When a 14 year old cat stops jumping onto the bed even with ramps and a monthly pain score that keeps climbing, the answer is not a stronger pill. It is a small set of clinic procedures: joint injections on a 4 to 6 week cycle, laser sessions of about 10 minutes, and underwater treadmill walks that start at 5 minutes. All 3 are prescribed and performed by a veterinarian, and every product and dose is set by prescription against body weight and kidney function.
What an injection course looks like
The usual interval is 1 injection every 4 to 6 weeks, and a first course of 3 injections is the common pattern. Which product is used, and at what volume, is a prescription decision tied to weight and kidney values, so this page gives timing and assessment only. Hips, stifles, and elbows are the usual targets; the spine is not injected. The visit runs 20 to 30 minutes including light sedation and recovery, and most cats go home the same day with a note to keep the room at 20 to 22 C for 24 hours.
The 4 assessment nodes that decide whether to continue
Procedures without a score are just spending. Fix 4 points on the calendar. Baseline: full examination, bloodwork, blood pressure, and a 20 second video of the cat walking 3 metres toward the camera. Day 14 after the first injection: a phone check on appetite, jumping, and litter box use. Week 6: the second injection plus a repeat of the same 5 item score. Month 3: a decision point, where a stable score means stretching the interval to 8 weeks and 2 cycles with no change means stopping.
| Modality | Session length | Frequency | Course | Recheck point |
|---|---|---|---|---|
| Joint injection | 20 to 30 min visit | every 4 to 6 weeks | 3 injections | day 14, week 6, month 3 |
| Laser | 10 min | 2 per week | 8 sessions in 4 weeks | week 4 |
| Underwater treadmill | 5 min first, to 20 min | 2 per week | 6 weeks | week 3 |
| Home range of motion | 3 to 5 min | 2 per day | 12 weeks | every 4 weeks |
The table is the whole schedule on 1 page. Photograph it, because the most common failure is not a bad procedure but a course that stops at session 2 when the cat seems better, then restarts 4 months later from zero.
Laser: 10 minutes, and why the clock is short
Photobiomodulation with a class 3b or class 4 laser runs about 10 minutes per session over 2 or 3 joint areas, with the coat parted and the probe held still for 20 to 30 seconds per spot instead of swept fast. The standard course is 2 sessions a week for 4 weeks, so 8 sessions, then 1 session every 2 to 4 weeks as maintenance. Everyone in the room wears eye protection, including the person holding the cat. Judge it on function, not on heat: 1 point off a 10 point pain score, or 1 new jump onto a 40 cm box, is a real result; a cat that seems looser for 2 hours and stiff again by evening has not improved.
Underwater treadmill: 5 minutes is the start line
Water at 28 to 30 C, depth to mid-thigh for session 1, belt at 0.5 to 0.7 km/h, and 5 minutes on the clock. Each session adds 1 to 2 minutes until the cat works 15 to 20 minutes, twice a week for 6 weeks. Most cats need 2 calm sessions with the same technician before they stop paddling; a cat that panics is not a candidate, because the stress response costs more than the exercise gains. Watch the tail and the ears, not the stopwatch, and stop at 3 minutes if the cat is hissing.
The 3 cats who should not be booked
First, a cat with an open wound, an active skin infection, or a joint injected in the past 48 hours: a flare in that window cannot be told apart from infection, so wait 10 to 14 days. Second, a cat with uncontrolled heart disease or a resting respiratory rate above 30: the treadmill is off the table until a cardiac check clears it. Third, a cat that freezes, pants, or has fainted on handling, since sedation for every session adds its own risk. Diabetes and kidney disease are not automatic exclusions, but they change the product, the monitoring, and the interval, and that call belongs to the vet.
The 10 minutes at home that protect the money
Twice a day, 3 to 5 slow circles per joint, stopping at the first resistance rather than pushing through it. A 10 minute walk on a non-slip path, 3 times a week, is enough for most cats over 13. Keep the house honest: a litter box with a 10 cm lip, a ramp at 30 degrees or less, bowls raised 10 to 15 cm, and 1 box per floor. Weigh every 2 weeks. A 5 kg cat should lose no more than about 50 g a month, and a cat that drops 0.5 kg in 4 weeks is losing muscle, which undoes the point of the injections.
What goes wrong in the 72 hours after
Mild soreness for 24 to 48 hours is expected and needs nothing. Call the clinic the same day for a temperature above 39.5 C, a joint that is hot or swollen at 72 hours, lameness worse than before the injection for more than 3 days, or a cat that refuses food for 24 hours. These are not reasons to wait for the next cycle, and they are the reason the day 14 call exists.
The honest arithmetic
On a 6 week cycle a year holds 8 to 9 injection visits, 16 laser sessions in the first year, and 12 treadmill sessions, and the per visit ranges sit in the cost tables. That total is a real constraint, so rank the 3. The injection course plus home work comes first because it is the option with the most support in cats; laser and treadmill add function and comfort, but they also add appointments a stressed cat has to survive. If the budget allows 1 modality, take injections, then add laser at the month 3 review if the score has not moved.
Where this fits in the year
Procedures do not replace the 6 monthly examination or the monthly score from the arthritis screening routine. They sit on top of it. A cat that gains 1 point of jump height and holds it for 12 months is a success even if the radiographs look the same, because the film shows bone and the score shows function. Keep the weight log beside the score sheet: the 2 numbers read together explain most bad weeks, as the weight monitoring guide sets out.
4 steps before the first appointment
- Score the 5 behaviours for 2 weeks so you have a baseline to compare against.
- Film 20 seconds of the cat walking 3 metres, on a hard floor, in daylight.
- Ask for bloodwork and blood pressure at the same visit, since both change the plan.
- Put the 4 assessment dates in the calendar before you leave the clinic.
Frequently asked
How often can a senior cat have joint injections?
The common schedule is 1 injection every 4 to 6 weeks, with a first course of 3, then an extension to 8 weeks if the monthly score holds. Anything more frequent than every 4 weeks needs a clear reason, and the product, volume, and dose are set by prescription against weight and kidney values.
Is laser therapy painful for an old cat?
A class 3b or 4 laser produces heat, so the probe is kept moving in small circles and the session stops at 10 minutes. Most cats tolerate it without sedation and some fall asleep. A cat that flinches or tries to leave is telling you the power setting is too high, which is a reason to adjust, not to push through.
Can we skip the treadmill and just walk at home?
For many cats over 13, yes. Ten minutes on a non-slip path 3 times a week plus twice daily range of motion covers the basics. The treadmill earns its place when the cat will not walk on a lead, is too heavy to exercise safely, or needs controlled load after surgery, and it always runs under a technician.