Canine geriatrics

Aging is a complex biological process. It leads to the progressive loss of the organism’s capabilities to maintain a state of equilibrium against internal (i.e. diseases) or external aggressors. Aging is therefore not a disease so to speak but a normal evolution of the body leading to gradual organ failure.

Geriatric medicine deals with the physical, mental, functional and social conditions of aged animals. It includes the prevention, the rehabilitation and the care and treatment of both acute and chronic conditions. It is the future of veterinary medicine seeing as the “senior” age class continues to grow amongst our patients.

In general, this group of patients can demonstrate different progressive pathologies that can co-exist which require a global and comprehensive approach. The main objective is to optimize the functional state and improve the quality of life of our patients (which will indirectly influence the quality of life of their owners). Geriatric medicine does not necessarily involve adding years to our patient’s life, but entails offering a better life to their remaining years!

A prolonged life expectancy of our furry friends, the intensified human-animal bond and owners that have become increasingly concerned about the well-being of their companion are a few of the many situations our veterinarians are confronted with due to the older age of our patients. A diagnostic plan adapted to each animal is established in order to detect early diseases for which their outcomes are still manageable. The physical health examination which was once annual now becomes bi-annual. Diagnostic tests would need to be added as well, which can provide information on the state of the internal organs and the function of hormones; these tests can also enable the detection of certain conditions prior to the onset of symptoms. Even though these tests are normal, they are extremely important, for they provide the veterinarian with values of comparison that they can base themselves on to analyze the evolution of the health of your animal throughout the years. A physical examination of a geriatric animal is much more complex than a simple physical examination. It includes a standard physical examination as well as a more profound examination of the eyes and the oral cavity, palpation of the thyroid gland, an evaluation of the main articulations as well as a rectal exam.

It is due to the information available concerning the most common conditions affecting our geriatric patients that it is possible to establish a standard geriatric health examination, which consists of:

Physical exam: In addition to the standard physical exam, the veterinarian searches for physical signs of cancer, arthritis, cardiac or pulmonary disease, periodontal disease and/or cataracts as well as an evaluation of the body weight of your dog.

Hematology: Allows for the diagnosis of infections, anemia, and certain types of cancer as well as coagulation and/or immune deficiencies.

Biochemistry: Allows for the detection of hepatic and renal diseases as well as endocrine conditions such as diabetes or Cushing’s disease.

Urine analysis: With a urine sample, the veterinarian can diagnose a renal disease, diabetes, a urinary tract infection as well as urinary crystals.

Stool analysis: Allows for the detection of intestinal parasites as well as bacterial overgrowth (may require more than one test!)

Additional tests: Depending on the health status of your animal, the veterinarian may insist on additional tests such as: measuring the arterial blood pressure, x-rays, ultrasound, electrocardiogram, and an evaluation of the thyroid gland (suspect: hypothyroidism), the adrenal glands (suspect: Cushing or Addison disease), the liver, the pancreas as well as intestinal function.

One can observe one or many of the following signs as your animal gets older:

Difficulty in climbing and/or descending stairs;
Difficulty in jumping (over obstacles, in cars…)
Stiffness in the articulations (difficulty in getting up, stiffness in the gait…)
Frequent “accidents” (urine and stools) in the house
Increase in thirst and need to urinate
Decrease in activity level
Excessive panting
Behavioral changes/cognitive changes: circling, repetitive movements, confusion, disorientation, excessive barking, less interaction with family members, less responsive when called, refuse to interact with family members when they return home.
Tremors/excessive shaking
Changes in the quality of the coat
Changes in sleep patterns
Decrease in appetite
Weight loss or gain

Periodontal disease: Infection of the dental roots and inflammation of the gums which can cause a great amount of pain to your animal. This condition can allow for the loss of teeth, bad breath and can be responsible for cardiac and renal problems. Such a disease can reduce your animal’s life expectancy and quality of life.

Obesity: Aging is accompanied by a slowing of the metabolism as well as a reduction of your animal’s physical activity level. Nowadays, more than half of the canine population weigh more than their ideal weight or can even be considered to be obese. Consequently, these animals are more at risk of serious diseases such as arthritis; diabetes; cardiovascular, respiratory and/or musculo-skeletal conditions.

Endocrine diseases (i.e. Cushing, Diabetes, and Hypothyroidism): The function of the adrenal glands, the thyroid gland and the pancreas may be abnormal. These conditions have a direct impact on the cardiac function, the digestive system as well as the liver and the kidneys.

Renal and urinary diseases: Kidney failure appears most commonly in a chronic state. It causes biochemical and electrolytic imbalances, anemia, a reduced immune function, coagulation deficiencies as well as alterations of the mental capacities of the animal. Urinary tract infections are frequent and can sometimes pass unnoticed. Nevertheless, these conditions are painful and can predispose to the formation of bladder stones/crystals by altering the urinary pH.

Hepatic diseases: Liver failure causes biochemical imbalances, anemia, coagulation deficiencies, a reduced immune function as well as an alteration of the mental capacities of the animal.

Cardiac problems: Symptoms include coughing, difficulty breathing, fatigue and inability for physical activity.

Arthritis: Very common pathology for older dogs, causing chronic pain and limiting their daily activities.

Loss of vision: Aging predisposes animals to diseases such as cataracts (i.e. opaque crystalline) and nuclear sclerosis (i.e. normal aging of the crystalline that becomes blue)

Loss of hearing: Neurogenic deafness, encountered frequently in older dogs, is a common degenerative process which is unfortunately irreversible.

Cancer: The early detection of tumors is essential in order to maximize the success of existing treatments. Such treatments require multiple interventions and can bring forth many side effects.

Senility: A dog affected by the cognitive dysfunction syndrome can appear disoriented, lose the ability to retain their urine and stools, sleep more than usual and interact less with the family members. Contrary to popular belief, this condition is treatable. See text: The cognitive dysfunction syndrome.

As they age, the nutritional needs of your animal changes. This is due to the slowing of the metabolism; a general decline in the physical activity level; the emergence of certain pathological conditions and of a normal process named peroxidation (destruction of cells no longer needed, germs and parasites by free radicals which circulate throughout the organism). High quality diets with the following characteristics are intended for older dogs:

Calories: An older dog requires a diet with fewer calories to prevent obesity and additional health problems.

Antioxidants: Peroxidation is a normal process, essential for the proper functioning of the organism. Since this process acts equally on healthy cells and their effects are cumulative, it is common to have a decrease in immunity as well as revealing indications of aging cerebral function. Antioxidants such as vitamin C and E, beta-carotene and selenium are added in large amounts for specific diets targeted for older dogs. Certain molecules such as lipoic acid and carnitine, when present in large enough quantities, limit the amount of free radicals that are produced by the organism. Omega 3 fatty acids allow for a healthy cellular membrane, thereby increasing the resistance of cells to the normal process of peroxidation.

Proteins: High quality proteins, in smaller quantities, help maintain healthy renal and cardiac function.

Fibers: Since constipation is most commonly due to the decline in the physical activity level of older dogs, it is important to increase the quantity of fiber available in the diet.

Minerals: Certain minerals such as phosphorus and sodium are present in moderate amounts in order to favor healthy renal and cardiac function.

Fatty acids: High quality fatty acids found in the diet limit the damages caused to the cartilages; help in maintaining healthy renal function; and limit the oxidative damages.