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Health & Veterinary Care for Older (Senior, Geriatric) Cats
Veterinary & Aquatic Services Department, Drs. Foster & Smith
veterinary exams & procedures
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Regular professional veterinary care is essential to the health of your older cat. Not since your cat was a kitten have regular checkups and vaccinations been so important. Preventive veterinary care can add years and quality to the life of your older cat. Consider yourself, your cat, and your veterinarian and staff a team whose main goal is to keep your cat happy, healthy, and in a loving relationship with you for as long as possible.

Because many of our pets are living longer, and we recognize that the earlier in a disease process we can make a diagnosis and start a treatment, the better the outcome, many veterinary clinics and hospitals have developed special preventive care programs for older animals. These are often called 'geriatric panels,' 'geriatric wellness programs,' 'geriatric screens,' or 'senior care programs.' These can include combinations of various diagnostic tests including blood tests, urinalyis, fecal exams, radiographs (x-rays), and EKGs. Ask your veterinarian which tests are appropriate for your cat. The various tests, exams, procedures, and services a veterinarian may recommend for an older cat are described below.

Wellness starts at conception

Your cat's health today is partially determined by the health of her father and mother on the day she was conceived. The vaccinations, nutrition, dental care, wormings, heartworm prevention and other parasite control your cat has had through her life have a direct bearing on her current health. The healthier we can keep a cat when she is young, the more likely she will be healthy as she grows older.

Weight management, diet and nutrition counseling

Every visit to your veterinarian should include a measurement of your cat's weight. Weight gain and unexplained weight loss may be the first signs of disease. The dose of most drugs, wormers, and heartworm preventives are based on weight, so having a current weight is important. If your cat's weight changes, consult your veterinarian about changing the dose of any medications or supplements your cat is taking. If you are concerned about your cat's weight or appetite, be sure to discuss it with your veterinarian.

A cat eatingYour veterinarian or veterinary staff should be able to recommend which foods and supplements your cat should receive based upon her weight and health status. The digestive systems of older cats do not react well to sudden changes. If a change in diet is recommended, make the change slowly over the course of a week or more, gradually adding the new food to the old.

Medical and behavior history

One of the main tools your veterinarian uses to determine if a disease process is occurring in your cat, is an accurate medical history. Monitoring your older pet and keeping records of signs of disease and changes in behavior will be valuable in making a proper diagnosis early in the course of a disease. Questions such as 'When did this symptom or sign first appear?', 'Is it getting better or worse?', and 'Is the sign or symptom always present, or is it intermittent?' are questions only you will be able to answer. If you are not sure whether a certain behavior or observation is indicative of a disease, ask your veterinarian.

Physical exam

Dr. Foster examining a catOlder cats should receive regular physical exams. How often these exams should occur depends upon the health status of your cat, but they should be at least annually. For some older cats, two or more exams per year may be recommended. Be sure to tell your veterinarian about any conditions you have observed and want evaluated. If you do not understand what your veterinarian is doing during an exam, ask.

Oral and dental exam

A physical exam should include an examination of the mouth, teeth, gums, tongue, and throat. Depending upon the personality of the cat, this can be very easy to do, or it can be almost impossible. Getting a kitten used to having her mouth opened while she is young, will help tremendously as she grows older.

Ophthalmic exams

Checking a cat's eyesAs cats age, routine ophthalmic (eye) exams are recommended. Changes in the eyes can be due to eye disease itself, or an indication of another disease process going on in the body.

Hair and coat care

During the physical exam, your veterinarian will evaluate the health of the skin and coat of your cat. Bathing, additional grooming, supplements, or certain diagnostic tests may be recommended.

Control of ectoparasites (parasites on the outside of the body)

The physical exam should include an examination of the skin and ears for any signs of external parasites such as fleas, ticks, lice, or mites. Your veterinarian will be able to recommend products to protect your cat from these parasites or treat your cat if parasites are found.

Control of endoparasites (parsites on the inside of the body)

A fecal exam should be run routinely to identify any intestinal parasites that may be present. Checking the fur around the anal area may help determine if your cat has tapeworms. Your veterinarian will be able to recommend which wormers your cat should receive.

Heartworm prevention

The frequency of heartworm tests depends on whether your cat has missed any doses of the preventive, the frequency of heartworm disease in your geographical area, and whether your cat is showing any signs of heartworm disease. Ask your veterinarian any questions you may have regarding the heartworm preventive in cats, the dose, and the frequency of administration.

Vaccinations

Because the immune system of an older cat may not be functioning as well as when she was young, it is very important to keep your cat up-to-date on her vaccinations. Consult with your veterinarian regarding which vaccines your cat should receive, and how often.

Urinalysis

Many veterinarians will recommend a urinalysis be performed on older cats. A urinalysis is really a series of tests, which provide a wealth of information. The sample is generally easy to obtain, and the test can be run in your veterinarian's office in a short amount of time. If you have noticed any change in the color, odor, or amount of your cat's urine, you have noticed her having difficulty urinating, or she has had 'accidents,' it is very important that a urinalysis be performed.

Blood count (CBC)

There are many tests which can be performed on blood. Several common tests which evaluate the cellular portion of the blood are included in a complete blood count. In some cases, your veterinarian may recommend that only one or two of these tests be performed.

Chemistry panel

The number of tests evaluating the various chemicals, enzymes, proteins, hormones, waste products, and electrolytes in blood is in the hundreds. Generally, a chemistry panel which will evaluate 6-12 of these components will be performed. This chemistry panel is a valuable tool in identifying diabetes mellitus, liver disease, kidney disease, and several hormonal diseases. The number of tests in the panel and how often they are performed will depend upon the health status of your cat.

Testing for FIV and FeLV

Older cats who are at risk of exposure to feline immunodeficiency virus or feline leukemia virus should be tested periodically to determine their infection status. An older cat infected with one of these viruses has special health care needs and vaccination schedules, frequency of dental exams, and other procedures may need to be modified.

EKG

An electrocardiogram (EKG) can be performed quite easily on cats. There are new instruments available, which can merely be held at the animal's side to obtain an EKG - with no wires leading from the machine needing to be attached (uncomfortably) to your cat. Again, whether your veterinarian recommends an EKG for your cat will depend upon results of the physical exam (were heart murmurs present?), the age and breed of your cat, and any signs of heart disease your cat may be experiencing.

Thyroid testing

Thyroid testing may also be recommended by your veterinarian, again based upon the results of the physical exam, the breed of your cat, and any signs of thyroid hormone deficiency or excess. Cats who are being treated for thyroid disease will need to have their thyroid hormone levels checked at regular intervals.

Radiographs

Especially if your cat is showing signs or has a history of heart, lung, kidney, liver, or gastrointestinal disease, radiographs (x-rays) may be recommended. As a cat grows older, it is often helpful to have a radiograph of the chest and abdomen taken while the cat is healthy. If the cat develops signs of disease, these 'normal' radiographs are valuable in providing a baseline by which to evaluate the radiographs taken after a disease process has started. In most cases, a cat who has or has had cancer will have radiographs taken, especially of the chest, to look for any spread of the disease.

Preanesthetic screening

A senior long-haired catAn older animal is generally at greater risk for having adverse reactions to anesthetics. An evaluation of liver and kidney function, blood components, and electrolytes are recommended for older cats who are going to be anesthetized. Knowing a problem exists beforehand is much better than finding out about the problem when your cat is in the middle of a surgical procedure. If abnormalities are found on the pre-anesthetic screen, the procedure requiring anesthesia may be postponed, the types and amounts of anesthetics used may be altered, or the method of performing the procedure may be changed.

Options for diagnostic tests and treatments

Newer procedures which are less invasive, shorter in duration, or may be performed with local anesthesia are becoming increasingly available in veterinary medicine. These include laser surgery, endoscopy, ultrasound, and electrosurgery. These can be excellent alternatives for older cats whose health problems may preclude them from the more traditional procedures.

Blood pressure monitoring

Until recently, measuring the blood pressure of animals was a tedious procedure, and unavailable in many veterinary hospitals. New instruments and techniques have made blood pressure measurement less cumbersome, and more veterinarians will have this diagnostic and monitoring procedure available.

Pain control

The issue of pain control in animals is being addressed more by veterinarians and in the veterinary literature. New medications have become available, which can help older cats who may have a terminal and painful disease.

Pet loss, euthanasia, and grief management

Euthanasia continues to be an option for many pet owners who do not want their terminally ill pet to suffer, or who may find the veterinary costs for continued treatment of their pet to be prohibitive. It is often helpful to discuss the process of euthanasia with your veterinarian well in advance of its occurrence. Which family members will be present during the procedure, when and where it will take place, options for handling the pet's remains, how the family members may want to say good-bye or provide a memorial for their pet, and how and with whom they will spend time immediately after the euthanasia are all important issues which should be discussed.

Home-based hospice care is becoming available through some veterinary hospitals and volunteer organizations. The concept behind pet hospice is to provide comfortable care for a terminally-ill pet at home. Such care may be helpful when the family members of a pet need more time to adjust to the imminent death of their pet. Hospice can be especially helpful in providing children time to understand that the family pet is dying, or giving time for a geograhically distant family member to come home to say good-bye and provide mutual support to the other family members.

Your veterinarian may be able to provide you with a referral to grief counseling services, pet loss support groups, or assist the family in other ways, such as helping them explain to young family members what has happened. Pet loss hotlines, books to help people grieving the loss of their pet, and other resources are also available to help family members through the grief process.

Summary

Older pets need regular veterinary care to prevent disease and/or diagnose it early in its course. Many veterinarians have special programs to monitor cats in their later years of life. Good communication between the owner, cat and veterinarian can keep the cat healthy and make her senior years be wonderful years. At the end of your cat's life, your veterinarian can help you in making decisions, provide support, understand and share your grief, and celebrate, with you, the life of your pet.

 
References and Further Reading

American Association of Feline Practitioners. Academy of Feline Medicine Panel Report on Feline Senior Care. 1998.

Becker, M. Caring for older pets and their families. Firstline; August/September 1998: 28-30.

Epstein, M; Kuehn, NF; Landsberg, G; et al. AAHA Senior care guidelines for dogs and cats. Journal of the American Animal Hospital Association 2005; 41(2):81-91.

Fortney, WD (ed). Veterinary Clinics of North America Small Animal Practice: Geriatrics. W.B Saunders Co, Philadelphia, PA; 2005.

Harper, EJ. Changing perspectives on ageing and energy requirements: Ageing and energy intakes in humans, dogs and cats. Waltham International Symposium on Pet Nutrition and Health in the 21st Century. Orlando, FL; May 25-29, 1997.

Hoskins, JD. Geriatrics and Gerontology of the Dog and Cat, Second Edition. W.B Saunders Co, Philadelphia, PA; 2004.

Hoskins, JD; McCurnin, DM. Implementing a successful geriatric medicine program. Supplement to Veterinary Medicine; 1997.

Landsberg, G; Ruehl, W. Geriatric Behavior Problems. In Hoskins, JD (ed) The Veterinary Clinics of North America Small Animal Practice: Geriatrics. W.B. Saunders Co. Philadelphia, PA; 1997: 1537-1559.

Ogilvie, GK; Moore, AS. Critical Issues in Senior Pets: Disease Prevention, health and wellness. Veterinary Forum 2006 (Dec):40-46.

Overall, KL. Clinical Behavioral Medicine for Small Animals. Mosby-Year Book, Inc. St. Louis, MO; 1997.

Thompson, S (moderator). Roundtable on pediatric, adult, senior, and geriatric wellness at every stage of life. Veterinary Forum; 1999 (January):60-67.

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