What diseases are common in senior cats?

Eight conditions that we commonly see in senior cats are hyperthyroidism, chronic renal failure, systemic hypertension, cancer, diabetes mellitus, inflammatory bowel disease, cardiac disease, and dental disease. Remember that senior cats are more likely than younger cats to experience multiple problems at once. If you focus on managing one disease, you may miss other problems. The case presented in "Still thriving after all these years" at the end of this article highlights why it is important to follow the AAFP/AFM panel report guidelines.

What is the best diet for senior cats?

For senior cats with ongoing clinical disease such as renal or gastrointestinal problems, special diets are available. But it can be challenging to get a cat to eat a special diet; it is more important that the cat eats something to maintain its body condition even if it will not eat the special diet. If a cat will not eat a special diet, other therapies may be indicated to address the disease.

Increasing the moisture content in the diet can also be beneficial in senior cats, especially those with renal insufficiency or failure. Canned cat foods are often a good option for these cats. It may also be prudent to offer tuna juice and other broths, as this may increase fluid consumption.

How often should senior cats have their teeth cleaned?

Bacteria associated with dental tartar and dental pain due to diseased teeth and gums contribute to the overall decline of all geriatric patients.^4,5 Older cats should continue to receive regular dental cleanings and extractions to make sure good dental health is maintained. With good dental health, secondary infections are less likely, as is decreased food intake due to dental pain.

Since dental procedures require general anesthesia (see also "What special anesthetic considerations do senior cats have?" below), and renal compromise due to hypotension is a concern, all senior cats should receive intravenous fluids before, during, and after their dental procedures. A good fluid choice for cats with underlying cardiac disease is 0.45% sodium chloride solution administered at a conservative rate to provide renal support and avoid fluid overload. Choose kidney-friendly anesthetics such as isoflurane and sevoflurane⁶ for these patients, with a goal to minimize hypotension. I often use a slow propofol intravenous induction followed by maintenance with an inhalant anesthetic such as sevoflurane. This protocol allows for a smooth, controlled induction and intubation, with the pet receiving intravenous fluids and being monitored during the induction period. Begin antibiotic therapy at least one hour before the dental procedure.⁵

What behavior issues are more common in senior cats?

Probably the most common behavior concerns in cats are inappropriate urination and defecation. In older cats, these behaviors are likely related to arthritis or any condition that causes pain or decreased mobility, other underlying diseases, or cognitive dysfunction. A comprehensive history as well as a complete physical examination and diagnostic workup will help identify these underlying conditions. Treatment should first be aimed at the health problems. Behavior modification may later be needed.

Another behavior concern in geriatric cats is a change in attitude, usually described as the cats' becoming more aggressive or cranky. Underlying disease or pain should also be considered as possible causes of these attitude changes. Cats with hyperthyroidism will often show behavior changes such as increased irritability or affection because of their disease.

Clients will comment that their cats are slowing down in their old age. While this is possible, it is prudent to make sure this lethargy is not due to an underlying disease such as cardiac disease, hypertension, or other metabolic concerns.