Top five health problems in older cats

What are the common health problems in older cats?

1. Hyperthyroidism in cats

2. Hypertension in cats

3. Chronic Kidney Disease in cats

4. Dental disease in cats

5. Arthritis in cats

1. What causes hyperthyroidism in older cats?

An overactive thyroid is very common in cats over 10 years of age. It is usually due to a non cancerous enlargement of one or both thyroid glands either side of their windpipe, which increases the amount of thyroid hormone the cat produces. Some rare cases of hyperthyroid cases are caused by a malignant tumour of the thyroid gland. Signs to look out for in your older cat include:

• Weight loss in spite of a ravenous appetite

• Drinking more water than usual

• Vomiting and diarrhoea

• Vocalising more often

• Sometimes a goitre (swelling) can be felt either side of the windpipe.

• A few cats however, become inappetent and lethargic with hyperthyroidism.

How is hyperthyroidism diagnosed and treated in older cats?

Hyperthyroidism can be easily detected with a blood test to measure thyroxine (T4) levels. If T4 levels are raised then treatment can be started in the form of tablets, liquid oral medication or a transdermal application (medication applied to the skin). An iodine restricted diet is also available as a management option in the form of Hills y/d. Iodine controls how active the thyroid glands are, so an iodine restricted diet can stabilise the thyroid levels. However no other food must be fed otherwise it is ineffective. Curative options include surgical thyroidectomy (removal of the thyroid gland(s) ) and radioactive iodine therapy.

Regular blood tests are needed for cats on medication to ensure their thyroid levels remain stable and to check the function of the kidneys.

2. What causes hypertension in older cats?

High blood pressure is usually secondary to other diseases such as hyperthyroidism and kidney disease. Less commonly, it occurs as a primary disease. Untreated high blood pressure can cause blindness due to detachment of the retina at the back of the eye. It can also cause damage to the brain, heart and kidneys. Symptoms may include:

• Bumping into things (sudden onset blindness)

• Depression and lethargy

• Breathing difficulties

• Dragging one or both hind-limbs

• Odd behaviour, wobbliness or seizures

• Signs of kidney disease (see below)

How is hypertension diagnosed and treated in older cats?

Many cats, however, have no obvious symptoms until their hypertension has deteriorated and caused damage to the eyes. As a result, sudden onset of blindness may be the first sign that we notice. Six monthly blood pressure checks in all cats over the age of 10 years are recommended. Blood pressure checks help spot changes in blood pressure early and reduce the risk of hypertension progressing undetected. Blood pressure measurements are very easy to do in the clinic; they are non-invasive and painless.

If your cat has high blood pressure, then medication can be prescribed by your vet to control it. Your vet will recommend regular follow up appointments to monitor blood pressure.

3. What causes Chronic Kidney Disease (CKD) in older cats

CKD can occur in cats of any age, but is more commonly seen in cats over 7 years of age. Kidneys are responsible for excreting waste via urine, regulating electrolytes in the body, producing certain hormones and regulating fluid balance in the body.

How is CKD diagnosed in older cats?

When a cat has CKD their kidney function declines. This can be detected with a blood test. Kidneys have a very large functional reserve, which means that they can lose a lot of their functionality before your pet shows signs of ill health. Unfortunately, by the time CKD is detected on a blood test, around 70% of kidney function has already been lost. In order to help your cat, you can monitor for the following signs:

• Urinating more

• Drinking more water

• Lethargy

• Poor appetite

• Weight loss

• Bad breath

• Poor coat

How is CKD treated in older cats?

Sadly, CKD is not reversible. However, the disease can be slowed down and supported by ensuring adequate fluid intake, making dietary changes, and using medications and supplements. The aim of management is to improve your cat's quality of life and slow the progression of the disease.

Cats with CKD need to be fed a diet consisting of a restricted amount of highly digestible protein. This needs to be done with care because too little protein is detrimental to their health. Dietary phosphorus levels need to be restricted because reduced kidney function means the cat is unable to process normal levels of phosphorus in regular cat foods. Prescription diets for kidney disease are available which account for these specific dietary needs. However, some cats find them unpalatable. In these cases, a phosphate binder can be added to their normal diet, to reduce the levels of phosphorus absorbed in the intestine. Other dietary benefits may include the addition of antioxidants and potassium supplementation, if tests show that their levels are too low.

Water intake is very important for cats with CKD because they cannot concentrate their urine very well. When too much water is lost through the urine, cats are at risk of dehydration. Therefore, water fountains are beneficial if your cat likes running water. Alternatively, multiple water bowls can be placed around the house to encourage water intake. Some cats prefer bottled or filtered water compared to tap water. Wide brimmed, ceramic bowls are often preferred to metal or plastic bowls. Wet foods are advantageous compared to dry foods, as they contain approximately 80% water. Litter tray hygiene and availability is very important because cats with CKD usually urinate more often.

4. Dental disease in older cats

Many older cats suffer from dental disease and will continue to eat even when their teeth are in terrible condition. They may only stop eating if the pain becomes very severe. Symptoms of dental disease may include:

• Pawing at the mouth

• Chewing on one side

• Teeth chattering

• Stepping back from the food bowl or hissing at it on occasion

• Bad breath.

How is dental disease diagnosed and treated in older cats?

Regular dental checks performed by your vet are important to detect dental disease early and start treatment. At home prevention of dental disease includes daily toothbrushing - which is easier said than done as a lot of older cats may not tolerate this. It is always ideal to start a programme of home oral care from an early age. There are oral gels and additives to the food or water which may help reduce the amount of bacteria and plaque on the teeth. They are not suitable for all cats though so it is sensible to discuss this with your vet. To improve your cat's quality of life it's important to get dental disease treated by your vet as soon as possible and not to be fooled into thinking their teeth are not causing them pain just because they continue to eat.

5. Arthritis in older cats

As cats get older their joints undergo the same arthritic changes that we experience. As the disease progresses you may see the following:

• Reluctance to jump

• Stiffness on waking

• Frequent grooming over sore joints

• Changes in behaviour

• Matted coat or reduced grooming

Anti inflammatory pain relief prescribed or administered by your vet can make your cat comfortable and improve their quality of life. Minor changes such as ramps or steps to favourite sleeping areas can help cats access areas they were previously finding painful. Ensure their litter tray is easily accessible and large enough for them to turn around comfortably in. It is important that there are no high sides that they might find painful to climb over to get in the tray.

Providing horizontal scratch mats as well as vertical scratch posts so the cat has a choice which is more comfortable to scratch. Joint supplements may help in the way of glucosamine, green lipped mussel and omega oils. Maintaining a healthy weight is important as obesity increases the workload on already sore joints.

When to visit your vet?

If you notice changes to your cat's habits such as appetite changes, weight loss, drinking more water, urinating more or behavioural changes, it's best to get them examined by your cat friendly vet to catch any age related issues early. Managing age related issues early on increases your cat's quality of life and in some cases can prolong it.

Further reading

Chronic Kidney Disease (CKD) in cats

Tops tips for cats with urinary or kidney disease

Is my cat too fat or too skinny? A guide to body condition scoring in cats

Cardiomyopathy (Heart Disease) in Cats

Help! My cat has bad breath

Arthritis & Degenerative Joint Disease in Cats

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This article was written by Amy Everden RVN, CSQP, ISFM CertFN. Amy is a registered veterinary nurse (RVN) who has worked in a variety of first opinion and 24 hour veterinary hospitals. In 2019 she completed her certificate in Feline Nursing with distinction.