what are the current recommendations for managing osteoarthritis pain in cats?

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Feline osteoarthritis (OA) pain management is multimodal, with anti-nerve growth factor (anti-NGF) monoclonal antibodies and NSAIDs as the two analgesic classes with proven efficacy in cats. OA is the primary source of chronic pain in cats, affecting well over a quarter of the feline population, with radiographic degenerative joint disease present in 61–93% of all cats and pain-associated clinical signs estimated in 40% of those cats.26 Frunevetmab, a felinized anti-NGF monoclonal antibody, is the most clinically attractive pharmacologic option for feline OA pain. It is administered as 3 monthly subcutaneous injections, producing positive treatment effects on mobility impairment and disability through 84 days.6 Because it is injectable, it eliminates the need for daily oral dosing — a recognized compliance barrier in cats.6 Adverse events attributable to frunevetmab are limited to skin-related reactions: dermatitis, pruritus, and alopecia.6 The long-term effects of repeated administration and optimal dosing conditions have not yet been fully characterized.2 NSAIDs remain a cornerstone of feline OA analgesia, though their use carries important caveats. Meloxicam and robenacoxib are approved in parts of the world (not the United States) for chronic musculoskeletal pain in cats.6 Both COX-inhibiting and non-COX-inhibiting NSAIDs (including grapiprant) are recognized analgesic options by the WSAVA.1 Despite evidence of efficacy and a safety profile acceptable in many cats including those with chronic kidney disease, the mechanism of action of this drug class produces adverse effects in some cats, and daily oral administration is problematic for many owners regardless of formulation.6 Acetaminophen (paracetamol) is contraindicated in cats. The WSAVA explicitly excludes it from feline analgesic options.1 Non-pharmacologic modalities are recommended as part of a multimodal plan, including weight control, therapeutic exercise, physiotherapy, laser therapy, acupuncture, mass