Health care is constantly changing and that is a wonderful thing for all of our pets. Veterinary care as a whole has changed so much since its beginning that the way medicine was practiced 100 years ago might be considered barbaric, even verging on malpractice, to the doctors of today. However, doctors work with the knowledge and tools available to them and as that improves, so does the care we are able to provide. Average life spans increasing as a result of new knowledge and technology is seen both on the human side of medicine as well as the veterinary side. As our pets are able to live longer our responsibility, as veterinarians and owners, is to provide the best care possible for all animals in all life stages. As Ralph Waldo Emerson said, "All diseases run into one - old age." However, I choose not to look at age as a disease, but simply as a new stage of pet's life. With more senior and geriatric animals, closer attention needs to be paid to conditions that worsen with age and how we can all best prevent and treat these conditions in order to allow our pets to age gracefully.
The reality is that owners and veterinarians must work together as partners to ensure that senior pets are able to comfortably enjoy these extra years. For veterinarians this means not only providing the best medical care during all life stages, but also knowing and educating owners on the more common conditions seen in senior pets. Since we all know that pets cannot talk to us and tell us what is wrong, it is important for owners to know what signs to watch for with different diseases so it does not get dismissed as an "old age thing" when it is a medical condition we can manage; thus, improving the quality of life.
Just a few medical conditions that owners should be more aware of and on the lookout for in their senior pets are problems with the senses (vision, hearing, taste, etc.), failure of different organ systems (liver, kidney, etc.), watching all new growths for signs of cancer, managing arthritis, and cognitive dysfunction. With pets living so much longer than they used to veterinarians need to educate owners about the importance of preventative medicine, more frequent veterinary visits and changes in their pet's behavior that warrant concern and medical attention. Caring for a geriatric pet is a new stage of life that owners deal with on a daily basis and they need the help of their veterinary partner to help them understand the different needs and diseases of an older patient.
As patients age, they often have issues with the senses. Nuclear sclerosis is a common issue that makes it more difficult for pets to judge distances. Some easy changes around the house can help with this. Using overhead lights instead of lamps, not moving the furniture around, using vibration along with your voice to interact with your pet, and avoiding dusk and dawn (when the shadowing makes things even more difficult can all help. Nuclear sclerosis is not the same thing as cataracts, but both conditions can affect vision. With cataracts, there are multiple stages and in the beginning the brain can help to “fill in” the gaps in what they are viewing, but if the stages progress total blindness is possible. Some of the same tips as far as not moving the furniture around and using vibrations, such as stomping your feet, can help your pet know where you are and not startle when approached. With age also can come the decrease in flavor of food. A couple easy tricks for helping with this is always feed pets in the same location and at the same time so they have that routine. If both vision and taste are not ideal, it may help to use cooked low-salt vegetables (such as carrots, green beans, or canned pumpkin) or adding some warmed up no-sodium vegetable broth to add to their usual kibble so they can use their sense of smell to find and even encourage them to eat.
Hearing loss is also possible, especially in dogs or cats that have chronic issues with allergies or ear infections. Hearing loss or totally deafness is very hard to definitively diagnose without going to see a neurologist who can use specific testing that shows specifically how the brain responds to different sound. However, most owners know their pets so well that they can pick up on when they seem to be having trouble hearing. Hearing loss is a more common complaint from dog owners than cat owners. The most common cause of hearing loss is an age-related change called otosclerosis. This process makes the tiny components of the inner ear less pliable and unable to function as they should and because the precise function of the ear is to transmit sound waves, the suppleness of the inner structure is critical to function. There are things you can do to make hearing impaired pet's life easier and these include teaching your pet visual cues paired with commands from an early age so that the impact of the hearing defect is minimized in daily life if it does occur. It is never too late to start training your pet with visual cues paired with the verbal cues they already know. Senior pets can learn to respond to hand signals for rewards and time spent teaching the new cues is a great investment in your relationship. If your pet does have hearing loss, you can also look into the use of vibration collars designed for pets with hearing loss to rouse and interest your pet the way sounds used to. Hearing loss can make the rituals enjoyed by both you and your pet (like greetings) different and impact your bond. There are even vibration collars that are remote controlled and you can train your pet that the vibration means you are home, so he/she can meet you at the door. This can be helpful for both hearing and vision loss.
Diseases that center around the brain and nervous system have clinical signs that are much harder for owners to recognize because they often are confused with signs or behaviors that people previously thought were just part of getting old. Due to huge advancements in our ability to test and image the nervous system, we now have a much better working knowledge on how the nervous system functions. This has led to discovering new neurologic diseases and gaining an even greater understanding of neurologic diseases in general. With this new knowledge, veterinarians have learned how to better diagnose and treat or manage these diseases. One of the most common neurologic diseases affecting our older patients is Cognitive Dysfunction Syndrome and one of the best ways to decrease its likelihood of occurring and help if it does is to keep your pet mentally stimulated. This can be done by teaching new tricks, which we mentioned above as ways that can help with issues with the senses as well. That saying that an old dog can’t learn new tricks is absolutely wrong and by learning new trick, it keeps the brain engaged. You can also get interactive toys, where a pet works to get kibble out of a toy or placing a ball in the bowl of food so your pet has to work to get to the food. Foraging games are great for pets and as they search for treats hidden in crumpled dixie cups or toys that are designed specifically for this purpose, it keeps that brain working!
The most common neurologic disease in older pets is called Cognitive Dysfunction Syndrome and it is associated with the brain aging and it has become prevalent in our geriatric patients, much like dementia or Alzheimer disease in humans. Since this is a very common syndrome, but a syndrome that most people are not familiar with, education and increased awareness is key. This is especially true because the clinical signs associated with this disease often start out very subtle and can be mistaken for normal changes associated with aging. However, when owners know what to look for and that the signs they are seeing may be associated with a disease, it is more likely that they will seek veterinary care and be able to find management options to allow all affected pets gain an even better quality of life.
As a general rule owners should watch for alterations in awareness, decreased responsiveness to stimuli, and deficits in learning. It should be stressed that any change can be a sign of the disease, not just the changes that are viewed as problems. For example, instead of simply being grateful for the silence that has come after years of your dog standing at the window and barking at the cars, it needs to be noted as a clinic sign of a disease. The first clue that owners usually see in a pet suffering from Cognitive Dysfunction Syndrome is confusion or disorientation, even in places that are very familiar to their pet.
Using the acronym DISHA, most clinical signs can be placed in one of the following five categories. One, Disorientation, including getting lost in familiar environments, general confusion, or an inability to navigate through familiar routes. This can manifest as a pet standing at the wrong side of the door to go out or getting stuck in a corner. As stated above, this is commonly the first clinical sign noticed. Two, Interactions with humans and/or animals may change in a positive or negative way. For example, a pet may become more or less playful overall or become less tolerant of the other animals in the house when they want to play. On the opposite end of the spectrum, a pet may seem to become almost dependent on a person or one of the other pets in the household, never leaving their side. There can be differences in how much affection a pet wants and how he wants to receive that affection. For example, a cat that usually just likes to rub on your leg on his terms, has now become a lap kitty who wants all of your attention. Unfortunately, there can also be an increase in irritability and/or aggression. Three, Sleep-Wake Cycle alterations that can manifest as not sleeping at night, not being able to settle down in the evenings, increased vocalization at odd times (such as barking for no apparent reason in the middle of the night) and sleeping more during the day. Owners often describe being able to hear their pet pacing back and forth all night. Four, Housetraining may deteriorate, along with other learned behaviors. This can be seen by the pet having accidents in the house. They may start urinating and/or having bowel movements in the house, but these can also be signs of other diseases so it is important to note whether the urine or feces appears normal, if the accidents are all happening in a specific spot or at a specific time. Animals also may become less able to perform basic commands, such as sit or stay. Many people attribute their older dogs not listening to them as hearing loss, but it may be that the dog simply does not know what is expected of him when you say sit. Finally, Activity levels can change. This can be seen as an increase or decrease in energy, appetite, interest in new things or places or people. A dog that used to beg to be walked every night, may appear frightened or unwilling to even leave the yard to go for his usual walk. As Cognitive Dysfunction Syndrome becomes worse the pet may become constantly restless with pacing, aimless wandering, or compulsive activity disorders such as excessive licking.
Cognitive Dysfunction Syndrome is caused by aging changes in the brain and it can affect multiple species, as early as 7 years of age. There are more treatment options available now than ever, but all are focused on supporting the brain. Veterinary treatments can involve the use of activities focused on maintaining physical and mental stimulus, offering a dietary change to a diet specifically made to support brain function (such as Hill's B/D), adding supplements that are known to help manage and even slow the disease progression, and/or prescribing medications based on the individual patient.
Another significant disease that affects most pets and people as they age is arthritis. It is critical to be able to recognize pain in your pet so it can be treated. Our pets can be masters at disguising pain and disease, and they certainly can’t tell us how they are feeling, so it can be very hard for owners to know if their pet is not feeling well. A pet’s ability to hide pain, illness, or any other signs of weakness originates from their natural instinct to protect themselves in the wild, even though they have been domesticated for so long. The problem is that in the animal kingdom, showing signs of weakness would make on animal more susceptible to attacks by predators or being isolated from their group of peers. In many cases, signs of pain are often subtle, indirect and extremely hard to pin-point. Thus, we rely heavily on you as a pet owner to recognize changes that might indicate your pet is in pain and our examination findings during veterinary visits. If you ever have any concerns that your pet is not acting like himself, please schedule a veterinary exam as soon as possible to ensure that we catch any problems as early as possible and treat the issue in order to halt or slow the progress as effectively as possible. We often view the age of our pet and what life stage they are in as we would if they were a human; for example, we think of a three year old dog as still being very young, but if that pet was a human they would be more like a college age human. This is because animals tend to age exponentially versus on a constant scale like humans do, and therefore changes in body confirmation and development occur at a much faster rate. This is why a dog that is only a few years old can already have medical issues that we generally do not think about occurring until they are much older. There are also a number of diseases that pets are born with (congenital issues) that can affect the muscles, joints, and bones and signs can be seen very early in life. A pet’s musculoskeletal system is not fully developed until 12 to 24 months of age, so they can start to show signs of pain while they are still developing, have issues when they are young that they grow out of, or start to show signs of disease only after their development is complete. This is why you are not able to have your pet tested/certified for the presence or absence of hip dysplasia until they are at least 2 years old; the body is just changing too much up until that point to have an accurate answer. There are a number of changes within the body (such as high heart rates, abnormalities when palpating a certain area, or changes in temperature), that can be recognized during physical examinations that act as signals for me that something is wrong and needs to be addressed. This is just another reason why bi-annual wellness examinations and yearly blood work are critical for catching diseases early – giving your pet the best prognosis for management and/or treatment of any issues that may be occurring.
Behavioral changes are one of the ways pets communicate that they are in pain. This can include the absence of normal behaviors (such as grooming, playing, or eating), changes in your pet’s reaction to touch (for instance, pets who don’t like to be petted at all or in certain spots anymore), and abnormal behaviors (such as vocalizing loudly, hiding from/avoiding human interaction, aggression, and posturing irregularly). Another sign that many people just attribute to normal aging changes is the unwillingness of their pet to jump up/down on furniture or use the stairs; however, this typically is seen if a pet is in pain and is not something that is a normal change at all. If you see any of these signs, a comprehensive physical exam and other diagnostics (such as blood work, digital radiographs, ultrasound, etc) are the only way we can pinpoint the root of the problem and get your pet feeling better. Once your pet has been examined and diagnosed with a pain-related issue, it is likely that they will need medications to help manage pain and inflammatory response. These pain medications are central to your pet’s health and comfort so it is extremely important to avoid missing doses or dosing improperly. There are various formulations and ways of administering pain medications for your pet and together we can work to find the right dosage and delivery method that suits your and your pet’s needs. By working together and having routine follow-up visits and blood work, the likelihood your pet receives the correct amounts of medications in order to remain comfortable day-to-day improves immensely. Always remember that human medications and over-the-counter medications are often dangerous, even fatal, to pets so never give your pet medications without consulting a veterinarian.
Pets that are diagnosed with pain-related issues need more than just medicine to aid in the healing process or to minimize discomfort. For some pets, they need to have a particular exercise regimen and for others, usually when dealing with an acute injury, it is critical that they are confined and not active in order for their injury to heal. For pets that have an acute injury where they need to stay quiet and confined in order to heal do not understand that running and jumping and rough playtime all contribute or exacerbate the condition that is causing them so much pain. It is vital that once we have recognized pain, uncovered the root of the problem, and have started pain management treatments and confinement, if necessary, that you do your best to help your pet rest since they won’t do it on their own! Crate training is one tool we highly suggest for owners to utilize for pain management and treatment – if your pet is anxious in a crate or is still too active, there are medication that can help.
If the root cause of your pet’s pain is determined to be a more chronic issue, such as arthritis or a congenital joint disease, keeping them active is very important. Just like with humans, exercising regularly helps to build strength in the muscles and helps prevent the joints from getting stiff. However, it is important to be sure that the exercise regimen does not do more harm than good. Low-impact activities are better for dogs with chronic pain, such as swimming or walking on a softer surface with more give than pavement (grass or an exercise track). You also want to be sure that you properly warm-up before exercising and work up slowly to a brisker pace when walking or jogging. It is also helpful to know that this is also true while a pet is young and the musculoskeletal system is still developing. You do not want to take large breed dogs for long runs on hard surfaces while they are still growing because it can negatively affect the joints and cause a pre-disposition for arthritis and other diseases as they age.
Another critical part of avoiding arthritis or management of the pain that comes from aging is weight monitoring. Maintaining an ideal weight is key to overall good health and can add years to your pet’s life. Weight management is a two-fold process involving the proper diet (both type of food and amount) and exercise. The good news is that our pets cannot feed themselves, so once the proper type of food and amount is determined you are in complete control of being sure that your pet achieves optimal body weight. It may be hard to resist those adorable, begging eyes but remind yourself that you are keeping them happier and healthier by restricting their calories and preventing obesity from affecting both the quality and longevity of life. One easy trick is to eliminate high-calorie treats and substitute praise, extra play time, or low-calorie treats (such as baby carrots, low sodium green beans, or canned pumpkin) as your pet’s reward. Your pet should have a nice hour-glass figure, with an abdominal tuck and easily palpated ribs and pelvic bones, if they are at the ideal weight. If you are unsure of whether your pet is at his ideal weight, we can help you determine this and advise you on a good diet and the proper amount to feed!
There are multiple mental and physical challenges that come as our pets age. However, hopefully this article has helped you to know what changes are most common and how to spot them. Noticing them more quickly, allows for more effective treatments and better outcomes. There are also a multitude of things that you can do at home to help your pet live its longest, happiest life and some of these habits should be started when your baby is still just a baby! Owners and veterinarians should work together to allow our pets to age gracefully and provide them with as much comfort as possible!