Geriatric Cat Care
Dr. Douglas Brum
The treatment of the geriatric cat varies according to individual requirements and the problems found. The following is a list of the most common geriatric problems and their general treatment recommendations: Nutritional concerns. The proper diet is very important in the care of a geriatric cat. There is no best food to feed a geriatric cat; this depends on the specific problems or nutritional requirements of the individual animal. For example, obesity is a very common problem of older animals because it directly correlates to a decreased longevity and may contribute to other problems. Overweight cats are more likely to become diabetic, develop liver disease (hepatic lipidosis) or suffer from feline lower urinary tract disease. Your veterinarian can prescribe or recommend special lower calorie, high fiber diets that make weight loss easier.
Additionally, on the basis of the geriatric work-up, special nutritional requirements or restrictions may be recommended. These diets attempt either to slow the development of the disease process, or improve specific organ function. Special diets for many diseases (even in the early stages) including kidney, liver, gastrointestinal, heart, dental and skin disease are available. Even diets for diabetes and cancer may be recommended. Proper nutritional management is a very important part of the care for your geriatric cat, especially since it is something that you have control over.
Dental disease. A common finding on a geriatric exam is dental disease and gingivitis (inflammation of the gums). Your veterinarian may recommend treatment that requires general anesthesia. You may be reluctant to put your older cat under anesthesia; however, if there is significant dental disease present, your cat will benefit greatly. Untreated dental disease leads to tooth loss, and may serve as a reservoir of infection for the rest of the body. In this manner, severe dental disease may pose a risk to other body systems.
Kidney disease. Kidney (renal) disease is a very common finding in the older cat. Asymptomatic cats usually have chronic (long standing) disease. Chronic renal disease is managed by feeding special diets that are low in protein and phosphorus. When treating kidney disease, the potassium level is also monitored. Sometimes the level will be low, and supplementation may be required. Other treatments might include Pepcid® (famotidine), phosphate binders and fluids to be given under the skin (subcutaneous) at home.
Hyperthyroidism. Hyperthyroidism is a very common disease of older cats. There are three treatment options. Generally, the safest and most effective treatment is radioactive iodine therapy, which usually requires referral to a specialized facility where cats usually need to be hospitalized for at least a week. The most common form of treatment is with oral medications (Tapazole® being the most common) that reduce the blood thyroid level. Finally the affected thyroid gland can be surgically removed.
Diabetes. The first sign an owner usually sees in a diabetic cat is excessive thirst or urination. Diabetes is generally managed by giving insulin injections at home. Dietary changes are also recommended. Occasionally, oral medications and diet alone can improve the blood sugar level, without the need for injections. Additionally some cats are only transient diabetics, and do not require life-long therapy.
Hypertension. The first aspect of treating hypertension in the cat is to identify and treat any possible underlying disease conditions (most commonly kidney disease and hyperthyroidism). Occasionally cats with hypertension will present with only ocular (eye) signs. Sudden blindness sometimes occurs due to retinal detachment or hemorrhage. Hypertension can also cause secondary cardiac changes and associated heart disease. A common drug used to treat hypertensive cats is amlodipine (Norvasc®).
Cardiac disease. Newly discovered heart murmurs are a common physical exam finding in the geriatric cat. Many times these murmurs are found before a cat is symptomatic of any cardiac disease. Finding a heart murmur in an older cat does not mean that the cat has cardiac disease, but it is an indication for further diagnostics. The most common cardiac disease in the senior cat is hypertrophic cardiomyopathy. This is often associated with hyperthyroidism or hypertension. Early detection of heart disease, treating underlying disorders and proper therapy may slow its progression.
Inflammatory bowel disease (IBD). Treatment of IBD includes prednisone and other immunosuppressive drugs, metronidazole, antacids and dietary changes. Sometimes IBD is associated with hepatitis and or pancreatitis.
Skin tumors. On the basis of the size, location and aspiration results, your veterinarian may recommend removal of one or many skin masses. Sometimes these masses may be removed with only local anesthesia, other times general anesthesia is required. Your veterinarian may also decide not to remove a mass. In this case, the mass should be closely monitored for any changes in size, shape or texture.
Unfortunately, cancer is a significant problem facing the geriatric cat. Lymphosarcoma is the most common type of cancer in the cat. Not all cancer needs to be fatal. Surgery, chemotherapy, even radiation therapy is available that can significantly extend your pet's quality time or produce a cure. The prognosis depends on the type and location of the cancer.