Material through courtesy MVP Reference and Data Library.

FELINE GERIATRICS Joan 0. Joshua, FRCVS

University of Liverpool, Veterinary Hospital, Liverpool, England J Small Anim Pract 5 (6):525-534, 1964

Longevity may be a hereditary factor in cats, as some show senile changes at 10 years and others are healthy at 20. The first evidence of senility is disregard of house training. Many old cats become less fussy about digging holes and covering excreta. They may use corners of the house and especially tubs and sinks, with no signs of guilt. Punishment is not the answer ; the owner must decide to live with it or consent to euthanasia for the cat. Similarly, attention to the fur decreases and the owner must take over the grooming. Agility decreases, but sight and hearing are not affected as in old dogs. Nails grow long because of less exercise and atony of the retractor muscles. Regular nail clipping is often needed. Old cats may become thin and frail without obvious cause and, with their decreasing metabolic rate, need extra warmth. They should not be left out at night. Food should be highly nutritious, easily digested, and given frequently in small portions. For adequate vitamin intake, concentrated supplements may be required.

Liability to dental calculus, paradontal disease, and alveolitis in-creases with age and the mouth should be inspected regularly. As nephritis and diabetes mellitus can cause excess tartar, the urine should be checked. Teeth should be extracted at any age, if indicated. Intubation is not easy and face masks are inconvenient; thiopental sodium i.v. is probably the best anesthetic. Carcinoma and inflamma-tion of the tongue are common, and difficult to differentiate. Carci-noma may also occur in the tonsils, pharynx and esophagus, rarely in the stomach. The stomach and esophagus are less liable to senile change. Atony of the anal sphincters may cause incarceration of a knob of feces which can be expelled by digital pressure. If this does not afford relief and the colon is full of large fecal masses, megacolon should be considered. Atony of the colon leading to megacolon is usu-ally first evident in middle rather than old age. Sympathectomy might be a better treatment than resecion.

The pancreas may fail in aging cats. Exogenous deficiency is characterized by increased appetite with loss of weight ; loose feces are persistent but not necessarily bulky or fatty. Trypsin tests should be made several times, as result vary even in normal cats. A persisting titer below 1 :20 is suggestive. Keratin-coated tablets or granules of pancreatin, preferably with bile salts, give excellent results. Dosage is based on response. Adenocarcinoma of exogenous tissue is reportedly common. Diabetes mellitus occurs oftener than generally believed, es-pecially after the age of 8. Signs are polydipsia and increasing weight loss, with appetite first increased and then decreased. Lens opacity is less frequent than in dogs. With insulin treatment, life expectancy may be 6 years or more. The dose usually is 5-11 units daily of protamine zinc or zinc suspension lente insulin. Keeping the urine constantly negative risks hypoglycemia, and the weight, water intake and appetite are more important criteria. Fatty degeneration of the liver occurs in

148 C. F. A.

Material through courtesy MVP Reference and Data library.

FELINE GERIATRICSJoan O. Joshua. FRCVS

University of Liverpool, Veterinary Hospital, Liverpool, EnglandJ Small Anim Pract 5 (6) :525-534,1964

Longevity may be a hereditary factor in cats, as some show senilechanges at 10 years and others are healthy at 20. The first evidence ofsenility is disregard of house training. Many old cats become less fussyabout digging holes and covering excreta. They may use corners of thehouse and especially tubs and sinks, with no signs of guilt. Punishmentis not the answer; the owner must decide to live with it or consent toeuthanasia for the cat. Similarly, attention to the fur decreases and theowner must take over the grooming. Agility decreases, but sight andhearing are not affected as in old dogs. Nails grow long because of lessexercise and atony of the retractor muscles. Regular nail clipping isoften needed. Old cats may become thin and frail without obvious causeand, with their decreasing metabolic rate, need extra warmth. Theyshould not be left out at night. Food should be highly nutritious, easilydigested, and given frequently in small portions. For adequate vitaminintake, concentrated supplements may be required.

Liability to dental calculus, paradontal disease, and alveolitis in­creases with age and the mouth should be inspected regularly. Asnephritis and diabetes mellitus can cause excess tartar, the urineshould be checked. Teeth should be extracted at any age, if indicated.Intubation is not easy and face masks are inconvenient; thiopentalsodium i.v. is probably the best anesthetic. Carcinoma and inflamma­tion of the tongue are common, and difficult to differentiate. Carci­noma may also occur in the tonsils, pharynx and esophagus, rarely inthe stomach. The stomach and esophagus are less liable to senilechange. Atony of the anal sphincters may cause incarceration of aknob of feces which can be expelled by digital pressure. If this does notafford relief and the colon is full of large fecal masses, megacolonshould be considered. Atony of the colon leading to megacolon is usu­ally first evident in middle rather than old age. Sympathectomy mightbe a better treatment than resecion.

The pancreas may fail in aging cats. Exogenous deficiency ischar~cterized by increased appetite with loss of weight; loose feces arepersistent but not necessarily bulky or fatty. Trypsin tests should bemade several times, as result vary even in normal cats. A persistingtiter below 1 :20 is suggestive. Keratin-coated tablets or granules ofpancreatin, preferably with bile salts, give excellent results. Dosage isbased on response. Adenocarcinoma of exogenous tissue is reportedlycommon. Diabetes mellitus occurs oftener than generally believed,es­pecially after the age of 8. Signs are polydipsia and increasing weightloss, with appetite first increased and then decreased. Lens opacity isless frequent than in dogs. With insulin treatment, life expectancy maybe 6 years or more. The dose usually is 5-11 units daily of protaminezinc or zinc suspension lente insulin. Keeping the urine constantlynegative risks hypoglycemia, and the weight, water intake and appetiteare more important criteria. Fatty degeneration of the liver occurs in148 C. F. A.

diabetes mellitus. Chronic passive congestion associated with right heart lesions is often not observed until terminal phases. Cirrhosis occurs as in the dog, and may follow idiopathic jaundice with renal signs. Liver neoplasia is common, frequently lymphocarcinomatous involvement, adenocarcinoma, or metastases from other sites. Liver disease usually causes anorexia and weight loss, nausea and some de-pression.

Neoplasia of the nasal cavity should be suspected if an aged cat has a unilateral discharge. Radiography is not necessarily helpful in diagnosis, but if the discharge is accompanied by wasting, euthanasia is justified. Lymphosarcoma is frequent in mediastinal and bronchial lymph nodes, and empyema is common in the thorax of cats at any age. Bronchitis is also common in winter in all cats, but pulmonary em-physema occurs rarely if at all. Pulmonary congestion, often associated with effusion, occurs in left-heart failure but heart disease is often inapparent until the stage of failure. It is rarer in old cats than dogs but the prognosis is grave. Cyanosis on minimal exertion, dyspnea, and sternal position with abducted elbows may appear suddenly. Most cats are unable to tolerate the digitalis group. Murmurs may not be evidence of cardiac insufficiency, and the significance of tachycardia, common in old cats, is unknown. Arterial thrombosis is a hazard of middle rather than old age ; resulting kidney infarcts can cause renal in-suffiency. Anemia is not uncommon but the cause may be obscure. It may be secondary. The tongue color is a better guide than mucous membranes, which may be pale normally. Occasionally there may be good response to vitamins.

Swollen, painful joints with periarticular changes, perhaps accom-panied by malaise and anemia, may respond to corticosteroids. Septic foci such as teeth should be treated. Any firm swelling associated with the bone of limbs, trunk, or skull in a cat over 6 years old should be radiographed. Malignant bone tumors are fairly common, and may appear to arise simultaneously from several sites.

Epileptiform convulsions occasionally develop in middle or old age. Small doses of primidone, phenytoin or potassium bromide may be satisfactory treatment if the patient can be easily and regularly dosed. A stroke syndrome occurs commonly, with sudden onset and unilateral signs. A fair proportion of patients recover spontaneously in 1-3 weeks. Locomotor ataxia may sometimes be of central origin. No records of brain tumors are known. Older cats may have stillborn kittens, then smaller litters, then abortion at 42-52 days, and finally infertility and endometritis. Spaying is indicated. Pyometra and endometritis are common in unbred females in middle and late life, and mammary neo-plasia in old queens that breed regularly. The more anterior mammae are usually affected ; malignancy is commonly high and metastasis early.

Aged cats may have chronic intersitial nephritis of unknown etio-logy, with no apparent relation to leptospiral agglutinins. Signs are thirst, dullness, lack of appetite, and weight loss. Vomiting may not occur, but in late stages ulcers in the pharyngeal region may cause dysphagia. The uremic odor is ammoniaca] in cats. Kidneys are often 3 ear Book, 1965 149

diabetes mellitus. Chronic passive congestion associated with rightheart lesions is often not observed until terminal phases. Cirrhosisoccurs as in the dog, and may follow idiopathic jaundice with renalsigns. Liver neoplasia is common, frequently Iymphocarcinomatousinvolvement, adenocarcinoma, or metastases from other sites. Liverdisease usually causes anorexia and weight loss, nausea and some de­pression.

Neoplasia of the nasal cavity should be suspected if an aged cathas a unilateral discharge. Radiography is not necessarily helpful indiagnosis, but if the discharge is accompanied by wasting, euthanasiais justified. Lymphosarcoma is frequent in mediastinal and bronchiallymph nodes, and empyema is common in the thorax of cats at any age.Bronchitis is also common in winter in all cats, but pulmonary em­physema occurs rarely if at all. Pulmonary congestion, often associatedwith effusion, occurs in left-heart failure but heart disease is ofteninapparent until the stage of failure. It is rarer in old cats than dogsbut the prognosis is grave. Cyanosis on minimal exertion, dyspnea, andsternal position with abducted elbows may appear suddenly. Most catsare unable to tolerate the digitalis g-roup. Murmurs may not be evidenceof cardiac insufficiency, and the significance of tachycardia, commonin old cats, is unknown. Arterial thrombosis is a hazard of middlerather than old age; resulting kidney infarcts can cause renal in­suffiency. Anemia is not uncommon but the cause may be obscure. Itmay be secondary. The tongue color is a better guide than mucousmembranes, which may be pale normally. Occasionally there may begood response to vitamins.

Swollen, painful joints with periarticular changes, perhaps accom­panied by malaise and anemia, may respond to corticosteroids. Septicfoci such as teeth should be treated. Any firm swelling associated withthe bone of limbs, trunk, or skull in a cat over 6 years old should beradiographed. Malignant bone tumors are fairly common, and mayappear to arise simultaneously from several sites.

Epileptiform convulsions occasionally develop in middle or old age.Small doses of primidone, phenytoin or potassium bromide may besatisfactory treatment if the patient can be easily and regularly dosed.A stroke syndrome occurs commonly, with sudden onset and unilateralsigns. A fair proportion of patients recover spontaneously in 1-3 weeks.Locomotor ataxia may sometimes be of central origin. No records ofbrain tumors are known. Older cats may have stillborn kittens, thensmaller litters, then abortion at 42-52 days, and finally infertility andendometritis. Spaying is indicated. Pyometra and endometritis arecommon in unbred females in middle and late life, and mammary neo­plasia in old queens that breed regularly. The more anterior mammaeare usually affected; malignancy is commonly high and metastasisearly.

Aged cats may have chronic intersitial nephritis of unknown etio­logy, with no apparent relation to leptospiral agglutinins. Signs arethirst, dullness, lack of appetite, and weight loss. Vomiting may notoccur, but in late stages ulcers in the pharyngeal region may causedysphagia. The uremic odor is ammoniacal in cats. Kidneys are oftenYear Book, 1965 149

smaller than normal, sometimes unilaterally, and surface irregularity may be palpable. Urine dilution may be minimal, but protein is usually present. Sulfosalicylic acid is the best test for protein, as impregnated strips may give false positives. Lymphosarcoma is the only common neoplasm and may be primary or secondary. Thirst, some wasting, and dilute urine are usual but proteinuria may not occur. In advanced cases, enlargement of the kidneys, and perhaps distortion, are readily pal-pable. Splenomegaly due to massive infiltration of mononuclear or plasma cells seems peculiar to the cat. There may be vomiting and in-appetence, weight loss and anemia. Palpation of the enlarged spleen cannot rule out lymphosarcomatosis. Response to splenectomy is ex-cellent. The spleen may be the primary site of reticulum cell sarcoma or metastatic carcinoma as well as lymphosarcoma. The most significant affections of lymph nodes in older cats probably are lymphosarcoma and a lymphatic leukosis resembling Hodgkin's disease. Palpable lymph nodes are usually bilaterally enlarged in the latter case, and spleen and liver may be involved. Biopsy confirms the diagnosis, but there is no satisfactory treatment.

smaller than normal, sometimes unilaterally, and surface irregularitymay be palpable. Urine dilution may be minimal, but protein is usuallypresent. Sulfosalicylic acid is the best test for protein, as impregnatedstrips may give false positives. Lymphosarcoma is the only commonneoplasm and may be primary or secondary. Thirst, some wasting, anddilute urine are usual but proteinuria may not occur. In advanced cases,enlargement of the kidneys, and perhaps distortion, are readily pal­pable. Splenomegaly due to massive infiltration of mononuclear orplasma cells seems peculiar to the cat. There may be vomiting and in­appetence, weight loss and anemia. Palpation of the enlarged spleencannot rule out lymphosarcomatosis. Response to splenectomy is ex­cellent. The spleen may be the primary site of reticulum cell sarcoma ormetastatic carcinoma as well as lymphosarcoma. The most significantaffections of lymph nodes in older cats probably are lymphosarcomaand a lymphatic leukosis resembling Hodgkin's disease. Palpable lymphnodes are usually bilaterally enlarged in the latter case, and spleen andliver may be involved. Biopsy confirms the diagnosis, but there is nosatisfactory treatment.