Osteoarthritis in cats: what we know, and mostly, what we don't know. . . yet.

Osteoarthritis (OA) is a degenerative joint disease that is considered the primary source of chronic pain in cats, affecting well over a quarter of the feline population. Despite its prevalence, detection and diagnosis rates remain low, as many owners are unaware of the signs of feline OA. There is limited knowledge regarding the management of feline OA, with only 29 publications available, many of which lack rigorous methodology. Furthermore, most research focuses on the efficacy of non-steroidal anti-inflammatory drugs, while proposed alternatives to alleviate feline OA pain - such as food restriction, weight loss, adjunctive musculoskeletal treatments with biologics, physiotherapeutic modalities and lifestyle changes - are primarily based on human clinical studies and veterinary research on other species, which introduces a high risk of bias. New promising avenues are being explored with anti-nerve growth factor monoclonal antibodies; however, the long-term effects of repetitive administration, optimal conditions for administration and specific indications have yet to be described. Research from the Groupe de recherche en pharmacologie animale du Québec (GREPAQ) on pharmacological and non-pharmacological therapies for feline OA suggests that a shift in the OA management paradigm may be warranted. An omega-3 enriched diet has demonstrated therapeutic efficacy comparable to standard pharmacological treatments, without side effects and with high compliance. In addition, it was equally effective for cats with severe OA as for those with moderate OA. By establishing a theoretical framework for feline OA management based on robust scientific evidence, veterinarians will be better equipped to select treatments tailored to the diagnosed (or suspected) manifestations and mechanisms of OA pain, ultimately improving the health and well-being of their feline patients. Future research should explore the concomitant use of different therapeutic approaches, as they may offer superior outcomes compared with a single treatment through additive or synergistic effects.