Feline musculoskeletal ageing: How are we diagnosing and treating musculoskeletal impairment?

Abstract

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.

Keywords: Musculoskeletal; chronic pain; degenerative joint disease; osteoarthritis.

Figure 1

Examples of cats exploring different heights in the consultation room at the Feline Healthy Ageing Clinic, University of Liverpool, UK

Figure 2

Examples of poor grooming and nail care showing (a) thickening of the nails and (b,c) matting of hair on the lower spine

Figure 3

A cat walking on a Tekscan pressure-sensitive walkway

Figure 4

Radiographs of a mature cat with spondylosis and degenerative joint disease. (a) Lateromedial view showing spondylosis in the lower spine at L6-L7. (b,c) Lateromedial views of the (b) right and (c) left stifle joints. Intrameniscal mineralisation is present in both stifle joints of this cat. An enthesiophyte is also present in both joints where the patellar ligament attaches to the tibial tuberosity and there is new bone formation on the patella and fabella. Note the mineralisation within the synovium in the right stifle joint. L = lumbar. Images courtesy of University Veterinary Practice, The University of Liverpool, UK

Figure 5

Examples of environmental modifications: (a) steps to allow access to the window sill; (b) elevated water bowl; (c) elevated feeding bowl; (d) flat feeding mat; (e) large, high-sided litter tray with easy access; and (f) sleeping places next to a heat source for the cats of one of the authors (ND). (a) Courtesy of Jeanette Bradshaw; (b,c) courtesy of Lucie Allcut; (d,e) courtesy of Kelly Eyre