Help improve feline chronic pain management with integrative therapies such as acupuncture, chiropractic, BAEO®, ozone, and other complementary modalities.
Most cats are very good at hiding pain. Guardians may not notice minor changes in movement and only bring their cats to see a vet when there is a major problem. Also, pharmacological treatments are limited for chronic, post-op or post-injury pain in cats. Fortunately, integrative therapies make a fabulous and effective addition to the treatment regimen for cats with chronic pain.
Signs of pain in cats
Not using the litter box due to pain may be misinterpreted as a urinary or defecation issue. The cat may find it difficult to climb into the litter box or get into position to urinate or defecate. They then develop urinary tract infections, anal gland issues, or constipation. In geriatric cats, you should always screen for arthritis if litter box issues are the primary symptom.
A cat’s reluctance to jump on things as they did before may go unnoticed by the guardian. You may want to ask the client to look for evidence of where their cat is lying down – e.g. fur or imprints in the area. If the cat is consistently lying close to the floor and nowhere higher, the guardian should bring the cat in for arthritis screening.
Seeking warm places can be a sign of pain since warmth will move the pain stagnation and help the cat move better.
Yowling at night can be a sign of pain and may be caused by multiple diseases such as hyperthyroidism, urinary tract infections, and even cognitive issues. Osteoarthritis should be ruled out as a cause of yowling or vocalization, especially in geriatric cats.
An unkempt appearance can mean the cat is unable to bend to clean some areas, suggesting a biomechanical problem. Another cause to consider is kidney disease, which may go hand-and-hand with arthritis.
If the cat is licking or removing hair in certain spots, especially over the joints or belly, consider pain rather than a skin issue, especially if they are not licking anywhere else.
Aggressive behavior, or an unwillingness to let other members of the family near them, can indicate the cat does not “feel well.” They may hide away or avoid contact with humans or other animals in the home. This reflects a need to self-protect, as they feel they are not well enough to defend themselves. There are many diseases to consider when this behavior occurs but always rule out biomechanical issues.
A change in gait or biomechanics is usually the last thing noticed by guardians as pain, since cats are very adept at hiding, illness or weakness.
The lack of Western medication for cats in chronic pain often results in early euthanasia or an inability to control or manage the pain. Because cats exhibit pain differently, they may go without proper diagnosis and be treated for other diseases, such as urinary or cognitive issues.
The primary area for osteoarthritis in cats is often the hips. Cats jump very large distances, leading to wear and tear on joints over time. Many cats also have spinal issues that go unnoticed because they will “slink around” rather than present a gait that is easy to observe. If a cat is over-grooming in the same spot over a joint, consider pain in that area and use proper diagnostics like x-rays to assist in ruling in arthritis.
Integrative alternatives for feline pain management
Luckily, integrative medicine offers many safe and effective alternatives for managing pain in cats.
Acupuncture
TCVM or TEAM (Traditional East Asian Medicine) is well known for assisting with pain. The location of the cat’s pain will determine which acupuncture points are used. For cats that won’t accept needles, alternative methods include using a laser or tuning fork on the points, or electrostimulating the points.
As mentioned above, common areas for arthritis in cats are the spine and hips. A great combination of acupoints for pain include UB18, 20, 21, 23, 32, 40, GB30, 34, and ST36
A small bleb of B12 inserted into the points with a 27-gauge needle is very effective. Treating the cat every one to three months is usually very good for pain management. Dipping the needles in appropriate Biologically Active Essential Oils® (BAEO®) is also effective.
Chiropractic or spinal manipulation techniques
Biomechanical techniques are helpful for preventing the early onset of arthritis or myofascial pain, or to treat post-diagnosis. Cats are very receptive to biomechanical manipulations like chiropractic, fascia release techniques, Tui Na, or craniosacral therapy.
Laser therapy
Cats respond very well to laser since treatment times are fast and the technique is less invasive than acupuncture and spinal manipulation. The downside is that laser therapy is less effective on its own than when combined with acupuncture or spinal manipulation.
Combining laser with BAEO® therapy is significantly more effective. Apply the BAEO® first then use laser therapy to carry the oils into deeper tissues. This will promote tissue healing and give an anti-inflammatory effect.
Shockwave therapy
Cats tolerate the percussive nature of shockwave therapy well. Directing shockwaves at the peri-spinal muscles or hip flexors and hamstrings is very beneficial for cats who cannot get into the little box or crouch to urinate or defecate. Sometimes, the pain is in the muscle tissues rather than the joints. The fascia planes and muscle tendons and ligaments restrict the range of motion around the joint. Loosening the tissue and fascia planes with shockwave therapy combined with BAEO® is very effective for restoring range of motion and movement in cats. Three hundred pulses into the tissue are usually sufficient for each region.
BAEO® blends
BAEO® combined with any hands-on therapy, or on its own, can be one of the safest and most powerful pain management methods in cats. The BAEO® must not carry any impurities; the wrong oil or an adulterated oil can harm a cat. Since 1997, this author has been using BAEO® without incident or injury to successfully manage pain and other diseases. Understanding what constitutes a BAEO® is beyond the scope of this article, but information may be found at the Veterinary Medical Aromatherapy Association (VMAA). This author’s observations have shown that impure essential oils can pose harm to cats, but BAEO® blends do not. The VMAA is dedicated to educating the public on safe and effective use of BAEO®.
The most effective BAEO® for pain management in cats is often combined with other modalities; however, there are hundreds of successful cases where only BAEO® was used. Designed by the author, the following blend used over painful areas, followed by moist heat to push the oils in deeper, is most effective:
The Back Blend Formula
15 ml carrier oil such as fractionated coconut oil (chemical free)
15 drops of Wintergreen (Gaultheria procumbens)
15 drops of Cypress (Cupressus sempervirens)
5 drops of Copaiba (Copaifera officinalis)
15 drops of Lemongrass (Cymbopogen flexuosus)
Apply 2 or 3 drops over the area using the baby application method. Then apply a moist, warm compress over the area for one to five minutes, depending on the cat’s tolerance. This can be done twice a day for three weeks; then take a week off, then repeat each month, three weeks on and one off.
The single oils can also be applied without dilution, using the baby application method, over painful areas four or five times a week without any issues. They are safe and effective.
Other single oils that are helpful include Frankincense (Boswellia carterii), Helichrysum (Helichrysum italicum), Copaiba (Copaifera officinalis) and Melissa (Melissa officinalis).
Any of these BAEO® can be combined with acupuncture, spinal manipulation techniques, laser, massage, or used their own for safe and effective pain management in cats.
Peptides
Peptides have become more popular as the public has discovered their benefits. They can also be successfully used with cats. As with all supplements, quality control and manufacturer integrity are of utmost importance. Do your research to find the best company to purchase peptides from.
Insulin was the first peptide ever used. Injecting peptides is more effective in pets than some oral preparations that are absorbed via the mucosal membranes. Peptides cannot be swallowed and absorbed whole. The use of injectable BPC-157 and TB-500 peptides in cats can manage pain well and promote tissue repair. They often come as a combined pair and can be injected with one insulin needle daily for eight weeks. Then take a break for four weeks and repeat over and over. The amount injected will depend on the product and is proportional to a human dose. If autoimmune conditions are suspected as the reason for pain and inflammation, the selection of KPV peptide may be more effective.
Peptide use in pets is relatively new and found to be very helpful as part of an integrative approach to pain in cats. Most research has been done on animals but there are not many studies yet for cats.
Homeopathy
Cats respond to homeopathy or homotoxicology very well. These remedies do not need to be digested and are therefore easily accepted without side effects. The use of homeopathic supplements and BAEO® (which do not interfere with homeopathics like impure essential oils will) can often provide enough pain management for years on their own. Cats do not dislike the taste of homeopathics and will respond to them better than supplements that often need to be digested, absorbed, and used in biochemical pathways. Guardians also find administering homeopathic medicine to cats easy compared to other therapies. This author has used a combination pain blend from a homotoxicology company to be very effective:
Homotoxicology blend
Combine Heel Traumeel and Zeel. Give up to ½ dropperful or 1 to 2 drops every 12 hours for maintenance. You can use it every 15 minutes to effect if needed.
PEMF
Pulsed Electromagnetic Field therapy is a soothing and easy way to treat pain and inflammation in cats. Often, guardians will purchase products to use at home. They find the cat will gravitate toward the pad when they turn it on. Using it once a day is most beneficial. There are several products to choose from.
Massage, craniosacral therapy, fascia release therapy
Any hands-on therapies are either well received by cats or fully rejected. Remember that the cat is in charge. Using BAEO® can increase effectiveness, as can combining them with tuning forks, crystals and colors. Different courses can support your knowledge on the techniques to use – e.g. from VMAA and Optimum Pet Vitality (OPV).
Ozone therapy
It is this author’s opinion that ozone should be part of any integrative plan of action for any disease. Ozone provides the needed oxygen and antioxidant capacity to allow the body to heal its own tissues. It is strongly antimicrobial, anti-inflammatory and promotes tissue healing. Rectal ozone is a fast and easy method of administration for cats. Injecting ozone around a painful area with a 27-gauge needle can promote healing. Ozone is safe to use with other modalities.
TEAM formulas
While cats do not digest herbs as well, tincture forms of TCM formulas can be beneficial. For pain, the TCM diagnosis should determine which formula you use.
- If the pain is from Xue (Blood) stagnation, then Shen Tong Zhu Yu Tong should be used.
- If the pain is from Xue and Qi Xu (Blood and Qi deficiency) then use Du Huo Ji Sheng Tang.
- If the pain is due to Kidney deficiency, then Shen Qi Wan should be used.
There are many other formulas to consider, depending on the diagnosis. These are the most frequently used classical formulas.
Supplements
Supplements should include those that build muscle and connective tissue, support joints, and manage inflammation. Consider creatine, green-lipped mussel and Ligaplex from Standard Process. The best supplement to consider is bone marrow soup.
Cats do not digest and absorb all supplements the way dogs or humans do. They also don’t tolerate many supplements added to their food. This author leans toward using food rather than supplements to provide repair molecules.
Diet
An evolutionary appropriate diet is the best for cats. They are carnivores, so providing a diet rich in protein and fats with very few carbohydrates is best. Diet is the best form of disease prevention and management. Cats need to eat a well-rounded diet. Dry food will dry up joints, tendons and ligaments along with muscle. It is also difficult to digest. Carbohydrates are pro-inflammatory and fats are anti-inflammatory. Proteins and fats are the building blocks for growing and repairing tissue. Changing diets can take time, especially if the cat is addicted to dry food. Study up on the best diet choices and how to transition to that choice effectively.
Prevention is the best medicine
Cats aren’t as likely to regularly see a veterinarian until disease develops. Training cat guardians to come in more frequently is paramount to prevention.
Educating clients on appropriate evolutionary feeding provides the foundation for preventing all disease in cats. A chiropractic appointment every three months and an examination of the cat’s biomechanics are also important. Help ensure movement to help build strong muscles and joints by encouraging guardians to play daily with their cats.
Intervention is most successful early on. Educating guardians is the key to this step in pain management, as well as the health and longevity of their cats.
Long term pain management for cats
Include the following:
- Chiropractic
- Acupuncture
- BAEO® blends
- Pulsed peptide use
- Ozone
- Diet
- Play and movement
Husbandry suggestions for geriatric cats with pain
Provide heated areas so the cat can choose when and if to use them. Sunlight is best, but safe red light or far infrared light can be used. Some PEMF mats also have heat.
Ensure safety and security for the older cat so they don’t have to outrun or outjump other animals in the household. Feed them on their own.
Offer more litter boxes with lower sides throughout the house so the cat doesn’t have to walk as far or climb as much to use them. Provide both covered and uncovered boxes to see which the cat prefers.
Provide safe, private, warm places for the cat to retreat to that don’t require jumping.
Encourage daily play to exercise the cat’s musculoskeletal system.
Conclusion
Recognizing pain in cats is difficult. Pain symptoms are often mistaken for other things and may go undiagnosed or unnoticed. The best treatment for pain in cats is to encourage them to build muscle and engage in movement early on to prevent abnormal wear and tear on the musculoskeletal system. Provide a diet that is healing, not hurting. Have cat guardians come in every three months for biomechanical adjustments and for catching things early. Even though Western medicine does not offer much for pain in cats, integrative medicine can provide a plethora of tools for pain, prevention, and repair.
AUTHOR PROFILE
Dr. Nancy Brandt graduated from the University of Minnesota College of Veterinary Medicine in 1990, and later began her studies in acupuncture, Chinese medicine, chiropractic medicine, and naturopathic modalities. In 1999, she founded her practice, Natural Care Institute. In 2017, Dr. Brandt founded UnBound Center for Animal Wellness, for special needs pets. She pioneered the field of Veterinary Medical Aromatherapy® and founded the Veterinary Medical Aromatherapy Association (nancybrandtdvm.com and sparkeducationonline.com).
