfaces can be seen. Osteophyte formation (black arrows) is visible at the medial ridge of both humeri (a,b), along the margin of the ulnar notch and on the anconeus (c). There is also a calcified plaque within the joint capsule adjacent to the ulnar notch (white arrow)
Figure 8
Figure 8
(a) Mediolateral radiograph of the right elbow. There is osteophyte formation at the distal humerus (yellow arrows), increased radiopacity beneath the ulnar trochlear notch (black arrows) and the supinator sesamoid bone is seen (white arrow). The mineralisation below the sesamoid bone is within the joint capsule. (b) The post-mortem specimen of the same joint shows roughening of the trochlear articular surface, with severe loss of cartilage and a number of ‘wear lines’ present on the humeral condyle
Figure 9
Figure 9
(a) Ventrodorsal radiograph of the right coxofemoral joint showing minimal change namely, a faint sclerotic line along the femoral neck (black arrows) and perhaps a narrowing of the joint space (white arrow). There is no suggestion of hip dysplasia. (b) On the post-mortem specimen of the same joint, irregularity of the articular surface can be seen on the right femoral head. (c) Osteophyte formation (arrow) is seen on the femoral head neck junction
Figure 10
Figure 10
Ventrodorsal radiograph of the pelvis showing extensive remodelling of both hip joints. Osteophyte formation is seen on the cranial and caudal acetabular edges and there is sclerosis affecting both femoral necks, consistent with osteophyte formation. Both femoral heads are misshapen, which may represent remodelling or a particular type of dysplasia. In this case hip dysplasia is present
Figure 11
Figure 11
(a) Mediolateral radiograph of the right stifle. Marked intrameniscal mineralisation (white arrow) is present; osteophyte formation is at the distal pole of the patella and along the trochlear margin (black arrows). (b) The post-mortem specimen of the same joint shows osteophyte formation along the trochlear margin (arrows); the proximal view of the articular surface of the tibia shows extensive irregular surfaces, loss of cartilage and ‘wear lines’ on the lateral and medial part of a the tibial plateau (c) (arrow)
Figure 12
Figure 12
(a) Mediolateral radiograph of the right stifle joint. Intrameniscal mineralisation (arrow) is seen. Note only one fabella is visible, which is not unusual in the cat. (b) The post-mortem photograph of the same stifle joint shows an irregular articular surface with a number of ‘wear lines’ running transversely on the medial part of the tibial plateau (arrow)
Figure 13
Figure 13
Mediolateral radiograph of the stifle joint. Intrameniscal mineralisation is present. There is also a spur of bone where the patellar ligament attaches to the tibial tuberosity (enthesiophyte). No osteophyte formation can be seen. The tibial enthesiophyte is not uncommonly seen in the feline stifle and, although it can be part of OA, it probably represents an isolated traumatic lesion in this case and is of doubtful clinical significance. Again, only one fabella is visible
Figure 14
Figure 14
Post-mortem specimen of the tibiotarsal joint. There is loss of articular cartilage and several ‘wear lines’ in the articular surfaces of both the distal tibia and tibial tarsal bone. Most pathology is affecting the lateral compartment of the joint
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