Case Report – The Geriatric Patient

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In Veterinary practice we have the privilege of seeing and treating all ages of pets.  Whilst there can be nothing cuter than the first puppy or kitten consult, we must not overlook the importance of the other end of the age range – our geriatric patients.  These pets have been part of our lives for many years, often accompanying us through major life events and we must ensure that they continue to receive the right level of care as they go through the inevitable ageing process.

A cat can start showing signs of old age from 11 years old and a dog at 8 years old although this can be very variable between breeds.  The signs can be both physical and / or behavioural.

One of the most common physical changes that we see is the development of osteoarthritis.

Cats can be subtle in their clinical signs so owners should look for these carefully.  Examples include:

  • A hesitation or reluctance to jump up to or down from surfaces
  • Toileting in inappropriate places – this can be due to discomfort / pain as well as cognitive (behavioural) changes.

Dogs are usually a little easier to read and so the perception of pain is quicker but signs include:

  • Stiffness after rest
  • Reluctance jumping into the car
  • Hesitation going up or down steps which can then lead to toileting issues as they are unable to access their usual area.

Cognitive changes are becoming more recognized now as our patients are living longer than ever before.  The situation can quickly become very difficult for owners to manage causing a breakdown in the close relationship they once had due to frustration and often a lack of sleep that they may cause.

Cats frequently become more vocal and show repetitive activity especially at night.

Dogs may show confusion with a loss of recognition and interest in their environment.  They may also experience increased anxiety for example when being left alone which can be perceived as neediness.

As mentioned previously, these behavioural changes can also cause inappropriate toileting issues, which can further disrupt the bond between owner and pet.

So what can we do to help?

Firstly clinical examination and a basic blood screen can rule out underlying diseases such as liver disease, kidney disease, hyperthyroidism in cats to name but a few.  All of these are common in our elderly patients and contribute to the signs that we have discussed.

Where appropriate, for example with osteoarthritis or thyroid disease, medication can be given to relieve the symptoms and very quickly improve the quality of life, which is the ultimate goal.

As an owner there are several things that you can adjust at home which can also make a big difference.  These include:

  • Raising food and water bowls a little off the ground to reduce the stretch of joints or the spine in arthritic pets.
  • Cats may benefit from a ramp to their favourite feeding and resting areas.
  • Laminate and wood flooring are great for modern lift but is a huge source of anxiety and creates difficulties for older pets who have less strength and awareness of limb placemen.  Non slip mats can make it easier for them to negotiate moving around the house.
  • Litter trays can be adapted by lowering the sides and placing larger trays to make it easier for a cat to get into it and move around.
  • Owners of dogs should increase the number of times their pet has access to the outside for toileting possibly using ramps to avoid steps.
  • Pheremone diffusers such as Adaptil or Feliway can be used to reduce anxiety especially at night or when left in the house alone.
  • Enhance the environment by using puzzle feeders.  This may help relieve frustration in animals with reduce mobility.
  • Research is on-going into dietary supplementation particularly looking at the role of Essential Fatty Acids and Antioxidants and there are indications that these can help prevent some of the changes noted.

In summary, with owners and the Veterinary practice working as a team we can greatly improve the quality of life of our geriatric pets and allow them to live the long happy life that they deserve.

Meet a few of our “oldies”

 

Barney is a handsome older gentleman at the age of 13.5 years.  He was struggling with stiffness and tremors but has a new lease of life after starting a combination of medication.

Barney

 

 

 

 

Harvey is one of our oldest patients at nearly 17 years old with numerous health concerns including diabetes, but with regular medication and assessments from us and changes made in the home from his very dedicated owner, he is still enjoying a good quality of life.

Harvey

 

 

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