Arthritis in cats: the hidden pain in older cats

If your older cat has quietly stopped doing something they used to do, jumping onto the windowsill, coming upstairs to sleep, keeping their coat as sleek as it once was, you may be looking at arthritis without knowing it. It is one of the most common conditions in older cats and one of the most missed, because cats are so good at hiding pain that most families never see a limp at all. What they see instead is a cat who has simply "slowed down with age".

Arthritis in cats, more precisely osteoarthritis or degenerative joint disease, is the progressive breakdown of the smooth cartilage that lines a joint, together with the inflammation, bony change, and stiffness that follows. It is a chronic, painful condition rather than a normal part of ageing, and while it cannot be cured, there is a great deal that can be done to keep an arthritic cat comfortable. This article explains why it goes unrecognised for so long, the behavioural signs worth watching for, how vets reach a diagnosis, what modern treatment involves, and how to tell when mobility loss has become a comfort question rather than a management one.

Why is arthritis in cats so easy to miss?

Cats almost never show osteoarthritis the way we expect pain to look. A dog with a sore hip limps, whimpers, or hesitates at the car boot. A cat with the same degree of joint disease usually just stops doing the things that hurt, quietly and without complaint, and adapts its whole routine around the discomfort.

That instinct is hard-wired. Cats are both predator and prey, and a cat that broadcasts weakness in the wild makes itself a target. Domestication has not undone that, so a pet cat in pain tends to withdraw and compensate rather than cry out. The result is that feline arthritis is overwhelmingly behavioural in how it presents, and behavioural signs are exactly the ones families put down to old age.

Radiographic studies have found signs of degenerative joint disease in the large majority of cats over the age of twelve, most of whom had never been reported as lame or sore by the people who lived with them. In other words, this is not a rare problem in a handful of unlucky cats. It is extremely common, and it is usually there long before anyone recognises it. International Cat Care describes degenerative joint disease as one of the most under-diagnosed conditions in older cats for exactly this reason.

What are the signs of arthritis in cats?

The signs are almost all changes in behaviour and routine, and they are easiest to spot if you know to look for a pattern over weeks rather than a single dramatic moment.

The most telling is a change in how a cat gets around vertically. A cat that used to leap onto a worktop or a favourite windowsill starts choosing a lower route, breaking the jump into stages, or stopping using that spot altogether. Reluctance on stairs, going up one step at a time, or pausing halfway, points the same way. Painful joints make the jumps and climbs a cat once did without thinking into something worth avoiding.

A matted or unkempt coat is one of the most reliable and most overlooked signs. Grooming requires a cat to twist and reach the spine, hips, and base of the tail, and when that hurts the cat does less of it. A coat that has become greasy, scurfy, or matted along the back, especially over the hindquarters, is often the first visible clue that something is sore. Some cats swing the other way and over-groom a single painful joint until the fur thins there.

Litter tray changes matter too. Climbing into a high-sided tray, crouching, and turning around all load the joints. A previously clean cat that starts toileting just outside the tray, or has accidents around the house, may be telling you the tray itself has become hard to use rather than that anything has changed in their toilet habits.

Alongside these, families often notice a cat hiding more, sleeping in new low-down spots rather than up high, becoming irritable or less tolerant of handling, particularly around the back end, and playing or interacting less than they used to. A subtle stiffness in the first few steps after a long sleep, which eases as the cat warms up, is a classic arthritis pattern. None of these on its own confirms arthritis. Together, and seen as a trend, they very often do. Our guide to recognising pain in older cats goes through the full behavioural picture in more detail.

How do vets diagnose arthritis in cats?

Largely from the history you give and a careful physical examination, supported by X-rays and blood tests where they help. There is no single blood test that confirms arthritis, so the diagnosis is built from the whole picture.

A vet will usually start by asking what has changed at home, which is why writing down the specific things you have noticed, before the appointment, is so useful. On examination they will gently feel and flex the joints, checking range of movement and watching for discomfort, thickening, or reduced flexibility. Cats do not perform on command in a consulting room, so this hands-on assessment and your account of daily life at home carry more weight than watching the cat walk, which is often how a dog would be assessed.

Vets may use a validated pain or mobility questionnaire to give structure to what you are seeing and to track it over time. The face component of feline pain assessment, the Feline Grimace Scale, looks at ear position, eye narrowing, muzzle tension, and whisker changes, and is reliable enough to be scored consistently. These tools turn a vague "something is different" into something that can be measured and rechecked. Radiographs may be used alongside them where the picture is unclear.

X-rays can confirm joint changes and rule out other problems, though the severity seen on an X-ray does not always match how sore the cat is, so imaging supports the clinical picture rather than replacing it. Blood and urine tests are often run alongside, both to check for other conditions common in older cats, such as kidney disease and hyperthyroidism, and because kidney function directly affects which pain medicines are safe to use.

How is arthritis in cats treated?

Treatment is about long-term comfort rather than cure, and it works best as a combination of approaches rather than any single one. The four pillars are pain relief, weight management, changes to the home, and treating any other conditions the cat has.

Pain relief is the medical backbone. A newer option, frunevetmab (Solensia), has changed the picture for many cats since its UK licensing in 2022. It is a monoclonal antibody given as a monthly injection at the vet practice, and it targets nerve growth factor, a key driver of chronic joint pain. It is the first treatment of its kind licensed for cats and has improved comfort and mobility for many, particularly those who cannot tolerate traditional anti-inflammatories. It is not right for every cat, and your vet will judge whether it suits yours and discuss any risks.

Non-steroidal anti-inflammatory drugs (NSAIDs), such as meloxicam, remain a mainstay for feline arthritis and can be used long-term. They come with an important caution: NSAIDs are excreted by the kidneys, and chronic kidney disease is common in exactly the age group that gets arthritis. That does not automatically rule them out, but it means kidney function must be checked before starting and monitored during treatment, and the dose kept to the lowest that works. The ISFM and AAFP consensus guidelines set out how NSAIDs can be used safely in cats with stable kidney disease, and this is a conversation to have openly with your vet rather than a reason to avoid effective pain relief. Other medicines, such as gabapentin, are sometimes added for their effect on chronic pain and to ease the stress of vet visits.

Weight is one of the most powerful non-medical levers. Every extra kilogram loads the joints with every step, and helping an overweight cat back towards a healthy weight, slowly and safely, often makes a visible difference to how they move.

Changes to the home are part of treatment, not an afterthought. Ramps or steps up to a favourite high spot, litter trays with a low side and one on each floor, soft warm bedding somewhere easy to reach, and food and water raised so the cat does not have to crouch all reduce the daily demands on sore joints. Gently brushing out the coat over the areas the cat can no longer reach keeps them comfortable and matt-free.

Finally, treating concurrent disease is essential. A cat with poorly controlled hyperthyroidism, kidney disease, or dental pain will not be comfortable however well the joints are managed, which is why the senior work-up looks at the whole animal.

When does arthritis become a quality-of-life question?

For most cats, arthritis is a long, manageable condition, and years of good time are realistic with the right combination of pain relief, weight control, home changes, and regular review. For some, particularly very elderly cats with several conditions at once, there comes a point where comfort can no longer reliably be restored, and mobility is often the clearest signal that the balance is tipping.

The signs the conversation is shifting tend to be a cat whose pain is no longer managed by the treatments that used to work, even at the upper end of safe doses; a cat who can no longer get to the things they need, the food bowl, the water, the litter tray, without struggle or accidents; a loss of interest in the things that defined them, a favourite person, a favourite window, gentle play; and more bad days than good when you look back over a fortnight rather than a single hard week. Often it is a quiet sense, felt before it can be put into words, that the cat is enduring their days rather than enjoying them.

If you are at that point, or worried you might be, our Quality of Life assessment is a structured way to think it through in the quiet before you talk to your vet. It does not give you an answer or a number that decides for you. It helps you see clearly what you are already seeing, across comfort, mobility, appetite, and the small pleasures your cat still has.

How we can help

We are a vet-led at-home euthanasia service. If the time does come, our visiting vets come to you, take time to explain everything, and use sedation first so your cat is calm and comfortable before the final injection. For a cat, whose stress often begins the moment the carrier comes out, being able to stay on a familiar blanket in their own home, with no car journey, frequently matters a great deal. There is no rush. Most visits last around an hour, paced by what your family needs, and we work across the UK.

If you would simply like to talk through where your cat is, with no obligation either way, our team is on the phone any day, including evenings and weekends. You can reach us through our contact page or read more about home euthanasia for cats. There is no script and no pressure, only time to listen.

A final note

Living alongside an arthritic cat is often a slow, quiet act of attention: noticing the jump that no longer happens, the coat that needs a little help, the step that has become a stretch too far. Recognising the pain your cat has been hiding is not a failure, it is the thing that lets you do something about it. Whatever stage you are in, you are not alone, and the aim throughout is the same: a cat who is comfortably themselves, for as long as that is possible.

Sources

• International Cat Care, guidance on degenerative joint disease and osteoarthritis in cats: https://icatcare.org/
• The Feline Grimace Scale, validated tool for assessing acute pain in cats: https://www.felinegrimacescale.com/
• ISFM and AAFP consensus guidelines on the long-term use of NSAIDs in cats, Journal of Feline Medicine and Surgery.
• British Small Animal Veterinary Association (BSAVA), Manual of Feline Practice and Manual of Canine and Feline Musculoskeletal Disorders, current editions.
• Royal College of Veterinary Surgeons (RCVS), Code of Professional Conduct, guidance on euthanasia and end-of-life care.