The Older Cat
Just like us, our feline friends slow down as they age. They may become less energetic, start to put on weight and their personality may change. Some cats 'mellow out' and become friendlier, wanting to spend more time with their people and wanting more cuddles. Others will become grumpier and will not like to be touched. Generally, older cats will spend more time sleeping and less time outside than they may have done in their youth.
However, you should always be conscious of the fact that changes in your cat's personality can be a symptom of pain or illness, not just old age.
Kidney disease, high blood pressure and hyperthyroidism are all common conditions in older cats. You should watch out for the symptoms to help ensure early diagnosis and treatment.
We therefore recommend that you take your cat for a check-up at the vets if you notice a change in their personality or day-to-day routine, irrespective of their age.
The Ageing Process
As with humans, ageing affects the cat's whole body, inside and out. The skin can become less elastic, the coat less glossy and your cat may even grow some white hairs. There can be deterioration of hearing, sight and even memory. Since older cats generally sleep more than younger cats, sleep/wake patterns will often change. Muscles and bones become weaker and the immune system will not be as strong as it used to be, meaning that your cat will be both more susceptible to picking up infections and less capable of fighting them off. Internal organs such as the heart, liver and the kidneys start to deteriorate.
However, it's not all doom and gloom - there are many medicines available which can reduce unpleasant symptoms for the cat and improve quality of life. Just because your cat is getting older this does not mean that he / she should have to accept ill health. Older cats can lead happy, active lives as well and, in fact, many older cats even still enjoy playing!
What is a Senior Citizen in Cat Terms?
Most vets will tell you that anything over 7 years old falls into the 'senior citizen' category. Regular veterinary check-ups are as important at this time of life as they were when your cat was a kitten. Noticing changes in your cat's behaviour or routine will enable early diagnosis and treatment, which in turn can considerably improve quality of life.
Dietary Changes
Weight loss can be an early symptom of illness at any age. If you have noticed that your cat is losing weight, you must take him / her for a check-up at the vets as a priority. In particular, older cats can develop medical conditions that cause them to lose weight, such as kidney or thyroid disease.
At the other end of the spectrum, some older cats have a tendency to put on weight. Weight gain must be taken as seriously as weight loss; obesity can shorten lifespan and, importantly, overweight cats have an increased risk of developing serious illnesses such as kidney disease, diabetes and arthritis.
The best thing to do if you are concerned about your cat's weight is to ask your vet. They will be best equipped to assess what weight is healthy for your cat, given their height & build.
There are now 'senior' branded pet foods available for your ageing feline friend. These senior diets are lower in calories and so reduce the likelihood of weight gain. Some sources will tell you that protein restriction is beneficial for older cats but there is no proof that this is the case for healthy cats. Protein restriction may help a cat with early kidney problems and, in this situation it would be worth discussing your cat's diet with your vet. Some of the 'senior' brands contain anti-oxidants and polyunsaturated oils, which again, may well be beneficial but there is no proof. It is always best to ask your vet for dietary advice.
If your cat is losing weight and / or has a poor appetite, you should take him / her to your vets for a check-up because there may be an underlying medical problem. If this is the case, they may suggest a special prescription diet (such as Hills g/d for early-stage kidney or heart failure). If not, your vet will nonetheless be able to advise you whether following a senior diet would be beneficial. If appetite is poor, it can help to feed smaller portions but increase the number of meals given. With cats, one of the main attractions to food is smell and since this sense can deteriorate with age, it can help to add foods that are very smelly - such as fish - to the diet to encourage eating. For example, there are several senior citizens at SHUA who will not eat their senior whiskas unless you mush up some tuna or sardines with it! Adding small quantities of vegetable oil or margarine can also help weight gain, as long as the extra fat doesn't induce diarrhoea!
Mouth Problems
Poor appetite, at any age, can be indicative of mouth problems. As with humans, toothache can cause immense pain in cats and it may be that some teeth need to be removed. Conditions such as gingivitis and stomatitis can make it uncomfortable and even painful to eat. A classic symptom of this is when the cat tries to eat but then 'runs away' from the food, sometimes growling/crying and/or pawing his/her mouth.
Having infected, bad teeth and gums is not only uncomfortable but can also be a risk too - a source of infection that can spread to and damage other organs of the body. The majority of animals with bad teeth are happier and eat better after a dental treatment.
Your vet may recommend a dental for your cat, regardless of their age. A large number of anaesthetics are given to older animals purely because they tend to have problems that need surgery. With an older animal, your vet will probably want to carry out blood tests before anaesthetising them, to check their general health. As with any other operation, they will only proceed if the potential benefits outweigh any risks involved.
Grooming
Regular grooming is important for your cat. If you notice that your cat isn't looking as tidy as usual or has areas where the fur is knotting or matted, don't just assume that they 'can't be bothered anymore'. Cats are pretty obsessive about keeping themselves clean and so for a cat not to groom themselves is usually indicative of any underlying problem - often a mouth or joint problem.
Keep a check on the claws. Younger cats often do not need claw trimming, but reduced activity can result in the claws overgrowing. They can curl round and even grow into the foot. Get your vet to check if you are not sure.
Arthritis and Stiff Joints
In an ageing cat, deterioration of joint function and arthritis is very common. Nonetheless, a visit to the vets is advisable. They can assess your cat and advise on any necessary weight control. Long-term treatment for arthritis in cats is more challenging than in dogs, since there are fewer drugs available. 'Cosequin DS Cat' is a nutritional supplement for supporting joint function in cats which can be purchased at online shops such as www.bestpetpharmacy.co.uk. It contains glucosamine and chondroitin - the same supplements recommended for humans - but in the correct feline dose. Your vet can discuss the options available and may offer you an "unlicensed product" - a drug that, although they feel would be beneficial to your cat, has not yet undergone the necessary legal procedures that allow it to be sold for use in cats. As with humans, finding the particular drug treatment that best suits your cat may take a little bit of experimentation. You should monitor your cat and tell your vet immediately if the medication is having any side-effects such as excessive thirst, reduced appetite, diarrhoea or vomiting. 'Nutraceutical' (meaning medical or nutritionally functional) diet supplements may be helpful, for example Hills or Royal Canin prescription foods. Alternative treatments such as acupuncture and reiki can also be highly effective.
Once the arthritis has settled down, medication might only be needed on bad days.
NB NEVER give human or dog medicines or painkillers to your cat. A cat's physiology and ability to metabolise drugs and medicines is VERY different to a human's and even a dog's. Even in tiny quantities, something as seemingly harmless as paracetamol can KILL a cat. ONLY give medication prescribed by your vet for your cat.
Increased Thirst
If you cat is drinking more than usual and this lasts longer than a day or two, then they should definitely be taken to the vets for a check-up. There could be many causes but of particular concern would be kidney or liver disease or possibly even diabetes. Even with serious illnesses such as these, there are treatments available that may slow progress of the disease and improve quality of life by making your pet more comfortable.
Healthy or Increased Appetite Combined with Diarrhoea and / or Missing the Tray
Often people will take their cat to be euthanased when it continually has diarrhoea and / or misses the tray, without investigating the reasons why this is happening. This is a very selfish attitude and you have to question the morality of such owners - discarding their pet when it is clearly ill and in need of some help and understanding.
There are several causes for symptoms such as these - some of which are treatable and some of which are not. For example, hyperthyroidism can present with these symptoms. Hyperthyroidism is a very treatable condition with a good prognosis.
If your cat is displaying symptoms such as these, you should take him/her for a check-up at your vets.
Senility
Cats can suffer from brain deterioration and they will display behavioural side-effects similar to those displayed by humans with Alzheimer's disease. If your elderly cat is behaving oddly it is worth getting a check-up at the vets. For example, your cat may seem a bit distant, disinterested in going out or in greeting you, sit staring vacantly at a wall or just seem confused. There has been some success with Alzheimer's-type drugs used for cats with Alzheimer's-type symptoms. However, other medical conditions can also present with these symptoms and so a professional veterinary opinion should be sought and further tests may be needed.
Kidney Disease
Cats are especially prone to kidney damage and there can be a variety of causes. Cancers, exposure to toxins, infection and immune system problems can all trigger the start of a slow process of damage, eventually leading to loss of function and kidney failure.
At the time of diagnosis of kidney disease, the original cause is often long gone and, in most cases, will never be known. The feline body starts with more kidney tissue than it needs and much of this tissue may be lost before symptoms develop and before blood tests can pick up on it. This slow, progressive process is called "chronic" kidney disease.
It is possible for healthy kidneys to suddenly suffer massive damage - this is called acute kidney disease - but this is far less common than chronic kidney disease.
Kidneys filter the blood and remove poisonous by-products produced by the body. These poisonous by-products are added to water to form urine. The kidneys also get rid of excess water into urine or, if water is lacking, can concentrate urine to minimise water loss. When kidneys are diseased, they lose this ability to concentrate urine and so the cat has to drink comparatively much more in order to get rid of the same amount of waste products.
Kidneys also regulate the amount of the various salts (e.g. sodium and potassium) within the body by excreting excess salts via the urine. Kidney disease can cause some of these salts to accumulate within the circulation, which then makes the cat unwell and perpetuates the kidney damage.
Another kidney function is hormone production. Hormones are responsible for many processes including regulation of blood pressure (by causing the blood vessels to expand or contract) and stimulating the body to produce red blood cells. In a diseased kidney, hormone production may be out of balance and so this can lead to problems such as high blood pressure or anaemia.
Kidney disease is usually diagnosed with a combination of blood and urine tests. Finding the cause of the disease is less easy. In some cases it can found by performing a biopsy (surgically removing a piece of the kidney for examination). Since this involves an operation, it would only be recommended by your vet if knowing the cause of the disease would greatly assist in the treatment of your cat. In many cases, kidney damage - which causes the symptoms - is irreversible.
Symptoms & treatment of kidney disease
Excessive drinking is an obvious symptom of kidney problems but can also be indicative of other illnesses or conditions. Early signs of excess thirst can be missed if your cat is discreet and prefers to drink when you aren't around. If this is the case, they can become quite ill before you realise anything is wrong.
As kidney disease advances, other symptoms that you may notice include poor appetite, weight loss, signs of dehydration, a sore mouth, bad breath, vomiting and weakness. With advanced kidney disease, there may be twitchiness or even fits. However, as with excessive drinking, these symptoms are common to many illnesses, not just kidney disease. A professional veterinary opinion should be sought.
Unfortunately, there is no cure for kidney disease. Treatment aims to minimise the symptoms by reducing toxin production, regulating salt levels and slowing down the progress of the disease. A cat which is unwell and severely dehydrated may benefit from being hospitalised at the vets and given intravenous fluids to re-hydrate and flush out toxins. Unless kidney damage is severe, they should respond to this treatment and improve.
There are various medications available to help manage your cat's symptoms, including:
- Anabolic steroids (which can help improve appetite and reduce weight loss)
- ACE inhibitors (which may preserve function in undamaged parts of the kidney)
- Anti-nausea drugs, appetite stimulants and anti-ulcer drugs (all of which may improve appetite)
- Potassium powder or tablets (to combat weakness resulting form excessive potassium loss)
- Medicine to reduce phosphate intake (which can slow the rate of kidney damage caused by phosphate accumulation in the body) This may be especially beneficial if the cat is not on a low-protein diet
Your vet will discuss all the options available to you and will recommend the best course of treatment for your cat.
Home care is also very important. The un-processed toxins can cause nausea, loss of appetite and sometimes mouth and stomach ulcers. To combat loss of appetite, you could try tempting the cat with food such as freshly cooked fish or chicken. Free access to water is essential, especially in the summer. If a cat has no access to water, they can dehydrate and toxins will accumulate rapidly. A low protein diet may be beneficial, since many of these toxins come from dietary protein. Maintaining a healthy appetite may, however, be more important than eating a special diet. This should be discussed with your vet.
Prognosis really depends on the severity of the kidney disease, the underlying cause and the rate at which the disease is advancing (and thus the rate at which damage is occurring) - something which only time can tell.
As with other terminal conditions, the most important factor is quality of life - the cat's general wellbeing and happiness. Some cats, despite being very thin and drinking lots, stay reasonably well for one to two years or more. Others can be unwell and deteriorate rapidly within weeks.
High Blood Pressure
Kidney disease can cause high blood pressure and, in turn, high blood pressure worsens kidney disease - somewhat of a vicious circle. Failing kidneys produce hormones that contract the blood vessels, thus raising the blood pressure (because there is now less space for the same volume of blood). Also, failing kidneys cannot eliminate excess salt, which leads to water retention in the circulation. This results in increased blood volume, which further raises the blood pressure (because there is an increased volume of blood trying to occupy that space).
Blood pressure can also rise in hyperthyroidism - sometimes for no visible reason.
High blood pressure can damage the eyes by rupturing the tiny blood vessels in the retina. The leaked blood covers the retina and, in some cases, this obscures vision. Rarely, high blood pressure can also cause retinal detachment.
When blood pressure is high, the heart has to work harder to circulate the blood. This reduces its efficiency and will eventually cause heart disease and heart failure. High blood pressure may also cause ruptures of the tiny vessels in the brain leading to changes in personality, seizures, collapse or other nervous-system symptoms.
Your vet may prescribe medication to relax & dilate the blood vessels, which in turn lowers the blood pressure. A low salt diet may also help. Your cat will need regular check-ups with your vet in order to monitor the condition.
Hyperthyroidism
Hyperthyroid means "too much thyroid hormone". The thyroid hormone is produced by the thyroid glands in the neck. It determines the body's metabolism, or running speed. If too much thyroid hormone is being produced, all bodily functions (the metabolism) speed up.
A cat with hyperthyroidism will eat lots but still lose weight at an alarming rate. He / she may be over-active, or even aggressive. Vomiting and diarrhoea (as well as missing the tray) are common symptoms but it should be noted that hyperthyroidism is not necessarily the only cause.
With hyperthyroidism, the heart rate will be rapid and this can lead to permanent heart damage. Blood pressure can also rise.
Hyperthyroidism can be diagnosed with a simple blood test. It is also a very treatable condition. There are two common options - tablets or surgery. Tablets are always administered as a first course of treatment in order to stabilise your cat's condition. Once stable, you can decide whether to continue with the tablets (which will be needed for the rest of the cat's life) or to opt for surgery.
The tablets block the excessive production of thyroid hormone and, in this way, manage the condition rather than curing it. These tablets are usually given two or three times daily, at regularly spaced intervals.
Surgery is riskier but may provide a cure. All animals have two thyroid glands and both will need assessing. Enlarged glands will be removed. If both glands are removed, this may carry an increased risk of post-surgical complications; on the other hand, if one gland is left, it may later start producing an excess of thyroid hormone (necessitating a further surgery or tablets).
Many cats will be at least middle aged when diagnosed with this condition and so thyroid operations on elderly cats are common. Surgery is a good choice if administering tablets is difficult or if the tablets do not seem to be working well.
One complication is that excess thyroid hormone can mask other problems, especially kidney damage. Hence, blood tests to check kidney function are often recommended prior to surgery.
A third option is radioactive iodine therapy, but this is only available at some specialist centres and is fairly expensive. This treatment aims to destroy all abnormal thyroid tissue but does mean that the cat has to be hospitalised for three to six weeks.
Summary
In summary, watch out for the following symptoms in your elderly cat:
- Decreased appetite
- Increased thirst
- Bad breath
- Weight loss
- Stiff joints, limping or difficulty jumping
- Lumps or bumps, especially if they are growing quickly
- Inactivity
- Trouble passing urine or faeces or doing so outside of the tray
- Disinterest, disorientated or trouble balancing
If you notice any of these symptoms, it is worth taking your cat for a check-up at the vets. Don't just assume it is 'old age' and that nothing can be done to alleviate the symptoms - in many cases there are things that your vet and / or you can do to improve their quality of life.
