VetInfo Digest                January 2003

Routine Health Care

The First Year

The Second Year

Young Adult Care

Middle Age

Older Dogs and Cats

 

This Month's Note:

There are many routine health procedures that can benefit dogs and cats. Veterinarians differ some over the importance of some of these procedures. It is necessary to adapt all general recommendations to a particular pet's needs and present condition. Health care procedures necessary in one geographic region, such as heartworm prevention, may not be necessary in another region. A pet's breed affects the choice of screening tests for health care problems. All of these factors combine to make it difficult to write a cookbook approach to routine health care. Despite these problems it seemed like a good idea to try to discuss the concept of preventative health care in this month's VetInfo Digest.

The biggest current controversies in routine health care are the roles that vaccination and diet play in protecting health. I will try to explain our thinking on vaccination, but I have avoided much talk about diet. The bottom line on dietary recommendations in pets is very simple. No one has much validated information to offer beyond the minimum requirements for major food components such as protein, water, vitamins and minerals. Therefore, you can either stick to the basics and try to provide these minimums (most commercial dog foods will do this) or you can try to decide what the optimum diet is for your pet, with whatever faith you can muster in the many potential approaches to diet. I wish that I could help more with this decision making but all I can do is point out that I rarely see identifiable nutritional deficiencies and that many of the claims of particular diet advocates can't be demonstrated in controlled studies, in the few instances in which these studies even exist. I do try to keep track of the many dietary claims and will provide information on dietary studies as they become available in the future.

 

The First Year

The first year of a pet's life is all about prevention of future disease and early detection of health care problems. Puppies and kittens go from infants to puberty to early adulthood in the span of one year.

Good nutrition is a cornerstone of health. It is possible to find thousands of different opinions on optimal dietary care for pets and there isn't room to cover all of them. Regardless of the diet chosen there are a few nutritional concepts that should be kept in mind, though. Kittens do not differ as much from adult cats as puppies do from adult dogs in their nutritional needs. We rarely find major nutritional problems in kittens.

The number one nutritional problem in puppies is probably overfeeding. Many people try to feed puppies by letting them have access to dry food continuously. Most puppies do not self-regulate their food intake and will become overweight if allowed to. This is particularly problematic for large breed puppies, as the rate of orthopedic problems such as hip dysplasia are dramatically increased in puppies who are overweight. In at least one study there was a 25% increase in the incidence of hip dysplasia in puppies fed free choice over puppies fed to maintain an ideal weight. Puppies should be thin enough that their last few ribs show or can be felt by running a hand across the ribcage without putting any pressure on the skin. Feeding foods designed specifically for puppies also helps control the total calcium intake. If adult foods are fed in sufficient quantities to meet the caloric needs of puppies they will usually provide more calcium than the puppy should have in the diet. Keeping puppies thin when they are young pays off major dividends over their lifetime. In a recent study done by the Purina (tm) company, keeping dogs thin their whole life increased their lifespan significantly, as well.

Vaccination against prevalent and dangerous diseases has also made a major contribution to the increased lifespan for pets. Not all vaccinations are necessary for every pet and some vaccinations should be used only in special instances.

At the present time it is possible to vaccinate dogs for the following conditions; distemper (D), parvovirus (P), adenovirus Type II (upper respiratory disease and hepatitis) (H, A2), several strains of leptospirosis (L), parainfluenza (P - even though there is already a P), bordetellosis (kennel cough), giardiasis (intestinal parasite), coronavirus (C), rabies, Lyme disease (borreliosis) and measles (because it cross protects puppies against distemper infection).

Cats vaccines are available for; rhinotracheitis (feline herpes virus I) (R), calicivirus (C), panleukopenia (feline distemper) (P), feline leukemia (FeLV), feline infectious peritonitis (FIP), feline immunodeficiency virus (FIV), chlamydiosis, bordetellosis, ringworm, and rabies.

Of these vaccinations, the most important ones for dogs are distemper, parvovirus and rabies. For cats, feline herpes virus, calicivirus, panleukopenia and rabies are considered to be the "core" vaccines and others are considered on a case by case basis. Vaccine guidelines will always be debatable, but there is general agreement for the initial vaccination series in puppies and kittens. Some veterinarians currently recommend avoiding vaccines that combine more than one agent, such as parvovirus and distemper. It is not clear whether there are any advantages or major disadvantages to this approach as this time.

Puppies should be vaccinated for the first time when they are between 6 and 8 weeks of age, using a vaccine that provides protection against distemper, parvovirus, adenovirus Type II and parainfluenza. These vaccinations usually show up as DHPP, DA2PP or something similar on invoices. If leptospirosis is a problem in the area the puppy lives in, it is reasonable to include vaccination for this disease, but it is best to be sure that the vaccine strain matches the strain that is causing disease in your area. Vaccination is repeated at 3 to 4 week intervals until the puppy is between 12 and 16 weeks of age. The type of vaccine used has some bearing on when the last vaccination should be given. High titer parvovirus vaccines stimulate an immune response in puppies capable of responding to vaccination by the time puppies are 12 weeks of age. Lower titer vaccinations have to be given the last time at 16 weeks of age to be sure that they have a chance to be effective. Coronavirus vaccination is not considered to be essential by most veterinary infectious disease specialists. Rabies vaccination is required to be given between 12 and 16 weeks of age in most states. Giardia vaccination is controversial but in highly endemic areas it may be considered. Bordetella vaccination (kennel cough) does not provide long term immunity but can protect against infectious tracheobronchitis, or kennel cough, for 6 to 9 months and may be appropriate for puppies attending obedience classes, being shown frequently or in other high exposure situations. The intra-nasal form of bordetella vaccine probably works better than the injectable form and should be used when exposure risk is high.

Kittens should be vaccinated for the first time between 6 and 8 weeks of age, using vaccines that protect against the symptoms of herpes virus and calicivirus infection and against infection with panleukopenia virus. These are usually referred to as RCP or FVRCP vaccinations. Vaccination should be repeated at 3 to 4 week intervals until the last vaccine is given when the kitten is over 12 weeks of age. If the age of the kitten is not clearly known, weight can be used as guide to age. Most kittens gain approximately 4 ounces of weight per week, so an 8 week old kitten usually weighs 2 lbs. Feline leukemia virus is most contagious to kittens but infection requires direct contact with a sick cat. For this reason, cats who will live indoors by themselves or with other cats known to be free from feline leukemia vaccination may not require vaccination against this disease. Feline immunodeficiency virus is spread through bite wounds, so this logic also applies to this vaccine. The feline infectious peritonitis vaccine should be reserved for use in multi-cat households and usually only in households with more than 5 cats. Many veterinarians will not use this vaccine even in that situation and we are very reluctant to use it in our practice. The ringworm vaccination helps decrease clinical signs but does not prevent infection and for this reason its use is questionable.

It is very important for puppies and kittens to receive vaccinations for the diseases they are most at risk for. Many of the diseases that we vaccinate for are most prevalent in young pets. The current controversies over the use of vaccinations do not apply to the kitten and puppy vaccination series. The vast majority of veterinarians are in agreement that these early vaccinations are critically important. Most veterinarians are also in agreement of the need for administering another dose (boostering) these vaccinations approximately 1 year after the initial series.

In areas in which heartworms are endemic it is best to start puppies and kittens on the prevention medications at 6 to 8 weeks of age. It is not possible to test for heartworm disease before a pet is 5 to 6 months of age, because all current tests require that adult heartworms be present for the test procedure to work. It takes approximately 5.5 months for heartworms to mature into adults after a pet is infected by the bite of a mosquito carrying the disease. Kittens may be tested for feline leukemia virus at any age. Testing for feline immunodeficiency virus prior to 5 or 6 months of age can lead to false positive or false negative results and is generally discouraged due to this problem. Positive tests for either FeLV or FIV should be repeated using different test procedures, unless clinical signs strongly support the presence of the disease.

Spaying (females) and neutering (males) have specific health benefits and help to reduce the problems with pet overpopulation. The present trend is towards early spay and neuter surgeries, especially for puppies and kittens already in animal shelters at a young age. Long term health care studies have been done to see if there are health problems associated with early spay and neuter procedures and so far there are no major problems identified.

Spaying female puppies before the first heat period drastically reduces the incidence of mammary cancer later in life. The rate of mammary cancer is dogs spayed before the first heat period is less than 1% and the rate of mammary cancer in dogs spayed after the second heat period is 25%. No studies have been done to confirm this, but the general feeling among veterinarians is that there is a similar reduction in mammary cancer in cats, although the percentages would be less since cats seem to be less prone to mammary cancer naturally. Many puppies, especially small breed puppies, have problems with retained baby teeth, which must be removed to maintain the health of the permanent teeth. One advantage of waiting until six months of age to spay or neuter puppies is the ability to combine the spay procedure with the extraction of retained deciduous teeth.

If there is reason to suspect that hip dysplasia, elbow dysplasia, patellar luxation or other orthopedic conditions may be present, it is best to screen for them at an early age because preventative or corrective surgeries work best when done early in the disease process. It is reasonable to screen for most of these types of conditions at 4 to 6 months of age. Unfortunately, these are progressive diseases and if they are not detectable at an early age it is not certain that they will not develop at a later date, so be prepared to do additional radiographs or diagnostic testing later, too.

Some veterinarians are currently recommending a routine blood chemistry screening test for puppies and kittens between 4 and 6 months of age. Their goal is to identify congenital disorders, especially liver and kidney disease, as early as possible. It is hard to argue against screening blood work in almost any case, since it is very unlikely to harm the pet. It is harder to figure out the cost effectiveness of these types of recommendations. In general, we try to assess the health status of the pet at each of the vaccinations periods, as well as the presurgical examination for spaying and neutering. If there is any reason to suspect a problem we push harder for blood chemistry screening procedures but we have not made these a standard recommendation in our practice, since we feel obligated to consider the cost-benefit ratio when making standard recommendations.

 

The second year (12 to 24 months of age)

When dogs have their first yearly physical exam, which is usually done when they are about 15 months of age, we do the first heartworm examination. It would be acceptable to do this sooner, as early as 6 months of age, if desired. Some consideration should be given to the months the puppy was born when testing at a younger age, though. A puppy born in January isn't likely to be exposed to mosquitos in the Northern states until it is three or four months of age, making testing unreliable until the puppy is 9 to 10 months of age, for instance. Cats are not routinely tested for heartworm disease because we still don't have really good tests for cats. It is not as common for cats to be overweight by one year of age but some are.

Surprisingly, many dogs are already on the way to being overweight by one year of age. It is often necessary to switch to a lower calorie diet or to change to a controlled feeding method by this age. Cats showing a tendency towards obesity should be given only the amount of food recommended for weight control per day, which usually requires switching them to regular meals instead of leaving food in their bowl all the time.

Fecal examination or routine deworming is reasonable at this age. In dogs fecal examination seems to be the norm and in cats routine deworming is likely to be favored. If heartworm medications containing dewormers are being given on a monthly basis it is probably better to stick with an occasional fecal examination than to add in another deworming procedure.

Veterinary dentists recommend starting dental cleansing starting this early, although this will depend on the pet. More than half of dogs and cats have tartar accumulation by one year of age.

It is reasonable to draw blood to run routine blood chemistry tests, to do a urinalysis and to consider screening radiographs to rule out hidden illnesses. Routing screening procedures can be justified at any age and veterinarians vary widely in their opinions about when and how to do general laboratory screens during physical examinations. We usually put these off one year, just to try to keep costs reasonable since puppies and kittens require vaccinations along with this year's physical examination.

 

Two years of age

If there are no obvious health concerns and no breed worries, many of our patients get a good physical examination and no other procedures at this age.

Some veterinarians insist on yearly heartworm examination for dogs. We tend to check for heartworms every two years. I think it is possible to justify every three year checks for this based on recommendations from the American Heartworm Society, especially in areas in which the risk is low. The newer heartworm prevention medications are very good but it is necessary to take a "herd health" attitude towards heartworm prevention and to detect any possibly resistance to the medications as early as possible. The only way to do that is to check for resistance on a routine basis. While I am comfortable with the two year interval, other vets think one year or three year intervals for testing are acceptable.

If OFA certification of hips or elbows is desirable to document good conformation for breeding purposes this may be done at two years of age.

 

Early Adult Years

Vaccinations become more controversial after the initial kitten or puppy shots and the one year booster. In some states, rabies vaccination is required by law at one year intervals and there isn't much point in arguing the necessity of this, except with the state legislature. However, there is good evidence that the three year vaccinations do provide immunity for three years. It is very likely that distemper and parvovirus vaccination provide long term immunity after the initial boosters. The exact duration of this immunity will vary from patient to patient but it is reasonable to assume that it lasts at least three to five years based on currently available data and it is likely it lasts longer than this. There isn't much hard evidence that more frequent vaccinations cause major problems in dogs but there simply isn't any reason to give any medication, including vaccinations, more frequently than necessary, regardless of safety.

In cats, adult vaccinations can have serious complications. In cats it has been shown that a form of cancer referred to as vaccine associated sarcoma occurs at vaccination sites. This form of cancer is very aggressive and probably results in the death of approximately 70% of affected cats within a year or two, even when surgical removal of the tumor is attempted. This reaction is most likely at rabies vaccination and feline leukemia vaccination sites but can occur with other vaccinations and even from non-vaccine injections of medications, in some cases. Therefore, it is much more important in cats to give vaccinations only when necessary. There is a set of guidelines on where to administer vaccinations in cats, in order to identify problems with individual vaccines and to allow the most aggressive treatment of vaccine associated sarcomas which several veterinary organizations have been promoting. The AVMA/AAHA/AAFP/VCS task force recommendations for administration of vaccines in cats are:

We have not been using the recommended vaccination sites and I think that many veterinarians do not follow this portion of the guidelines. Our thinking is that most of our clients aren't going to allow us to amputate a let if a vaccine reaction occurs. So we vaccinate in the flanks, hoping to give ourselves adequate room to remove a tumor without affecting underlying bony tissues. Over time, the value of these different approaches will become more clear. Many veterinarians have changed their routine vaccination sites and we do get questions about this. If your vet is suddenly vaccinating in different sites, this the most likely reason.

We give the kitten vaccination series and follow these with one year boosters. We use feline leukemia vaccinations when it seems likely that a kitten might be exposed to a carrier of feline leukemia. This would include kittens that go outdoors, kittens that live with a cat who goes in an out, kittens in multiple cat households in which more than 2 or 3 other cats live and kittens who will be attending shows or other events in which it is possible for them to be in close contact with other cats. After the one-year booster, we stop giving feline leukemia vaccination unless we think the risk of exposure is very high. Most cats develop strong natural immunity to this virus by the time they are 18 months of age. We give rabies and RCP vaccinations at three year intervals in adult cats. I think that it is likely that we will go to a longer duration between RCP vaccinations in the future as more information on the duration of protection afforded by vaccination becomes available. We do not use any other vaccinations in cats in our practice at the current time. We will probably begin to use the feline immunodeficiency virus vaccine in the future, providing that it continues to seem safe for use as "real world" safety information accumulates over the course of this year, the first that the vaccine has been available.

One of the big problems with changing vaccination schedules for veterinarians has been the use of the vaccine as the "hook" to get clients to bring their pets in for yearly physical examinations. We have been using a three year vaccine interval for some time. We have noticed that about a third of our clients do skip the yearly physical examination when vaccinations are not due. This is a problem, because the physical examination is very important. At least a fourth of the pets we examine on routine physical examinations have an overlooked health problem, such as an infected ear, severe dental disease, tumors or skin disease. Clients could probably find many of these problems on their own, if they looked for them, but they don't. I bring my own dogs to the clinic two or three times a year for examination because I know that I will do a better job of it at the clinic.

I have asked some of my clients why they don't come for the yearly physical examinations when we don't expect to provide vaccinations. There are lots of reasons that people skip yearly physicals, such as cost, inconvenience, fearing discomfort for their pets and the perception that we don't do much when we examine a pet. This last perception worries me the most. I can do a pretty thorough physical examination of a dog or cat in 10 to 15 minutes. I know that I am seeing much more than the average pet owner when I look into the pet's mouth, check out its eyes and ears, listen to its chest, palpate its abdomen, flex and extend joints and examine the skin and hair coat. Keeping track of the pet's weight over time, especially as pets age, is also a very important aspect of the yearly physical examination. Even when a pet is normal and the examination is pretty quick the exam is still valuable. Over the long term it helps us identify health trends and can be a valuable point of reference when problems occur in the future.

I think that the emphasis on vaccinations as a means of attracting clients to the veterinary hospital for routine health care is going to be much less over the next few years, as veterinarians begin to adopt routine health care programs that emphasize catching problems early and managing long term problems more closely. There is a lot of room for improvement in routine veterinary care. We are just starting to try to evaluate when routine lab work should be done, what sort of dietary changes are necessary with age and how to make our yearly physical examinations "age appropriate." We will provide better preventative care as a replacement for vaccine income and vaccination driven physical examinations.

From the ages of about 3 to 5 years, there are a few things that are very important to track. Almost all cats and most dogs will require tartar removal and tooth polishing to maintain optimal dental health by the time they are 5 years of age. Some dogs and cats will require more frequent dental visits. This is an area of veterinary medicine that is very underemphasized. Many of our clients have reservations about routine dental care due to the use of anesthetics. I think that we can help many cats by cleaning teeth during routine visits because most of the tartar in cats occurs on the outside surface of the teeth and usually only a few teeth are affected. It is much harder to do an effective job of dental care in dogs because tartar tends to accumulate on the inner surface of the teeth and because dogs have more teeth than cats do, making some of them hard to work on when a dog is not anesthetized.

Most of the hormonal diseases, such as hypothyroidism (dogs mostly), hyperthyroidism (cats mostly), diabetes and hyperadrenocorticism do not occur in young adult pets frequently enough to justify routine screening procedures at this age. Testing for these conditions should probably be reserved for pets with clinical signs. Routine screening procedures such as complete blood counts, urinalysis and blood chemistry examinations are reasonable on a yearly basis. Where cost is a factor it may be better to consider screening tests once during the early adult years, to establish some baseline values specific to your pet.

Many pets begin to show signs of arthritis associated with orthopedic conditions such as hip dysplasia, elbow dysplasia and cruciate ligament weakness during their early adult years. This is a good time to consider the use of glucosamine and chondroitin products, as they seem to be best used early in arthritis to try to slow the progression of the disease.

 

Middle Age

I think of middle age in dogs as starting around 5 or 6 years of age for small breed dogs and perhaps a little younger for big breeds. In cats, I tend to think that middle age has a little later onset, perhaps 6 to 8 years of age.

This is the age when routine physical examinations become much more important. It is also a time when weight control seems to be an overwhelming necessity. It is estimated that well over 50% of older dogs and nearly that percentage of cats, are overweight. For some reason veterinary clients have a hard time believing the following statement, but it is true: If your pet is overweight it needs to eat less. This is true even if your large breed dog is only eating a cup of food a day. Pets vary widely in the amount of food it takes for them to maintain or gain weight but the bottom line is that an overweight pet is getting more food than it needs. You can cut back safely on the food intake once your vet has determined that the weight gain is due to fat accumulation and not something else.

Weight loss should also be carefully monitored. This is the age when diabetes often occurs in both dogs and cats. Early hyperthyroidism in cats sometimes occurs between five and nine years of age and weight loss is often the only recognizable sign in this age range. Keeping track of weight can be the key to early recognition of the chronic illnesses that are more common with age.

If your pet has never had routine blood work run in the past, this is the age to ask your vet to consider a blood panel. It is very helpful to have some idea what the normal laboratory values are for a pet prior to the time that it reaches the geriatric years. Some pets will have variations that can be very confusing later in life if they are not identified when their health seems normal.

Your vet should begin to pay more attention to your pet's eyes during this age period. Eyelid tumors begin to occur in middle age and it is best to remove these when they are relatively small, as that affects the eyelid margin the least. Dog breeds that are prone to tear deficiency, such as cocker spaniels, should be tested for tear production if there is any indication of eye irritation. Screening for glaucoma is important in pets and checking eye pressure at least once is a worthwhile screening procedure during this age period in both dogs and cats.

It is a good idea to begin to monitor blood pressure in cats toward the end of their middle age years. Blood pressure measurement in cats can be stressful and it helps a lot if they have been through the procedure a few times before it is critically important to know if they have high blood pressure (hypertension) when they are older.

Intact (not neutered) male dogs often begin to have prostate problems as they get older. A prostate examination and evaluation of the testicles for cancer should be done during yearly physical examinations. Female dogs and cats should be checked for mammary tumors. Lumps and bumps start to appear on pets as they reach middle age. Often these are benign conditions but it is best to have lumps examined by your vet and many lumps should be checked for cancer by aspiration of lump tissue with a needle and syringe and examination of the tissue microscopically. It is also reasonable to biopsy any suspicious lump. This can get tiresome since many pets will end up with five or ten visible lumps as they age -- but it can also provide early diagnosis of serious cancers and the only really good chance to cure them.

 

Older Dog and Cats

We vaccinate older pets on the same schedule that we vaccinate adult pets, every three years. Once in a while we skip vaccinations for older pets with other health problems, preferring not to push their immune system too hard when they are already ill. Some veterinarians and some veterinary clients push for antibody titer measurement (measuring the protection against a disease) as a way to determine if vaccinations are necessary. We are unwilling to rely on titer information at the present time. It is known that for many diseases there is protection when titers can't be measured and for other diseases a lack of protection exists despite high antibody titers. Until there is a better understanding of how to accurately measure the protection afforded by the body's immune system, we think that establishing reasonable vaccination intervals based on the best available information is the better approach.

We try very hard to pay attention to joint mobility during examinations of older pets. Both dogs and cats develop arthritis frequently as they age. Identifying these problems can improve the quality of a pet's life dramatically. Most pets who seem weak are actually experiencing pain that is inhibiting motion. There are a number of effective medications for dogs with arthritis pain and using one of them will help to improve your pet's quality of life. The situation is a little harder for cats, where we have more limited medication options, but in most cases it is still possible to help cats with arthritis pain. These medications require monitoring and it is important to let your vet know of any problems that occur, especially a loss of appetite or other gastrointestinal signs, when using them. Weight control is also very important in arthritic patients. Losing a few pounds can make a huge difference in mobility and lessens the need for pain control, as well. Providing pain relief from chronic arthritis is a valuable service to your older pet.

Most pets begin to have hardening of the lenses of the eyes at about eight years of age. This shows up as a blue haziness when the eyes reflect light. In most cases this condition, referred to as nuclear sclerosis of the lens or as lenticular sclerosis, does not cause blindness but it may interfere with vision. A number of dog breeds and Siamese cats become more prone to glaucoma (increased pressure in the eye) with age. Dogs frequently develop tear deficiency which causes mucous accumulation around the eyelids. This is sometimes mistaken for allergy or infection. It is less common in cats but occasionally occurs in them, too. Dry eyes are painful and there are good treatments for this condition, so early diagnosis is a good idea. Eye examinations should be part of the physical exam in older pets, including tests for tear deficiency and eye pressure where they seem indicated.

Hormonal diseases become more common as pets age. Hyperthyroidism in cats becomes very common after nine years of age. Hyperadrenocorticism (Cushing's disease) occurs most commonly in dogs nine years of age or older. Diabetes is fairly common in both dogs and cats with age. It is hard to figure out if dogs and cats should be checked for these diseases on a routine basis but if there is any indication of problems it is reasonable to rule out these diseases. Many veterinarians now consider yearly thyroid hormone measurement to be a reasonable test for cats over nine years of age and definitely recommend it for cats experiencing weight loss.

There are a number of pet food companies marketing "senior" diets at the present time. Most of these are just lower calorie diets. This is good and it is reasonable to use them, but they don't address specific needs, such as reduced protein for pets with kidney or liver failure, so don't count on them for these purposes.

Routine blood chemistry testing should probably be a regular part of the yearly physical exam for older pets. These tests can help point out the possibility of the hormonal diseases and they also can help in the early detection of organ failure, especially liver and kidney failure.

Heart failure is more common as pets age. Cats tend to develop cardiomyopathy, or heart muscle weakness, and dogs tend more towards heart valve failure. When a heart murmur can be detected in a cat it is best to have a cardiac ultrasound examination done. This is the only really good test to rule in or rule out cardiomyopathy. In dogs, heart murmurs are most commonly due to valve failure and auscultation (listening to the heart) is sufficient in many cases to establish this. There is no need to treat for heart disease based solely on the presence of a murmur that is due to valve failure. Treatment should be started once signs of heart failure occur. The earliest signs are tiring readily, increased respiratory rate and coughing. In cats the first sign and sometimes the only sign of heart failure is an increase in respiratory rate. Some signs of heart failure do show up early in chest X-rays and it is not uncommon for veterinarians to advise taking screening X-rays at particular ages, such as 12 or 14 years of age. Just like routine lab work, this is a procedure that can provide a great deal of benefit and isn't likely to cause harm, so if you wish to be cautious it is something to consider.

Hypertension is very common in older cats and is not uncommon in dogs. It is reasonable for your vet to check blood pressure on a routine basis in older dogs and cats. This is a little more difficult in pets and so there may be an additional charge for this service. It is usually necessary to take the blood pressure three or four times and to average the values, sometimes discarding ones that are very different from the others, to get a reliable measurement. It can take some time to get this done while keeping the pet as calm and relaxed as possible, so be a little patient with your vet. The blood pressure information is valuable enough to justify taking some time to get it.

Many older pets have really severe dental disease. It is astounding how much better these pets can feel when their dental problems are taken care of. This is a time when many of our clients become reluctant to allow anesthetic procedures but is is almost always a mistake to try to avoid dental care in older pets who have visible periodontal disease and in cats with severe feline odontoclastic resorption lesions (FORLs). There are very good anesthetic protocols for older pets. Discuss your fears with your vet and make sure that your vet is prepared to provide a high quality anesthetic procedure, but don't avoid dental care solely due to anesthetic fears. Comfort is important and few things provide greater comfort than relief of dental pain.

When pets reach very old ages, in the region of 16 to 18 years of age for cats, 12 to 14 years of age for large dogs and 14 to 16 years of age for smaller dogs, it is best to consider scheduling routine physical examinations at closer intervals. Close attention to weight is critical and it is worthwhile to weigh your pet once a month at home between veterinary examinations, if possible. Continued weight loss should trigger a search for an underlying cause.

Canine cognitive dysfunction is a form of senility that is thought to be fairly common in older dogs and a similar condition occurs less frequently in cats. Mention changes in your older cat or dog's normal behavior to your vet during routine examinations. These can signal problems with cognitive dysfunction or with other chronic older age disorders. Urinary incontinence is not uncommon in older female dogs and occurs in older male dogs. You and your vet need to take the time to discuss these problems carefully, as they can often be controlled. This can be life saving for the pet, especially when incontinence or confused behaviors are leading to thoughts of euthanasia.

One of the paradoxes of veterinary medicine is that we often see our younger patients much more frequently than our older ones, despite the fact that the younger ones have fewer chronic health problems. It isn't a good idea to avoid the frequent office visits for puppies and kittens and it makes sense that pets need to be seen a little less frequently during their relatively healthy young adult and even middle age years. Older pets need to be seen more frequently, though. It is best to budget for this as your pet ages because it is usually less expensive to prevent problems and to keep them under control when they can't be prevented, than to deal with them once they have become a crisis.

 

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This page was last edited  06/15/04

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