The Geriatric Cat

Question 1

what age is a cat classed as senior?

Answer 1

11-14 years

Question 2

what age is a cat classed as geriatric?

Answer 2

15+ years

Question 3

what are the common conditions seen in geriatric cats?

Answer 3

hyperthyroidism
hypertension
CKD
feline cognitive dysfunction (FCD)
dental disease
degenerative joint disease
diabetes mellitus
intestinal lymphoma
inflammatory bowl disease

Question 4

what are the signs of hyperthyroidism?

Answer 4

PUPD
increased appetite
weight loss

Question 5

what are the signs of hypertension?

Answer 5

systolic BP >160mmHg
vision issues
dilated pupils
blood in eye
blindness

Question 6

what are the signs of CKD?

Answer 6

lethargic
unkempt
weight loss
azotemia
submaximally concentrated urine

Question 7

what percentage of cats are affected by FCD?

Answer 7

more than 50% over 11 years old and more than 80% over 16 years old

Question 8

what is crucial when managing a cat with FCD?

Answer 8

stability of the home environment

Question 9

what are the main dental diseases seen in older cats?

Answer 9

gingivitis
periodontal disease
tooth resorption

Question 10

what are the signs of diabetes melitus?

Answer 10

PUPD
increased appetite
weight loss

Question 11

what are the signs of intestinal lymphoma?

Answer 11

digestive issues

Question 12

what percentage of feline cancer diagnoses are intestinal lymphoma?

Answer 12

30%

Question 13

what are the signs of inflammatory bowel disease?

Answer 13

cat becomes ravenous as they cannot absorb the food they are eating

Question 14

when should inflammatory bowel disease be considered?

Answer 14

alongside differential for hyperthyroidism

Question 15

how can diseases in the geriatric cat be detected?

Answer 15

pre-assessment forms
history
parameters
clinical exam

Question 16

what can be discussed on a pre-assessment form to detect disease?

Answer 16

behavioural changes
other pets (behaviour towards)
household changes
current medication

Question 17

what can be discussed when taking patient history to detect disease?

Answer 17

parasite control
vaccination status
any diet changes
confirm signalment

Question 18

what may cause behavioural changes in senior cats?

Answer 18

pain
FCD

Question 19

how should a geriatric nurse consult be structured?

Answer 19

history taking
weigh
blood pressure measurement - discuss findings
clinical exam - discuss findings
diagnostic tests if required
recommendations
summerise and arrange revisit

Question 20

what does the order of a nurse consult ultimately depend on?

Answer 20

individual patient

Question 21

what recommendations may be made during a geriatric nurse consult?

Answer 21

set up at home
routine
need for referral

Question 22

what type of food should senior cats be fed?

Answer 22

wet rather than dry to improve water intake

Question 23

how should diet changes be made?

Answer 23

gradually

Question 24

what are the main aspects of a senior diet?

Answer 24

reduced energy
reduced fat
reduced calcium
reduced phosphorus
increased fibre

Question 25

why is it important that senior diets have reduced energy and fat?

Answer 25

less active

Question 26

why is it important that senior diets have reduced calcium and phosphorus?

Answer 26

supports the kidneys

Question 27

why is it important that senior diets have increased fibre?

Answer 27

increase satiety and support weight loss prevent constipation

Question 28

what is water vital for?

Answer 28

maintaining acid base balance osmoregulation

Question 29

how can cats be encouraged to drink?

Answer 29

always have water readily available cats +1 round the house different bowl types fountains water in food

Question 30

how often should water intake be measured?

Answer 30

6 monthly even in multi-cat households

Question 31

how can % weight change be calculated?

Answer 31

(difference in weight / original weight) x100%

Question 32

what should be done if a 5% weight change is seen?

Answer 32

may not be significant - monitor monthly

Question 33

what should be done if a 5-10% weightloss is seen?

Answer 33

significant - intervention needed

Question 34

what should be done if a >10% weightloss is seen?

Answer 34

serious - diagnostic tests needed

Question 35

what patients should have their blood pressure measured?

Answer 35

all older cats

Question 36

is primary hypertension common?

Answer 36

seen but not that common

Question 37

when is secondary hypertension seen?

Answer 37

CKD hyperthyroidism other endocrine disorders

Question 38

what are the systemic effects of hypertension?

Answer 38

occular damage (retinal oedema/detachment) left ventricular hypertrophy progressive renal failure bleeding into CNS ataxia disorientation seizures coma sudden death

Question 39

what methods of indirect BP measurement are there?

Answer 39

oscillometric doppler

Question 40

what is the downside of oscillometric BP measurement?

Answer 40

not great if patient moves

Question 41

what should be considered when taking BP measurements?

Answer 41

situational hypertension traveling impact on hypertension think about the venue where BP is to be measured

Question 42

describe the process of BP measurement

Answer 42

select suitable cuff clip and listen for pulse once pulse heard inflate sphygmomanometer to 20mmHg above the point where the sound of the pulse is lost release air out of the cuff until pulse is heard again repeat measurement 3-5 times and take and average

Question 43

where can BP be measured from?

Answer 43

tail limbs

Question 44

what is indicated by a SBP of <120mmHg?

Answer 44

hypotension heart failure shock hypovolaemia

Question 45

what is indicated by a SBP of 120-160mmHg?

Answer 45

normal

Question 46

what is indicated by a SBP of 160-180mmHg?

Answer 46

grey area could be due to stress

Question 47

what is indicated by a SBP of >180mmHg?

Answer 47

hypertension CRF hyperthyroidism endocrine disorders

Question 48

what are the key areas to consider when doing a clinical exam on a cat?

Answer 48

allow cat to come out of its basket of it's own accord don't restrict them to the exam table if safe use non-slip mats and bedding full head to toe exam assess gait

Question 49

what may be seen on gait assessment which indicates DJD?

Answer 49

stilted on HL thoracolumbar spine arched muscle loss over femurs goes to sit in sternal and rolls into lateral for comfort

Question 50

what are the key parts of a clinical exam for a geriatric patient?

Answer 50

auscultate systematically observe respiratory pattern and rate check for goitre examine muscles and joints for asymmetry and ROM

Question 51

what are the 2 most common tests used to screen geriatric cats?

Answer 51

urinalysis blood analysis

Question 52

what is the benefit of urinalysis?

Answer 52

basic useful information cheap easy

Question 53

what needs to be considered about urinalysis for cats?

Answer 53

collection method

Question 54

what is a normal urine dipstick reading?

Answer 54

SG >1.035 protein <1+ blood - gluconse - ketones - UPC <0.2

Question 55

what is the benefit of blood sampling?

Answer 55

useful information assess major body systems and organs

Question 56

what are the downsides of blood sampling?

Answer 56

restraint may be painful cat needs to be starved (+6 hours) expensive

Question 57

why must biochemistry not be EDTA contaminated?

Answer 57

EDTA will increase potassium levels

Question 58

why must glucose monitors be calibrated to cats when testing cat samples?

Answer 58

glucose ratio in plasma and RBC differs between cats and dogs

Question 59

what must be taken into consideration when restraining cats?

Answer 59

accommodate individual consider temperament disease/injury patient preference age

Question 60

what percentage of cats over 12 years old have radiographic changes associated with DJD?

Answer 60

90%

Question 61

what is the gentlest way to extend patient limbs for IV/blood sampling?

Answer 61

handler to push

Question 62

why is providing support and literature for owners so crucial?

Answer 62

can give information from reputable sources prevent googling and scaring themselves/finding unreliable information

Question 63

who are the best people to run cat clinics?

Answer 63

nurses those with special interest

Question 64

where should cat clinics be held?

Answer 64

quiet area seperate entrance won't be interupted

Question 65

when should cat nurse consults be held?

Answer 65

quiet time of day not end of day to reduce client and nurse stress early morning for starved cats?

Question 66

how long do cat consults need to be?

Answer 66

<30 mins

Question 67

how can you promote cat clinics?

Answer 67

mailing list cards for cats over 10 vets promote in vaccines discuss initially at kitten checks social media reception