Your Cat Is Not Just Slowing Down: Spotting Arthritis, the Pain Cats Are Built to Hide

Here is one of the most under-appreciated facts in feline medicine: studies using X-rays have found arthritic changes in the joints of the large majority of cats over the age of 12 — in some studies approaching 90% — and degenerative joint disease turns up in a surprising number of cats as young as six. Yet if you ask a room of cat owners how many have an arthritic cat, only a handful of hands go up.

The gap between those two numbers is not a mystery. It exists because arthritis in cats looks almost nothing like arthritis in dogs — or in people. A dog with a sore hip limps. A person with a sore knee complains. A cat with painful joints does something far more inconvenient for the humans watching: it simply does less, quietly, over months and years, until the change is so gradual that it gets filed away as "he's just getting old."

Slowing down is not a diagnosis. Very often, it is a symptom. This guide covers why the pain hides so well, the specific behaviours that give it away, and the genuinely good treatment options that now exist.

Why Cats Almost Never Limp

There are two reasons feline arthritis stays invisible, and both come down to how cats are built.

The first is evolutionary. Cats are small, solitary predators who are also prey. An animal that visibly advertises weakness gets eaten, so cats evolved to mask pain with a thoroughness that borders on stubbornness. A cat in real discomfort will still purr, still eat, still greet you at the door.

The second is anatomical, and it is the one that catches even experienced owners out. Canine arthritis usually strikes one joint harder than its partner, so the dog shifts weight off the sore leg and you see a limp. Feline arthritis is overwhelmingly symmetrical — both elbows, both hips, both knees, or the spine. When both sides hurt equally, there is no good leg to limp onto. The gait stays even. What changes instead is what the cat is willing to attempt.

The joints most often affected are the elbows, hips, stifles (knees), hocks and the lower spine. Elbows are among the commonest sites, which matters because elbow pain shows up on the way down from a height rather than on the way up.

A vet walks through the everyday signs of feline arthritis and what you can change at home.

The Signs That Actually Matter

Forget limping. Arthritis in cats is a disease of small, missing behaviours — things your cat used to do and has quietly stopped doing. Look for:

• Hesitating before a jump. The cat sits at the base of the sofa, gathers itself, considers, and then goes. That pause is the tell. Comfortable cats launch without deliberation.
• Breaking one jump into two. A cat who used to leap straight onto the kitchen counter now goes via a chair. This is one of the most reliable early signs, and owners rarely report it — because it doesn't look like a problem, it looks like the cat found a smarter route.
• Reluctance to jump down. Landing loads the elbows and shoulders hard. A cat that will still climb up but stands on the bed complaining before descending is telling you something specific.
• Lower jump height. Windowsills, beds and shelves that were once routine become "not worth it," and favourite perches get abandoned.
• Bunny-hopping the stairs with both back legs together, or taking them one step at a time instead of at a run.
• A scruffy, matted coat — especially over the lower back, hips and base of the tail. Grooming means twisting a painful spine, so cats who cannot reach simply stop, and the fur mats exactly where the flexibility used to be.
• Overgrooming one specific spot, often a knee, elbow or wrist, sometimes down to a bald patch. Cats lick what hurts.
• Toileting just outside the litter box. Climbing over a high-sided box and holding a crouch are both painful. This is frequently misread as behavioural spite when it is orthopaedic pain.
• Overgrown, thickened claws. Arthritic cats scratch less, so their claws stop shedding their outer sheaths.
• Irritability when handled, particularly over the hips or lower back — a swipe or a hiss during petting that never used to happen.
• Sleeping more, playing less, hiding more. The classic "he's just an old man now" package.

What an X-Ray Can (and Cannot) Tell You

Here is a genuinely counter-intuitive point: in cats, the severity of arthritis on an X-ray correlates poorly with how much pain the cat is in. A cat with dramatic-looking bony changes may be comfortable; a cat with modest changes may be miserable. Radiographs confirm that disease is present, but they cannot measure the suffering.

Which is why you are the most important diagnostic instrument in the room. Your cat will be flooded with adrenaline at the clinic and will stalk across the consult table as though nothing hurts. The behaviours that reveal arthritis only happen at home. So before the appointment:

• Film your cat on your phone jumping up onto and down from its usual perch, and climbing the stairs. Thirty seconds of footage is worth more than any description you can give.
• Write down what has changed over the last year — the perch it abandoned, the mats that appeared, the shortcut it invented.
• Ask your vet about validated owner questionnaires such as the Feline Musculoskeletal Pain Index, which turn these fuzzy observations into a score you can track over time.

Because arthritis is a diagnosis of function rather than film, a vet will sometimes propose a pain-relief trial: treat for a few weeks and watch whether the cat starts jumping again. If it does, you have your answer.

Real cats filmed before and after arthritis treatment — the change in how they move is the clearest argument for not writing pain off as age.

Treatment Has Genuinely Changed

For decades feline arthritis was hard to treat, because cats metabolise most painkillers badly. That has shifted, and it is worth knowing what is now on the table.

• Anti-NGF antibody injections. A monthly injection given at the vet (sold as Solensia, active ingredient frunevetmab) targets nerve growth factor, a key driver of arthritis pain. Approved by the FDA in 2022 and licensed in the UK and EU, it is an antibody rather than a drug cleared by the liver — which makes it an option for cats whose kidney or liver values rule out anti-inflammatories.
• Anti-inflammatory painkillers (NSAIDs). Meloxicam and robenacoxib are licensed for cats, though the permitted duration varies by country — long-term meloxicam is licensed across much of Europe and Australia but is not labelled the same way in the US. Kidney values are normally checked before starting and monitored during treatment.
• Gabapentin, often used alongside other drugs, and doubly useful because it takes the edge off both nerve pain and the anxiety of a vet visit.
• Weight loss. Unglamorous and enormously effective. Every extra gram is load on an inflamed joint, and slimming an overweight arthritic cat reliably improves mobility.
• Omega-3 fatty acids (EPA and DHA) and prescription joint diets have reasonable supporting evidence. Glucosamine and chondroitin supplements are sold everywhere, but the evidence in cats is thin — discuss it before spending.

Never give your cat human painkillers. Paracetamol (acetaminophen) is lethal to cats even in small doses, and ibuprofen and aspirin are dangerous. Cats lack the liver enzymes to process them safely.

Redesigning the House Around Sore Joints

Medication does the heavy lifting, but small environmental changes hand an arthritic cat back its independence — and most cost nothing.

• Cut a low entrance into the litter box or buy a shallow-sided one, and put a box on every floor of the house so a stiff cat is never far from one.
• Build a staircase to the favourite perch — a stool, a stack of sturdy boxes, or a purpose-made pet ramp lets the cat reach the windowsill without a painful landing.
• Put down non-slip rugs or runners on laminate, tile and polished wood. Slipping is frightening and painful for a cat with weak hindquarters.
• Raise the food and water bowls slightly, so the cat is not crouching down onto sore elbows to eat.
• Provide a soft, warm bed at floor level. Warmth genuinely eases stiff joints, which is why heated pet beds are so popular with senior cats.
• Take over the grooming your cat can no longer manage — gentle daily brushing of the lower back and hips — and keep the claws trimmed, since they are no longer wearing down naturally.
• Keep the cat gently moving. Short, low, non-jumping play sessions maintain muscle mass, and muscle is what stabilises a bad joint.

A short, practical summary of the early red flags worth watching for at home.

The Bottom Line

Arthritis is not a rare misfortune that strikes a few unlucky cats. It is close to a normal part of feline ageing, and its central cruelty is that it is invisible by design — the same instinct that once kept a small predator alive now hides its pain from the one person able to do something about it.

So change the question you ask about your ageing cat. Not "is he limping?" but "what did he used to do that he doesn't do any more?" The windowsill he has abandoned, the mats appearing over his hips, the chair he now uses as a halfway step to the counter — these are not the harmless quirks of old age. They are a cat telling you, in the only language available to it, that something hurts. And unlike so much of what goes wrong in an old cat, this one is very treatable.

This article is general information, not veterinary advice. If your cat has become less active, stopped jumping, or is grooming poorly, book a check-up — and take video of the behaviour with you.