Osteoarthritis in Cats:
Recognising the Signs and How Physiotherapy Can Help
Author: Karen Goodall AdvCertVPhys MIRVAP (VP) (ICH) | Veterinary Physiotherapist, Old Flatts Farm, Treeton
Feline Osteoarthritis: Far More Common Than Owners Realise
Osteoarthritis (OA) in cats is one of the most significantly underdiagnosed conditions in veterinary medicine. Studies suggest that radiographic evidence of OA is present in over 90% of cats aged 12 and over, and in approximately 60% of cats over the age of six (Hardie et al., 2002; Lascelles et al., 2010). Despite this prevalence, the condition is routinely missed — not because it is absent, but because cats express pain and discomfort in ways that are fundamentally different from dogs, and often invisible to owners until the disease is already well advanced.
Unlike dogs, cats do not vocalise pain reliably, do not limp in the classic sense, and do not present with the obvious gait changes that prompt owners to seek veterinary attention. Instead, feline OA presents as a gradual, subtle shift in behaviour: a cat that sleeps more, plays less, grooms differently, avoids heights, or becomes quietly less social. These changes are so easily attributed to personality or ageing that many cats live with significant, unmanaged joint pain for months or years.
The goal of this article is to change that. Understanding what feline OA actually looks like — and how physiotherapy, adapted specifically for cats, can meaningfully improve comfort and quality of life — is the foundation of better care for older and arthritic cats.
How Feline OA Differs From Canine OA
While osteoarthritis in dogs and cats shares the same underlying pathology — progressive degeneration of articular cartilage, joint inflammation, bony change, and pain — the two species differ substantially in how the condition presents, which joints are most affected, and how it must be managed. These differences are clinically important and directly shape the physiotherapy approach.
| Feature | Dogs | Cats |
|---|---|---|
| Most affected joints | Hips, elbows, stifles, hocks, spine | Spine (most common), hips, elbows, tarsi — often multiple joints simultaneously |
| Primary clinical sign | Lameness, altered gait, reluctance to exercise | Behaviour change: reduced activity, altered grooming, withdrawal, aggression when handled |
| Pain expression | Vocalisation, guarding, overt lameness | Subtle: hiding, reduced interaction, altered facial expression, reluctance to be touched |
| Diagnosis | Often identified by owners; radiographs confirm | Frequently owner-undetected; requires specific feline pain assessment tools and radiographs |
| Secondary muscle loss | Visible hindlimb and gluteal atrophy common | Generalised muscle loss (sarcopenia) common in senior cats; harder to detect due to coat |
| Treatment tolerance | Generally accepts hands-on treatment well | Highly individual; requires patient, low-stress approach; session duration often shorter |
These differences mean that a physiotherapy programme designed for a dog with OA cannot simply be applied to a cat. Feline OA rehabilitation requires species-specific assessment tools, a low-stress handling approach, and treatment modalities selected for their tolerability as well as their efficacy.
Recognising OA in Your Cat: What to Look For
Because cats rarely limp or vocalise pain from OA, owners need to know what to look for instead. The signs are behavioural and functional rather than obviously orthopaedic, and they are easy to miss without knowing what is normal for your individual cat. The following are the most characteristic presentations of feline OA:
Changes in Activity and Mobility
- Reluctance or inability to jump to heights previously managed without hesitation — the cat’s favourite chair, worktop, or window sill
- Landing heavily or awkwardly when jumping down, or choosing to descend via intermediate surfaces rather than jumping directly
- Reduced range of motion in the spine when turning, stretching, or changing direction
- Stiffness after rest, particularly first thing in the morning or after sleeping in a cold area
- Shorter, less fluid movement — the cat appears “stiffer” or “older-looking” in how they walk
Changes in Grooming
- Reduced grooming of areas difficult to reach with an arthritic spine or limbs — particularly the lower back, base of tail, and hindquarters
- Matting or coat deterioration in specific regions that the cat can no longer comfortably access
- Conversely, over-grooming or licking at a painful joint area
Changes in Behaviour and Temperament
- Increased hiding, withdrawal from family interaction, or reduced socialisation
- Aggression, hissing, or sharp reaction when touched in specific areas — particularly the lower back, hips, or hindlimbs
- Reduced play behaviour or disengagement from activities previously enjoyed
- Changes in litter tray use — difficulty getting in and out of high-sided trays, or avoiding the tray and toileting elsewhere
- Altered sleeping positions or reluctance to settle in previously preferred spots
Changes in Muscle Condition
- Visible or palpable loss of muscle mass, particularly along the spine and over the hindquarters, which can be difficult to detect in long-coated cats
- Reduced body condition despite adequate nutrition
How Physiotherapy Helps Cats With OA
Physiotherapy for cats with OA follows the same core principles as canine OA rehabilitation — addressing pain, muscle health, movement quality, and the home environment — but the approach must be adapted substantially for the feline patient. Session duration is typically shorter. Handling is more patient and deliberate. The treatment environment is designed to minimise stress, as a cat that is anxious or fearful will not tolerate hands-on treatment and will not benefit from it. Every feline physiotherapy session begins with careful observation and reading of the cat’s body language before any hands-on work begins.
Hands-on manual therapy — gentle massage, myofascial release, passive range of motion, and careful joint mobilisation — can provide significant relief for cats with OA when applied with appropriate technique and patience. The feline spine is the most commonly affected region, and paraspinal muscle guarding and thoracolumbar tightness are extremely common findings in older cats. Gentle soft tissue work in these areas can markedly improve comfort and movement quality.
Passive range of motion (PROM) exercises help maintain joint mobility in cats that are reducing their own movement due to pain. Unlike dogs, cats will typically not comply with exercises they find uncomfortable — which means the physiotherapist must work within the cat’s tolerance, progressing slowly and reading behavioural cues continuously throughout the session.
Cats versus dogs: Manual therapy in cats requires a lighter touch, shorter sessions, and careful attention to stress signals. A cat that freezes, flattens ears, or twitches its tail is signalling discomfort — the experienced feline physiotherapist will recognise and respond to these cues before they escalate.
Laser therapy is particularly well-suited to feline OA management because it is non-invasive, pain-free, and well-tolerated by most cats — including those who are too painful or anxious to accept hands-on treatment readily. Photobiomodulation reduces joint inflammation, decreases pain, and supports tissue healing at a cellular level, and is one of the most evidence-supported modalities in feline rehabilitation (Lascelles and Robertson, 2010).
For cats with spinal OA — the most common presentation — laser therapy applied along the thoracolumbar region can produce rapid improvements in comfort, mobility, and willingness to engage with manual treatment. Many cats become visibly more relaxed during laser application, which also makes it a useful treatment for building a positive association with the physiotherapy environment over successive sessions.
Cats versus dogs: Because cats are often reluctant to remain still for long periods, laser application in feline patients is typically more targeted and of shorter duration per region than in dogs. Protective goggles are used throughout.
Exercise prescription for cats with OA is fundamentally different from the approach used in dogs. Cats cannot be led, prompted with food rewards in the same systematic way, or directed through specific exercises on command. Instead, feline therapeutic exercise is largely environment-based: the home environment is structured to encourage the specific movement patterns and ranges of motion that the rehabilitation programme requires, within a level of difficulty the cat can comfortably manage.
Examples include positioning food, water, and resting spots at heights that encourage gradual, supported climbing; using puzzle feeders at floor level to encourage spinal flexion and extension; placing beds on low platforms that require a gentle, achievable step rather than a jump; and introducing low obstacles that encourage controlled limb placement. The programme is designed around the cat’s natural behaviours and daily routine rather than against them.
Cats versus dogs: There are no “exercises” for cats in the conventional sense. Feline rehabilitation uses environmental enrichment and structured daily routines to achieve therapeutic movement goals — patience and creativity are as important as clinical knowledge.
Many cats with OA benefit significantly from warmth — a well-heated home, a self-warming or electrically heated orthopaedic bed, and avoidance of cold, draughty resting areas can all reduce joint stiffness and improve daily comfort. Heat increases local circulation, softens tight periarticular tissues, and reduces muscle guarding — the same physiological mechanisms that make it effective in dogs apply equally to cats.
Owners can also apply gentle warm compresses to stiff areas with their cat’s cooperation — though this requires a calm cat who accepts handling. Your physiotherapist will advise on appropriate home thermotherapy techniques and safety considerations for your individual cat.
Key point: Never apply heat over swollen, acutely inflamed, or recently injured joints. Use only gentle warmth — cats are sensitive to heat and burns can occur with improper use of heated pads or compresses.
Environmental modification is one of the most impactful components of feline OA management and is often underutilised. The goal is to reduce the daily physical demands that OA makes painful while preserving the cat’s independence, choice, and quality of life. Small changes to layout, access, and resting areas can make a substantial difference to how a cat with OA navigates their daily routine.
Key home modifications: Provide low-sided or front-entry litter trays to eliminate painful high-step entry. Position food, water, and beds on the ground floor where possible, or provide step access to preferred elevated areas. Use non-slip surfaces under bowls and in sleeping areas. Ensure the cat has access to warm, draught-free resting spots at multiple levels. Consider a ramp or step system to favoured high spots to replace demanding jumps. Avoid forcing the cat to share space with dogs or other cats if interaction is causing stress-related guarding.
Hydrotherapy in Cats: A Note
Hydrotherapy, which forms a valuable part of canine OA rehabilitation, is very rarely appropriate for cats. Most cats are highly averse to water immersion and the stress of hydrotherapy would far outweigh any therapeutic benefit. In exceptional cases where a cat is highly water-tolerant, warm water therapy may be considered — but this is the exception rather than the rule, and the decision requires careful individual assessment.
This is one of the most clinically significant differences between feline and canine rehabilitation: several modalities routinely used in dogs — including hydrotherapy, treadmill work, and many forms of exercise equipment — are simply not transferable to cats. Effective feline physiotherapy draws on a smaller toolkit but applies it with greater specificity and patience.
The Role of Veterinary Collaboration
Feline OA management is most effective when physiotherapy and veterinary care are coordinated as part of an integrated plan. Cats with OA frequently benefit from concurrent veterinary medication — including NSAIDs licensed for cats and appropriate joint supplements — alongside physiotherapy. Pain that is inadequately managed pharmacologically will limit what physiotherapy can achieve; conversely, physiotherapy addresses the muscle loss, movement quality, and functional decline that medication alone cannot resolve.
Veterinary sign-off is required before beginning a feline physiotherapy programme, and we work closely with referring vets to ensure that our assessment findings and treatment plans are communicated and coordinated with the broader clinical picture.
Frequently Asked Questions
My cat doesn’t limp — could they still have OA?
Yes — and this is the single most important thing for cat owners to understand. Cats rarely limp from OA in the way dogs do. Instead they change their behaviour: resting more, grooming less, avoiding heights, becoming more withdrawn, or reacting sharply to touch in painful areas. Radiographic studies consistently show OA present in the majority of middle-aged and older cats regardless of whether owners have noticed any signs. If your cat is over seven years old and has changed in any of the ways described in this article, an OA assessment is worthwhile.
Is physiotherapy stressful for cats?
In experienced hands, no — but feline physiotherapy does require a fundamentally different approach from canine work. Sessions are shorter, the environment is calm and cat-friendly, and the physiotherapist reads and responds to the cat’s body language throughout. Many cats tolerate and even appear to enjoy gentle soft tissue work and laser therapy once they have become accustomed to the environment. Stress reduction is not an afterthought in feline physiotherapy — it is a core clinical priority.
Can physiotherapy help an older cat who has been stiff for a long time?
Yes. The same principle that applies in dogs applies in cats: it is never too late to begin, and even cats with longstanding OA and associated muscle loss can experience meaningful improvements in comfort, mobility, and quality of life with appropriate physiotherapy. The goals may be more modest than in a younger cat presenting early, but reduced pain, improved ease of daily activities, and a better quality of life are achievable at every stage.
How does feline OA physiotherapy differ from what I would receive for my dog?
In several important ways. Sessions are shorter and the handling approach is more patient and observational. Exercise prescription is environment-based rather than handler-directed. Hydrotherapy is almost never used. The most commonly treated area is the spine rather than the peripheral joints. Treatment intensity is calibrated carefully to the individual cat’s tolerance, and building a positive association with the treatment environment over successive visits is itself a clinical priority. The underlying principles are the same — pain management, muscle support, movement quality, home environment — but the application is species-specific throughout.
Scientific References
Hardie, E.M., Roe, S.C. and Martin, F.R. (2002). Radiographic evidence of degenerative joint disease in geriatric cats: 100 cases (1994–1997). Journal of the American Veterinary Medical Association, 220(5), 628–632.
Lascelles, B.D.X., Henry, J.B., Brown, J., Robertson, I., Sumrell, A.T., Simpson, W., Wheeler, S., Hunter, L., Chandler, K., Vitt, J. and Griffith, E. (2010). Cross-sectional study of the prevalence of radiographic degenerative joint disease in domesticated cats. Veterinary Surgery, 39(5), 535–544.
Lascelles, B.D.X. and Robertson, S.A. (2010). DJD-associated pain in cats: what can we do to promote patient comfort? Journal of Feline Medicine and Surgery, 12(3), 200–212.
Gruen, M.E., Griffith, E.H., Thomson, A.E., Simpson, W. and Lascelles, B.D.X. (2015). Detection of clinically relevant pain relief in cats with degenerative joint disease. Journal of Veterinary Internal Medicine, 29(1), 74–82.
Benito, J., Depuy, V., Hardie, E., Zamprogno, H., Thomson, A., Simpson, W., Roe, S., Hansen, B.D. and Lascelles, B.D.X. (2013). Reliability of accelerometry-based activity monitors versus owners’ perceptions of activity in arthritic cats. Journal of Feline Medicine and Surgery, 15(3), 189–197.
Book a Feline Mobility Assessment
If your cat is moving less freely, grooming differently, avoiding heights they used to manage, or has simply become quieter and less engaged — OA may already be affecting their quality of life. We offer feline-specific physiotherapy assessments in a calm, cat-friendly environment, working alongside your vet to build a tailored management plan. Our clinic is based at Old Flatts Farm, Treeton (Rotherham/Sheffield).
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