Back to Main PageGERIATRIC HANDBOOK
WELLNESS CARE FOR THE GERIATRIC CAT:
THE CAT CARE CLINIC GERIATRIC PROGRAM
WHY
Why is preventative health care so important, especially for the geriatric cat? Most health problems in cats occur during the first six months of life, or in the "golden years". These can usually be treated, and - even if not curable - can lead to a comfortable and improved quality of life which can mean many additional healthy years for your cat. With a geriatric program, we regularly check or monitor older cats in order to detect problems early - when they can be best managed or treated. In addition to helping these important family members, clients benefit by having controlled health care costs as early disease management is less costly than crisis episodes.
WHEN
How old is old?
Old age itself is not a disease. As with people, the age at which a cat becomes "geriatric" varies. It is safe to say that by 10 years of age, a cat is considered geriatric. However, many veterinarians now consider "geriatric" to start anywhere between 7 and 10 years of age. The average life span of cats has been said to be 12-15 years of age. However, with improved health care, we are seeing many cats between 15 and 20 years of age, and a few of our patients have reached their 24th birthday! Just to give you an idea.....with improved health care, 30 % of the cat population is over 7 years of age, and 18% are older than 10years. To see how this relates to human years, please see our chart on the other side of this page.
AGING CHART - COMPARED WITH HUMANS
WHAT
The Cat Care Clinic Geriatric Program provides you with information specific for your cat. You will be provided with written information individualized for your cat, as well as followup phone consultation to test results and necessary followup recommendations. The program consists of the following:
Veterinary care
1. Comprehensive physical examination: A thorough exam done every 6 months is essential for the older cat. Did you ever wonder what we are looking for on a physical examination? See the next page to find out!
2. Diagnostic testing - This is very important as an aid in early detection of disease. We follow the recommendations of the American Association of Feline Practitioners which state that the package of tests that we call the "geriatric profile" be performed at least annually for the healthy geriatric cat, but more frequently if abnormalities.
See page 2 for tests we recommend and what they mean.
3. Managing common geriatric diseases
4. Dentistry
5. Nutrional advice
6. Preventing infectious diseases and public health concerns
7. Client education
8. When its time to say goodbye...supporting geriatric cats and you
Home Care
1. Love and attention
2. Preventing illness when possible
3. Making a comfortable and safer environment for the older cat
4. Good nutrition
5. Dental home care
6. Nursing Care
7. Recognizing signs of illness
8. Calling for advice and medical care, and understanding what you and your veterinarian can do to help care for your cat.
Please feel comfortable to ask or call for more information on the geriatric care program, and to discuss your pet's care. Our doctors and staff are available to help you give your cat the best chance for a comfortable and long life.
________________________________________________________________________TOPICS FOR THE RIGHT SIDE:
How Comprehensive Examinations Benefit Your Geriatric Cat
Why Should My Cat Have Diagnostic Testing If It Acts Normal?
What You Can Do To Help Your Older Cat At Home
Common Signs Of Geriatric Medical Conditions
How To Conduct A Home Exam
Monthly Checklist For A Happy And Healthy Geriatric Cat
Home Care Tips Specific For Geriatric Cats
What You Can Do To Manage Common Geriatric Diseases
Does it really matter what my cat eats?
When It's Time To Say Goodbye/Resources For Pet Loss Support
_HOW COMPREHENSIVE EXAMINATIONS BENEFIT YOUR GERIATRIC CAT
Significant aging changes and disease progression can occur over short periods of time for older cats; therefore, the American Association of Feline Practitioners recommends semiannual visits for cats starting at 7-10 years of age. By carefully evaluating the information you provide us regarding your cat's history along with semi-annual physical examinations, we are often able to help detect disease early. The information that you provide us is critical to helping your cat! For example, behavioral changes or subtle changes in eating or drinking are significant and may indicate a treatable medical condition. Furthermore, because cats often appear healthy despite being affected by significant disease, owners may not be sensitive to changes as they occur, such as weight loss. Regularly scheduled visits help determine changes in weight and body condition, and allow for implementation of other aspects of the preventive program.
Comprehensive physical examination for the older cat include the following:
* Weigh the patient to evaluate and discuss management of weight problems. Comparing serial weights with those from previous visits helps us detect significant weight changes, a possible sign of an underlying problem. Nutritional counseling is given for overweight cats. Cats that are underweight or have had significant weight loss, could be suffering from diabetes mellitus, hyperthyroidism, or a number of other diseases.
* Evaluate the hair coat for skin parasites, hair loss, scabs, sores, or a dull or greasy hair coat.
* Evaluate the skin for tumors, infection, or sores.
* Check ears for infection, growths, or mites.
* Check eyes, including a retinal exam, to evaluate for a number of different abnormalities. The most common eye abnormality in older cats is cataracts, followed by those caused by high blood pressure.
* Check nose for discharge, sneezing or other problems.
* Perform an oral examination to check for dental disease, paleness or yellowing of gums (seen with anemia or liver disease), and tumors or sores in the mouth.
* Check throat for redness, growths, or other problems.
* Palpate the neck for enlarged thyroid glands, which could indicate hyperthyroidism.
* Listen to the heart to detect irregular heart beats or an abnormal rate. This can be a sign of heart disease, but is also seen with a thyroid condition, anemia, high blood pressure, etc.
* Listen to lungs and chest cavity to aid detection of asthma, pneumonia, cancer or infection.
* Palpate abdomen to detect irregularities in the liver, spleen, kidneys, bladder, stomach, intestines, and lymph nodes. Kidneys that are too small, too large, or irregular are usually a sign of kidney disease. Intestinal disorders include inflammatory bowel disease, parasites, and cancer. Liver disease can begin in the liver or can occur secondary to many other diseases.
* Examine for lameness if limping or concerns about the way the patient is walking or is holding a leg.
* Perform a neurologic exam when needed to determine the location of a nerve problem.
* Take a temperature on patients who are not completely healthy.
WHY SHOULD MY CAT HAVE DIAGNOSTIC TESTING IF IT ACTS NORMAL?
Many feline diseases have gradual onsets and subtle signs, making it difficult to recognize that a cat is sick. By performing certain diagnostic tests at different points in you cat's life, we can detect many diseases before your cat appears ill. Early disease detection can allow for early treatment which can often prevent or delay disease progression, and is usually less extensive and more cost effective. For example, cats with kidney disease often show no signs or symptoms in the early stages of the disease. Owners are often unaware of subtle changes in their cat's appetite, thirst, or urination, and changes they notice could be from any number of common diseases. In such cases, detection of disease in the absence of laboratory data is difficult.
Establishing your cat's normal values will help to compare with future test results. If your cat is sick, comparison of lab results to previous ones tells us whether treatment is working or the disease is progressing. We provide our clients with diagnostic testing that is sensitive enough to detect early disease, minimally stressful for the cat, and cost effective. (in bold or italics)
As with all medical care, diagnostic testing should be tailored to the individual patient. However, based on the frequency of certain diseases in the geriatric population and the goal of early intervention, the American Association of Feline Practitioners recommends annual testing for apparently healthy geriatric cats which detects the most common diseases and more. For cats that are sick or that have been diagnosed with a previous chronic disease, testing should be at least twice yearly. This testing, our "Geriatric Profile" includes the following:
*Complete Blood Count (CBC): The CBC helps diagnose some infections, anemia, dehydration, certain clotting problems, blood parasites, and cancer of the blood cells
*Blood Chemistry profile with electrolytes: Tests for kidney disease, diabetes, liver disease, and electrolyte abnormalities.
*Total T4 by RIA: The best screening test for hyperthyroid disease. Additional
thyroid testing may be needed in certain patients.
*Complete urinalysis: By measuring the kidney^1s ability to concentrate urine, we can often detect early kidney disease before we are able to detect it by blood tests. The microscopic evaluation of the urine looks for infection, blood, and abnormal crystals.
*Blood pressure: Hypertension (high blood pressure) is common in cats
with hyperthyroid or chronic kidney disease - the 2 most common feline geriatric diseases. If untreated, hypertension can lead to blindness, strokes, heart disease and further kidney disease.
There are cetain situations in which additional diagnostic testing may be needed for your cat. This will depend on your cat's health, previous lab test results, if your cat goest outdoors, and exposure to other cats that could be harboring infectious diseases.
Diagnostic testing is an important part of feline geriatric preventative healthcare. It aids in the diagnosis of disease and its severity, giving us important information to make treatment recommendations for your cat.
WHAT YOU CAN DO TO MANAGE COMMON GERIATRIC DISEASES
The first step to managing the diseases of older cats is to recognize that a problem exists. Whether detected at home or at the clinic, the 4 most common older cat conditions that we see can be successfully managed for long periods of time.
1. Behavioral changes or problems are most frequently associated with an underlying medical condition. Treatment for the underlying cause as well as retraining can stop many unwanted behavioral changes. For example, cats with arthritis, thyroid or kidney disease may stop using the litter box. Once the medical condition is treated, as well as changes in location or cleaning of the litter box occur, most cats never have another problem.
2. Kidney disease is the leading cause of death in older cats. Initially the signs are subtle and often overlooked. Cats with kidney disease usually urinate large volumes, often detected as larger urine balls in clumping litter or soaked gravel litter. To compensate for this fluid loss, cats often drink more water. The kidney condition can also cause vomiting, as well as appetite and weight loss. Early detection is best to slow the progression of this disease. There is no cure, except for kidney transplant in certain situations, but the progression of disease may be prevented or delayed with proper management. We've had feline patients live five years (and more!) after diagnosis!
3. Hyperthyroidism is the most common endocrine (glandular) disease in cats, and is most frequently seen in cats 10 years of age and older. The disease is due to excess circulating thyroid hormone,which can affect many organs, including the heart and liver. Signs can include a ravenous appetite and weight loss, vomiting and/or diarrhea, and increased urination and/or water consumption. This is usually a treatable (potentially even curable) with several treatment options.
4. Arthritis in not uncommon in older kitties, often causing unrecognized pain. Owners often think their cat is "slowing down" or less social, with the cat not wanting to move or be touched due to the pain. There are new medications that are helpful in many cases and that do not have side effects.
Other concerns in the older cat include dental disease that can cause pain and reduce appetite, diabetes mellitus (high blood sugar), hypertension (high blood pressure), constipation and cancer.
DOES IT REALLY MATTER WHAT MY CAT EATS??
The nutritional needs of older cats can change, and a thorough evaluation of what your cat eats, the findings on physical examination, and diagnostic testing is important to make appropriate dietary recommendations. A healthy geriatric cat should consume a well balanced, nutritionally complete and palatable diet, sufficient in taurine and potassium. It is important to note that not all diets labeled as "senior diets" are appropriate for the geriatric cat. Please ask us to help evaluate diets if you wish to feed one of these "senior diets".
Fresh water should always be available to encourage water consumption in geriatric cats.
*********Also check AW's newsletter article on nutrition to see if anything should be added from that to this section.
Cats with underlying medical conditions usually require a special diet to specifically aid with the disease found. Aged kidneys have more difficulty breaking down and excreting certain substances from the body. This can even lead to a toxic situation for your cat. Therefore, at the earliest evidence of kidney disease, you should start feeding a diet lower in phosphorus, protein, and salt. Low salt diets are often recommended for patients with high blood pressure or heart disease.
Weight control is very important. Some older cats need lower calorie, high fiber dieets to prevent obesity. Other cats need higher calorie diets to maintain or increase body weight.
As cats age, they often have more difficulty with small, dry stools. Plenty of fresh water and high fiber diets are often all that is needed to help prevent constipation. However, if constipation is not corrected by increasing fiber and water intake, medication may be prescribed to help soften stools or increase intestinal motility.
PREVENTING PAINFUL TEETH WITH DENTAL CARE
Dental disease is a common and often overlooked cause of significant discomfort in the geriatric cat, and can contribute to a general decline in attitude and overall health. Dental disease can cause pain, as well as spread of infection to other parts of the body. Some cats will have behavioral changes, with irritability, due to their pain. Signs of severe dental disease are loss of appetite, bad breath, drooling, and pawing at the mouth. It is remarkable how appropriate treatment often leads to a marked improvement in quality of life and activity.
Your geriatric cat's teeth should be examined by a veterinarian a minimum of every 6 months. If followup care, such as a dental prophylaxis (dental cleaning) or another procedure is recommended, it is important to schedule it for as soon as possible to prevent further disease. Although some lesions can be visible during routine inspection, a thorough examination of the mouth cannot be performed in most cats without sedation or anesthesia. Dental x-rays are often needed to evaluate the extent of the dental disease.
We use isoflurane gas anesthesia, which is the safest gas anesthetic available. It is effective and cats awake quickly. Pre-anesthetic testing is performed prior to anesthesia to help identify health problems which might preclude anesthesia. If there are indications that anesthesia presents a risk to the cat's health, the dental procedure can be delayed until the problem can be corrected or controlled. Your kitty will receive intravenous fluids during the day of the anesthesia and dental procedure.
A combination of veterinary and home care leads to the best results for dental health.
Your participation in the oral health program slows progression of dental disease. Without home care, many older cats will need dental cleaning under anesthesia on a yearly basis. We will demonstrate options for home care, which include tooth brushing (do NOT use human toothpaste or baking soda which can cause problems in cats!), cleaning the teeth with gauze, enzymatic dentrifice placed in the mouth, CET Chews, and T/D diet (if not contraindicated due to other health problems). The teeth should be reevaluated at every veterinary visit, a minimum of every 6 months.
PREVENTING INFECTIOUS DISEASES AND PUBLIC HEALTH CONCERNS
COMBINE THESE 2 SECTIONS
WHAT YOU CAN DO TO HELP YOUR OLDER CAT AT HOME
With the excellent home care that you can provide at home along with regular veterinary visits and advances in feline preventative healthcare, many of our older cats are living longer. Even cats with age related diseases can be comfortably and successfully managed and therefore enjoy a good quality of life for many years. YOU are a very important part of that care by helping us detect problems early, when easiest to treat. To help you recognize early signs of disease we are providing you with the following information:
I. Common signs of geriatric medical conditions
II. How to conduct a home exam
III. Monthly checklist for a happy and healthy geriatric cat
IV. Home care tips specific for geriatric cats
I. COMMON SIGNS OF GERIATRIC MEDICAL CONDITIONS
The 3 most commonly underrecognized signs of medical conditions are 1) behavioral changes, 2) changes in water consumption, and weight changes.
1. Behavior changes can include missing or not using the litter box, crying or howling, being irritable or aggressive. 80% of behavior changes in geriatric cats have an underlying medical condition that can be effectively treated! What might appear as an older cat "just getting old", "trying to get attention" or "acting up" may be due to a medical problem that we can treat.
2. Changes in water consumption - An increase in water consumption is usually related to a medical condition, such as diabetes or kidney disease. You might also note that the litter pan is "flooded" or contains more urine that previously.
3. Weight gain or weight loss - Weight changes are difficult to detect when we see our kitties each day. It is not unusual for large fluctuations in weight to go unnoticed.
Other common signs of medical conditions are:
Increase or decrease in appetite
Increase or decrease in urine or stool
Moving more slowly, not jumping, or not using the litter pan, which may be signs of arthritis
Vomiting or diarrhea
Poor hair coat
Vocalizing, which can indicate a loss of hearing or high blood pressure
Loss of vision can be related to high blood pressure or cataracts
II. HOW TO CONDUCT A HOME EXAM
Regular physical examinations are the key to keeping you cat healthy. Problems may be detected early with semiannual veterinary examinations in conjunction with owners performing monthly "home exams".
To examine your cat, start by looking at your cat and comparing one side of the body with the other. This helps to detect eye, ear, and body irregularities. Then use both hands to feel your cat, beginning at the head and working towards the tail. Be gentle but firm. Feel for lumps, scabs and mats. Note whether your cat is painful in an area, or jumps or flinches when touched. If you brush your cat's teeth or are able to check the mouth, note whether there is pain, tartar accumulation, redness to the gums, abnormal odors, or irregularities in the mouth.
III. MONTHLY CHECKLIST FOR A HAPPY AND HEALTHY GERIATRIC CAT
We have provided a checklist to help you differentiate between possible underlying
medical problems and normal aging changes. Please review the checklist monthly and let us
know if there are any concerns, changes or questions. (Attached)
IV. HOME CARE TIPS SPECIFIC FOR GERIATRIC CATS
You can help your older cat in several ways to prevent discomfort and possible behavioral problems:
Be sure your cat has a warm and safe place to escape the general noise and traffic of the household.
Block off isolated, hard to reach hiding places, so that your cat does not get stuck in an inaccessible location.
Put food and water dishes in a quiet, easily accessible place. Make sure that fresh water is always available.
Make sure litter pans are easy to get to, and that your cat does not need to climb steps or jump to reach the litter pan. Litter pans should be cleaned daily, but more frequently if needed. Provide at least one litter pan per cat per floor. Litter pans with lower sides may be easier to get into for arthritic cats.
Have a quiet place and soft bedding for comfortable sleeping. "Safe snuggle" is a warmed bed that is safe, esuring that your kitty stays warm but without cocern of burn.
Help with grooming, since older cats often have more difficulty with keeping themselves clean. This will also help prevent hairballs. Mats can be uncomfortable, but also difficult to remove. Please ask us how to remove mats or where to take your cat to have this done.
Feed ONLY foods recommended by your veterinarian. If your cat is unwilling to eat these foods, please call for further suggestions.
Note any changes in your older cat's behavior or any signs of a sick cat. Please call right away for an appointment to check your cat so that we can attempt to help as early as possible.
For older cats who cannot see as well, keep the furniture in the same location.
Keep follow-up appointments for rechecks, and check all older cats a minimum of twice yearly.
Call if any questions or concerns.
Our staff is trained to teach you nursing care techniques such as administering oral medications, insulin or fluids. We have clients who are performing these treatments at home and would be glad to speak with you about their experiences.
WHEN IT'S TIME TO SAY GOODBYE
When you and your family need to say goodbye to your beloved pet
Despite all of our love and care, a time comes when we need to say goodbye to our feline companion. No one can ever be truly prepared for this loss, but knowing what to expect can ease the decision-making process and the grief. Sometimes a pet dies naturally, and sometimes a humane decision is made to euthanize a cat. We understand your loss, and wish to support you as much as possible. We also have a list of the following available to help you: brochures on pet loss, reading materials for both adults and children to aid with the grief of pet loss, numbers for support groups and pet loss hotlines. Please don't hesitate to let us know how we can help.
The decision to euthanize a pet should involve participation of the entire family. Planning in advance helps the family prepare for the loss of a beloved pet. When you near this sad time, please ask us to discuss the following with you:
What happens during the euthanasia procedure
Should I/we be present during the euthanasia - this is often beneficial to the grieving process
Consider an autopsy, which may provide you with answers about the illness and may help other cats with similar illnesses
What should be done with the body - private cremation, general cremation or home burial
Normal manifestations of grief
How you will say goodbye and/or memorialize your pet
The Cat Care Clinic's policy differs from many hospitals in that we do not charge for the euthanasia procedure for a pet that has been seen here within the last year. We do make donations in memory of these wonderful creatures that have touched our lives, both to Cornell Feline Health Center and to the Cat Care Clinic Help Fund, which helps those felines and humans less fortunate than ourselves. We also allow others to memorialize their cat in such a way if they choose to do so.
RESOURCES FOR PET LOSS SUPPORT
Pet Loss Support Hotlines
University of California-Davis 916-752-4200
University of Florida 352-392-4700; then dial 1 and 4080
Michigan State University 517-432-2696
Chicago VMA 630-603-3994
Virginia-Maryland Regional College of Veterinary Medicine 540-231-8038
The Ohio State University 614-292-1823; petloss@osu.edu
Tufts University 508-839-7966
Cornell University 607-253-3932
Iowa State University 888-478-7574
Client Information Brochures
Pet Loss, available from the AVMA
When Your Animal Dies, available from the AVMA
Books
For Adults
Your Aging Cat, Kim Cambell Thorton and John Hamil, DVM
Cornell Book of Cats, Mondecai Siegal, ed.
When Your Pet Dies: How to Cope with Your Feelings, Jamie Quackenbush, MSW and Denise Graveline
A Final Act of Caring: Ending the Life of an Animal Friend , Mary and Herb Montgomery
For Children
The Tenth Good Thing About Barney, Judith Viorst
Goodbye My Friend , Mary and Herb Montgomery
Web Sites
AVMA Pet Loss Page www.avma.org/care4pets/avmaloss.htm
Iowa State University Pet Loss Support Hotline www.vetmed.iastate.edu/support/
Delta Society Pet Loss and Bereavement www.petsforum.com/deltasociety/dsn000.htm
Cornell Feline Health Center web.vet.cornell.edu/public/fhc/FelineHealth.html
American Animal Hospital Association www.healthypet.com/
Hill’s Pet Nutrition www.hillspet.com/
Maturing-Aging-Loss www.purina.com/Pet_Care/Cat_Care/Aging.html
Cat Fancy On-Line Feline Library www.animalnetwork.com/cats/library
Winn Feline Foundation www.cfainc.org/winn/winn.html
Feline CRF Information Center www.best.com/~lynxpt/
Associations
American Association of Feline Practitioners 1-800-204-3514; www.avma.org/aafp
Cornell Feline Health Center 607-253-3414; web.vet.cornell.edu/public/fhc/FelineHealth.html
American Animal Hospital Association 1-800-883-6301; www.healthypet.com/