Weight Management and Enrichment Feeding

Obesity is one of the leading health challenges in domestic cats, and it significantly increases the risk and severity of osteoarthritis (OA).

Extra weight places more stress on joints, fuels inflammation, and worsens chronic pain—often resulting in decreased activity, further weight gain, and reduced quality of life. Beyond OA, overweight cats face greater risks of diabetes, lower urinary tract disease, and other costly comorbidities.

As veterinary teams, we play a key role in helping clients understand the connection between body condition, pain, and behavior—and in offering realistic strategies that fit into their daily routines.

Why Feeding Habits Matter

  • Prevalence: Over half of cats in the U.S. are overweight (Association for Pet Obesity Prevention).
  • Natural behavior: Feral cats spend ~12 hours a day hunting, compared to 3 hours or less for domestic cats.
  • Impact: Traditional “bowl feeding” may meet nutritional needs but removes opportunities for stalking and problem-solving. This lack of stimulation can contribute to overeating, boredom, stress, and behavioral issues (scratching, chewing, aggression).

Clinical insight: Position enrichment feeding not just as weight management, but as a multimodal welfare tool that addresses physical, emotional, and behavioral health.

The Concept: Frequent Feasts of Tiny Eats

Encourage clients to divide daily rations into 4–6 small meals rather than one or two large feedings. This mimics a cat’s natural hunting rhythm and reduces the tendency to overeat. Free-choice feeding allows nibbling but does not address the behavioral enrichment cats need.

Enrichment Feeding Strategies You Can Recommend

Commercial Puzzle Feeders

  • Wide variety available—balls, mazes, cups, and dispensers.
  • Help slow down eating while engaging cats physically and mentally.
  • Tip: Keep a small selection in-clinic to demonstrate and recommend specific products.

DIY Puzzle Toys

  • Hollow toys with wet food (freeze for added difficulty).
  • Toilet paper rolls in boxes with kibble dropped in.
  • Ice cube trays or egg cartons with food hidden under scrunched paper or toys.
  • Treasure hunts—encourage owners to hide small portions of food throughout the house.

Add More Challenge

  • Place puzzles inside paper bags or boxes to require additional effort.
  • Vary hiding spots and puzzles to maintain novelty.

How to Communicate With Clients

  • Start simple: Recommend one or two easy enrichment methods to avoid overwhelming owners.
  • Reframe the benefit: Position this as a way to keep cats healthier and happier while reducing boredom-driven behaviors.
  • Pair with weight management: Use enrichment feeding as part of a structured plan that also includes diet adjustments and OA pain management when appropriate.

Key Takeaway for Veterinary Teams

Frequent, enrichment-based feeding strategies can break the obesity–arthritis cycle, reduce stress behaviors, and improve feline welfare. By guiding clients toward small, practical changes—like puzzle feeders or creative DIY options—we not only support healthier body condition but also enrich the human–cat bond.

Monique Koll, DVM, CCRP, CVPP

Certified Cat Friendly Veterinarian by the Feline Veterinary Medical Association

#frequentfeastsoftinyeats

References

 

Understanding Feline Osteoarthritis

Osteoarthritis (OA) in cats is highly prevalent but frequently under diagnosed.

While often associated with senior dogs, studies show that feline OA is widespread and clinically significant:

  • >90% of cats over age 12 have radiographic evidence of degenerative joint disease (DJD).
  • ~60% of cats over age 6 are affected radiographically.
  • ~40% are believed to experience arthritis-related pain.

This distinction between radiographic disease and clinical pain is critical. Not all cats with radiographic OA will have detectable pain, but chronic joint disease predisposes them to maladaptive pain syndromes.

Why It Matters: Pain Pathophysiology

OA in cats doesn’t just cause local joint pain. Over time, changes in the central nervous system lower pain thresholds and create maladaptive pain states:

  • Allodynia: non-painful stimuli trigger pain.
  • Hyperalgesia: painful stimuli cause exaggerated responses.

This explains why cats may appear variable day-to-day, with waxing and waning signs, and why untreated OA often becomes more refractory to management over time.

Etiology in Cats

Unlike dogs, where OA is often secondary to developmental orthopedic conditions, cats more commonly develop primary or idiopathic OA. Contributing factors include:

  • Age-related cartilage degeneration.
  • Breed predispositions (e.g., Scottish Folds with osteochondrodysplasia).
  • Maine Coons, where up to 25% show hip dysplasia leading to OA (Loder & Todhunter, 2018).
  • Trauma, patellar luxation, and hip dysplasia (less frequent than in dogs).

Clinical Recognition: Why It’s Difficult

Cats rarely show overt lameness. Evolutionarily, masking pain reduces predation risk, meaning many clinical signs are subtle:

  • Reduced jumping or altered jump strategy.
  • Decline in grooming, leading to a matted or greasy coat.
  • Changes in play, hiding behavior, or reduced social interaction.
  • Altered litter box habits due to difficulty entering, posturing, or climbing stairs.

These are often misattributed to “normal aging.”

Diagnostic Approach for Veterinary Teams

Diagnosis should be multifactorial, integrating:

  • Client history: Targeted questioning about activity, mobility, grooming, litter use, and behavior.
  • Physical exam: Orthopedic palpation, pain response, and range of motion testing. Note: absence of exam pain ≠ absence of disease.
  • Imaging: Radiographs are helpful but not definitive. Studies show poor correlation between radiographic changes and clinical pain (Freire et al., 2011). Disease may precede radiographic findings.
  • Pain trials: Therapeutic trials with analgesics can provide both diagnostic and clinical value.

Communicating With Clients

  • Educate that “slowing down” or “getting old” often indicates pain.
  • Encourage home video capture of mobility tasks (stairs, jumping) to illustrate subtle changes not seen in clinic.
  • Explain the disconnect between radiographs and pain to manage expectations about diagnostics.

Bottom Line

Feline OA is common, under-recognized, and a significant contributor to chronic pain syndromes. Early detection—through careful history, exam, client observation, and imaging—enables proactive, multimodal management that can preserve mobility and quality of life.

References

  • Hardie EM, Roe SC, Martin FR. Radiographic evidence of degenerative joint disease in geriatric cats: 100 cases (1994–1997). JAVMA. 2002;220(5):628-632.
  • Slingerland LI, et al. Cross-sectional study of the prevalence and clinical features of OA in 100 cats. Vet J. 2011;187:304-309.
  • Enomoto M, et al. Anti-nerve growth factor monoclonal antibodies for the control of pain in dogs and cats. Vet Record. 2018.
  • Loder RT, Todhunter RJ. Demographics of hip dysplasia in the Maine Coon cat. J Feline Med Surg. 2018;20(4):302-307.
  • Lascelles BDX, et al. Relationship of orthopedic exam, goniometric measurements, and radiographic signs of DJD in cats. BMC Vet Res. 2012;8:10.
  • Freire M, et al. Radiographic evaluation of feline appendicular DJD vs. cartilage pathology. Vet Rad Ultrasound. 2011;52(3):239-247.

Recognizing Signs of Feline Osteoarthritis Pain

Cats are skilled at concealing discomfort, making osteoarthritis (OA) a frequently underdiagnosed condition.

While radiographic evidence suggests that up to 90% of cats over 12 years have OA in at least one joint, overt lameness is uncommon (Zamprogno et al., 2010). Instead, pain often manifests as subtle behavioral and mobility changes that can be overlooked or misattributed to “normal aging.”

Key Indicators in the Clinical Setting

Veterinary teams should be alert to the following common indicators of OA pain:

  • Altered jumping behavior: Hesitation, false starts, or using intermediate surfaces (e.g., toilet lids, chair backs) before reaching a desired height. Look for scratch marks that suggest climbing rather than fluid leaping.
  • Stair navigation changes: Slower ascent/descent, “bunny hopping,” or pausing mid-flight.
  • Reduced play and activity: A decline in spontaneous bursts of running or interactive play.
  • Gait or posture changes: Bilateral disease often prevents obvious limping, but cats may appear stiff, hesitant, or walk gingerly.
  • Behavioral shifts: Irritability, withdrawal, hiding, or decreased social interaction.
  • Poor grooming or coat quality: Discomfort may prevent adequate grooming of hips, spine, or back.
  • Elimination issues: Reluctance to use litter boxes with high sides or difficulty posturing for defecation.
  • Appetite and weight changes: Chronic pain may suppress appetite and alter energy balance.

Leveraging Client Observation

Because many signs are more apparent in the home than in clinic, engaging clients as “pain reporters” is critical. Encourage owners to:

  • Capture short home videos (10–30 seconds) of their cat performing key activities (stair use, jumping, running, play).
  • Store videos over time in a dedicated folder for comparison during follow-up visits.
  • Note any new irritability, sleep disturbances, or social withdrawal, which can reflect pain sensitization.

Clinical Application

  • History-taking: Direct owners toward specific mobility-related questions instead of vague “any limping?” prompts.
  • Monitoring: Use client-provided videos alongside validated pain checklists (e.g., Enomoto et al., 2020) to track subtle changes.
  • Communication: Frame OA as a painful disease rather than “just aging” to increase client buy-in for diagnostics and treatment.

References

  • Zamprogno H, Hansen BD, Bondell HD, et al. Item generation and design testing of a questionnaire to assess degenerative joint disease-associated pain in cats. Am J Vet Res. 2010;71(12):1417-1424.
  • Enomoto M, Lascelles BDX, Gruen ME. Development of a checklist for the detection of degenerative joint disease-associated pain in cats. J Feline Med Surg. 2020;22(12):1137-1147.

Practical Pain Relief Strategies

Chronic pain in cats is more than an inconvenience—it’s a welfare issue.

Arthritis is one of the most common sources of chronic pain in older cats, and untreated pain can affect mobility, grooming, appetite, mood, and sleep. As trusted advocates for feline health, veterinary teams play a crucial role in recognizing, managing, and educating clients about feline osteoarthritis (OA).

Below is an overview of current pain management options, along with practical tips for incorporating them into your treatment plans and client conversations.

Solensia® (frunevetmab)

  • What it is: The first and only FDA-approved therapy for chronic OA pain in cats.
  • Mechanism: Blocks nerve growth factor (NGF), reducing chronic pain signaling.
  • Efficacy: Clinical studies show significant improvement in activity and comfort.
  • Administration: Monthly subcutaneous injection, given in-clinic.
  • Side effects to monitor: Vomiting, mild injection site pain, pruritus (esp. head/neck), scabbing, or alopecia.

Pro Tip: Position Solensia as a first-line option when discussing long-term OA care with cat owners, especially for those reluctant to manage daily oral medications.

Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

  • Options: Meloxicam (Metacam®), robenacoxib (Onsior®). Long-term use approved outside the US, but often used off-label domestically.
  • Risks: GI upset most common; kidney issues possible if dehydrated.
  • Monitoring: Ensure adequate hydration, appetite, and perform routine blood work for long-term patients.

Pro Tip: Frame NSAIDs as effective for cats with stable renal function. Reinforce with clients the importance of hydration and recheck bloodwork compliance.

Oral Analgesics (Off-Label)

  • Gabapentin: Effective for neuropathic pain, but sedation is common.
  • Tramadol: Limited use due to poor palatability and GI side effects.
  • Amantadine: Can reduce central pain sensitization and improve quality of life.

Pro Tip: Use gabapentin or amantadine as adjuncts in multimodal pain management. Clearly explain “off-label use” to clients to build trust and transparency.

Nutritional Support & Supplements

  • Omega-3 fatty acids: Therapeutic diets enriched with fish oil show measurable benefits.
  • Adequan®: Injectable polysulfated glycosaminoglycan that supports joint health.
  • Other therapies: CBD and alternative products are under study—discuss evidence-based use and caution with clients.
  • Avoid: Glucosamine/chondroitin, which lack proven efficacy in cats.

Pro Tip: Nutritional support is an easy “entry point” for client compliance. Provide written diet recommendations and make supplements available in-clinic to encourage follow-through.

Lifestyle & Environmental Support

  • Encourage owners to modify the home environment (e.g., ramps, accessible litter boxes, soft bedding).
  • Predictable routines reduce stress, which can amplify pain perception.
  • Consider pre-visit medications (gabapentin, pregabalin) for cats prone to anxiety or stress in the clinic.

Pro Tip: Create a handout with practical at-home adjustments owners can make. Pair medical management with environmental changes to maximize outcomes.

Key Takeaway for Veterinary Teams

Pain is not a normal part of aging. With the right combination of pharmacologic, nutritional, and environmental support, cats with arthritis can maintain mobility, comfort, and quality of life well into their senior years. Veterinary teams are uniquely positioned to lead these conversations and empower clients with clear, evidence-based options.

Managing Feline Osteoarthritis

Effective management of osteoarthritis (OA) in cats requires more than prescribing a single medication.

A whole-cat approach—addressing pain, nutrition, lifestyle, rehabilitation, and owner education—ensures better outcomes and improved quality of life. Because cats mask pain and tolerate treatment modalities differently from dogs, individualized, multimodal care is essential.

The CARE Quad Framework organizes management into four pillars:

  • Pain Management
  • Nutrition & Weight Control
  • Lifestyle & Environmental Modifications
  • Rehabilitation Techniques

Not every therapy is appropriate for every patient, but understanding the range of options allows veterinary teams to design tailored, evidence-based treatment plans.

1. Pain Management

  • Injectable monoclonal antibody therapy (e.g., Solensia®): Monthly treatment targeting nerve growth factor.
  • NSAIDs (e.g., robenacoxib/Onsior®): May be used under close monitoring for renal/hepatic safety.
  • Adjunctive medications: Gabapentin, amantadine, or tramadol can be considered for neuropathic or refractory pain.
  • Polysulfated glycosaminoglycan (Adequan®): Often administered SQ in cats; some positive clinical experience reported.
  • Joint injections: Steroids, hyaluronic acid, PRP, or stem cell therapies—used less frequently in cats, but possible in select cases.
  • Surgical options: Femoral head and neck ostectomy (FHO) or total hip replacement for severe hip OA; other joint procedures may be considered.

2. Nutrition and Weight Management

  • Weight reduction: Obesity worsens joint stress and inflammation; even small losses improve mobility.
  • Therapeutic diets: Prescription formulations (e.g., Hill’s k/d + j/d) address concurrent conditions and provide joint support.
  • Omega-3 fatty acids: Marine-based (fish oil, green-lipped mussel). Require high-quality, contaminant-tested products with certificates of analysis. Introduce gradually to minimize GI upset.
  • Supplements: Evidence does not support glucosamine/chondroitin in cats. Focus instead on omega-3s and prescription diets.

3. Lifestyle and Environmental Modifications

  • Accessibility: Ensure food, water, and litter boxes are on one level; provide low-entry litter pans sized to 1.5× body length.
  • Mobility aids: Ramps, steps, and stable platforms help maintain vertical space access.
  • Surfaces: Rugs or yoga mats improve traction on slick floors.
  • Comfort: Soft, orthopedic bedding and self-heating pads support joint relief.
  • Enrichment: Encourage short play sessions (2–5 minutes), stalking/pouncing activities, and low-impact hunting-style toys to maintain muscle tone and mental well-being.

4. Rehabilitation and Complementary Therapies

  • Therapeutic exercise: Light activity to preserve muscle mass and flexibility.
  • Modalities: Laser therapy (in-clinic), pulsed electromagnetic field therapy (e.g., Assisi Loop®) can be helpful adjuncts.
  • Manual therapy: Gentle massage or stretching when tolerated.
  • Acupuncture: Effective in select patients; requires experienced practitioners skilled in feline handling.

Clinical Application for Veterinary Teams

  • Diagnostics: Frame OA as a painful disease process, not “normal aging.” Combine history, orthopedic exam, and imaging when possible.
  • Owner education: Provide clients with home observation tools (video capture of mobility tasks, behavioral checklists). Reinforce that changes in grooming, play, or jumping are red flags.
  • Treatment planning: Start with the foundations (analgesia, weight management, environmental changes) and layer in additional therapies as indicated.
  • Monitoring: Regular rechecks and owner feedback help adjust protocols and ensure ongoing pain control.

Key Takeaway

Feline OA requires a multimodal, individualized approach. By integrating pharmacologic, nutritional, lifestyle, and rehabilitative strategies, veterinary teams can transform arthritis from a silent, progressive disease into a condition that is actively managed—preserving mobility, comfort, and the human–cat bond.

Environmental Modification / Enrichment Strategies

Osteoarthritis (OA) is highly prevalent in the feline population

With approximately 40% of cats showing clinical signs and up to 90% of cats over 12 years demonstrating radiographic evidence in at least one joint (Slingerland et al., 2011). Because cats are adept at masking pain, OA can be under-recognized in practice. Simple environmental modifications and enrichment strategies can significantly improve comfort, mobility, and quality of life for feline patients.

Targeted Enrichment and Play

  • Kicker Toys: Encourage natural predatory behaviors while supporting rear limb strength and flexibility. Kicker toys can be recommended as a low-impact way to promote movement and preserve muscle tone.
  • Scratching Alternatives: Horizontal scratching surfaces are more accessible for cats with forelimb OA than vertical posts. Recommend low-profile scratchers or wall-mounted options close to the ground.

Modifying Rest and Shelter

  • Accessible Boxes and Hideaways: Traditional boxes may be difficult for arthritic cats to enter. Cutting a low entry or positioning boxes on their side creates a safe, low-effort retreat.
  • Elevated Resting Areas: Cats often prefer perches and lookouts. Pet ramps, stairs, or wide stable platforms allow cats to continue using elevated spaces safely. Heated or padded bedding may further enhance joint comfort.

Litter Box Considerations

Inappropriate elimination in senior cats warrants medical evaluation, but OA should be considered as a contributing factor.

  • Recommend litter boxes with low-entry sides.
  • Place boxes on multiple levels of the home to reduce stair use.
  • In advanced cases or with concurrent cognitive decline, consolidating essential resources in one location can be beneficial.

Flooring and Nail Care

  • Traction Aids: Slick floors deter movement and increase risk of slips. Non-slip mats, yoga runners, or low-pile rugs can improve mobility and confidence.
  • Nail Management: Overgrown nails compromise gait and comfort. Routine trimming is especially important in older cats with reduced activity.

Resource Accessibility

  • Encourage owners to consolidate food, water, litter, beds, and enrichment on a single accessible level of the home.
  • Suggest raised food and water bowls to reduce neck and shoulder strain during feeding.

Clinical Application

Veterinary teams can educate owners on these modifications during wellness visits or OA rechecks, framing them as practical, low-cost interventions that complement medical management. By integrating environmental strategies with analgesics, weight control, and physiotherapy, we can improve mobility and preserve independence in geriatric feline patients.

  • Monique Koll, DVM, CCRP, CVPP Certified Cat Friendly Veterinarian, Feline Veterinary Medical AssociationReferences
  • Slingerland LI, Hazewinkel HA, Meij BP, Picavet P, Voorhout G. Cross-sectional study of the prevalence and clinical features of osteoarthritis in 100 cats. Vet J. 2011;187(3):304-9.
  • Enomoto M, Lascelles BDX, Gruen ME. Development of a checklist for the detection of degenerative joint disease-associated pain in cats. J Feline Med Surg. 2020;22(12):1137-1147.