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Preventative Health Care for the Senior Cat

"Old Age is not a Disease"


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Old age is not a disease in and of itself. Instead it is a sum of a number of physiologic changes. Our goal at Four Seasons Animal Hospital is to provide high-quality care to all life stages, including the senior cat. We do this by controlling risk factors, detecting disease before sickness, delaying the progression of existing disorders, and improving function when disease is present.



What’s happening at this age:

Senses



Hearing loss is common in geriatric cats. This can be caused by cochlear degeneration, chronic otitis, or arthritis of the middle ear bones. Bulging of the eyes and atrophy of the iris are also normal aging processes that are not significant in an older cat. However, blindness is a serious disorder which results from hypertension or diabetic cataracts.



Dental Diseases



Dental disease is extremely common in senior cats. Most cats by age 7 have significant periodontal disease and these painful teeth are the most likely cause of anorexia in older cats. For most cats, regular dental cleanings should start at age 7.



Cardiopulmonary Disease



Primary heart or lung diseases are rarely a cause of significant illness in older cats. Hypertension does develop secondary to renal and thyroid disorders, and blood pressure screening is recommended in geriatric cats with renal or thyroid disorders.



Renal Diseases



Kidney size and filtration ability decreases as cats’ age. Beginning at approximately age 8 most kidney functions begin to decline. Early detection and treatment of renal disease will do more than any thing else to prolong the life of your cat.


How Old Is Your Cat

In Human Years

Cat Years

Human Years


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40


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96

As certified Cat Friendly Practice members of the American Association of Feline Practitioners we adhere to their programs in preventative health care. The table below summarizes the AAFP recommendations. However, from the cat owner’s perspective, a program must be affordable and manageable. Four Seasons Animal Hospital recommendations are listed as a more economical alternative.



Senior Cats (9-13 years)



Four Seasons Animal Hospital Recommendations



  • Biannual Exam

  • Dental Cleaning every 2 years or as needed

  • CBC Blood Profile

  • Mini Chemistry Blood Profile

  • Urine Dip w/ERD Screen


AAFP Recommedations (American Association of Feline Practioners)



  • Biannual Exam

  • Annual Dental Cleaning

  • General Chemistry Blood Profile

  • T4 (thyroid) Blood Profile

  • Complete Urinalysis

  • Annual Blood Pressure Check


Geriatric Cats (14+ years plus)



Four Seasons Animal Hospital Recommendations



  • Biannual Exam

  • Annual Dental Cleaning and/or Antibiotic Pulse Therapy

  • Geriatric Blood Panel

  • Blood Pressure Check if Idicated

  • Complete Urinalysis w/ERD Screen

  • Potassium Supplement

  • Renal Diet


AAFP Recommedations (American Association of Feline Practioners)



  • Biannual Exam

  • Annual Dental Cleaning

  • CBC/Platelet Count

  • Geriatric Panel

  • Annual T4 (thyroid) Blood Panel

  • Annual Blood Pressure Check

  • Complete Urinalysis w/ERD Screen


Dental DiseaseHealth Concerns for the Senior Cat



Dental disease is often unnoticed in older cats. The infection and associated periodontitis results in intermittent septicemia that can lead to kidney disease, hepatitis, and heart disease.



Symptoms- The symptoms may include: Not eating, weight loss, bad breath, chattering teeth, abnormal chewing, decreased grooming, and chronic nasal discharge.



Treatment- Options for treatment include biannual dental cleanings and antibiotic pulse therapy to control peridontitis.



Prevention- Prevention includes tooth brushing or gauzing, CET Chews, or feeding Feline Prescription T/D diet.



Kidney Disease



Chronic renal failure is the most common disorder in older cats. After age 8, progressive kidney dysfunction occurs in all cats. In fact, if a cat lives long enough it will ultimately die from kidney failure.



Symptoms- Symptoms are often not recognized until late in the disease process. They include drinking excessive water, weight loss, bad breath, and vomiting. Early diagnosis depends on monitoring urine protein. This is done through a urinary screen which allows the problem to become apparent even before results can be seen in blood work.



Treatment- Chronic renal disease can be successfully controlled for months or even years. Cats in renal failure are treated with home administration of subcutaneous fluids, antacids, phosphate control drugs, potassium supplements, and prescription diets low in phosphorus and protein.



Prevention- Feeding a diet low in phosphorus is the most important factor in retarding the progression of chronic renal disease. As the disease progresses potassium supplementation and protein restriction further correct the symptoms of anorexia, weight loss, and vomiting. We recommend all cats over age 10 to be fed a senior type diet. All cats over age 15 to be fed a renal failure diet and receive a potassium supplement.



Monitoring- We suggest monitoring urine protein starting at age 10 to detect renal disease before toxicity occurs. Once toxicity is present and all cats over 15 years we recommend at least annual testing of BUN, Creat., Phosphorus, Urinalysis, and CBC to follow toxicity and anemia.



Diabetes



Inability of the pancreas to produce enough insulin to meet the body’s needs causes Diabetes. This can be caused by a smaller than needed pancreas for the cat, or a larger than needed pancreas for the cat. Therefore, obesity prevention is diabetes prevention.



Symptoms- Diabetes is characterized by an unquenchable thirst, increased appetite, weight loss, and increased urine output. Loss of housetraining occurs secondary to the increased urination and bacterial infection of the urinary tract. Chronic diabetes results in cataracts, and rear limb lameness secondary to neuropathy.



Prevention- Avoid obesity! Fat cats need to be fed either dry diet type food; or, if always ravenous, canned food to provide protein biofeedback to curb hunger. Skinny cats rarely, if ever, become diabetic.



Treatment- Diabetes usually requires insulin given twice daily forever. Some obese cats’ insulin can be discontinued with weight loss, a high protein diet, and oral hypoglycemics.



Monitoring- Diabetic cats need daily to weekly blood sugar levels early in the disease. Once regulated, blood glucose, urinalysis to check for urinary tract infections, and fructosamine levels to measure blood sugar control should be done annually.



Thyroid Disease



Hyperthyroidism is a disease caused by excessive production of thyroid hormones due to tumors of the thyroid gland. These tumors are almost always benign. Hyperthyroidism's effects on the heart and blood pressure are unapparent but deadly.



Symptoms- Symptoms of hyperthyroidism include weight loss despite increased appetite, restlessness, frequent crying, vomiting, and a rapid heart rate. If untreated, the secondary cardiac disease results in congestive heart failure, or rear limb paralysis caused by massive aortic stroke of the rear limbs.



Treatment- Hyperthyroidism can be treated 3 ways: 1) twice daily administration of methimazole will control thyroid levels, but must be given for life. 2) Radioactive Iodine treatment at a referral center. 3) Surgical removal of hyperplastic thyroid nodules at a referral center.



Monitoring- Initially a CBC, Thyroid level, and liver enzymes need to be evaluated every 2-3 weeks. Long term monitoring requires annual thyroid levels and a complete blood count with platelets.



Hypertension



Hypertension in cats usually occurs secondary to chronic renal failure or hyperthyroidism. In general, 65% of cats with kidney disease have high blood pressure.



Symptoms- Symptoms of hypertension are sudden: sudden death, sudden blindness, and sudden seizures. All these are a result of vascular damage and rupture secondary to high blood pressure.



Treatment- Hypertension associated with thyroid disease is treated by treating the thyroid disease. Hypertension secondary to renal failure requires life long treatment with antihypertensive drugs.



Monitoring- Systemic blood pressure should be determined every 6-12 months along with monitoring thyroid levels and renal levels.



Arthritis/ Pain Control



Cats experience pain under the same circumstances as humans. Chronic pain is most often associated with dental disease and osteoarthritis. Unfortunately, cats are unique in that they cannot metabolize non-steroid pain medicines. Aspirin and aspirin like drugs are toxic to cats.



Symptoms- Cats may be reluctant to jump or use stairs, become irritable, litterbox problems arise, aggression toward owners or other pets can occur.



Treatment- Management of arthritis in cats is difficult. Cartilage protective agents such as Cosequin resolve some symptoms. Rimadyl injections can be used in addition when pain flare-ups occur. Steroids can be used, but long term use produces side effects.



Monitoring- X-Rays can be taken to determine the severity of osteoarthritis. Annual chemistries are recommended to monitor for side effects of arthritis medicines.



Nutrition



Nutritional recommendations in senior cats differ with the health problems they encounter. Commercial "Urinary Health" diets are magnesium deficient, may worsen kidney disease, and contribute to bladder stone formation; therefore, these diets are not recommended for older cats. The following recommendations apply to the healthy senior cat.



Protein- Unlike the dog, protein restriction is not recommended in older cats unless elevation in blood toxicity is evident. A protein content of 25 -30% in the diet is suggested. However, after age 15, we assume some degree of kidney disease exists and recommend a lower protein diet.



Energy- Activity decreases with age, so fewer calories are required in senior cats. Obese cats are at increases risk for arthritis, diabetes, liver disease, and early mortality. Obesity control starts at age 2. All senior cats should be on a reduced calorie diet.



Phosphorus- Phosphorus restriction appears to be more important than protein restriction in retards to the progression of chronic renal disease in senior cats. We suggest a phosphorus restricted diet for all cats over age 12.



Potassium- Potassium depletion is common in senior cats, especially those with renal insufficiency. Acidifying "Urinary Health" diets worsen the problem. We recommend that all cats over 15 years of age receive a potassium supplement.



Summary of Nutritional recommendations:



Healthy Cat 12-15 years old: Adequate Protein, Phosphorus Restricted, Non-acidifying, Restricted Calorie Diet:  Hills Prescription Diet G/D or similar



Healthy Cat 15+ years old: Reduced Protein, Phosphorous Restricted, Non-acidifying, Normal Calorie Diet with a Potassium Supplement: Hills Prescription K/D Diet  or similar with Tumil K Powder as a supplement.



Senior Cat with Renal Disease: Reduced Protein, Phosphorous Restricted, Non-acidifying, Normal Calorie Diet with a Potassium Supplement: Hills Prescription canned K/D Diet, Purina canned NF Diet, or Royal Canin canned Renal Support Diet with Tumil K Powder as a supplement.

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