medical
Since the release of the medical AAFP Senior Care Guidelines in 2025, our understanding has come a long way, and today’s cat owners demand a better standard of care. In human medicine, gerontology lacks sufficient specialists for various reasons. In feline medicine, it is easy for most of us to love caring for geriatric cats; they are usually medical our favorite patients. We could probably populate a feline gerontology specialty with passionate veterinarians.
To address recent advancements and a growing interest in senior feline medicine, we offer revised recommendations in the 2024 AAFP Feline Senior Care Guidelines. We regard seniors as an age descriptor. Although senior is established as greater than 10 years of age in the 2024 AAHA/AAFP Feline Life Stage Guidelines, certain cats can be considered senior earlier than 8 years of age and possibly even earlier in specific breeds or genetically predisposed animals.
The Task Force believes geriatric is more a comment about medical health status, and no specific age is attached to it. The Task Force also recognizes the newer model of frailty, which has a significant role in the care of older humans and is increasingly important in feline medicine.
The senior cat wellness visit
Domestic cats have medical experienced increased life expectancy because of finer veterinary care, improved nutrition, and more educated, active owners. This enables veterinarians to take a holistic view of the rating and management of geriatric feline patients. Client education to use subtle alterations that can signal an underlying condition can enable clients to collaborate with the veterinarian in noting their feline friends more diligently.
Regular examination allows health maintained and disease to be detected early, most commonly leading to simpler disease care and prevention and potentially greater quality of life; it costs less and works better than crisis. Ideally, provide longer appointments for older cat visits. Although we tend to enter from the stand of representing the cat, insight into client assets, capabilities, behaviors, and beliefs allows us to address the concerns of clients.
Sending a questionnaire to be filled out in advance and inquiring about client goals early in the visit make this possible. Open-ended questioning of all body systems provides more valuable information. Client observations can assist the veterinarian in identifying subtle changes; however, numerous clients are not aware of slow changes until we pose provocative questions. Home videos recorded by the client of the activities of the medical patient’s cat might be of help in gaining more information about the cat’s health status. Getting a complete and methodical history will take some time longer initially but tends to yield a more accurate diagnosis and efficient treatment of the elderly cat.
Since age brings with medical it a higher risk and other alterations, such as cognitive dysfunction, reduced senses, pre-frailty or frailty, and possible health problems, all older cats will need increased care at home. Although age is not a risk factor for frailty by itself, frailty does become more prevalent with increasing age. Individualized care for the specific cat, using the five pillars of a healthy feline environment.
Inform clients of the value of supplying key resources such as litter boxes, food dishes, water drinking, beds, scratching posts, hideaways, and three-dimensional spaces in several areas of the home. Ask clients to supply items that assist the aging cat, such as night lights for better visibility in darker spaces, ramps and steps for easier travel to loved spaces, and multiple resting surfaces and places. Low-sided, wide-based water and food bowls that do not rub against the whiskers are best for older cats. Older cats need medical access to food that is safe from distractions and interruptions. Elevating food bowls might be helpful for cats with DJD, and warming and scenting foods may stimulate eating.
Anesthesia
Medical diagnostic ultrasonography, endoscopy, placement of a feeding tube, and surgery all necessitate sedation or anesthesia. Retrospective data provide evidence of greater mortality in cats than in dogs and greater mortality in cats aged more than 12 years compared to 1-5 years. Yet risk factors were found, and anesthetic management has evolved to reduce adverse events. The AAFP Feline Anesthesia Guidelines emphasize stress minimization, e.g., previsit gabapentin, gentle handling, and perioperative nursing.
Tachycardia is poorly tolerated, and reduced cardiac reserve makes the elderly patient less capable of compensating for fluid loss or overload. Suggested fluid medical rates for anesthetized cats are ml/kg/h to account for feline blood volume and the high incidence of hypertrophic cardiomyopathy. Observe that this is lower than in dogs. The amount and type of fluid utilized are affected by numerous variables, such as the patient’s signalment, physical status, duration, and nature of the procedure.
Diabetes mellitus
DM is a frequent endocrinopathy in medical older cats. The majority are comparable to human type II diabetes, particularly in cats older than 10 years, where pancreatic beta cell damage and peripheral insulin resistance are the pathophysiologic basis. Corticosteroid administration can predispose susceptible individuals.
Nutritional therapy with low-carbohydrate, high-protein canned food can be beneficial to these patients if they are compliant. The majority of diabetic cats and insulin dependent upon diagnosis. The faster the normalization of the cat’s blood glucose, the higher the chances of clinical remission. Lower blood glucose on diagnosis, no hypercholesterolemia, lower mean 12-h blood glucose on day 17 of treatment, and higher insulin-like growth factor at 1-3 weeks after diagnosis are other factors shown to be related to a high chance of remission.
Long-acting insulins can help to achieve this objective. The existence of underlying diseases, including pancreatitis, influences clinical, exocrine pancreatic, glycemia, diagnosis remission and control of glycemia. Exocrine pancreatic insufficiency can be seen as a comorbidity in diabetic cats.
Gastrointestinal disease
Every body system changes with aging, and some of the medical deeper changes are seen in the GI tract. Alterations in pharyngeal, esophageal, and GI motility and gastric pH changes cause a change in the GI microbiota that results in reduced digestibility and chronic weight loss. Weight loss can be the sole manifestation of disease of the digestive system in medical cats. Constipation is another frequent GI disease in older cats. Its cause is most probably multifactorial. Hypokalemia can contribute to sluggish GI motility, and constipation can be a sign of hypercalcemia. Painful posturing to defecate and passage of hard, dry stool exacerbate the issue. Stool assessment may be made with fecal scoring charts.
Inflammatory bowel disease, neoplasia, pancreatitis triaditis, painful posturing, pancreatic insufficiency, parasitism are general considerations for weight loss in the absence of other clinical manifestations. For a conclusive diagnosis, examination beyond routine laboratory testing is necessary. Other diagnostics are ultrasonography of the abdomen and measurement of serum feline pancreatic lipase immunoreactivity, trypsin-like immunoreactivity, cobalamin, and folate. Pancreatitis cannot be diagnosed by ultrasonography or blood work alone, but together they can make it more probable to make a proper diagnosis. Likewise, a negative parasitic fecal exam should not be over-interpreted and only indicates that there were none in the sample submitted.
Complex disease management
Comorbidities are the rule rather than the exception in gerontology, and cats are no different from humans in this medical respect. The explanation for the frequent occurrence of comorbidities with aging cats is hypothetical, yet this may have something to do with a mixture of exogenous stress leading to oxidative damage, exposure to infectious agents over time, and immune system imbalance. When homeostasis of the immune system fails, sensitivity to pathogens from the outside is diminished by immune senescence, and hypervigilance of autologous tissues can simultaneously take place and, in some instances, are termed inflaming changes.
Although particular inflaming discussion is medical mostly confined to the human gerontology literature, the Task Force believes the concept of frailty assists in describing a part of the multifaceted conditions that may converge in the cat.
The frailty prevention model theory defines three levels of care primary, reducing risk factors and the onset of disease, secondary, delaying the course of disease, and tertiary, limiting or minimizing impairments, disabilities and complications that accrue from disease. The cats’ first two levels are out of the way by the time they reach the senior stage of their lives. The third group of reduction of impairment is their concern now.
Conclusion
When a serious illness is diagnosed, we need to be truthful with the medical client, but many of us struggle to break this kind of news. Owners might ask for life-sustaining treatments that we consider futile and damaging, creating considerable ethical distress. If the method of ethical decision-making were less personal and subjective, we might be able to reduce some distress in our profession. A working group of the European College of Veterinary Anesthesia and Analgesia has developed the ‘Veterinary Ethics Tool to support ethical decision-making.
It utilizes a series of tables and checklists and incorporates a traffic light system with green valid reasons for the clinical procedure, orange reconsider procedure and your responsibilities, and red consider alternative treatment options to direct the veterinarian. The Serious Veterinary Illness Conversation Guide is another tool based on similar recommendations created for human doctors working with patients at the end of life.
Guidelines and checklists for serious illness conversations can assist in keeping us on track, sort through complicated issues, and create a plan to medical proceed. One of the most important parts of this conversation is to ask the owner what their cat would want under the circumstances they are facing. It assists in shifting the owner’s mindset away from what they desire. One should apply the right gender and cat name during these communications.
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