You’ve heard me say it before- old age is not a disease. That being said, old age does make pets more susceptible to certain conditions, most of which are treatable, reversible, or even curable if discovered soon enough. People often notice that their older pets are slowing down, losing weight, sometimes gaining weight, seem less interactive than before. THESE ARE NOT SIGNS OF AGING, THEY ARE SIGNS OF DISEASE. Our goal with old pets is to be even more proactive to protect their quality of life.
How old is your cat or dog?
The most common problem we see in older dogs and cats is arthritis, or chronic pain. Arthritis is a progressive degenerative disease characterized by inflammation of joints and pain. The really good news is that when detected and treated early, we can dramatically slow down that process and increase your pet’s quality of life. This is why we check each joint so carefully for signs of pain. Even if your pet isn’t limping yet, we should start treatment so it never comes to that. Arthritis is the single most common finding when a client says their pet is “slowing down.” The reason the pet isn’t as active as before is IT HURTS TO MOVE. Dogs and cats are not like humans, they don’t whine and complain when they are sore, they simply avoid doing the things that make them hurt, which is walking and moving around. Let me be absolutely clear- when we find signs of inflammation, or decreased range of motion, or pain with palpation of a joint on the exam, we need to act NOW because your pet is IN PAIN NOW. We don’t wait until the muscles have wasted away from disuse and your pet can’t even get up from laying down. That’s way too late. We act NOW to prevent your pet from ever suffering like that.
For the cat to the left and the dog below, it's too late. Neither one of these poor critters has much muscle mass remaining on their rear legs. All we can do at this point is to give them medication to make them more comfortable, but without intense physical therapy and probably even WITH it, these pets are suffering with poor quality of life and serious mobility issues.
It's up to all of us to prevent this from happening. The whole reason to do physical exams is to detect and treat problems before they have a negative effect on the patient's quality of life. These pictures show what happens when arthritis is not treated early.
Another common disease in older dogs and cats is chronic kidney disease (CKD). Unfortunately this is also a progressive degenerative disease which has a terrible effect on your pet’s quality of life. Left untreated, pets with CKD drink excessively but despite the increased water intake are chronically dehydrated because they are also urinating too much. Cats will often urinate outside the litter box, dogs that had been previously house trained urinate in the house. Dehydration is a very uncomfortable condition often resulting in decreased appetite, and in a vicious cycle also worsens the CKD. CKD also causes protein to be lost in the urine. Between the decreased appetite from chronic dehydration and the protein being lost in the urine, pets with CKD often lose weight, sometimes dramatically. Other problems that CKD can cause are increased risk for urinary tract infections, electrolyte imbalances, and hypertension (high blood pressure). However, when caught early through routine senior lab work, before the pet is feeling bad and losing weight, we can prevent any of these things from happening.
Hyperthyroidism is a disease that older cats get that can cause dramatic weight loss despite a great appetite. In fact, cats can eat you out of house and home and still die of starvation due to hyperthyroidism if left untreated. Cats with hyperthyroidism also may have vomiting and diarrhea. They are typically pretty darn active, so you may mistakingly believe that they’re losing weight because of old age. OLD AGE DOES NOT CAUSE WEIGHT LOSS. Luckily hyperthyroidism has numerous treatments and even a cure available, so no cat has to suffer this way. Hyperthyroidism is diagnosed on routine senior lab work.
Older dogs can actually have the opposite problem, hypothyroidism. This is a less common disease that can cause weight gain despite a decreased appetite or normal food intake, lethargy, feeling cold, a particular pattern of hair loss, and a general sense of malaise. Testing for hypothyroidism is not nearly as straightforward as one might think, because the T4 level on a blood test can be artificially lowered by many other conditions, such as dental disease, arthritis, or any illness. It’s called “euthyroid sick syndrome” and it sure does complicate the diagnosis of hypothyroidism! We don’t screen for hypothyroidism. In other words, we test for it when there are specific clinical signs of the hypothyroidism, but we don’t include a T4 on every senior lab panel because even abnormal results will be ignored if there are no clinical signs of the disease.
Cognitive dysfunction, sometimes called Alzheimer’s because of its similarity to the human disease, is another problem that older pets can get, particularly dogs. Canine cognitive dysfunction (CCD) is sometimes hard to diagnose, because there is no specific laboratory test for it. Some signs of this disease are disturbed sleep-wake patterns especially pacing at night, confusion, and decreased interaction with family. CCD can mimic other diseases such as arthritis or liver disease or brain disorders. However there are treatment options that can slow or even reverse some of the effects, some as easy as just giving a specially formulated diet for that purpose.
Old dog vestibular disease is a scary condition that people often think is a stroke. Dogs will out of the blue start spinning in circles, falling over, rolling, and can’t stand up. They may vomit and sure as heck don’t want to eat. There are many causes for these symptoms, ranging from ear infection to brain tumor, but the most common is inflammation of the vestibular nerve for reasons unknown. The good news is that the vast majority of dogs recover completely from old dog vestibular disease, and a simple examination can determine whether or not a brain tumor or ear infection could be the cause. Once old dog vestibular disease is diagnosed, we manage the symptoms of nausea with medications similar to dramamine for sea-sickness, because the vestibular nerve is what causes both conditions.
Heart disease, particularly valve disease, is a common cause of heart murmurs in dogs as they age. In many cases, they have a murmur but are otherwise completely fine- they are NOT in heart failure. Heart failure is characterized by fluid build up either in the lungs causing shortness of breath, panting for no reason, or sometimes even collapse; or fluid build-up in the abdomen making the belly swell. We want to prevent dogs from getting to the heart failure stage, and can do so with medications. Cats are a little different, of course. In most old cats, a heart murmur is caused by hyperthyroidism and it goes away once the hyperthyroidism is controlled. In both dogs and cats, heart worm disease is a cause of heart disease. Cats usually get symptoms similar to asthma, or they simply drop dead without warning. Dogs get right-sided congestive heart failure with fluid build up in the abdomen, shortness of breath, and a heart murmur. Obviously, the way to prevent heart failure due to heart worm disease is monthly year round heart worm prevention medication. We don’t stop heart worm prevention in old dogs and cats because their hearts are the least able to survive the infection.