Canine Geriatric Medicine

Michael Schaer, DVM
Geriatrics: The branch of medicine dealing with the problems of ageing and diseases of the older animal.

How old is old?
Giant:  > 7 years
Medium:  > 9-10 years
Small:  > 10 years

The Big Baddies

  • Cancer
  • Renal failure
  • Heart failure
  • Chronic progressive lung disease
  • End stage liver
  • Necrotizing pancreatitis
  • Intestinal volvulus


Signs of Chronic Illness

  • Weight loss
  • Increased thirst/urination
  • Cough
  • Weakness
  • Persistent vomiting/diarrhea
  • Altered mental state

Signs of Acute Illness

  • Sudden vomiting/diarrhea
  • Mental depression
  • Anorexia
  • Difficulty breathing
  • Pain
  • Weakness
  • Seizures/fainting
  • Fever

Vomiting  DDX (Differential diagnosis)

  • Gastric irritation
  • Pancreatitis
  • Major organ dysfunction
  • Intoxication
  • GI obstruction: foreign body/tumor
  • Metabolic disease: DKA, hypercalcemia

Vomiting  Data Base
CBC
Serum chemistries
Radiographs: chest/abdomen
Ultrasound: abdomen

Fever  DDX
Infection
Immune
Neoplasia
Metabolic
Excitement/environment
Necrosis
Drug reaction

Fever Data Base
Thorough history
CBC
Serum chemistry
Urinalysis and/or culture
Radiographs: chest/abdomen
Serology where indicated
Cytology and culture  where indicated

Weakness  DDX
Neurological
Muscular
Orthopedic
Metabolic
Cardiovascular
Anemia
Any chronic debilitating illness

Weakness  Data Base
Thorough Hx
Meticulous PE
CBC
Serum chemistries
ECG
Others as needed

Increased Thirst/Urination  DDX
Diabetes mellitus
Diabetes insipidus
Chronic renal disease
Pyometra
Cushings
Chronic liver disease
Psychogenic PD (polydypsia – increased thirst)
Hyperthyroid
Diuretic drugs/others
Hypercalcemia

Data Base for PD/PU (polydypsia/polyuria – increased thirst, increased urination)
CBC
Serum chemistry profile
Urinalysis and/or culture
o And/or radiographs
o And/or abdominal ultrasound

Labored Breathing  DDX
Pleural space  fluid, masses
Heart  congestive failure, dysrhythmias
Lung  edema, inflammation, infiltrate

Minimal Data Base for Dyspnea (difficult breathing)
Chest radiographs
CBC
Serum chemistries
Urinalysis
Heartworm test; other serology
ECG and/or echocardiogram
Cytology or biopsy

Adverse Drug Reactions
More common than most think
Difficult to predict
Individual variation
Can occur with any single drug
Drug interactions also common

Phenothiazine tranquilizers:  Severe hypotension, prolonged sedation
Ace inhibitors: Renal failure
Metronidazole: Neurotoxicity
Cimetidine:  P450 inhibitor
Theophylline:  Restlessness, GI, neuro

Common Sense Rules
Keep blind pets away from swimming pools
Keep deaf pets away from traffic
Provide roughened floor surface for weak animals
Second guessing can jeopardize your pet
Don”t mess with Mother Nature
Avoid excesses

The Dos
Do tend to their needs
Do feed appropriately
Water free choice
Extra opportunities for natures ways
Yearly veterinary visits

The Don’ts
Don’t  restrict water
Don’t   ignore acute signs of illness
Don’t force exercise in hot weather
Don’t be your own doctor

Things to Avoid with the Geriatric Pet
Forced exercise in the unconditioned pet
Obesity
Water deprivation
Environmental temperature extremes
Unhealthy teeth
Ignoring abnormal signs or behavior
Mental stress

Old is NOT Dead
Animals die from disease or organ failure
They rarely die from old age
Age brings out the best in all of us right?

Dog Owners and Breeders Symposium
July 28, 2001
University of Florida
College of Veterinary Medicine