Your cat jumps onto the sofa and lands awkwardly. She used to leap onto the bed without a second thought. Now she walks around it. You tell yourself she's just getting older. But here's what most Indian cat parents don't realise: cats are experts at hiding pain. By the time you notice something is wrong with your cat's joints, the problem has often been there for months.

Joint problems in cats include osteoarthritis (the most common, affecting 60–90% of older cats), septic arthritis caused by bacterial infection, immune-mediated arthritis where the body attacks its own joints, structural conditions like patellar luxation and hip dysplasia, cancerous joint disease, and trauma such as cruciate ligament tears or hip dislocation. Most are diagnosed with a physical exam and X-rays. Treatment ranges from pain management and weight control to surgery, depending on the cause and severity.

Key Takeaways

• Osteoarthritis is very common in cats but massively under-diagnosed because cats rarely limp the way dogs do they hide discomfort through behaviour changes instead.
• Approximately 60% to 90% of older cats have osteoarthritis, yet most are never treated because their signs are mistaken for "normal ageing."
• Joint problems in cats fall into five broad types: degenerative (osteoarthritis), infectious (septic arthritis), immune-driven, cancerous, and structural or traumatic.
• The main things to watch for are reluctance to jump, reduced grooming, stiffness after rest, personality change (irritability, hiding), and difficulty using the litter box.
• Never give human painkillers aspirin, ibuprofen, and paracetamol are toxic to cats. Feline pain must be managed with medications prescribed specifically for cats.
• Maintaining a healthy weight is one of the most effective things you can do for a cat with joint disease.

How do cat joints work — and why do they break down?

A joint is wherever two bones meet and need to move. The ends of the bones are coated in articular cartilage a smooth, slippery material that lets bones glide against each other without friction. The whole joint is enclosed in a capsule lined by the synovial membrane, which produces joint fluid the natural lubricant that keeps everything moving smoothly. Around the joint, ligaments hold the bones in alignment, and tendons anchor the muscles that move the joint.

When any part of this system is damaged cartilage wearing down, the synovial membrane inflaming, ligaments tearing, bones being knocked out of position the result is pain, swelling, and loss of movement.

Some joint diseases, such as arthritis, affect the joint membranes themselves. Other types of joint conditions affect the tendons, cartilage, bursae, and fluid within the joint. Joint disorders may be congenital (present at birth) or may be the result of injury to the joint, abnormal development, immune-related conditions, cancer, or infections.

The added complication with cats specifically is that their pain behaviour is subtle and inward. A dog with a bad hip limps visibly. A cat with the same bad hip climbs to a lower shelf and stops asking to go outside. The internal management of pain is a survival adaptation from their wild ancestry and it means joint disease goes unnoticed for far too long in most households.

What are the types of joint disorders in cats?

Each type looks different on X-rays, requires different lab tests, and responds to completely different treatments. This is why "my cat has joint pain" is just the starting point your vet needs to figure out which kind.

Osteoarthritis: the most common joint disease in cats

Osteoarthritis (OA) — also called degenerative joint disease or degenerative arthritis is the most common joint problem in cats and one of the most under-treated conditions in all of companion animal medicine. The joint cartilage in freely moving joints degenerates over time, leading to loss of joint movement and, in many cases, pain.

Approximately 60% to 90% of older cats have osteoarthritis. About 90% of cats over 12 years old have radiographic evidence of joint disease. This is not a rare condition. It is one of the most common sources of chronic pain in the cats sitting in Indian living rooms right now — and most of them are getting nothing for it.

What actually happens inside the joint

Joint degeneration can be caused by trauma, infection, the body's own immune system, or malformation during development. This leads to inflammation of the joint membrane, continued cartilage destruction and inflammation, and abnormal joint function. When the cartilage thins, bone starts rubbing against bone. The synovial membrane thickens and scars. Bony outgrowths (osteophytes) form. The joint fluid decreases in volume and viscosity. Pain signals amplify over time so the longer OA goes untreated, the more the nervous system becomes sensitised to pain, which is why starting management early genuinely matters.

In cats (unlike in dogs), OA is not generally related to orthopedic conformation issues except in Maine Coon cats, which are predisposed to hip dysplasia. This means a perfectly normal-looking cat can develop severe OA as it ages, simply from cartilage wear and inflammation.

Signs of osteoarthritis in cats

Signs of osteoarthritis include lameness, joint swelling, wasting away of muscle, thickening and scarring of the joint membrane, and a grating sound during joint movement. But the clinical picture in cats is often more behavioural than mechanical:

• Reduced jumping either not jumping at all, or only reaching lower surfaces than before
• Difficulty getting in or out of the litter box, especially high-sided ones
• Reduced grooming, or inability to groom the back, tail, and hindquarters properly which shows as a matted or greasy coat in those areas
• Stiffness when getting up after sleep, especially after a long rest
• Altered gait slightly wide-based in the hind legs, or a "careful" walk
• Sleeping more, hiding more, less interested in play
• Irritability when touched or picked up, especially over the lower back or hips
• House-soiling (a cat who associated the litter box with the effort of getting in)

The condition is common in cats but it may not be noticed because cats often hide signs of pain. This is the single most important sentence in this blog. A cat does not tell you its hip hurts. It just quietly stops doing the things that make the hip hurt.

Spondylosis deformans

A related degenerative condition worth knowing: spondylosis deformans is a non-inflammatory degenerative condition of the spinal column where bony growths develop along the underside of the vertebrae. It develops as cats age. It does not typically cause signs, but it may cause stiffness, pain, or other problems especially in the lower back.

Septic arthritis: when infection reaches the joint

Septic (infectious) arthritis is usually caused by bacteria that spread through the blood or enter the body as a result of trauma (with penetrating wounds) or surgery. Other causes of septic arthritis include rickettsiae and spirochetes.

In practical terms in India, the most common route is a bite wound particularly in cats that go outdoors, get into fights, or have contact with street animals. A cat bite puncture wound may look small on the outside but can introduce bacteria deep into a joint capsule. Another route is post-surgical contamination, or blood-borne infection spreading from elsewhere in the body.

Signs of septic arthritis include lameness, swelling, pain of affected joint(s), fever, listlessness, loss of appetite, and stiffness. The joint may be hot and painful to touch. The cat may be clearly unwell not just lame but visibly ill with fever and lethargy.

Treatment consists of antibiotics administered by mouth or intravenously, flushing of the joint cavity, and surgical removal of dead, damaged, or infected tissue in severe cases. Septic arthritis needs prompt veterinary attention left untreated, it destroys cartilage permanently and can become life-threatening.

Immune-mediated arthritis: the body attacking itself

The body's own immune system can cause inflammation of joints (immune-mediated arthritis). It generally affects several joints at once. In some types, joint cartilage and bone are gradually destroyed.

Two key forms in cats:

Feline progressive polyarthritis resembles rheumatoid arthritis in people. It is a destructive form that damages joint cartilage and the bone underneath. It typically affects young to middle-aged male cats. Signs progress over months stiffness, swollen joints in the feet and legs, gradually worsening lameness, fever, and weight loss.

Systemic lupus erythematosus (SLE) is the most common form of immune-mediated arthritis that causes joint inflammation without destruction of cartilage and bone. It may affect other organ systems, including the skin.

Signs of immune-mediated arthritis include lameness, pain and swelling in multiple joints, fever, a general feeling of illness, and persistent loss of appetite. These signs commonly come and go periods of relative normality alternating with flare-ups, which can make the condition hard to pin down without proper testing.

Diagnosis needs X-rays, biopsy of joint tissue, blood tests, and examination of joint fluid (a joint tap). Treatment involves anti-inflammatory medications and chemotherapeutic drugs. The outlook for recovery is uncertain relapses are relatively common.

Structural disorders: patellar luxation and hip dysplasia

These are conditions of abnormal joint development, present from birth or developing as the cat matures.

Patellar luxation

This hereditary disorder is caused by abnormal development of the kneecap (patella). Displacement of the kneecap can be associated with multiple deformities of the hindlimb, involving the hip joint, femur, and tibia. Cats of any age can be affected.

Signs vary based on severity. In mild cases, lameness occurs infrequently, and the kneecap can be manually moved back. As displacement becomes more severe, the dislocated kneecap is more often out of place, the limb is consistently lame, and bone deformities may be present. There are several surgical options for treatment, depending on the severity of the displacement. Cats are less severely affected than dogs and have an excellent outlook for recovery good news for families dealing with a young cat with this condition.

Hip dysplasia

Hip dysplasia is an abnormal development of the hip joints. It is rare in domestic cats but occurs more commonly in purebred cats particularly Maine Coons. It is characterised by a loose hip joint that eventually leads to degenerative joint disease (osteoarthritis). Signs of hip dysplasia vary, and lameness may be mild to severe.

Most cats require no surgical treatment; however, lifestyle changes such as weight reduction may help reduce discomfort. In severe cases, surgical options including femoral head ostectomy can help. Hip dysplasia in cats is much more manageable than in large-breed dogs, and most cats do well with appropriate support.

Joint trauma: cruciate tears, fractures, hip dislocation

Cranial cruciate ligament tear

Tearing of the cranial cruciate ligament of the knee joint is usually caused by serious injury. However, injuries are more likely to occur when the joint structure is already weakened by degeneration, the animal's own immune system, or defects in conformation of the joint. A tear can make the knee unstable and can lead to cartilage injury, buildup of joint fluid, bony outgrowths, and thickening of the joint membrane.

Signs include lameness, pain, joint swelling, fluid buildup, and a grating sound when the joint is moved. Physical therapy, weight reduction, and anti-inflammatory drugs ease inflammation and degenerative joint disease. The outlook after surgery is good as long as degenerative joint disease has not progressed too far.

Joint fractures

The shoulder, elbow, carpal (wrist), hip, stifle (knee), and tarsal (ankle) joints are those most commonly involved in fractures due to injury. In young cats, the growth plate at the ends of bones is particularly vulnerable. Signs include lameness, pain, and joint swelling. The goal of treatment is to allow the fracture to heal in proper alignment while maintaining joint and limb functions usually done by holding the fracture internally with pins, wires, or screws. The outlook for recovery is good as long as damage to the joint is not severe.

Palmar carpal ligament breakdown

When cats fall or jump badly, the wrist (carpus) can hyperextend, tearing the palmar carpal ligaments and causing collapse of the joint. This is a rare problem in cats. Signs include lameness, swelling of the carpal joint, and a characteristic stance in which the heel touches the ground. Surgery is usually required, involving fusing the affected joints. The outlook for recovery is good.

Hip dislocation

Hip dislocation is usually the result of injury or trauma a road accident, a fall, an attack. Signs include lameness, pain during movement of the hip joint, and a shortened limb. X-rays confirm the dislocation. Nonsurgical treatment involves forcefully moving the joint back into place (closed manipulation) and using slings. If this doesn't hold, surgical stabilization is needed. The outlook for recovery is usually excellent.

Cancerous arthritis

Cancerous arthritis is most commonly caused by a synovial cell sarcoma the most common malignant tumour involving the joints. Signs include lameness and joint swelling. When diagnosed, spread of the cancer to the lungs has already occurred in about 25% of animals. Amputation of the limb is usually recommended to alleviate pain and prevent spreading where possible.

What does joint pain actually look like in a cat?

This deserves its own section, because it is so easy to miss. Cats do not whimper. They do not drag a leg across the floor and look at you with sad eyes. The signs are quieter, and they layer on each other over weeks.

Watch for these behaviour shifts especially in cats over 7 years old:

• Jumping lower or not jumping at all. This is often the first sign. A cat who used to reach the top of the bookcase now goes only to the second shelf. A cat who slept on the bed now sleeps on the floor mat beside it.
• Litter box issues. Difficulty stepping over a high-sided litter box. Sometimes eliminating just outside the box, not in it because stepping in hurts. Treating a cat for a "behaviour problem" when the real cause is arthritis is unfortunately common.
• Grooming changes. Pain in the hips and spine makes it hard to twist and reach the lower back, base of tail, and hindquarters. These areas become matted, greasy, or overgrown with loose hair while the face and neck (easy to reach) remain well-groomed.
• Personality changes. Hiding more. Less interest in being petted. Swatting or hissing when touched in areas that weren't previously sensitive particularly the lower back and hips. A formerly sociable cat becoming grumpy or withdrawn.
• Muscle wasting. Over months, the muscles of the hindquarters visibly shrink from reduced use. The spine and pelvis become more prominent.
• Stiffness after rest. The cat gets up slowly, walks stiffly for a minute, then loosens up exactly like a person with arthritis on a cold morning.

In Indian households, these signs often go unnoticed because cats are largely indoor animals and their world is small. A cat in a Mumbai flat who stops jumping onto the kitchen counter may be labelled "less naughty" when actually she is just hurting.

How are joint problems diagnosed?

A vet will need a careful history of the cat's lameness, any previous injuries, and its overall health. The veterinarian will also perform a full examination that aims to identify the exact location of the lameness and any changes in the musculoskeletal tissues.

Step 1 — History. When did you first notice anything? What specifically changed jumping, grooming, litter box use? Is the cat indoor-only or does it go outside? Any past injuries? Video of the cat's gait at home is extremely helpful many cats are tense at the vet and won't show their normal movement.

Step 2 — Physical and orthopaedic examination. The vet palpates each limb and joint, feeling for swelling, heat, thickening, pain on flexion and extension, crepitus (grating), and muscle asymmetry. In cats this requires patience, as they often resist being handled. Your observations at home are genuinely important diagnostic information.

Step 3 — X-rays. X-rays show increased fluid within the joint, soft-tissue swelling around the joint, the formation of bony outgrowths, hardening and thickening of bone beneath the cartilage, and sometimes a narrowed joint space. X-rays can distinguish OA from septic arthritis, reveal fractures, confirm hip dysplasia, and stage the severity of the condition.

Step 4 — Blood and urine tests. To check for systemic infection, immune-mediated disease markers, kidney and liver function (critical before prescribing NSAIDs), and metabolic disease.

Step 5 — Joint fluid analysis (arthrocentesis). A joint tap drawing a small amount of fluid from the affected joint under sedation is the definitive test for septic arthritis (bacteria visible on microscopy, high white cell counts) and immune-mediated arthritis. Laboratory tests on fluid removed from the joint may help to confirm the diagnosis and identify the cause.

Step 6 — Advanced imaging. CT scans are sometimes used for fracture assessment. MRI, while expensive, can show soft tissue damage not visible on X-ray.

Treatment options for cats with joint disease

Medical management

Treatments for OA can be either medical or surgical. Medical therapy may include weight loss (when appropriate), controlled exercise on soft surfaces, warm compresses of the affected joint, and the use of appropriate drugs to reduce pain and inflammation.

NSAIDs (non-steroidal anti-inflammatory drugs) are generally the first treatment used for pain in OA. In cats, options include meloxicam (used carefully due to kidney risk) and robenacoxib. Importantly NSAIDs must never be given without a vet prescription in cats. Cat kidneys process these drugs differently from dogs and humans, and even short-term use in a cat with early kidney disease can be catastrophic.

Frunevetmab (Solensia) is a monoclonal antibody approved specifically for relief of pain due to osteoarthritis in cats. It works by blocking nerve growth factor (NGF), a molecule elevated in arthritic joints that drives pain. Given as a monthly injection by the vet, it avoids the kidney risks of NSAIDs and shows good results many cats show visible improvements in mobility and behaviour within the first two months.

Gabapentin addresses chronic pain differently from NSAIDs and is especially helpful for older cats who cannot take NSAIDs safely. It manages the neurological component of chronic pain sensitisation.

Corticosteroids are used for immune-mediated arthritis and for situations where NSAIDs are contraindicated, but carry their own risks with long-term use.

For septic arthritis: antibiotics by mouth or IV, joint flushing, and sometimes surgical debridement.

For immune-mediated arthritis: anti-inflammatory medications and sometimes immunosuppressive drugs.

Joint support supplements

Other treatments, such as joint fluid modifiers, may help prevent cartilage degeneration. Glucosamine and chondroitin supplements support cartilage structure, while omega-3 fatty acids particularly EPA and DHA have good evidence for reducing joint inflammation. A 2025 research review found that a diet enriched with omega-3 fatty acids is therapeutic for cats with moderate and severe OA.

For cats who won't take tablets, products that can be mixed into food like the glucosamine + chondroitin + omega-3 formula in Gerisure Powder from Areion Vet  make supplementation practical for daily use. For cats comfortable with tablets, comprehensive joint supplements like Pet Joint Tablet by Petcare combine glucosamine hydrochloride, chondroitin sulphate, and boswellia in a feline-appropriate dose. The Himalaya Ayurvedic Mobility Plus Tablet blends garlic, guggulu, and avocado in a natural anti-inflammatory formula for joint and hip support. Always start any supplement with your vet's guidance these are supportive tools alongside the main treatment, not a replacement for diagnosis.

Surgical options

Surgical options include joint fusion, joint replacement, cutting of the joint, and amputation. Surgeries specific to individual conditions include:

• Patellar luxation repair (deepening the groove the kneecap sits in, realigning the attachment point)
• Cruciate ligament repair
• Femoral head ostectomy (FHO) for severe hip dysplasia
• Open joint flushing and debridement for septic arthritis
• Fracture fixation with pins, plates, or screws
• Hip relocation for dislocation
• Amputation for cancerous joint disease

The outlook for recovery depends on the location and severity of the joint disease and your vet will give you a realistic picture of what to expect.

Managing a cat with joint problems at home

These are the changes that make the most difference in day-to-day quality of life:

Ramps and steps. Provide low-angled ramps or step stools to reach the sofa, bed, or windowsill these are the places that matter most to an arthritic cat. Replacing a big jump with a small step up lets them keep accessing their favourite spots without pain.

Litter box. Use a box with at least one low-cut entry point, so the cat doesn't have to step high to get in. The tray should be on a flat, non-slip surface. Don't put it behind a step or in a difficult-to-reach location.

Bedding. Thick, cushioned bedding with gentle support. Orthopedic memory foam cat beds are available and worth the investment for a senior cat with OA. Position beds at floor level and at the base of ramps to encourage them.

Food and water bowl height. Slightly elevated bowls 10 to 15 cm reduce the need for the cat to bend the neck and neck-spine junction while eating. This matters especially for cervical OA.

Warmth. Cats with arthritis are more comfortable when warm. Cold floors worsen stiffness provide a heated or well-insulated sleeping area, especially in winter months or in air-conditioned flats.

Grooming assistance. A cat who can no longer groom the hind end needs your help. Gentle daily brushing of the back, haunches, and base of tail and trimming of the area around the hindquarters if needed prevents matting and skin problems.

Nail trimming. Arthritic cats scratch less and may have difficulty grooming their claws. Trim claws every 8 to 12 weeks to prevent painful overgrowth into the paw pads.

Weight management. This is the single most important long-term intervention. Even a modest 10 to 15% reduction in body weight significantly reduces joint load. Work with your vet on a calorie-controlled feeding plan if your cat is overweight.

Pain monitoring. Learn what your cat's normal behaviour is, so you can detect changes early. A simple check every few weeks "is she jumping as high? Grooming herself? Using the box normally? Being as social as usual?" gives you the information your vet needs.

Can joint problems in cats be prevented?

Not all joint disease is preventable some structural conditions are inherited, and OA is partly an inevitable consequence of ageing. But you can meaningfully slow progression and reduce severity.

Maintain a healthy weight from early in life. Overweight cats develop OA earlier and more severely. This is the highest-impact prevention tool available. Obesity is the most modifiable risk factor.

Ensure a balanced diet. A complete, high-quality commercial diet provides the building blocks for joint tissue maintenance. Discuss omega-3 supplementation with your vet if your cat is senior or at breed-level risk.

Choose appropriate indoor environments. Don't force a cat to make large jumps for every essential item litter box, food, and sleeping areas should all be at a manageable height for a medium-sized cat.

Manage injuries promptly. A bite wound that develops septic arthritis, a ligament partially torn that develops degenerative changes, a fracture poorly healed that leaves a joint unstable these lead to chronic joint disease. Early, complete treatment of injuries protects joint health in the long run.

Screen senior cats routinely. From age 8 onwards, twice-yearly vet visits with X-rays of the joints (or at minimum, a careful orthopaedic exam) can catch early OA before it becomes severe. Early detection allows early intervention which genuinely changes quality of life.

Know your breed's risk. If you have a Maine Coon, Scottish Fold, Persian, or other breed with known joint susceptibility, discuss early monitoring with your vet. Scottish Folds carry a cartilage disorder (osteochondrodysplasia) affecting all joints that begins in kittenhood this is a breed ethics issue as well as a health one, and all Scottish Folds should be monitored for progressive joint disease from a young age. Animeal's guides on how to prevent lethargy in your cat and cat not eating but active both touch on the metabolic and weight factors that indirectly protect joints.

FAQs

How do I know if my cat has arthritis?
The signs are mostly behavioural reduced jumping (or jumping to lower surfaces than before), difficulty with a high-sided litter box, reduced grooming of the back and hindquarters, stiffness after sleep, hiding more, and irritability when touched over the lower back or hips. Cats do not limp dramatically the way dogs do. Approximately 60% to 90% of older cats have osteoarthritis, but most are never diagnosed because the signs are subtle and owners attribute them to normal ageing. If your cat is over 7 years old and you've noticed any of these changes, bring it up at your next vet visit.

Can I give my cat human pain relief for joint pain?
Absolutely not. Aspirin, ibuprofen, naproxen, and paracetamol (acetaminophen) are toxic to cats even a single dose can cause severe kidney damage, liver failure, or death. Cats metabolise these drugs completely differently from humans. Pain relief for a cat must come from a veterinarian who prescribes a drug that is safe for feline kidneys and liver at the correct dose. Common veterinary options include meloxicam, robenacoxib, gabapentin, and frunevetmab injections.

Are there cat breeds more prone to joint problems?
Yes. Maine Coons have a higher rate of hip dysplasia than most domestic cats. Scottish Folds have a breed-level cartilage disorder (osteochondrodysplasia) that causes painful joint disease in all four limbs and the spine essentially every Scottish Fold develops progressive joint disease, often severe. Persians and Himalayans may also be more susceptible to OA. Any cat can develop OA with age, but these breeds need monitoring earlier and more closely.

What does "joint fluid analysis" involve?
Joint fluid analysis (arthrocentesis) means drawing a small sample of the fluid inside the affected joint, under sedation or light anaesthesia, to look at it under a microscope. In septic arthritis, you'll see bacteria and very high numbers of infection-fighting white cells. In immune-mediated arthritis, you'll see a different pattern of inflammatory cells. In OA, the fluid looks different again increased volume but normal to slightly elevated cell counts. It is the key test for distinguishing infectious from immune-mediated arthritis, and your vet needs this information to prescribe the right treatment.

Can a cat with arthritis have a good quality of life?
Yes with appropriate management. OA cannot be cured, but it can be managed well. With appropriate management, cats with OA can live a normal lifespan. The combination of pain medication (or a monthly frunevetmab injection), a healthy body weight, appropriate environmental modifications (ramps, low litter box, warm bedding), and joint supplements can allow an arthritic cat to be comfortable, social, and engaged for many years. The key is diagnosis and intervention before the disease becomes severe.

When should I take my cat to the vet for joint concerns?
Take your cat in for an assessment if you notice any of the following: reluctance to jump that is new or worsening, changes in litter box use that can't be explained by the box itself, reduced self-grooming of the back or hindquarters, persistent stiffness after rest, personality changes like unusual irritability or hiding, a visible limp or lameness in any limb, a swollen warm joint, or any sudden inability to bear weight on a limb. In young cats, a sudden lameness after a jump or fight is an urgent concern it may be a ligament tear, fracture, or bite-wound infection that needs same-day attention.

References

1. Harari, J. (Aug 2018, modified Mar 2026). Joint Disorders in Cats. Merck Veterinary Manual. https://www.merckvetmanual.com/cat-owners/bone-joint-and-muscle-disorders-of-cats/joint-disorders-in-cats
2. Merck Veterinary Manual. Overview of Musculoskeletal Disorders and Diseases in Cats. https://www.merckvetmanual.com/cat-owners/bone-joint-and-muscle-disorders-of-cats/overview-of-musculoskeletal-disorders-and-diseases-in-cats
3. Merck Veterinary Manual. Lameness in Cats. https://www.merckvetmanual.com/cat-owners/bone-joint-and-muscle-disorders-of-cats/lameness-in-cats
4. Epstein, M.E. Osteoarthritis in Dogs and Cats. Merck Veterinary Manual. https://merckvetmanual.com/musculoskeletal-system/arthropathies-and-related-disorders-in-small-animals/degenerative-arthritis-in-small-animals
5. VCA Animal Hospitals. Arthritis in Cats. https://vcahospitals.com/know-your-pet/arthritis-in-cats
6. SpectrumCare. Cat Pain Medications. https://spectrumcare.pet/cats/medications/cat-pain-medications
7. SpectrumCare. Cat Pain Management Cost. https://spectrumcare.pet/cats/costs/cat-pain-management-cost