Dr. Angie Krause (00:00)

Welcome back to Tails of Truth where we tell the truth about veterinary medicine. I'm Dr. Angie and this is JoJo veterinary nurse extraordinaire. And today we're going to be talking about pain and arthritis in senior kitties.

JoJo (00:15)

Alright, the kitties get an episode.

Dr. Angie Krause (00:18)

The kitties need their own episode. And unfortunately, this is one thing that most senior kitties suffer from that's under treated. And the good news is we have so many more ways to treat it than we did 10 or 20 years ago. So life is improving for kitties.

JoJo (00:36)

Absolutely. ⁓

That's good, so the first acknowledgement is that kitties do have pain. They may not tell you, or they are telling you pretty subtly.

Dr. Angie Krause (00:42)

That...

Right, yes, we've just been too dense as a society to get it, but now we do. And I think even veterinary medicine, there were times where we didn't treat pain in cats, which is ridiculous and archaic. Yeah, we're so over that. We're done with that.

JoJo (01:00)

Ridiculous. Yes. Okay. We

are. So let's start with what pain in cats might look like. And the first thing I thought of was the grimace scale, which people may not have heard of. that is, what is that? G-R-I-M-A-C-E, grimace. And basically what that does is because pain is hard to sometimes see in a cat. mean, we'll give you ways that we do see pain in cats, signs of it.

Dr. Angie Krause (01:14)

I love the Grimace scale.

Yes.

JoJo (01:28)

But this is facial postures, if you will. Like just little microcosms of shifts in your cat's face that might be signs of pain. Is that a fair way to explain the grimace scale?

Dr. Angie Krause (01:31)

Mm-hmm.

Yes, it's basically like ear position. They call it muzzle position, whisker position, you know, their eyes. Like it's important. And if you're a cat person, you're going to look at this and get it. And you're like, yeah, I already knew that intuitively something in your body knew it. Now you might not have known, ⁓ that ear position or that muzzle position is tied or like, you didn't know it intellectually, but you know it.

JoJo (01:54)

Mm-hmm.

Dr. Angie Krause (02:08)

because you've lived with cats and loved cats for so long that you know when it's not right.

JoJo (02:12)

right?

So as a cat person living with a cat, what signs might they see that their cat is having issues with osteoarthritis or other body pain?

Dr. Angie Krause (02:24)

I think number one is they stop moving. So the grimace scale can be helpful for arthritis and body pain, but I often think of using that along with like abdominal pain or dental pain. But I think cats that have arthritis and they often have it along their spine and in their hips, they often just stop moving, which as cats age, sometimes that's really difficult to notice.

maybe cats stop jumping up on the bed, they're not on the couch, they're not curious about what's on the counter. And those are the, ⁓ the signs that I think it's important to watch for, especially like they don't want to go up the stairs or they're staying on one floor.

JoJo (03:06)

Right, because a cat that just stops moving, I think that's one of the lies we sell ourselves or have sold ourselves, probably not our cat guardians that are listening, but overall, well, cats are just lazy. Right, so I think that, right, that's the lie.

Dr. Angie Krause (03:17)

Cats are lazy.

Yes. Or that they should sleep 20 hours a day.

JoJo (03:24)

⁓ yeah, I think so many people still believe that.

Dr. Angie Krause (03:27)

Right. They really don't. They should be active. And of course there is a spectrum and there are different personalities and different types of kitties. But yeah, your cat shouldn't be sleeping all of the time and not moving. So they're probably painful.

JoJo (03:42)

Right, so if they're not wanting to access the stairs, if they're not jumping and being curious on count, well, a lot of people don't let their cats on counters anymore. I noticed that. Couches. The I see cats miss their jumps too.

Dr. Angie Krause (03:56)

Yes, but like back to the counter thing, is anyone, and this is a bit of a tangent, but is anyone really successful at keeping their cats off the counter? Is that really a thing? I want to know.

JoJo (04:07)

Yeah, okay,

that's one for the comments. I don't know. I feel like people really really really try

Dr. Angie Krause (04:10)

Yes.

Don't you think that their cats are just on the counter when they leave?

JoJo (04:17)

Probably I mean I've seen those awful foil tricks where people cover their counters and foil to keep their cats, but I don't know

Dr. Angie Krause (04:23)

Yeah.

Yeah, I tried all that when I got these two I didn't try the foil, but I tried the thing that would ⁓ like spray air, like it would just be like an air spray. Yeah, so like the stimulus wasn't coming from me and they're just like, whatever, I don't care.

JoJo (04:35)

or like, yeah.

Right? Well, in the foil

one, that's why I said it awful, because most cats end up just jumping on it anyhow. I guess it's keeping your counter clean. I don't know. No. OK, so they slow down their movement or they're not moving as much. It could be a sign of arthritis.

Dr. Angie Krause (04:47)

Yeah, cats are gangsters. I know. They're ape. Yeah.

Absolutely. Or they don't want to be pet or maybe they get, they're more guarded. Maybe they fight with other animals in the house. Maybe they will turn around and bite you when you pet them. So any of those changes would cue me. Absolutely. I think this is really overlooked. And for everyone that wants to say, my cat

JoJo (05:13)

Hmm, litter box changes too.

Right?

Dr. Angie Krause (05:22)

got mad at me and so they pooped outside the box. Like I promise you that's not really what's happened. But cats that are not using the litter box often, especially in their senior years, they've never had a problem before. Sometimes they just can't get in the box. Or once they get in the box, the litter is too deep and they feel unstable. So they choose to stay on solid ground where they can posture.

JoJo (05:43)

Right.

I was gonna say that they're having difficulty posturing. You know, I thought of something else when you were saying that that was evidence of body pain, but it escaped me. Maybe it'll come back.

Dr. Angie Krause (05:56)

So yeah, cats just cannot stay postured in the litter box on uneven ground. And so that can be a sign. so cats that are going outside the box and I will often treat them for multiple things. And one of them is arthritis and

We have multiple ways to treat arthritis now in kitties. And I'm gonna start with my favorite one, which probably is gonna be disappointing for some people. But my number one favorite treatment right now is an injection called Solensia And I know, and it's even number one over CBD. And I love CBD and I'll use CBD too. But if I...

JoJo (06:24)

Uh-oh.

⁓ boy.

That is a

giant statement coming from you. Yeah.

Dr. Angie Krause (06:38)

Yeah.

The lives I've seen it turn around are so many. I've seen so many favorable responses that I hate to deprive my patients of it. A lot of times I'll start with a more, something more natural, be like, let's start with CBD and see how it goes. But usually I'm like, let's do it all. And I start with Solensia and then I add CBD to get all the benefits. It's not that I don't want to use CBD because it has other benefits besides arthritis.

but cats that I give Solensia to, which I wouldn't say it's new, but it's newer in my career. I mean, it's been out for several years and it is an injectable medication. has monoclonal antibodies that help reduce pain and it is so effective. It's an injection you give once a month, although I have some patients where the injection lasts much longer than a month and it is a game changer.

for cats and I'm excited about it and I know a lot of integrative or holistic veterinarians hate it. And I wish that they would spend a year in private practice and use it and see how many patients benefit from it before they start hating it.

JoJo (07:52)

Yeah, that does get some feedback, right? Because I think it's fair to say anything injectable can feel scary. I think that's fair to say.

Dr. Angie Krause (08:00)

Sure, because you can't take it back, right? It's there. You can't take it back.

JoJo (08:04)

Right, so when you say it's been life-changing, what are you seeing?

Dr. Angie Krause (08:07)

⁓ cats are living longer. Like I know it's adding time to my senior patients. They're happier. They're more active. I hear stories all the time about, now they're back sleeping on my bed or before they would never come upstairs to go to bed with me anymore. And now they come up the stairs with me every night. And so not only am I getting that experience back for my cat, my patient, but I'm getting that back for my client, the person.

And so being able to reconnect cats and the people that love them is the best. And maybe they're playing with the other animals in the house. I can't, mean, it just has to feel so good to not be that painful.

JoJo (08:50)

I've heard some of our clients talk about how appetite has increased since I think you when you're really painful sometimes you don't like food is so low on the list you know and I think that inner cat household dynamic also is super important or they say I feel like I have a kitten again so it's almost like this de-aging process not that that's what's happening but that they're getting to live their senior years with a better higher quality of life

Dr. Angie Krause (08:59)

Right.

Yes.

Yeah.

Yes, it's miraculous. And the reason why it's controversial is because they, you, mean, I don't invite you to do this, but you're going to do it anyways. If you go to Facebook or if you Google, Solensia danger, like Google, Solensia was some like scary word and you're going to find it. My cat was killed by Solensia. And I think, well, first of all, we, don't really have

any correlation of anything, any negative impacts of Solensia. But I think what happens anytime you have a medication that you're giving to a group of senior cats or dogs, other things are going to come up and it's going to feel like that there is causation, but maybe there's only correlation. Meaning I gave my cat Solensia and then they started having seizures.

But what happened is you gave your cat Solensia and the brain tumor that was already there became symptomatic. And so I'm really careful. Now, just to say, like I'm not above it all. I look at, Librela is something I don't use. That's for dogs. And that has actually had some correlations that are provable of some negative results happening there.

JoJo (10:26)

and that's for dogs.

Dr. Angie Krause (10:35)

But I don't see that in Solensia and I'm not getting any reports of that. And so I feel I don't equate Solensia and Librela Brela for that reason. And so I don't like this idea that we get everyone together and then we take all of our negative. I mean, I know these people are scared and I know people feel like

Solensia caused it. And I know they feel that way. And I don't want to take that away from them. But correlation just doesn't equal causation. And to make these kind of big sweeping statements like Solensia killed my cat without really knowing that deprives thousands, hundreds of thousands of cats in their senior years from getting

life saving and life changing care. It's kind of like if we were to draw a human equivalent, it's like when there was a study that said HRT, estrogen replacement therapy in women causes breast cancer. And so they took it away from all these women. And then there was a whole generation of women that had to go through menopause without the benefits of hormone replacement therapy. That's what it feels like.

to me for cats. feels like so unjust. Now, if someone can give me...

JoJo (11:53)

Mmm.

Dr. Angie Krause (12:01)

like a peer-reviewed article that says, Solensia has this known side effect. Here's the rate, the prevalence, and I can have that discussion with my client and then we can decide if this is worth that. I'm open to that, but I feel like all these kind of one-off of Solensia killed my cat, upsets me for all the cats it could be helping.

JoJo (12:21)

Hmm.

I hear that. I would say too that there is this piece where if you again equate it to human medicine, if we think about it, I want to say that when someone comes into your exam room, because I've seen it again and again, you are going to believe them when they tell you this, my cat had this after Solensia right? Like, I do believe that you sit there and you listen and you take that and, and validate that experience. Because if we were to to equate that to human medicine, you give me erythromycin,

I'm gonna be in the emergency room. You give Angie erythromycin, she might actually heal from whatever she has. Like same medicine, different bodies. So different reactions. I think Solensia might have, maybe have had negative impact on some cats, you know, because we're talking about different bodies, different reactions. So like you said, to just be sweeping with it is an injustice.

Dr. Angie Krause (13:15)

Right.

JoJo (13:16)

Like I don't wanna take erythromycin from everybody because I end up in the emergency room from it. It's actually a very effective medicine.

Dr. Angie Krause (13:22)

Right, exactly. And so I love Solensia. So I really encourage people to use it. The worst thing I've ever seen is that it doesn't work. I've had a few patients where it doesn't work or it will work and then it stops working. And that's a big bummer. Yeah, so that has happened. But for the most part, my cats on Solensia, my patients on Solensia, stay on it. Everyone's happy.

JoJo (13:24)

Okay.

Hmm.

That's so discouraging.

And it doesn't always work with the first injection. Sometimes it needs a month or two.

Dr. Angie Krause (13:54)

Yes, I've seen

that happen too, where people just kind of stick with it. So anyway, so Solensia is my number one. My number two is CBD. Yes, the HempRx feline drops.

JoJo (13:59)

Okay.

See ya.

I don't know where the camera is. yeah. Okay.

Dr. Angie Krause (14:09)

Yeah, no, you got it. Yes.

And you can get those in our online store, boulderholisticvet.com. And they're my absolute favorite for cats. I have tried so many CBD products or hemp products for kitties. And this is my favorite from a palatability perspective, from a potency perspective, how much CBD you're getting per drop. And it's my absolute favorite. And I feel like

cats have really great results. I would say a little bit second to Solensia. The thing I love about Solensia, like we're going back to Solensia. Can you tell I'm in love? It's such a winner is that it's one injection for the month or maybe longer. And, you know, trying to get cats to, you know, take medication or, you know, you remembering the supplement like that is definitely a barrier for

JoJo (14:48)

it's such a winner in your book yeah

Dr. Angie Krause (15:04)

a lot of kitties and people, but I do feel like I see really great results with CBD. Now where CBD wins over Solensia is that not only am I helping that arthritic pain, but then I'm helping anxiety and I'm helping overall sense of wellbeing. I'm decreasing inflammation everywhere. so...

JoJo (15:26)

Right, and if you're talking about senior kitties, then you're also supporting kidney disease with the CBD as well, yeah.

Dr. Angie Krause (15:28)

Yeah.

Yeah. Intestinal

disease. So my cats with like IBD and chronic kidney disease, like I'm winning. And so can I have both of these please? Yes.

JoJo (15:42)

right? Yeah,

I was just gonna ask from a cost perspective because off the top of my head, I don't remember how much Solensia is but it's not inexpensive.

Dr. Angie Krause (15:49)

It's not inexpensive. It's about, I'm gonna guess it's somewhere between 80 to $90 a month. Yeah.

JoJo (15:55)

That's what I thought it was. Yeah, somewhere

around there without, but you can probably do that as a technician appointment.

Dr. Angie Krause (16:00)

Yes, that can always be a nurse appointment so you don't need to see your veterinarian for that. Yeah. And then...

JoJo (16:05)

Yeah, okay. And where CBD

also wins is if you have a kitty who just is so unhappy at the veterinary office. ⁓ CBD might be the winner in that case. So that you could just put a drop or two in their food and nobody, no harm done. Nobody's had to go for a car ride. Nobody's had to be in the carrier. Yeah.

Dr. Angie Krause (16:13)

Yes.

Absolutely.

Right.

No car rides. That's true.

Or you get a house call vet to come give you that Solensia. but I, I do like, I do like them both together if I can have them. And with the CBD, the HempRx feline for an average 10 pound cat, one to two drops twice a day usually does the trick, but you can give three to four drops twice a day, in the food, or sometimes I will put it on a treat like a freeze dried treat.

JoJo (16:30)

Mm-hmm.

Dr. Angie Krause (16:51)

and absorbs right in.

JoJo (16:53)

Okay, so those are the two main hitters for kitty pain and arthritis. Do you have a number three?

Dr. Angie Krause (16:58)

I mean, but wait, there's more.

Oh, for sure. I have more. Yeah, I really like, what do you think it is?

JoJo (17:01)

⁓ keep going. What's number three on your list? I have a guess but. ⁓

Actually, when I thought about it, might be on your list. I would imagine the veterinarians are prescribing gabapentin.

Dr. Angie Krause (17:14)

yeah, I didn't even think about that. Actually it wasn't even on my list. But you know what? Gabapentin can be good for some, for some pain. The thing I...

JoJo (17:21)

but that really

is just pain masking.

Dr. Angie Krause (17:23)

It's pain masking. It's, yes.

JoJo (17:24)

versus the others.

Well, is Solensia pain masking? Okay. And CBD is doing a little bit of both.

Dr. Angie Krause (17:28)

Yeah, it is. Yeah, definitely pain masking.

Yeah, I mean, it's anti-inflammatory, is, you it's still, I mean, on some level, it's still pain masking, but it's helping. And I...

JoJo (17:35)

Right.

Yeah, well, I think gabapentin

gets a lot of attention because it's somewhat sedating, can be. And so, well, then you're gonna see your kitty sleeping more. And it's so inexpensive.

Dr. Angie Krause (17:47)

Yes. Yeah.

Yeah,

it's inexpensive and that sedation wears off over time. And so if your kiddies on gabapentin every day, then it's gonna, that sedating quality will not continue past the first couple of weeks. The reason why gabapentin is not high on my list is because it tastes so bad and giving your cat gabapentin, now if you can give it in a capsule or if you have found a way to compound it.

JoJo (17:57)

Hmm.

Yeah,

Dr. Angie Krause (18:19)

Yeah, ugh, it's gross.

JoJo (18:20)

a mini melt or marshmallow flavor apparently is the big win with cats. Yeah, so weird.

Dr. Angie Krause (18:24)

I know, isn't that so weird?

So I, you know, I don't mind it, but it has to be, it's best for nerve pain. And I definitely have some patients that are on gabapentin every day. It's just, it's not my go-to. It's just okay. Yeah. But it's great for, my number three is fish oil.

JoJo (18:38)

Okay, then what was it? What made your number three then?

⁓ such a good one. Yeah.

Dr. Angie Krause (18:45)

such a good one. And

I feel like it's so overlooked. And now if your cat doesn't like fish or is sensitive to fish, this is this is a bad one, because you just want to be able to pour the oil on the food and we have ⁓ ultra EFA. So we have a fish oil product on our website, Boulderholisticvet.com. So you can go check that out. And I think it's really palatable. And I think most cats think it tastes good if they like fish.

But a lot of cats are either in, like fish or I like poultry. there's, they really do. And so if your kitty will eat it, I love it. It's reducing inflammation for, you know, all systems. It's great for their coat. I like it. It's lubricating the joints. We all should be on fish oil.

JoJo (19:18)

How they live in the bird or the fish camp. Yeah.

lubricating their joints.

We all should be, it's apparently fantastic for brain health.

Dr. Angie Krause (19:36)

Yes. Yeah. So all the things. And then I would say my last is we do have non-steroidal anti-inflammatory drugs for cats, but we only want to use those short term. And so we can send you home with a few days of them, but they're not really great, like long term. It's more for acute pain. It's not a long-term solution.

JoJo (19:54)

So that's more for acute pain. Like your cat,

like you dropped a weight on your cat, on your cat's foot. Just so you know, that's a story for Dr. Angie, if you didn't hear that episode. I accidentally dropped a weight on her kitty's foot-ish. That's the short story of it. Yeah, I would say that sounds wrong. So it says for a short term pain.

Dr. Angie Krause (20:01)

I know.

Yeah, just rolled. Well, I didn't drop it. He just rolled. Yeah.

So that's

for short term pain. So we can use it for a time. Can you think of anything else that I'm missing? Anything else besides acupuncture and massage?

JoJo (20:23)

No, know what's, yeah, acupuncture,

chiropractic care. No, but I did think of my thing that I forgot as another way of identifying pain, as if they stop grooming.

Dr. Angie Krause (20:28)

Yeah.

That's huge. They're either painful or they're too big and they can't reach. Well, okay. I've also had, let's see, last week I saw three cats. I didn't think their body condition was completely unreasonable. They were just such big cats with maybe a little excess and they just could not, and they were short hair. They could not groom their back. And so sometimes they're just too big. But a lot of times it is arthritis because

JoJo (20:36)

Yeah.

⁓ like they're chunker.

Dr. Angie Krause (21:02)

If look at a healthy cat, how they have to contort themselves to groom everything is pretty acrobatic.

JoJo (21:07)

Yeah,

yeah, so if they start matting when they weren't before, that could be a sign of pain, but also over grooming.

Dr. Angie Krause (21:10)

Yes.

Over grooming, yes.

JoJo (21:15)

Yeah,

so those are the ones I was like, yeah, those are signs of pain. I'm sure, I mean, we just touched the surface of there are probably so many other identifiers of pain.

Dr. Angie Krause (21:23)

so many. Yeah, but this is a good start.

JoJo (21:25)

So I can't think of any others, but I just want to say how excited I am that we have a 20 nearly 25 minute episode about options for cats with pain. Can we just celebrate that?

Dr. Angie Krause (21:34)

Yes.

Let's celebrate that. Cats deserve all the episodes that where they have all these options.

JoJo (21:43)

Right? So have the dialogue with your veterinarian. See what's a good fit. Try it on. You don't have to stay with the same treatment plan if it's not working.

Dr. Angie Krause (21:48)

Yeah.

Yeah,

do it all. Try one at a time. And the other thing I'll say is cats respond very well to massage. And so that's something else to I know as my as my Katie's in my lab. Okay, if you are listening to this, we have a gift for you. You can go to our website, boulderholisticvet.com. And if you click on the tab that says learn more,

JoJo (21:58)

That's a good one as you're sitting there massaging your kitty in your lap

⁓

Dr. Angie Krause (22:19)

It will have a section with our online courses and you can get one of our courses for free using the code truth tales and you can spell it T A I L S or T A L E S. And you can get that for free.

JoJo (22:31)

All right, and just let us know we

just launched a brand new website. We feel really, really proud of it. And we hope we've made navigating it easy so cat people can find the cat things. So we'd love to hear about it. We're proud of it.

Dr. Angie Krause (22:42)

Yes. And

we want you to leave a review wherever you're watching this podcast. And we want you to leave us a comment. Ask us a question. Tell us what you want to hear about. Tell us about your cat. And we'll see you next time. Bye.

JoJo (23:00)

Bye.

Dr. Angie Krause (00:00)

Welcome back to Tails of Truth where we tell the truth about veterinary medicine. I'm Dr. Angie and this is JoJo veterinary nurse extraordinaire. And today we're going to be talking about pain and arthritis in senior kitties.

JoJo (00:15)

Alright, the kitties get an episode.

Dr. Angie Krause (00:18)

The kitties need their own episode. And unfortunately, this is one thing that most senior kitties suffer from that's under treated. And the good news is we have so many more ways to treat it than we did 10 or 20 years ago. So life is improving for kitties.

JoJo (00:36)

Absolutely. ⁓

That's good, so the first acknowledgement is that kitties do have pain. They may not tell you, or they are telling you pretty subtly.

Dr. Angie Krause (00:42)

That...

Right, yes, we've just been too dense as a society to get it, but now we do. And I think even veterinary medicine, there were times where we didn't treat pain in cats, which is ridiculous and archaic. Yeah, we're so over that. We're done with that.

JoJo (01:00)

Ridiculous. Yes. Okay. We

are. So let's start with what pain in cats might look like. And the first thing I thought of was the grimace scale, which people may not have heard of. that is, what is that? G-R-I-M-A-C-E, grimace. And basically what that does is because pain is hard to sometimes see in a cat. mean, we'll give you ways that we do see pain in cats, signs of it.

Dr. Angie Krause (01:14)

I love the Grimace scale.

Yes.

JoJo (01:28)

But this is facial postures, if you will. Like just little microcosms of shifts in your cat's face that might be signs of pain. Is that a fair way to explain the grimace scale?

Dr. Angie Krause (01:31)

Mm-hmm.

Yes, it's basically like ear position. They call it muzzle position, whisker position, you know, their eyes. Like it's important. And if you're a cat person, you're going to look at this and get it. And you're like, yeah, I already knew that intuitively something in your body knew it. Now you might not have known, ⁓ that ear position or that muzzle position is tied or like, you didn't know it intellectually, but you know it.

JoJo (01:54)

Mm-hmm.

Dr. Angie Krause (02:08)

because you've lived with cats and loved cats for so long that you know when it's not right.

JoJo (02:12)

right?

So as a cat person living with a cat, what signs might they see that their cat is having issues with osteoarthritis or other body pain?

Dr. Angie Krause (02:24)

I think number one is they stop moving. So the grimace scale can be helpful for arthritis and body pain, but I often think of using that along with like abdominal pain or dental pain. But I think cats that have arthritis and they often have it along their spine and in their hips, they often just stop moving, which as cats age, sometimes that's really difficult to notice.

maybe cats stop jumping up on the bed, they're not on the couch, they're not curious about what's on the counter. And those are the, ⁓ the signs that I think it's important to watch for, especially like they don't want to go up the stairs or they're staying on one floor.

JoJo (03:06)

Right, because a cat that just stops moving, I think that's one of the lies we sell ourselves or have sold ourselves, probably not our cat guardians that are listening, but overall, well, cats are just lazy. Right, so I think that, right, that's the lie.

Dr. Angie Krause (03:17)

Cats are lazy.

Yes. Or that they should sleep 20 hours a day.

JoJo (03:24)

⁓ yeah, I think so many people still believe that.

Dr. Angie Krause (03:27)

Right. They really don't. They should be active. And of course there is a spectrum and there are different personalities and different types of kitties. But yeah, your cat shouldn't be sleeping all of the time and not moving. So they're probably painful.

JoJo (03:42)

Right, so if they're not wanting to access the stairs, if they're not jumping and being curious on count, well, a lot of people don't let their cats on counters anymore. I noticed that. Couches. The I see cats miss their jumps too.

Dr. Angie Krause (03:56)

Yes, but like back to the counter thing, is anyone, and this is a bit of a tangent, but is anyone really successful at keeping their cats off the counter? Is that really a thing? I want to know.

JoJo (04:07)

Yeah, okay,

that's one for the comments. I don't know. I feel like people really really really try

Dr. Angie Krause (04:10)

Yes.

Don't you think that their cats are just on the counter when they leave?

JoJo (04:17)

Probably I mean I've seen those awful foil tricks where people cover their counters and foil to keep their cats, but I don't know

Dr. Angie Krause (04:23)

Yeah.

Yeah, I tried all that when I got these two I didn't try the foil, but I tried the thing that would ⁓ like spray air, like it would just be like an air spray. Yeah, so like the stimulus wasn't coming from me and they're just like, whatever, I don't care.

JoJo (04:35)

or like, yeah.

Right? Well, in the foil

one, that's why I said it awful, because most cats end up just jumping on it anyhow. I guess it's keeping your counter clean. I don't know. No. OK, so they slow down their movement or they're not moving as much. It could be a sign of arthritis.

Dr. Angie Krause (04:47)

Yeah, cats are gangsters. I know. They're ape. Yeah.

Absolutely. Or they don't want to be pet or maybe they get, they're more guarded. Maybe they fight with other animals in the house. Maybe they will turn around and bite you when you pet them. So any of those changes would cue me. Absolutely. I think this is really overlooked. And for everyone that wants to say, my cat

JoJo (05:13)

Hmm, litter box changes too.

Right?

Dr. Angie Krause (05:22)

got mad at me and so they pooped outside the box. Like I promise you that's not really what's happened. But cats that are not using the litter box often, especially in their senior years, they've never had a problem before. Sometimes they just can't get in the box. Or once they get in the box, the litter is too deep and they feel unstable. So they choose to stay on solid ground where they can posture.

JoJo (05:43)

Right.

I was gonna say that they're having difficulty posturing. You know, I thought of something else when you were saying that that was evidence of body pain, but it escaped me. Maybe it'll come back.

Dr. Angie Krause (05:56)

So yeah, cats just cannot stay postured in the litter box on uneven ground. And so that can be a sign. so cats that are going outside the box and I will often treat them for multiple things. And one of them is arthritis and

We have multiple ways to treat arthritis now in kitties. And I'm gonna start with my favorite one, which probably is gonna be disappointing for some people. But my number one favorite treatment right now is an injection called Solensia And I know, and it's even number one over CBD. And I love CBD and I'll use CBD too. But if I...

JoJo (06:24)

Uh-oh.

⁓ boy.

That is a

giant statement coming from you. Yeah.

Dr. Angie Krause (06:38)

Yeah.

The lives I've seen it turn around are so many. I've seen so many favorable responses that I hate to deprive my patients of it. A lot of times I'll start with a more, something more natural, be like, let's start with CBD and see how it goes. But usually I'm like, let's do it all. And I start with Solensia and then I add CBD to get all the benefits. It's not that I don't want to use CBD because it has other benefits besides arthritis.

but cats that I give Solensia to, which I wouldn't say it's new, but it's newer in my career. I mean, it's been out for several years and it is an injectable medication. has monoclonal antibodies that help reduce pain and it is so effective. It's an injection you give once a month, although I have some patients where the injection lasts much longer than a month and it is a game changer.

for cats and I'm excited about it and I know a lot of integrative or holistic veterinarians hate it. And I wish that they would spend a year in private practice and use it and see how many patients benefit from it before they start hating it.

JoJo (07:52)

Yeah, that does get some feedback, right? Because I think it's fair to say anything injectable can feel scary. I think that's fair to say.

Dr. Angie Krause (08:00)

Sure, because you can't take it back, right? It's there. You can't take it back.

JoJo (08:04)

Right, so when you say it's been life-changing, what are you seeing?

Dr. Angie Krause (08:07)

⁓ cats are living longer. Like I know it's adding time to my senior patients. They're happier. They're more active. I hear stories all the time about, now they're back sleeping on my bed or before they would never come upstairs to go to bed with me anymore. And now they come up the stairs with me every night. And so not only am I getting that experience back for my cat, my patient, but I'm getting that back for my client, the person.

And so being able to reconnect cats and the people that love them is the best. And maybe they're playing with the other animals in the house. I can't, mean, it just has to feel so good to not be that painful.

JoJo (08:50)

I've heard some of our clients talk about how appetite has increased since I think you when you're really painful sometimes you don't like food is so low on the list you know and I think that inner cat household dynamic also is super important or they say I feel like I have a kitten again so it's almost like this de-aging process not that that's what's happening but that they're getting to live their senior years with a better higher quality of life

Dr. Angie Krause (08:59)

Right.

Yes.

Yeah.

Yes, it's miraculous. And the reason why it's controversial is because they, you, mean, I don't invite you to do this, but you're going to do it anyways. If you go to Facebook or if you Google, Solensia danger, like Google, Solensia was some like scary word and you're going to find it. My cat was killed by Solensia. And I think, well, first of all, we, don't really have

any correlation of anything, any negative impacts of Solensia. But I think what happens anytime you have a medication that you're giving to a group of senior cats or dogs, other things are going to come up and it's going to feel like that there is causation, but maybe there's only correlation. Meaning I gave my cat Solensia and then they started having seizures.

But what happened is you gave your cat Solensia and the brain tumor that was already there became symptomatic. And so I'm really careful. Now, just to say, like I'm not above it all. I look at, Librela is something I don't use. That's for dogs. And that has actually had some correlations that are provable of some negative results happening there.

JoJo (10:26)

and that's for dogs.

Dr. Angie Krause (10:35)

But I don't see that in Solensia and I'm not getting any reports of that. And so I feel I don't equate Solensia and Librela Brela for that reason. And so I don't like this idea that we get everyone together and then we take all of our negative. I mean, I know these people are scared and I know people feel like

Solensia caused it. And I know they feel that way. And I don't want to take that away from them. But correlation just doesn't equal causation. And to make these kind of big sweeping statements like Solensia killed my cat without really knowing that deprives thousands, hundreds of thousands of cats in their senior years from getting

life saving and life changing care. It's kind of like if we were to draw a human equivalent, it's like when there was a study that said HRT, estrogen replacement therapy in women causes breast cancer. And so they took it away from all these women. And then there was a whole generation of women that had to go through menopause without the benefits of hormone replacement therapy. That's what it feels like.

to me for cats. feels like so unjust. Now, if someone can give me...

JoJo (11:53)

Mmm.

Dr. Angie Krause (12:01)

like a peer-reviewed article that says, Solensia has this known side effect. Here's the rate, the prevalence, and I can have that discussion with my client and then we can decide if this is worth that. I'm open to that, but I feel like all these kind of one-off of Solensia killed my cat, upsets me for all the cats it could be helping.

JoJo (12:21)

Hmm.

I hear that. I would say too that there is this piece where if you again equate it to human medicine, if we think about it, I want to say that when someone comes into your exam room, because I've seen it again and again, you are going to believe them when they tell you this, my cat had this after Solensia right? Like, I do believe that you sit there and you listen and you take that and, and validate that experience. Because if we were to to equate that to human medicine, you give me erythromycin,

I'm gonna be in the emergency room. You give Angie erythromycin, she might actually heal from whatever she has. Like same medicine, different bodies. So different reactions. I think Solensia might have, maybe have had negative impact on some cats, you know, because we're talking about different bodies, different reactions. So like you said, to just be sweeping with it is an injustice.

Dr. Angie Krause (13:15)

Right.

JoJo (13:16)

Like I don't wanna take erythromycin from everybody because I end up in the emergency room from it. It's actually a very effective medicine.

Dr. Angie Krause (13:22)

Right, exactly. And so I love Solensia. So I really encourage people to use it. The worst thing I've ever seen is that it doesn't work. I've had a few patients where it doesn't work or it will work and then it stops working. And that's a big bummer. Yeah, so that has happened. But for the most part, my cats on Solensia, my patients on Solensia, stay on it. Everyone's happy.

JoJo (13:24)

Okay.

Hmm.

That's so discouraging.

And it doesn't always work with the first injection. Sometimes it needs a month or two.

Dr. Angie Krause (13:54)

Yes, I've seen

that happen too, where people just kind of stick with it. So anyway, so Solensia is my number one. My number two is CBD. Yes, the HempRx feline drops.

JoJo (13:59)

Okay.

See ya.

I don't know where the camera is. yeah. Okay.

Dr. Angie Krause (14:09)

Yeah, no, you got it. Yes.

And you can get those in our online store, boulderholisticvet.com. And they're my absolute favorite for cats. I have tried so many CBD products or hemp products for kitties. And this is my favorite from a palatability perspective, from a potency perspective, how much CBD you're getting per drop. And it's my absolute favorite. And I feel like

cats have really great results. I would say a little bit second to Solensia. The thing I love about Solensia, like we're going back to Solensia. Can you tell I'm in love? It's such a winner is that it's one injection for the month or maybe longer. And, you know, trying to get cats to, you know, take medication or, you know, you remembering the supplement like that is definitely a barrier for

JoJo (14:48)

it's such a winner in your book yeah

Dr. Angie Krause (15:04)

a lot of kitties and people, but I do feel like I see really great results with CBD. Now where CBD wins over Solensia is that not only am I helping that arthritic pain, but then I'm helping anxiety and I'm helping overall sense of wellbeing. I'm decreasing inflammation everywhere. so...

JoJo (15:26)

Right, and if you're talking about senior kitties, then you're also supporting kidney disease with the CBD as well, yeah.

Dr. Angie Krause (15:28)

Yeah.

Yeah. Intestinal

disease. So my cats with like IBD and chronic kidney disease, like I'm winning. And so can I have both of these please? Yes.

JoJo (15:42)

right? Yeah,

I was just gonna ask from a cost perspective because off the top of my head, I don't remember how much Solensia is but it's not inexpensive.

Dr. Angie Krause (15:49)

It's not inexpensive. It's about, I'm gonna guess it's somewhere between 80 to $90 a month. Yeah.

JoJo (15:55)

That's what I thought it was. Yeah, somewhere

around there without, but you can probably do that as a technician appointment.

Dr. Angie Krause (16:00)

Yes, that can always be a nurse appointment so you don't need to see your veterinarian for that. Yeah. And then...

JoJo (16:05)

Yeah, okay. And where CBD

also wins is if you have a kitty who just is so unhappy at the veterinary office. ⁓ CBD might be the winner in that case. So that you could just put a drop or two in their food and nobody, no harm done. Nobody's had to go for a car ride. Nobody's had to be in the carrier. Yeah.

Dr. Angie Krause (16:13)

Yes.

Absolutely.

Right.

No car rides. That's true.

Or you get a house call vet to come give you that Solensia. but I, I do like, I do like them both together if I can have them. And with the CBD, the HempRx feline for an average 10 pound cat, one to two drops twice a day usually does the trick, but you can give three to four drops twice a day, in the food, or sometimes I will put it on a treat like a freeze dried treat.

JoJo (16:30)

Mm-hmm.

Dr. Angie Krause (16:51)

and absorbs right in.

JoJo (16:53)

Okay, so those are the two main hitters for kitty pain and arthritis. Do you have a number three?

Dr. Angie Krause (16:58)

I mean, but wait, there's more.

Oh, for sure. I have more. Yeah, I really like, what do you think it is?

JoJo (17:01)

⁓ keep going. What's number three on your list? I have a guess but. ⁓

Actually, when I thought about it, might be on your list. I would imagine the veterinarians are prescribing gabapentin.

Dr. Angie Krause (17:14)

yeah, I didn't even think about that. Actually it wasn't even on my list. But you know what? Gabapentin can be good for some, for some pain. The thing I...

JoJo (17:21)

but that really

is just pain masking.

Dr. Angie Krause (17:23)

It's pain masking. It's, yes.

JoJo (17:24)

versus the others.

Well, is Solensia pain masking? Okay. And CBD is doing a little bit of both.

Dr. Angie Krause (17:28)

Yeah, it is. Yeah, definitely pain masking.

Yeah, I mean, it's anti-inflammatory, is, you it's still, I mean, on some level, it's still pain masking, but it's helping. And I...

JoJo (17:35)

Right.

Yeah, well, I think gabapentin

gets a lot of attention because it's somewhat sedating, can be. And so, well, then you're gonna see your kitty sleeping more. And it's so inexpensive.

Dr. Angie Krause (17:47)

Yes. Yeah.

Yeah,

it's inexpensive and that sedation wears off over time. And so if your kiddies on gabapentin every day, then it's gonna, that sedating quality will not continue past the first couple of weeks. The reason why gabapentin is not high on my list is because it tastes so bad and giving your cat gabapentin, now if you can give it in a capsule or if you have found a way to compound it.

JoJo (17:57)

Hmm.

Yeah,

Dr. Angie Krause (18:19)

Yeah, ugh, it's gross.

JoJo (18:20)

a mini melt or marshmallow flavor apparently is the big win with cats. Yeah, so weird.

Dr. Angie Krause (18:24)

I know, isn't that so weird?

So I, you know, I don't mind it, but it has to be, it's best for nerve pain. And I definitely have some patients that are on gabapentin every day. It's just, it's not my go-to. It's just okay. Yeah. But it's great for, my number three is fish oil.

JoJo (18:38)

Okay, then what was it? What made your number three then?

⁓ such a good one. Yeah.

Dr. Angie Krause (18:45)

such a good one. And

I feel like it's so overlooked. And now if your cat doesn't like fish or is sensitive to fish, this is this is a bad one, because you just want to be able to pour the oil on the food and we have ⁓ ultra EFA. So we have a fish oil product on our website, Boulderholisticvet.com. So you can go check that out. And I think it's really palatable. And I think most cats think it tastes good if they like fish.

But a lot of cats are either in, like fish or I like poultry. there's, they really do. And so if your kitty will eat it, I love it. It's reducing inflammation for, you know, all systems. It's great for their coat. I like it. It's lubricating the joints. We all should be on fish oil.

JoJo (19:18)

How they live in the bird or the fish camp. Yeah.

lubricating their joints.

We all should be, it's apparently fantastic for brain health.

Dr. Angie Krause (19:36)

Yes. Yeah. So all the things. And then I would say my last is we do have non-steroidal anti-inflammatory drugs for cats, but we only want to use those short term. And so we can send you home with a few days of them, but they're not really great, like long term. It's more for acute pain. It's not a long-term solution.

JoJo (19:54)

So that's more for acute pain. Like your cat,

like you dropped a weight on your cat, on your cat's foot. Just so you know, that's a story for Dr. Angie, if you didn't hear that episode. I accidentally dropped a weight on her kitty's foot-ish. That's the short story of it. Yeah, I would say that sounds wrong. So it says for a short term pain.

Dr. Angie Krause (20:01)

I know.

Yeah, just rolled. Well, I didn't drop it. He just rolled. Yeah.

So that's

for short term pain. So we can use it for a time. Can you think of anything else that I'm missing? Anything else besides acupuncture and massage?

JoJo (20:23)

No, know what's, yeah, acupuncture,

chiropractic care. No, but I did think of my thing that I forgot as another way of identifying pain, as if they stop grooming.

Dr. Angie Krause (20:28)

Yeah.

That's huge. They're either painful or they're too big and they can't reach. Well, okay. I've also had, let's see, last week I saw three cats. I didn't think their body condition was completely unreasonable. They were just such big cats with maybe a little excess and they just could not, and they were short hair. They could not groom their back. And so sometimes they're just too big. But a lot of times it is arthritis because

JoJo (20:36)

Yeah.

⁓ like they're chunker.

Dr. Angie Krause (21:02)

If look at a healthy cat, how they have to contort themselves to groom everything is pretty acrobatic.

JoJo (21:07)

Yeah,

yeah, so if they start matting when they weren't before, that could be a sign of pain, but also over grooming.

Dr. Angie Krause (21:10)

Yes.

Over grooming, yes.

JoJo (21:15)

Yeah,

so those are the ones I was like, yeah, those are signs of pain. I'm sure, I mean, we just touched the surface of there are probably so many other identifiers of pain.

Dr. Angie Krause (21:23)

so many. Yeah, but this is a good start.

JoJo (21:25)

So I can't think of any others, but I just want to say how excited I am that we have a 20 nearly 25 minute episode about options for cats with pain. Can we just celebrate that?

Dr. Angie Krause (21:34)

Yes.

Let's celebrate that. Cats deserve all the episodes that where they have all these options.

JoJo (21:43)

Right? So have the dialogue with your veterinarian. See what's a good fit. Try it on. You don't have to stay with the same treatment plan if it's not working.

Dr. Angie Krause (21:48)

Yeah.

Yeah,

do it all. Try one at a time. And the other thing I'll say is cats respond very well to massage. And so that's something else to I know as my as my Katie's in my lab. Okay, if you are listening to this, we have a gift for you. You can go to our website, boulderholisticvet.com. And if you click on the tab that says learn more,

JoJo (21:58)

That's a good one as you're sitting there massaging your kitty in your lap

⁓

Dr. Angie Krause (22:19)

It will have a section with our online courses and you can get one of our courses for free using the code truth tales and you can spell it T A I L S or T A L E S. And you can get that for free.

JoJo (22:31)

All right, and just let us know we

just launched a brand new website. We feel really, really proud of it. And we hope we've made navigating it easy so cat people can find the cat things. So we'd love to hear about it. We're proud of it.

Dr. Angie Krause (22:42)

Yes. And

we want you to leave a review wherever you're watching this podcast. And we want you to leave us a comment. Ask us a question. Tell us what you want to hear about. Tell us about your cat. And we'll see you next time. Bye.

JoJo (23:00)

Bye.