The senior patient

Question 1

What is the difference between senior & geriatric pet?

Answer 1

Senior: reached the last 1/4 of its life
Geriatric: living past it’s expected lifespan

Question 2

Chornological age vs biological age?

Answer 2

Chronological age: how long u been alive
Biological age: how cells and tissues have aged based on physiological evidence

Question 3

Frailty ?

Answer 3

Dec functional reserve; decline in physiological and cognitive performance, vulnerable to dx, more suceptible to drug effects

Question 4

Immunosenescence

Answer 4

Immune dysfunction, remodelling of lymphoid tissues, suceptible to infections, autoimmune disease and neoplasia

Question 5

Inflammaging?

Answer 5

chornic inflammation

also caused by obesity

Question 6

What to monitor when monitoring for early detection

Answer 6

• 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

Question 6

Heart dx concerns in dogs?

Answer 6

• MMVD
• DCM
• Pericardial dx
• Arrythmia
• Systemic hypertension

Question 7

What CV dx in senior cats?

Answer 7

• Hypertrophic CM
• Systemic hypertension

Question 8

CLS of Heart dx?

Answer 8

• Lethargy, syncope, cough, exercise intolerance, inc resp rate
• PE: murmur, arrythmia, pulse deficit, weak pulses, retinal bleeds

Question 9

What heart diagnostics might we do?

Answer 9

Echo, NT-proBNP, cardiac troponins, BP, Holter monitor, RR

Question 10

Main Renal issues seen in older pets?

Answer 10

• Reduced GFR, glomerulosclerosis, interstitial fibrosis

Question 11

CLS of renaldx?

Answer 11

Lethargy, anorexia, weight loss, V+ PUPD, incontinence

Question 12

Diagnosis of renal dx?

Answer 12

Cachexia, oral ulcers, abnormal kidney palpation, low SG, proteinuria,
anaemia, hypertension and retinal changes, uraemia and elevated SDMA,
electrolyte imbalance, radiography, ultrasonography

Question 13

Tx for renal dx

Answer 13

• NUTRITION, ACE-inhibitors, ARBs; anti-hypertensives; electrolytes; fluids* Monitor: Urinalysis; UPC; CBC; chem; BP; weight; eye exam

Question 14

Neuro exam in older pets?

Answer 14

• similar to aleimers dx - beta amyloid plaques/ senile plaques
• IC dx?
• Chronic pain related to anxiety?

Question 15

what drug may help cognitive decline ?

Answer 15

Selegiline

Question 16

What does DISHAA stand for?

Answer 16

• Disorientation; social Interaction; Sleep-wake cycle; Housetraining; Activity; Anxiety

Question 17

MSK in odl animals?

Answer 17

OA -> cats hide pain and rarely have crepitus

Question 18

Immune system in older animals?

Answer 18

Immunosenescence - reduced response
Auto-immune dx
neoplasia

better to have them vaccinated

Question 19

Common neoplasia in dogs?

Answer 19

Question 20

Common neoplasia in Cats?

Answer 20

• Lymphoma
• SCC
• Soft tissue sarcoma
• Injeciton site sarcoma

Question 21

Neoplasia CLS?

Answer 21

Weight los, anorexia, V+, D+ dyspnoea, coughing, limping, PUPD, palpable mass, pain, bhvr changes, haematuria

Question 22

HyperT in cats?

Answer 22

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

Question 23

Hypothyroidism CLS & Dx?

Answer 23

Weight gain, lethargy, ‘sad ‘ expression, mental dullness, alopecia and coat changes, bradycardia, inappetence, anaemia
Dx: Pe, CB, biochem, TT4, TSH
Tx: Levothyroxine

Question 24

Diabetes mellitus?

Answer 24

CLs: PUPD, polyphagia, weight loss, blindness, DA, neuropathy
Dx: Blood glucose, fructosamine, urinalysis & culture
Tx: insulin diet exercsie glucose monitoring

Question 25

Vision

Answer 25

• dec vision
• Hardening of lens - loss of focus

Question 26

Hearing?

Answer 26

• Progressive loss
• Sudden change due to compensation

Question 27

Dental dx?

Answer 27

• 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

Question 28

Senior & geriatric screeening protocols?

done annually or 6 monthly

Answer 28

• 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

Question 29

Minimum geriatric database in dogs?

Answer 29

• PE
• Haematology
• Biochemistry
• Urinalysis with UPC

Question 30

Minimum geritric databas ein cats?

Answer 30

• PE
• Haematology
• Biochem (incl SDMA)
• Urinamysis with UPC
• Total T4
• BP

Question 31

Vision & hearting recommendations for owners

Answer 31

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

Question 32

Mobility recommendations?

Answer 32

non slip floors (yoga mats), ramps, non clip booties, strollers, swimming

Question 33

Skin health recommendations?

Answer 33

brushing, bathing, diet

Question 34

Cognitive problems/ restlessness recommendations?

Answer 34

Analgesia, anti-anxiety meds, sedatives

Question 35

When is euthanasia appropriate?

Answer 35

• QoL - uncontroleld pain, temrinal dx
• Welfare concerns - patient unable to function

QoL charts helpful & pain scoring

Question 36

What three areas of QoL

Answer 36

Emotional
Social
Physical