When to see a vet urgently
Contact a vet immediately if your cat has any of the following:
- sudden severe lameness or inability to bear any weight on a leg;
- a deep wound, heavy bleeding or an obvious change in leg position;
- rapidly increasing swelling, a pus-producing wound and deteriorating general health;
- severe pain, collapse or breathing difficulty after an accident.
Overview
Tendons are strong connective tissue structures attaching muscles to bones. Inflammation of a tendon is called tendinitis. If it spreads to a tendon sheath, the structure that allows the tendon to glide, tenosynovitis develops. In cats, these conditions usually follow injury and may cause local pain and restricted movement.
Tendon sheath inflammation can also develop directly from injury or infection in the area; it does not always extend from inflammation that began in the tendon. Fluid may accumulate in the sheath during inflammation, increasing swelling and impairing tendon movement.
Tendon tissue heals relatively slowly because its blood supply is limited. Scar tissue formed during repair may be less organised or resilient than the original tendon. Pain relief and recovery of the tissue's ability to tolerate loading therefore do not always occur together.
Causes
- mechanical injuries, such as cuts, bruising and strains;
- excessive physical strain from jumps or sudden movements;
- infected bite wounds;
- arthritis and inflammatory joint diseases;
- metabolic disorders weakening connective tissue.
An injury may be open, such as a cut, or closed without a visible skin break. Both forms have been described in feline Achilles tendon injuries. Signs can also start during an ordinary jump, so you may not witness a clear accident. Investigations then establish whether there is inflammation, a partial tear or another structural injury.
A small skin puncture from a bite can hide deeper tissue damage. The absence of swelling or pus immediately after a fight does not rule out infection. Nevertheless, lameness near a bite does not automatically mean a tendon sheath infection: an abscess, joint or another tissue may be painful.
Risk factors
- active cats spending much time outdoors;
- cats that fight;
- older cats, with more fragile tissues;
- obese cats, with excessive limb loading.
There is little research on risk factors for feline tendon and tendon sheath diseases. Achilles injuries without major trauma have been described in older cats, but this cannot be generalised to inflammation of every tendon. Excess weight or activity cannot establish the cause either. Symptoms, findings and the structure of the injury are decisive.
Typical symptoms
- lameness that worsens after activity;
- local tenderness when examined by touch;
- swelling over the tendon;
- restricted limb movement;
- lethargy and reduced activity;
- pus discharge and fever in infectious tenosynovitis.
You may also notice shorter steps, avoiding stairs, less jumping or increased licking of a particular area. A cat may use a leg partly even when an injury needs treatment. Conversely, severe lameness may arise from a fracture, claw injury or bite abscess rather than a tendon.
The Achilles tendon in the hindlimb consists of several tendon components attaching to the heel bone. Significant damage can allow the hock to drop lower than usual, making the cat appear to walk on the whole rear foot. Not every partial injury causes this posture. Leg appearance alone does not reveal the extent of damage.
Complications and consequences
- chronic lameness;
- fibrosis and restricted joint movement;
- tendon rupture in severe injuries;
- systemic infection in pus-producing forms.
Scarring can reduce tissue flexibility, while severe injury impairs force transmission through the tendon. An infected tendon sheath requires different treatment from a closed overuse injury. Pus, increasing pain or deteriorating general health should therefore not be treated as a simple strain.
Symptoms persisting or returning as loading increases may mean the tissue is not ready for exercise or the original cause remains uncontrolled. Report new lameness during treatment or rehabilitation to the vet.
Diagnosis at the vet
- clinical examination and examination of the limb by touch;
- X-rays to rule out fractures;
- soft tissue ultrasound to assess tendon and tendon sheath inflammation;
- blood tests for inflammatory changes;
- bacterial testing if infection is suspected.
The history establishes symptom onset, any fall, fight or cut, and whether the cat can use the leg. The vet locates pain by also examining the paw, claws, bones, joints and neurological function. This avoids confusing similar-looking causes of lameness.
X-rays help assess bones, joints and possible bone damage at a tendon attachment. However, normal X-rays do not rule out tendon injury. Ultrasound can examine fibre structure, tendon continuity and surrounding fluid, and distinguish partial from complete rupture. Other imaging may be considered in difficult cases.
Ultrasound can also monitor healing, but an image does not always reveal the precise age of an injury or when the tendon is fully healed. Imaging is combined with clinical examination before loading increases.
Suspected infection may require a sample from a deeper injured area or tendon sheath fluid. Bacterial culture helps target antibiotics. Blood tests provide information about general health and a possible inflammatory response, but cannot locate the problem in a tendon on their own.
Treatment
Treatment depends on whether the tendon is intact, partly damaged or completely torn, and whether infection is involved. Milder injuries may be managed with controlled rest, vet-prescribed pain relief and planned rehabilitation. Loading is restricted according to diagnosis; the same rest period or exercise programme does not suit every cat.
Some injuries need external support or surgical repair. A significant Achilles rupture, for example, may need tendon suturing and temporary hock support to prevent premature loading of the repair. Surgery is chosen according to function and the extent of injury, rather than lameness duration alone.
A pus-producing tendon sheath infection needs treatment targeting bacteria and sometimes flushing, cleaning and surgical opening of the affected area. Washing the skin surface alone may not reach a deep infection. Antibiotics are not, however, used automatically for a closed, uninfected tendon injury.
Pain treatment is matched to other diseases and medicines. Do not give human painkillers, combine two NSAIDs or combine an NSAID with a corticosteroid yourself. If a prescribed medicine causes vomiting, diarrhoea or loss of appetite, contact the vet before the next dose.
Home care and rehabilitation
Ask for written instructions on permitted activity, wound care and follow-up. Arrange a recovery area that prevents high jumps, with food, water and the litter tray within easy reach. Exercises are demonstrated at the practice where needed. Do not stretch or massage a painful leg forcefully without instructions from the treating professional.
If your cat has a splint or bandage, keep it clean and dry and prevent licking or chewing. Monitor visible toes and the upper bandage edge: swelling, unusual coldness, redness, smell or discharge warrants contact. A wet, slipped or suddenly troublesome bandage also needs checking. Do not tighten it or rebuild a splint yourself.
During rehabilitation, loading increases gradually according to the agreed plan. Record how your cat bears weight, whether swelling increases and whether pain follows exercise. Wanting to play or briefly walking without lameness does not show that the tendon can tolerate free outdoor access and jumping. New pain or a change in leg position needs a review of the plan.
Prognosis
The outlook depends on injury location and extent, tendon continuity, any infection and the success of support and rehabilitation. Treatment may restore good function, but no single healing time applies to every tendon disease. Tendon repair or prolonged support also needs monitoring for possible wound and bandage problems.
Prevention
- prevent injuries and falls;
- keep weight under control;
- clean and treat wounds promptly;
- avoid excessive strain in older cats.
Prevention cannot remove every possibility of tendon injury. Have a low threshold for veterinary assessment of wound depth and lameness, even if the skin shows only a small mark. Weight management and a safe environment support function, but rest or a dietary change alone cannot replace investigating new symptoms.
Important for cat owners
Tendinitis and tenosynovitis are uncommon but painful conditions in cats, causing lameness and reduced quality of life. Remember that even mild but persistent lameness warrants a veterinary visit. Timely help can prevent complications and preserve normal mobility.
This article provides general information and does not replace veterinary care. If you notice signs of illness in your cat, contact a vet.
Frequently asked questions
Can a tendon be damaged without a visible wound?
Yes. A closed injury can occur through stretching or during a jump. If your cat limps or the leg changes position, the absence of a visible skin break does not rule out a tear.
Does tendinitis show on an X-ray?
X-rays mainly help assess bones and joints. Tendon structure is usually examined better with ultrasound or other soft tissue imaging where necessary. Normal X-rays alone do not rule out injury.
Can a cat return to normal activity as soon as the limp stops?
Not necessarily. Less pain does not guarantee full tendon strength. Follow the treating vet's and rehabilitation professional's instructions when increasing activity.
This article is for general information only and is not a guide to treatment. If you notice the first signs of illness, contact your vet.
Paw4care editorial team
Sources
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