Nursing the Geriatric Cat

Question 1

what age cats are considered senior?

Answer 1

11-14 years

Question 2

what age cats are considered geriatric?

Answer 2

15+ years

Question 3

what conditions commonly affect geriatric cats?

Answer 3

hyperthyroidism

hypertension

CKD

feline cognitive dysfunction

dental disease

DJD

diabetes mellitus

intestinal lymphoma

inflammatory bowel disease

Question 4

what are the main signs of hyperthyroidism?

Answer 4

increased thirst, urination, appetite, weight loss

Question 5

what systolic value is considered hypertensive?

Answer 5

> 160mmHg

Question 6

what is the main issue associated with hypertension in geriatric cats?

Answer 6

vision issues - dilated pupils, blood in eyes, blindness

Question 7

what are the main signs of CKD in geriatric cats?

Answer 7

lethargy, unkempt, weight loss, urine and blood build up of waste products

Question 8

what are the main dental issues affecting geriatric cats?

Answer 8

gingivitis
periodontal disease
tooth resorption

Question 9

what type of DJD are geriatric cats affected by?

Answer 9

osteoarthritis

Question 10

why is inflammatory bowel disease sometime hard to identify in cats?

Answer 10

cats become ravenous because they cannot absorb the food they are eating - often misidentified for hyperthyroid initially

Question 11

how can we begin to detect disease in geriatric cats?

Answer 11

pre-assessment forms - behavioural changes, other pets, household changes, current medications

history - parasite control, vaccination status, diet (&changes), confirm signalment

diagnostic parameters

clinical examination

Question 12

what is the ideal standard feline consultation structure?

Answer 12

history-taking - pre-assessment form discussion, weight

BP measurement + discuss

clinical exam + discuss

diagnostic tests if required + discuss

recommendations

summarise and arrange a revisit

Question 13

how does discussion of each point of the consultation help cats?

Answer 13

breaks up appointments, gives cat a break

Question 14

what recommendations should we be giving about feline senior diets?

Answer 14

reduced energy, fat, calcium, phosphorous (kidney support)

increased fibre (not if underweight)

encourage wet over dry for hydration

Question 15

what recommendations should we be giving around water intake for healthy senior cats?

Answer 15

very important in maintaining acid-base balance and osmoregulation

should always be readily available - how many + where

methods of encouraging water intake

periodic measurement of water intake - 6 monthly

Question 16

why is it important to regularly monitor senior cats weight?

Answer 16

to ascertain trends - small mount lost monthly can add up and be indicative of a larger issue

calculate % loss

Question 17

how can we calculate % weight loss?

Answer 17

(difference in weight / original weight) x 100

Question 18

at what % weight loss would we be concerned?

Answer 18

5-10% is significant weight loss

> 10% is serious

Question 19

when is hypertension seen in cats?

Answer 19

primary - not common

secondary - CKD, hyperthyroidism, endocrine disorders

Question 20

what are the ocular effects of hypertension?

Answer 20

retinal oedema

retinal haemorrhage

retinal detachment

Question 21

what does hypertension do to the CVS?

Answer 21

left ventricular hypertrophy

Question 22

what does hypertension do tot he kidneys?

Answer 22

progressive renal failure

Question 23

what neurological signs are can be caused by hypertension?

Answer 23

bleeding into the CNS

ataxia

disorientation

seizures

coma/sudden death

Question 24

what do we need to consider when taking a blood pressure?

Answer 24

situational hypertension - can we do home visit?

travelling hypertension - how did they get here?

area for appointment - quiet, no foot traffic, dedicated room

Question 25

which aspect of the tail should the doppler probe be placed on?

Answer 25

ventral aspect - run finger along until find tiny dip in tail bone

Question 26

what is considered a hypotensive BP?

Answer 26

SBP <120mmHg

Question 27

what might cause hypotension in cats?

Answer 27

heart failure, shock, hypovolaemia

Question 28

what is a normal BP in cats?

Answer 28

120-160mmHg SBP

Question 29

what is considered a hypertensive BP?

Answer 29

>180mmHg

Question 30

what can a SBP of 160-180mmHg be attributed to?

Answer 30

"grey area" - can be due to stress

Question 31

how can we make our clinical examination more cat-friendly?

Answer 31

use a clinical examination form to direct handling allow cat to come out of carrier of own accord (if possible) do not restrict to the examination table use a non-slip mat, blankets, bedding examine from head-to-toe

Question 32

how might we identify DJD in senior cats?

Answer 32

examine/gait observation/behaviour/home videos stilted on hindlimbs t-l spine arched muscle loss over femurs goes to sit in sternal then rolls into lateral to improve comfort

Question 33

how can we assess the respiratory system of senior cats

Answer 33

auscultate systematically observe pattern as well as rate

Question 34

how can we perform a very basic check of thyroid function?

Answer 34

palpate neck for a thyroid goitre

Question 35

how should we examine the muscles and joints?

Answer 35

check both asymmetry and range of motion

Question 36

what are the advantages of urinalysis?

Answer 36

gives basic useful information cheap and easy variable collection techniques

Question 37

what are the normal urine parameters in terms of: USG, protein, blood, glucose, ketones, UPC

Answer 37

USG >1.035 protein ≤1+ blood -ve glucose -ve ketones -ve UPC <0.2

Question 38

what can we check for in urine under the microscope?

Answer 38

sediment and bacteriology

Question 39

should cats be starved for blood samples?

Answer 39

yes, generally 6 hours

Question 40

how does EDTA contamination affect blood results?

Answer 40

will increase potassium results

Question 41

what is important to remember when checking feline blood glucose?

Answer 41

ensure calibrated to feline setting - cats have smaller/different shape blood cells to dogs

Question 42

what type of T4 should we test for and why?

Answer 42

request total T4 - total is more specific/cheaper initially free T4 not influenced by other illnesses but more expensive

Question 43

how can we accommodate older cats during restraint?

Answer 43

consider temperament, presence of disease/injury, preference, age (DJD?) push from behind to extend limbs rather than pull try not to restrain legs if possible - towel wrap?