In addition, the AAFP/AFM report states that fecal analysis and parasite control should be done in cats at risk of exposure to internal and external parasites, so consider performing a fecal examination (centrifugation and a direct smear).

These tests provide a good overview of the principal organ systems and will help you identify problems early.¹

What is the recommended healthcare program for senior cats with clinical signs of disease?

Perform a thorough physical examination at least every six months, depending on the patient's medical condition and health status. Some patients may need to be seen more often if they have rapidly progressing or changing clinical signs. Weight evaluation and comparisons and body condition scoring are essential in assessing a pet's clinical condition as well as evaluating a pet's response to therapy.

Blood pressure measurement is even more important in cats with clinical signs. High blood pressure can be caused by many of the diseases and conditions seen in everyday practice (e.g. hyperthyroidism; diabetes mellitus; renal, hepatic, and cardiac insufficiency; obesity) as well as by less commonly seen diseases (hyperadrenocorticism, pheochromocytoma, mineralocorticoid-secreting tumors [primary hyperaldosteronism]). Also, many of the clinical signs seen in senior cats could be due to high blood pressure, including acute blindness (due to retinal hemorrhage or detachment), hyphema, dilated pupils, increased tortuosity of retinal vessels, decreased or increased appetite, vomiting, increased water consumption, increased urination, weight loss, lethargy, heart murmurs, seizures, collapse or syncope, abnormal behavior, proteinuria, and epistaxis. Moreover, high blood pressure can be a silent killer with no overt clinical signs. Also keep in mind that the primary problem can be essential hypertension—high blood pressure with no identifiable cause. As mentioned earlier, normal blood pressure in cats is 145 to 160 mm Hg or less (systolic reading).²

Other diagnostic tests that should be performed annually or more often, depending on the underlying disease, in senior cats include

• A complete blood count—a hematocrit; red blood cell count, indices, and morphology; a white blood cell count; a differential white blood cell count (evaluated cytologically); a total protein concentration; and a platelet count
• A complete serum chemistry profile with electrolytes
• A total T₄ concentration by radioimmunoassay
• A complete urinalysis collected by cystocentesis, including urine specific gravity, urine sediment cytology, and glucose, ketones, bilirubin, and protein measurement
• An FeLV antigen test and an FIV antibody test in any sick cat, even if it has been previously tested (these viruses can be an underlying cause of many of the clinical signs seen in cats)

Also as stated above, the AAFP/AFM report states that fecal analysis and parasite control should be done in cats at risk of exposure to internal and external parasites, so consider performing a fecal examination (centrifugation and a direct smear). In senior cats with clinical signs of disease, also consider heartworm antigen and antibody testing if indicated.