Are your companion animal patients ageing disgracefully?

This group of patients are likely to have an increasingly complex number of medical conditions and co-morbidities which if left untreated may lead to a reduced quality of life. Cats and small breed dogs are generally considered to be geriatric from 10 years of age.

Common problems affecting geriatric patients include kidney disease, neoplasia, hypertension, cardiac disease, urinary incontinence, endocrine disease, dental disease, osteoarthritis, and cognitive dysfunction. These conditions may not be unique to the elderly dog or cat, but they are much more common in this age group. In senior and geriatric medicine, emphasis should be placed on identifying problems in the preclinical stage through regular health checks and blood monitoring.

The commonality of kidney disease

Kidney disease is one of the most commonly encountered diseases in small animal practice and the prevalence of kidney disease increases as the animal ages (it is said that if a cat lives long enough then it will eventually develop kidney disease). The incidence of kidney disease in geriatric cats is around 30% and 10% in dogs.

Although kidney disease is progressive, early diagnosis and prompt interventions could slow the rate of progression, thus improving the patient's quality of life and survival time. SDMA is a new marker of kidney disease which can be beneficial in detecting early stages of kidney disease in both dogs and cats. It is a reliable marker of kidney function and increases earlier than serum creatinine (SDMA increases when approximately 40% of renal function has been lost, compared to 75% loss for creatinine).

In addition, SDMA is not affected by lean muscle mass so it is a more accurate marker of kidney function in poorly muscled animals. In some cases SDMA detected chronic kidney disease around 17 months earlier than creatinine in cats and 9 months earlier in dogs.

Hypertension in geriatric patients

Hypertension is also common in older dogs and cats, probably as a result of it's association with diseases such as kidney disease, hyperthyroidism and hyperadrenocorticism, which are more commonly diagnosed in older animals. Sustained systemic hypertension can lead to damage of 'target organs' including the kidneys, eyes, heart and brain.

Blood pressure screening will ensure occult hypertension is identified. Goals of therapy should be to identify underlying conditions that are likely to be the cause of secondary hypertension and to treat them directly as well as initiating specific anti-hypertensive therapy.

The incidence of certain endocrine diseases also increase with advancing age. Hyperthyroidism and diabetes mellitus in cats and hyperadrenocorticism in dogs is generally identified in senior or geriatric patients.

Being aware of the increased incidence of certain disease groups, increases the likelihood of early diagnosis. Early interventions will subsequently reduce the risk of longterm consequences which could otherwise have a serious negative impact on the animal's quality of life.

Join us for an overview of the problems faced in senior and geriatric patients, at the Huntingtower Hotel in Perth on 31 October 2017. The course will cover the complexities of geriatric medicine, from hyperthyroidism to chronic kidney disease and beyond.