inopets.com   Caring For Older Cats, Continue P-2

Hypertension – High Blood Pressure

Just as in humans, high blood pressure will eventually damage your cat’s body. It is harder to take the blood pressure of cats than it is of humans and the results are not always as accurate. But many veterinarians have the specialized equipment to do it. Agitation will falsely raise your cat’s blood pressure. So several readings need to be taken. Most vets begin treatment if your pet’s blood pressure is over 170 but some do not think it is warranted unless it is higher (180 mmHg). If your cat is over 8-9 years old, you might inquire if the test is available.

Most cats with high blood pressure have the problem because of hyperthyroidism and/or kidney disease. The most common sign that owners notice is reduced vision or blindness. High blood pressure slowly destroys small blood vessels. Those in the eyes, heart and kidneys are particularly susceptible. It is still unclear if kidney failure is causing the high blood pressure or vice versa. Perhaps both processes are at work.

Luckily, there are several medications that will help keep it under control. The one most commonly used is amlodipine (Norvasc, etc.). (This drug is in a group called calcium channel blockers). If your cat balks at accepting its daily pill portion, compounding pharmacies can prepare something less bitter.

Some veterinarians also recommend a reduced salt diet.

(My hypertension article was also referenced earlier)

Diabetes

Diabetes often strikes mature or elderly cats that are overweight. Owners usually bring these pets to veterinarians because of the large amount of water they are drinking, too much time in the litter box urinating or a sudden loss of weight. (A single elevated blood or urine glucose test does not prove that your cat is diabetic)

Some veterinarians associate diabetes with feeding diets that are too high in carbohydrates. Almost all cats with the problem do better on a higher protein, higher fiber, low carbohydrate diet.(ref).

Once your cat’s blood glucose level has been stabilized, having a blood Free T-4 and a urine microalbumin test is a good idea since elderly cats often have multiple health issues. You can read more about diabetes in cats here.

The Dangers Of Being Too Thin

As cats approach 12, they may have a harder time maintaining their traditional body weight. Those that are abnormally thin are at greater risk of dying, just as overly thin humans are (ref).

If you notice that your elderly cat has lost weight, the first thing to do is to have it examined by a veterinarian. The vet will do the routine tests that usually identify common diseases of older cats. If these tests come back negative, try some things on your own:

Old cats can be quite fussy about what they eat. Many have dental problems, vision problems and an apparent reduced sense of smell and taste. Those with digestive disturbances can be less able to absorb nutrients in ordinary diets.

So select canned or fresh, meat-based diets that are high in calories. Most older cats prefer the ones that have a pungent aroma. Warming their food to body temperature (102 F) will also make it more appealing. Feed your cat small amounts more frequently. Some cats prefer your presence and petting while they munch. Off their food in shallower bowls.

Weight loss problems in elderly cats are almost never due to parasites. So repeated worming medications are not likely to help. Don’t give in to feeding human Tuna, potted meats, scraps or baby foods because you will just exchange one problem for another.

If, after one month of following these suggestions, your cat has not gained substantial weight, the best thing to do is to have your veterinarian refer you to a veterinary internist practicing in a multi-specialty clinic, a veterinary school teaching hospital or just to accept that your cat is nearing the end of its life. If specialty care is not an option, your regular vet can supply your pet with palliative treatment for specific symptoms as they occur. With guidance from central laboratories, local vets anywhere in America can perform almost all of the laboratory tests that a specialists might run, obtain help in interpreting the result and suggest further tests that are needed.

Your Old Cat’s Teeth

Most of the old cats I see have some amount of dental disease. Although few have cavities many have lost much of the gum that surrounds the base of their teeth as well as heavy accumulations of tartar (plaque, calculus).

You can prevent this problem by starting to brush your cat’s teeth when it is a kitten and by supplementing your cat’s diet with food products and treats marketed to keep cat’s teeth clean.(ref)

This is more than a case of simple hygiene; bacteria that surround the base of teeth can move to the kidneys and heart valves (periodontal disease). They are a constant source of inflammation and discomfort.

If your cat is loosing weight, reluctant to eat, drooling or chewing gingerly, examine its teeth. All cats with advanced dental problems have a very strong, unpleasant breath.

Periodically having your veterinarian clean your cat’s teeth will slow this problem down. Since general anesthesia in elderly cats is not without risk, when I see older cats with severe dental disease, I usually suggest that all severely affected teeth be extracted rather than cleaned again and again. Cats do very well without many teeth, they seem perfectly happy after all these bad teeth are gone and their appetite and weight often returns to normal.

When you “brush” your cat’s teeth at home, use toothpaste designed for cats. I prefer a rubber fingertip applicator over a toothbrush because it allows you to better massage the pet’s gum line and reach inner surfaces of the teeth and gums. Start getting your cat used to the procedure when it is a kitten. To have significant benefit, home tooth care needs to start when the cat is young – before changes are severe.

Eye Changes And Cataracts

What most owners call cataracts in their cats is actually a change called nuclear sclerosis of the lens. When it is just a slight haze, it does not appear to affect a cat’s vision. Another common change is a lacy appearance to the colored portion of the eye, the iris (iris atrophy).(ref)

Cats with hypertension often have irreversible changes in the rear interior portion of their eyes (their retinas) that do effect, or prevent vision.

Heart Problems

Cats are not prone to the type of heart attacks that occur in humans. When they do develop heart problems, they are usually a type called cardiac myopathy. Cardiac myopathy often produces clots that lodge in the lower portions of the venous system causing rear leg paralysis. Many breath with an open mouth and tire easily. Many veterinarians suspect that there is a relationship between hyperthyroidism and heart problems (ref 1, ref 2 ). So vets often check the thyroid status, kidney function and blood pressure of cats that arrive with suspected heart problems.

Liver Issues

Besides the hepatic lipidosis that is caused by sudden refusal to eat, elderly cats sometimes develop cholangiohepatitis, a form of chronic hepatitis. Making the diagnosis can be difficult and often involves biopsying the cat’s liver using an ultrasonically guided needle. It is something best done at a specialty clinic. When your veterinarian suspects a liver issue, a needle biopsy or one obtained through open surgery is really the only way to find the root cause. Other than cholangiohepatitis, tumors of the liver are another cause of hepatic problems that is often encountered.

Constipation

Intestinal motility often drops off in elderly cats making them prone to constipation. Dehydration will further complicate this problem as will arthritis. This problem can usually be managed by clipping long-haired cats, increasing the amount of fiber in their diets and the amount of water that they consume. When this is not enough, giving them periodic hair-ball remedies containing petrolatum or administering lactulose usually control the problem. Petrolatum-based remedies must not be over-used and lactulose must be used cautiously in diabetic cats. Never give your cat phosphate enemas such as Fleet.

If the problem is occasional and mild, you can try adding a teaspoon full of rice bran or psyllium seed powder or a tablespoon of wheat bran to your cat’s diet. Two teaspoons full of unsweetened canned pumpkin is another alternative. If your cat is bloated and uncomfortable or can not pass stool, it needs to visit the vet.

Personality And Behavior Changes

Many of the personality changes you see in older cats are not due to changes in their brain. The infirmities that affect old cats also affect their behavior. Arthritis can limit your pet’s ability to do the things it once enjoyed, high blood pressure can affect its vision, obesity and diabetes limit their mobility and kidney, deaf cats no longer respond to familiar voices and intestinal problems can cause them to loose litter box training.

Words commonly used by owners in describing this problem are dazed, confusion, disorientation, forgetful of past learning and pleasures, trapped in corners, spacey, aimless wandering, less playful, more irritable.

Many elderly cats have changes in their sleep-wake cycles. It is common for them to be up more at night, yowling, pacing, and aimless wandering or restless but a few withdraw into themselves, playing less and sleeping more.

Hyperthyroidism is often suspected in these cases. One normal blood test for hyperthyroidism is not enough in cats with these behavioral changes. Repeated or more sophisticated tests may be required to confirm hyperthyroidism in old cats with personality or behavior changes.

In some cases, the problem is in their brain itself. This is cognitive dysfunction syndrome or, simply, senility. In humans, this would be called Alzheimer’s disease. There are physical health problems that can cause similar signs, things like hyperthyroidism or certain tumors, but many of these cats just no longer possess their youthful brain function.

Sometimes you can make schedule changes to minimize the problem. Things like confining the cat to other areas of the house, playing soft music or keeping the cat awake and active until you go to bed. Keeping food, water and litter box conveniently available to the cat might also help.

Some cats improve when given selegiline (Anipryl), a medication approved for brain infirmities (CCDS, senility) in dogs. In a few cats, a nightly dose of antihistamine allows them to sleep better. Some seem to do better on tranquilizers like diazepam (Valium) or anti-anxiety medications like amitriptyline (Elavil). They are all worth a try when other treatable causes have been ruled out.

Dealing With Arthritis Pain

Many older cats have decreased mobility and joint pain due to arthritis. However, they rarely limp or have visible joint enlargement. They are often reluctant to jump onto sofas or chairs or to climb stairs and they may have difficulty getting into their litter boxes, preferring to defecate next to the box.

Cats do not show pain the way children or dogs do – they disguise it well. They may walk with a shortened, mincing or tippy-toed gait and the range of motion of their joints is decreased. They may meow or nip at you if you manually over-flex or extend their legs. This pain is usually worse in the shoulders and elbows.

Or you may just observe that your pet doesn’t play like it once did or it may be irritable with you or other pets.

If your pet is carrying a leg or reluctant to use one, the problem is probably not the generalized arthritis of old age.

Cats do not tolerate common pain medications well. In all other species, NSAID’s (Non-steroidal anti-inflammatory drugs like Rimadyl = Zenecarp = carprofen) are the first choice in the relief of arthritis inflammation and pain. Cats just don’t metabolize or react to these drugs like most animals do (ref). So they are dangerous to give to your cat for prolonged periods. When you decide that the benefits of a pain-free (and possibly shorter) life outweigh things as they are now, these medications can be given. But cats on long-term NSAID’s need to be monitored closely for toxic side effects (hidden bleeding into the digestive system, anemia, kidney and liver toxicity, intestinal perforations, etc. )

Narcotics, such as fentanyl, control pain well in older cats. But most veterinarians are too intimidated by the DEA (ref) to prescribe them for any length of time (ref).

That leaves us with considerably less effective methods of pain control. The most commonly used one is a glucosamine and chondroitin nutritional supplement. Many owners of older, arthritic cats are pleased with their performance of these products and there is certainly no harm in giving them to your cat in reasonable doses.

Another option are injections of Adequan (polysulfated glycosaminoglycan). They are an option if oral glucosamine/chondroitin is not effective. The company hypes this product shamelessly (ref), but perhaps it might help your pet. It is not approved by the FDA for use in cats, but you can discuss its use with your veterinarian.

Since both glucosamine/chondroitin and Adequan are usually used as part of a multi-facetted pain control program, it is hard to judge their true effectiveness.

Controlled weight loss is important if your arthritic cat is overweight.

The warmth of an electric heating pad, used as a cat bed-liner, is also helpful as are good nail care, ramps, and litter boxes and food dishes with low sides. Some arthritic cats appreciate a gentle massage.

There may come a time when steroids, such as prednisolone, are legitimate alternatives to a cat in constant discomfort. Cats can tolerate these medications for quite some time when the dose is cautious, intermittent, and the cat is closely monitored for the side effects all steroids cause.

Never give your cat Tylenol or aspirin and do not apply topical liniments without veterinary supervision.

Cat Cancer

The frequency of cancers increase with age in everyone, cats included. And almost every treatment that is available to humans is available, somewhere, for your cat. The question I cannot answer is if your cat would want to undergo some of these treatments if it could discuss the matter with you. You know your cat best, and you are the one who can best make that decision – not your veterinarian.

There are endless variations of cancer and they can appear anywhere in your cat’s body. For a tumor to be named and identified, a portion of it (a biopsy) must be sent to a pathologist. That is the only way a valid treatment plan can be put together.

Some of the symptoms that might lead you and your veterinarian to suspect cancer in an elderly cat are lumps, bumps and unhealed sores anywhere on its body, weight loss, loss of appetite, difficulty eating or swallowing, chronic diarrhea or vomission, bleeding or discharges, persistent lameness, difficulty breathing, urinating or defecating.

Read more about cancer in old pets here.

Will More Frequently Visits To My Veterinarian Make My Cat Live Longer

There are certain diseases of cats that have early warning signs that your veterinarian will detect before you do. That is why an annual blood test (geriatric or wellness profile), dental, and physical exam including a blood pressure check might extend your pet’s life. If you yourself detect changes in your cat’s body weight, activity level or any other bodily function, bring the pet in regardless of the date of its last exam. The American Association of Feline Practitioners recommends a veterinary visit for elderly cats every 6 months and it is true that the earlier certain diseases are detected, the more options you might have to treat them (ref).

Elderly, indoor pets, other than those in shelters or group homes or other extraordinary situations, have passed the point in their lives when vaccinations and fecal exams are of benefit to them. Do not agree to them. If your veterinarian still sends yearly vaccination and fecal check reminders to elderly clients, perhaps it is time to look for another health care provider for your pet.

Don’t leave your cat’s health up to your veterinarian. Just as important as your vet’s skills, are your observations of your pet at home. Weight loss accompanies most of the diseases of aged cats (other than early diabetes and certain liver, heart and tumor problems where weight increases). So keep records and weigh your cat frequently. Check its body surface, limbs and mouth for changes and keep note of its urine and elimination habits when you change its litter box.

Are There Other Things Can I Do To Keep This Buddy Of Mine With Me Longer

– I’ll Miss This Cat So Much !

There will always be, hucksters, marketers and even some veterinarians who claim that they will provide you with amazing remedies and treatments outside the borders of traditional veterinary or human medicine. We all love our pets so much that we really want to believe them. I am a product of the Midwestern Prairies,Texas A&M University and the NIH , so I do not believe in treatments that are not based on provable science or that can not be nailed down through examining the results. You may not agree with that, and if so, there are endless potions, concoctions, homeopathic remedies, fountain-of-youth herbal blends and “new age” medicine that will be offered to keep you and your pet healthy and young forever. Most of the products offered to you will be safe and there is no harm in trying them if you wish. (But I would prefer that you just say a prayer to God to watch over this small creation of His in this life or the next)

Life and health extension is possible. The field is in it’s infancy and, to date, the only thing that definitely works in species from monkeys to mice is caloric restriction (ref), and, perhaps, rapamycin-like drugs (ref). But one of my chief pleasures in life is feeding my pets and it is one of their chief pleasures too. So I am not about to practice caloric restriction in my pets or suggest that you do either. Just keep them trim and don’t overdo it.

End Of Life Issues

I have an article on dealing with terminally ill pets and the grief that causes. You can read it here.

Dr Bernard Rollin, of the Department of Philosophy at Colorado State University has written an article for veterinarians on this subject. He cautions against keeping suffering animals alive too long. You can read it here.

Ron Hines DVM PhD

Lots of my articles are plagiarized and altered on the web to market products and services. There are never ads running or anything for sale with my real articles – other than my time. Try to stay with the ones with http://www.2ndchance.info/ in the URL box or find all my articles at ACC.htm.

Contact Dr. Hines

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