Senior Health Care for Dogs and Cats PDF

VTHT 2201 Canine and Feline Clinical Management Senior Health Care  Goals ⚫ Maintain pet's health over a longer lifespan ⚫ Minimize problems through preventive health care and early diagnosis − Manage chronic diseases to maintain a high...

VTHT 2201 Canine and Feline Clinical Management Senior Health Care  Goals ⚫ Maintain pet's health over a longer lifespan ⚫ Minimize problems through preventive health care and early diagnosis − Manage chronic diseases to maintain a high quality of life in spite of disease − Help owner prepare for and deal with pet's death  Life Stages (the younger years) ⚫ Puppy & Kitten, up to 1 year − Large breeds – up to 18mos − vaccinations − parasite control − nutrition − behavior − OHE, neuter ⚫ Adult, 1- 6 years − Large breeds - 18 months - 4 years − vaccinations, annual exam, dental care, exercise − care as needed for illness, injury  Life Stages (getting older) ⚫ Mature adult, 7-10 years (5-8yrs for large breeds) − client education − manage nutrition, exercise, environment − grooming, dental care − regular check-ups − diagnostic profile: CBC, Chem Panel, UA, ECG, BP Life Stages (the senior years) ⚫ Senior 11+ (9+ for large breeds) − client education − manage nutrition, exercise, environment ⚫ May need to adjust lifestyle − grooming, dental care − regular check-ups − diagnostic profile: CBC, Chem Panel, UA, ECG, BP, x-rays  Metabolic and Physiologic Changes of Senior Pets ⚫ Basal metabolic rate slows ⚫ Cardiac output and lung capacity reduced ⚫ Digestion may be impaired ⚫ Diminished kidney & liver function ⚫ Diminished immune function; bone marrow less active ⚫ Nerve conduction slows ⚫ Muscle mass reduced, less joint flexibility  An Ounce of Prevention ⚫ Feed diet formulated for senior dog/cat − fewer calories; reduce obesity − higher digestibility; increase available nutrients − less protein, but higher quality - less strain on kidneys − nutritional supplements: joint health, coat condition ⚫ Regular, moderate exercise − maintain joint health, flexibility − strengthen bones and muscles − improve cardiopulmonary capacity  “Senior Friendly” Environments less tolerance of temperature extremes soft, warm bedding “steps” to access sofa/bed, ramps on porch steps low wall on litter box elevate food and water bowls for large dogs keep food for cats on the floor, not high counter use mats/runners to make slippery floors navigable blind dogs/cats - don't move furniture! use hand signals with deaf dogs younger dog may become dominant; don't fight it  Hygiene ⚫ Grooming − trim nails regularly − regular brushing - dogs and cats − hypoallergenic shampoo; coat conditioner ⚫ Dental Care − Calculus accumulates over time − bacteria in oral cavity - source for infection in other body systems − dental cleaning requires anesthesia  At Home Assessments ⚫ Owner observations − check monthly for lumps/bumps − check mouth, ears, eyes monthly − note stiffness, muscle weakness − note change in exercise tolerance, coughing − note changes in appetite, increased water consumption − note change in frequency of urination, straining − note diarrhea, constipation  Veterinary Care ⚫ Annual or Semi-annual veterinary exams − vaccinations, parasite control ⚫ Diagnostic Screening − Fecal, Heartworm test − CBC, Chem Panel, UA − ECG, BP − X-rays  Disease Onset ⚫ Chronic - long duration, marked by recurring episodes of illness, often progressive; chronic conditions are often incurable, but progress can be slowed and symptoms managed for months to years ⚫ Acute - rapid onset, usually short course of disease; many acute conditions resolve with treatment ⚫ Peracute- sudden onset, severe with rapid progress, so may not get enough time to treat patient  Managing Chronic Disease ⚫ Slow the progress of disease ⚫ Improve the symptoms of disease ⚫ Closely monitor response to therapy, modify as needed ⚫ May include medication, nutrition, physical therapy, home nursing care, and diagnostic monitoring  Osteoarthritis ⚫ More common in dogs, esp. large breeds ⚫ Stiff and sore, hard to stand up ⚫ Worse after intense activity/during cold weather ⚫ Improves with regular to moderate exercise ⚫ May respond to nutritional supplements: Cosequin, joint diets ⚫ Pain management − NSAID - Rimadyl, Metacam ⚫ do NOT give if pet is not eating and drinking or has V/D − Opioid - Tramadol  Chronic Renal Failure ⚫ Older cats often affected ⚫ Kidneys lose ability to concentrate urine ⚫ Earliest signs are polyuria and polydipsia ⚫ BUN, Crea elevated ⚫ NO clinical signs until at least 75% renal function is lost ⚫ Progressive & ultimately fatal - no cure, but condition can be managed for months to years Managing Chronic Renal Failure ⚫ Dietary management- kidney diet − low protein, low phosphorus, moderately low sodium ⚫ Fluid management- owners may give SQ fluids ⚫ Regular check-ups & diagnostic work are vital  Congestive Heart Failure ⚫ Common in older dogs ⚫ Cardiac output is not adequate to perfuse the tissues and deliver oxygen ⚫ Many causes-valvular disease, cardiomyopathy, arrhythmias ⚫ Symptoms associated with the body's compensatory mechanisms − tachycardia, hypertension, fluid retention, cardiac hypertrophy and dilation  CHF ⚫ Early signs - exercise intolerance, coughing ⚫ Diagnosis - exam, radiographs, ECG, ultrasound, bloodwork, UA ⚫ DO NOT STRESS CHF PATIENTS − may need to postpone or do without stressful diagnostic procedures − be prepared to provide oxygen if needed  Neoplasia ⚫ Very common especially with aging ⚫ Symptoms depend on tissues involved-skin mass, limping, diarrhea, vomiting, coughing, ascites, blindness ⚫ Neoplastic mass may be benign or malignant − Benign - cells have normal morphology; mass grows slowly; no metastasis − Malignant - cell morphology abnormal; often rapid growing; metastasize to other tissues  Diagnosing Neoplasia ⚫ MUST have cytology or biopsy to make diagnosis ⚫ Cytology - aspirate cells from mass ⚫ Biopsy - excise a section of tissue from mass, preserve in formalin; submit for histopathology ⚫ CBC, Chem Panel, UA, radiographs, ultrasound  Treating Neoplasia ⚫ Benign tumors may be treated by surgical excision ⚫ Malignant tumors may be successfully treated in early stages; usually surgical excision followed by chemotherapy or radiation ⚫ Debulking tumor may improve quality of life and extend life span a short time  Caring for Cancer Patients ⚫ Nutritional support - a/d; force feeding; omega-3 fatty acid supplements ⚫ Anorexia, nausea - Pepcid AC; Cerenia ⚫ Immunosuppressed - no MLV vaccines; susceptible to infection ⚫ Anemia - patient may be weak, easily stressed; be careful with diagnostic and treatment procedures