The senior patient Flashcards
What is the difference between senior & geriatric pet?
Senior: reached the last 1/4 of its life
Geriatric: living past it’s expected lifespan
Chornological age vs biological age?
Chronological age: how long u been alive
Biological age: how cells and tissues have aged based on physiological evidence
Frailty ?
Dec functional reserve; decline in physiological and cognitive performance, vulnerable to dx, more suceptible to drug effects
Immunosenescence
Immune dysfunction, remodelling of lymphoid tissues, suceptible to infections, autoimmune disease and neoplasia
Inflammaging?
chornic inflammation
also caused by obesity
What to monitor when monitoring for early detection
- CV dx
- Chronic renal dx
- Cognitive dysfunction
- OA
- Immune problems
- Neoplasia
- Thyroid problems
- Diabetes mellitus
- Cushing’s dx
- Vision & hearing
- Dental dx
- Multiple organ involvement
Heart dx concerns in dogs?
- MMVD
- DCM
- Pericardial dx
- Arrythmia
- Systemic hypertension
What CV dx in senior cats?
- Hypertrophic CM
- Systemic hypertension
CLS of Heart dx?
- Lethargy, syncope, cough, exercise intolerance, inc resp rate
- PE: murmur, arrythmia, pulse deficit, weak pulses, retinal bleeds
What heart diagnostics might we do?
Echo, NT-proBNP, cardiac troponins, BP, Holter monitor, RR
Main Renal issues seen in older pets?
- Reduced GFR, glomerulosclerosis, interstitial fibrosis
CLS of renaldx?
Lethargy, anorexia, weight loss, V+ PUPD, incontinence
Diagnosis of renal dx?
Cachexia, oral ulcers, abnormal kidney palpation, low SG, proteinuria,
anaemia, hypertension and retinal changes, uraemia and elevated SDMA,
electrolyte imbalance, radiography, ultrasonography
Tx for renal dx
- NUTRITION, ACE-inhibitors, ARBs; anti-hypertensives; electrolytes; fluids* Monitor: Urinalysis; UPC; CBC; chem; BP; weight; eye exam
Neuro exam in older pets?
- similar to aleimers dx - beta amyloid plaques/ senile plaques
- IC dx?
- Chronic pain related to anxiety?
what drug may help cognitive decline ?
Selegiline
What does DISHAA stand for?
- Disorientation; social Interaction; Sleep-wake cycle; Housetraining; Activity; Anxiety
MSK in odl animals?
OA -> cats hide pain and rarely have crepitus
Immune system in older animals?
Immunosenescence - reduced response
Auto-immune dx
neoplasia
better to have them vaccinated
Common neoplasia in dogs?
Common neoplasia in Cats?
- Lymphoma
- SCC
- Soft tissue sarcoma
- Injeciton site sarcoma
Neoplasia CLS?
Weight los, anorexia, V+, D+ dyspnoea, coughing, limping, PUPD, palpable mass, pain, bhvr changes, haematuria
HyperT in cats?
Weight loss, hyperactive, aggressive, tachyP,tachyC, poor cat, V+ D+ pupd polyphagua
Dx: total T4 & free T4
Tx: Medical - carbimazole, methimazole, diet
Surgical - thyroidectomy
radioactive iodine
Hypothyroidism CLS & Dx?
Weight gain, lethargy, ‘sad ‘ expression, mental dullness, alopecia and coat changes, bradycardia, inappetence, anaemia
Dx: Pe, CB, biochem, TT4, TSH
Tx: Levothyroxine
Diabetes mellitus?
CLs: PUPD, polyphagia, weight loss, blindness, DA, neuropathy
Dx: Blood glucose, fructosamine, urinalysis & culture
Tx: insulin diet exercsie glucose monitoring
Vision
- dec vision
- Hardening of lens - loss of focus
Hearing?
- Progressive loss
- Sudden change due to compensation
Dental dx?
- Periodontal dx & oral neoplasia
- Inc risk of pathological bone fractures due to loss of bone density
- effect on systmeic health: periodontitis leads to chornic inflammatory dx process
Senior & geriatric screeening protocols?
done annually or 6 monthly
- Clinical exam (including dental checks and BCS)
- Preventative medicine (annual vaccines, parasites)
- Screening protocols (haematology/biochemistry/urinalysis)
- T4 and blood pressure (cats)
- May include radiographs or ultrasound
Minimum geriatric database in dogs?
- PE
- Haematology
- Biochemistry
- Urinalysis with UPC
Minimum geritric databas ein cats?
- PE
- Haematology
- Biochem (incl SDMA)
- Urinamysis with UPC
- Total T4
- BP
Vision & hearting recommendations for owners
Vision
* Night-lights, stair lights, lit up feeding areas, don’t rearrange furniture, close
pools, pet gates, halo, avoid startling them
Hearing
* Use visual cues, scent
Mobility recommendations?
non slip floors (yoga mats), ramps, non clip booties, strollers, swimming
Skin health recommendations?
brushing, bathing, diet
Cognitive problems/ restlessness recommendations?
Analgesia, anti-anxiety meds, sedatives
When is euthanasia appropriate?
- QoL - uncontroleld pain, temrinal dx
- Welfare concerns - patient unable to function
QoL charts helpful & pain scoring
What three areas of QoL
Emotional
Social
Physical
