Geriatric Cats Research Articles

Proteinuria in cats. Prognostic marker or mediator?

Practical relevance Numerous tests are available to the practitioner for quantifying proteinuria. It is important to understand the advantages and limitations of these tests and how the information gained can contribute to optimal patient management. Patient group Cats with chronic kidney disease or systemic hypertension, as well as geriatric cats without overt evidence of disease (including renal dysfunction), are at particular risk of proteinuria. Evidence base Several longitudinal studies of cats seen in first opinion clinics have shown an association between proteinuria and decreased survival time. However, it is unknown whether the deaths that occur in proteinuric cats are due to progression of renal disease because it is often difficult to ascribe a cause of death to a single underlying aetiology in clinical patients. It is also unknown whether proteinuria is contributing to disease progression in these cats or whether proteinuric renal disease is intrinsically more rapidly progressive. Clinical significance More aggressive investigation and management of patients with proteinuria may be appropriate since they are more likely to have progressive disease and/or increased mortality.

Idiopathic inflammatory bowel disease in cats. Rational treatment selection.

Practical relevance Inflammatory bowel disease (IBD) is a common diagnosis in cats with chronic gastrointestinal signs. Its management presents clinical challenges, not least because rational therapy relies on a definitive diagnosis, and current understanding of the underlying pathogenesis has, to date, limited the development of specific therapies. The mainstays of treatment remain dietary manipulation and immunosuppressive therapy, but treatment failures are not uncommon. A logical clinical approach is important and there are a number of alternative or adjunctive treatments that can prove useful in refractory cases. Evidence base This article draws on data from clinical trials in humans, in vitro studies, prospective and retrospective studies in cats with naturally occurring IBD, and clinical experience to discuss the work-up and treatment selection for cats with idiopathic IBD. Patient group IBD affects young adult to geriatric cats of both sexes. Audience Companion animal and feline practitioners are at the front line when it comes to managing these often challenging cases.

Significant Association between Tooth Extrusion and Tooth Resorption in Domestic Cats

Abnormal extrusion of canine teeth is often noted in middle-aged and geriatric domestic cats. The same age group of cats also is commonly affected by tooth resorption (TR). This study explored the relationship between these two phenomena of unknown etiology. Using digital radiography, the distance between the alveolar margin (AM) and cementoenamel junction (CEJ), referred to as the AM-CEJ distance, was measured in clinically and radiographically healthy maxillary canine teeth of 24 TR-affected and 29 TR-free cats. The mean AM-CEJ distance of maxillary canine teeth of cats with and cats without TR was 2.68-mm and 2.22-mm, respectively. An analysis of covariance adjusting for age revealed a significant correlation (p = 0.02) between tooth extrusion and TR. Extrusion of the maxillary canine teeth became clinically apparent when an AM-CEJ distance of 2.5-mm or greater was evident in the absence of horizontal or vertical alveolar bone loss. Based on this criterion, 15 of 24 cats with TR (63.0 %) exhibited extrusion of maxillary canine teeth, compared to 9 of 29 cats without TR (31.0 %). Four extruded and five non-extruded maxillary canine teeth were evaluated histologically. Cementum of extruded teeth was significantly thicker compared to that of non-extruded teeth. Four of 4 canine teeth with extrusion (100 %) showed histological evidence of resorption, compared to 1 of 5 canine teeth without extrusion (20.0 %). These results suggest that tooth extrusion is linked to or may be caused by similar factors responsible for the development of TR.

Ageing does not significantly affect performance in a spatial learning task in the domestic cat ( Felis silvestris catus)

A spatial learning task was used to examine cognitive function in 36 cats (1.0–15.1 years of age), with a control for motor function. No significant age-related decline in cognitive function was found. Initial selection of 75 cats showed no significant age differences between young (0–3 years), adult (3.1–8 years), senior (8.1–12 years) and geriatric cats (12.1–15.1 years) locating food rewards in a holeboard box. Consequently, the senior and geriatric groups were combined because of a concern that age effects may not be seen in the 8–12-year-old cats. Differences between these three age groups of cats to learn the position of three food rewards in an array of 30 otherwise empty (food-scented) positions were non-significant. Differences between age groups remained non-significant for retrieval of rewards from these three positions even when masked with a tissue paper cover. There was no significant effect of age on speed of reaching each criterion. Although the total number of errors was similar, there was a significantly increased proportion of working memory errors (when the cat returned to a previously baited position) and decreased proportion of reference memory errors (when the cat put a nose or paw in an empty position) with increasing age. There was no effect of age on motor function, with success in a plank-crossing test related only to plank width. These findings support previous work suggesting that the cat differs from other species in the way in which it demonstrates age-related declines in cognitive function. Further studies using different testing methodologies are required to assess other cognitive functions that may decline with age.

Cognitive dysfunction and the neurobiology of ageing in cats

With improvements in nutrition and veterinary medicine the life expectancy of pet cats is increasing. Accompanying this growing geriatric population there are increasing numbers of cats with signs of apparent senility. A recent study suggests that 28 per cent of pet cats aged 11 to 14 years develop at least one geriatric onset behavioural problem, and this increases to over 50 per cent for cats of 15 years of age or older. While behavioural changes may result from systemic illness, organic brain disease or true behavioural problems, the possibility of age-related cognitive dysfunction is often overlooked. Studies have revealed a number of changes in the brains of geriatric cats that showed signs of cognitive dysfunction, and potential causes include vascular insufficiency leading to hypoxia, increased free radical damage and the deposition of beta-amyloid plaques and/or the modification of other proteins. By recognising the importance of behavioural changes in old cats, investigating them fully for potentially treatable medical conditions, and instigating dietary and environmental modifications to meet their changing needs, we can make the lives of our geriatric cats much more comfortable and rewarding.

Canine and feline microbiota as analyzed by the human I‐chip cluster in different groups.

Intestinal microbiota supports the host organisms with many beneficial effects including improved digestion and absorption, resistance to disease and allergy, and intestinal motility. It is thought that modulation of the microbiota via dietary intervention can be achieved. The objective of this study was to evaluate the human I-chip, a bacterial DNA microarray chip (TNO, The Netherlands), as a tool to study the microbiota of dogs and cats. Stool samples from 13 puppies, 17 adult and 27 geriatric dogs, and 12 adult and 29 geriatric cats were analyzed. DNA extracted from stool samples were fluorescently labeled and hybridized on the oligonucleotide chip. Intensity of hybridization was quantified as a ratio to the background signal. The results, as analyzed by cluster analysis, showed that companion animals had different profile of microbiota compared to humans. Bacteria such as L. casei and L. rhamnosus, found in literature to be abundant in human microbiota, were undetectable in dogs and cats. Dog and cat samples were also clearly different, with dog, puppy and cat samples clearly clustering within each group. In summary, the human I-chip showed large differences between the microbiota of dogs, cats, and age groups. It also showed inherent differences between human and companion animal microbiota, suggesting that further work is needed to determine the utility of the human I-chip for companion animal analysis.

Considering older cats

Considering older cats

Middle ear tumours with brainstem extension treated by ventral bulla osteotomy and craniectomy in two cats

Two geriatric domestic shorthaired cats (DSH) were treated surgically with a ventral bulla osteotomy and craniectomy for middle ear tumours that invaded the calvarium. Both cats had a history of vestibular disease. One cat had a normal neurological examination. Both cats underwent computed tomographic imaging of the head. After intravenous injection of an iodinated contrast material, one cat had a ring-enhancing intracranial lesion and the other had a uniform contrast-enhancing intracranial lesion, which either communicated with the bulla or was associated with bulla osseous lysis/production. One cat had a papillary adenoma and the other had an adenocarcinoma. Both cats had prolonged survivals (630 days; alive and lost to follow-up at 840 days), which is longer than reported in cats with middle ear neoplasia. Craniectomy, in addition to ventral bulla osteotomy, may be part of the treatment plan for middle ear tumours that invade the calvarium.

Fluoroquinolone-induced retinal degeneration in cats.

Although the exact mechanism of fluoroquinolone-induced retinal degeneration in cats remains to be elucidated, it appears from the literature that a similar retinal degeneration can be reproduced from either direct intravitreal injection of high concentrations of drug or exposure to UVA light and drug in laboratory animals. (19,25) The fluoroquinolone molecular structure is also similar structurally to other drugs that are known to directly induce retinal degeneration, including the cinchona alkaloids and halogenated hydroquinolones. Experimental evidence suggests that both the parent compound and its breakdown products via metabolism and photodegradation are active inducers of retinal degeneration. (18,25) Development of toxicoses also appears to be dependent on the maximum concentration of active drug, metabolite, or both reaching the retina over time. (18) Evaluation of the literature suggests that risk factors predisposing cats to fluoroquinolone-induced retinal degeneration may include the following: 1) large doses or plasma concentrations of drug, 2) rapid IV infusion of the antibiotic, 3) prolonged courses of treatment, and 4) age. Theoretically, other risk factors may also be involved including the following: 1) prolonged exposure to UVA light while the antibiotic is being administered, 2) drug interactions, and 3) drug or metabolite accumulation from altered metabolism or reduced elimination. To date, there are no published reports suggesting that the dose of fluoroquinolones should be reduced in geriatric cats or those with renal or hepatic failure. However, accumulation of fluoroquinolone metabolites in dogs and of the parent compound in humans with decreased renal function has been reported. (8-10) In humans with decreased renal function has been reported. (8-10) humans, fluoroquinolone doses are typically decreased in response to the degree of renal impairment. (28) In general, all fluoroquinolone antibiotics should be reserved for severe or recurrent infections, and whenever possible their use should be based on results whenever possible their use should be based on results of culture and susceptibility tests. When indicated, the fluoroquinolones, including enrofloxacin, can be used with limited risk of developing retinal degeneration in cats, provided the manufacturer's guidelines are adhered to and dose reduction is considered in geriatric cats or those with renal impairment. Dosing on renal impairment. Dosing on exact body weight using split dosing (2.5 mg/kg, PO, q 12 h) and avoidance of rapid IV infusions, and drug interactions may help to reduce the risk of retinal degeneration in some cases. Furthermore, monitoring cats for mydriasis and avoidance of UVA light while undergoing treatment may also be of benefit. Further evaluation of the pharmacokinetics of enrofloxacin and the other fluoroquinolones is required in geriatric cats or those with mild to moderate renal or liver impairment to determine whether drug accumulation, elevated peak concentrations of drug, or both may be occurring in this subset of cats. Therapeutic monitoring of drug concentrations may not always be feasible because of time and cost, but renal panels with dose or frequency reduction in response to the degree of renal impairment and the site and severity of infection may help to reduce retinal toxicosis.

Echocardiographic and Radiographic Changes Associated with Systemic Hypertension in Cats

The purpose of this study was to assess the effects of systemic hypertension (SHT) on echocardiographic and radiographic cardiovascular variables in affected cats compared with healthy geriatric cats. Secondary objectives were to determine whether there were any relationships between these findings and age or systolic blood pressure (SBP). Fifteen healthy cats (<8 years of age with normal SBP) and 15 hypertensive cats (SBP > 180 mm Hg) were studied. Each cat was evaluated for standard echocardiographic parameters and 4 different aortic root dimensions. Seventeen variables were measured from right lateral and dorsoventral radio‐graphic views. Left ventrical wall thickness was greater in the SHT group (5.1 ± 0.9 mm) than in the healthy cats (4.2 ± 0.5 mm). Left ventricular hypertrophy in the SHT cats often was not severe, and mean measures were considered normal. Some cats had asymmetrical septal hypertrophy (ASH) in the basilar portion of the septum as determined from the 2‐dimensional view of the left ventricular outflow tract. ASH was greater in cats with SHT. Comparisons of the proximal ascending aorta indicated the presence of dilatation in the SHT cats, and comparison of the ascending aorta to the aortic annulus was helpful in differentiating between the 2 groups. The distal aortic root measurements and ratios evaluated by echocardiography were significantly different between the 2 groups of cats (P= .0001) and were significantly correlated with SBP (P= .0001) but not age (P > .3).

Radiographic evidence of degenerative joint disease in geriatric cats: 100 cases (1994-1997).

To determine prevalence of radiographic evidence of degenerative joint disease (DJD) in geriatric cats. Retrospective study. 100 cats > 12 years of age. One investigator reviewed radiographs and for each articulation (or group of articulations) that was visible assigned a grade of severity (0, 1, 2, 3) for DJD. Another investigator reviewed medical records and recorded signalment, environment, previous disease, diseases evident at time of radiography, FeLV vaccination and infection status, feline immunodeficiency virus serologic status, serum creatinine concentration, serum globulin concentration, and any other important findings. Associations between DJD of grade 2 or 3 and variables recorded from the medical record were determined. Radiographic evidence of DJD was evident in 90% of cats. Neurologic disease was associated with lesions in the lumbosacral portion of the vertebral column. Severe lesions were found in 17% of the elbow joints, but an underlying cause was not determined. Degenerative joint disease was detected radiographically in most geriatric cats and may be an overlooked cause of clinical disease. Clinicians should be alert to the possibility that DJD is associated with neurologic signs.

Echocardiographic and radiographic changes associated with systemic hypertension in cats.

The purpose of this study was to assess the effects of systemic hypertension (SHT) on echocardiographic and radiographic cardiovascular variables in affected cats compared with healthy geriatric cats. Secondary objectives were to determine whether there were any relationships between these findings and age or systolic blood pressure (SBP). Fifteen healthy cats (>8 years of age with normal SBP) and 15 hypertensive cats (SBP > 180 mm Hg) were studied. Each cat was evaluated for standard echocardiographic parameters and 4 different aortic root dimensions. Seventeen variables were measured from right lateral and dorsoventral radiographic views. Left ventricle wall thickness was greater in the SHT group (5.1 +/- 0.9 mm) than in the healthy cats (4.2 +/- 0.5 mm). Left ventricular hypertrophy in the SHT cats often was not severe, and mean measures were considered normal. Some cats had asymmetrical septal hypertrophy (ASH) in the basilar portion of the septum as determined from the 2-dimensional view of the left ventricular outflow tract. ASH was greater in cats with SHT. Comparisons of the proximal ascending aorta indicated the presence of dilatation in the SHT cats, and comparison of the ascending aorta to the aortic annulus was helpful in differentiating between the 2 groups. The distal aortic root measurements and ratios evaluated by echocardiography were significantly different between the 2 groups of cats (P = .0001) and were significantly correlated with SBP (P = .0001) but not age (P > .3).

Prevalence of ocular abnormalities in cats with hyperthyroidism.

The purpose of this study was to investigate the occurrence of ocular abnormalities in hyperthyroid cats. One hundred hyperthyroid cats and 30 clinically normal, geriatric cats were studied. In both groups, ophthalmic examination was performed by use of slit-lamp biomicroscopy and indirect ophthalmoscopy after application of 1% tropicamide to dilate the pupil. Ocular abnormalities were common in both the hyperthyroid and euthyroid cats. Approximately 75% of all eyes were affected with 1 or more abnormalities, and the range of abnormalities involved all structures of the eye. Significant differences between the euthyroid and hyperthyroid cats were found in the prevalence of prominent suture lines, nonpigmented deposits on the posterior lens capsule, hyperreflective ring around the optic nerve, and hyperpigmentation of the area centralis, but all of these abnormalities were more common in the euthyroid cats than in the cats with hyperthyroidism. Active retinal lesions were only observed in 3 hyperthyroid cats (3%). The results of this study indicate that hyperthyroidism does not seem to be a frequent cause of abnormalities in the eyes of cats.

Gastrointestinal Disease and Its Management

Gastrointestinal (GI) diseases involving the alimentary tract and hepatobiliary system are common in geriatric dogs and cats. Inflammatory disorders predominate, but motility disturbances and degenerative lesions may also cause GI signs in affected animals. Treatment is directed at correction of the underlying cause and often requires tissue biopsy. The prognosis is good in many diseases with appropriate drug nutritional, and/or surgical therapy.

First workshop and clinic on neuropathology in geriatric dogs and cats. Wiesbaden, Germany, May 4-5, 1995

First workshop and clinic on neuropathology in geriatric dogs and cats. Wiesbaden, Germany, May 4-5, 1995

Respiratory Tract Tumors

Laryngeal and tracheal tumors are relatively rare in dogs and cats and best treated by surgical removal. Primary tumors also are rare and usually malignant and in an advanced clinical stage at the time of diagnosis. Metastatic pulmonary disease is a frequent sequela to many forms of cancer in geriatric dogs and cats; definitive treatment is rarely successful.

Behavioral Problems of Geriatric Dogs and Cats

Dogs and cats that have been perfectly acceptable pets for many years may develop behavioral problems with old age. Most often these problems develop in animals that have never been very well behaved but have been tolerated by the owners until the problem has somehow exacerbated secondary to some other geriatric problem. The behavioral problems of old dogs most likely to be encountered by the practitioner are those of deaf dogs, dogs that house-soil because of renal, cardiovascular or gastrointestinal problems, and dogs that are aggressive because of a change in the number of animals or humans in the household or that are aggressive secondary to a chronic painful condition such as arthritis. Common feline problems may concern changes in the cat's environment. The treatment of behavioral problems of old animals is similar to the treatment of the problems of young animals, except that the physical limitations and disabilities of the old, usually ill, animal must be considered. Owners should be advised of the behavioral problems that may occur secondary to degenerative diseases and also be persuaded to keep social and environmental changes to a minimum in an old animal's life.