1. Creevy KE, Grady J, Little SE, et al. 2019 AAHA canine life stage guidelines. J Am Anim Hosp Assoc 2019;55(6):267–90.
  2. Quimby J, Gowland S, Carney HC, et al. 2021 AAHA/AAFP feline life stage guidelines. J Feline Med Surg 2021;23(3):211–33.
  3. Ray M, Carney HC, Boynton B, et al. 2021 AAFP feline senior care guidelines. J Feline Med Surg 2021;23(7):613–38.
  4. Hua J, Hoummady S, Muller C, et al. Assessment of frailty in aged dogs. Am J Vet Res 2016;77(12):1357–65.
  5. Banzato T, Franzo G, Di Maggio R, et al. A frailty index based on clinical data to quantify mortality risk in dogs. Sci Rep 2019;9(1):16749.
  6. Lian J, Yue Y, Yu W, et al. Immunosenescence: a key player in cancer development. J Hematol Oncol 2020;13(1):151.
  7. Kirkwood KL. Inflammaging. Immunol Invest 2018;47(8):770–3.
  8. Dysart LM, Coe JB, Adams CL. Analysis of solicitation of client concerns in companion animal practice. J Am Vet Med Assoc 2011;238(12): 1609–15.
  9. Sharifi-Rad J, Rayess YE, Rizk AA, et al. Turmeric and its major compound curcumin on health: bioactive effects and safety profiles for food, pharmaceutical, biotechnological and medicinal applications. Front Pharmacol 2020;11:01021.
  10. Burge K, Gunasekaran A, Eckert J, Chaaban H. Curcumin and intestinal inflammatory diseases: molecular mechanisms of protection. Int J Mol Sci 2019;20(8):1912.
  11. Enomoto M, Lascelles BDX, Gruen ME. Development of a checklist for the detection of degenerative joint disease-associated pain in cats. J Feline Med Surg 2020;22(12):1137–47.
  12. Gruen ME, Lascelles BDX, Colleran E, et al. 2022 AAHA pain management guidelines for dogs and cats. J Am Anim Hosp Assoc 2022;58(2): 55–76.
  13. Yin S. Low stress handling restraint and behavior modification of dogs & cats: techniques for developing patients who love their visits. 1st ed. Davis (CA): CattleDog Publishing; 2009.
  14. Carney HC, Little S, Brownlee-Tomasso D, et al. AAFP and ISFM feline-friendly nursing care guidelines. J Feline Med Surg 2012;14(5): 337–49.
  15. Slingerland LI, Hazewinkel HA, Meij BP, Picavet P, Voorhout G. Crosssectional study of the prevalence and clinical features of osteoarthritis in 100 cats. Vet J 2011;187(3):304–9.
  16. Grubb T, Sager J, Gaynor JS, et al. 2020 AAHA anesthesia and monitoring guidelines for dogs and cats. J Am Anim Hosp Assoc 2020;56(2):59–82.
  17. Bellows J, Berg ML, Dennis S, et al. 2019 AAHA dental care guidelines for dogs and cats. J Am Anim Hosp Assoc. 2019;55:49–69.
  18. Harvey CE, Shofer FS, Laster L. Association of age and body weight with periodontal disease in North American dogs [published correction appears in J Vet Dent 1994;11(4):133]. J Vet Dent 1994;11(3):94–105.
  19. Kouki MI, Papadimitriou SA, Kazakos GM, et al. Periodontal disease as a potential factor for systemic inflammatory response in the dog. J Vet Dent 2013;30(1):26–9.
  20. Verstraete FJ, Kass PH, Terpak CH. Diagnostic value of full-mouth radiography in dogs. Am J Vet Res 1998;59(6):686–91.
  21. Verstraete FJ, Kass PH, Terpak CH. Diagnostic value of full-mouth radiography in cats. Am J Vet Res 1998;59(6):692–5.
  22. Reiter AM, Lewis JR, Okuda A. Update on the etiology of tooth resorption in domestic cats. Vet Clin North Am Small Anim Pract 2005;35(4): 913–42.
  23. Soukup J, Lewis J. Oral and maxillofacial tumors, cysts, and tumor-like lesions. In: Lobprise HB, Dodd Jr, eds. Wiggs’ veterinary dentistry principles and practice. Hoboken (NJ): Wiley; 2019:131–53.
  24. Cline MG, Burns KM, Coe JB, et al. 2021 AAHA nutrition and weight management guidelines for dogs and cats. J Am Anim Hosp Assoc 2021; 57(4):153–78.
  25. Laflamme DP, Ballam JM. Effect of age on maintenance energy requirements of adult cats. Compend Contin Educ Pract Vet 2002;24:82.
  26. Cupp C, Perez-Camargo G, Patil A, et al. Long-term food consumption and body weight changes in a controlled population of geriatric cats. Compend Contin Educ Small Anim Pract 2004;26:60.
  27. Bermingham EN, Thomas DG, Morris PJ, et al. Energy requirement of adult cats. Br J Nutr 2010;103(8):1083–93.
  28. Kealy RD, Lawler DF, Ballam JM, et al. Effects of diet restriction on life span and age-related changes in dogs. J Am Vet Med Assoc 2002;220: 1315–20.
  29. Teng KT, McGreevy PD, Toribio JL, et al. Strong associations of ninepoint body condition scoring with survival and lifespan in cats. J Feline Med Surg 2018;20:1110–8.
  30. Perez-Camargo G. Cat nutrition: What is new in the old? Compend Contin Educ Pract Vet 2004;(suppl 26):5–10.
  31. Swanson KS, Kuzmuk KN, Schook LB, et al. Diet affects nutrient digestibility, hematology, and serum chemistry of senior and weanling dogs. J Anim Sci 2004;82:1713–24.
  32. Buffington CA. Lack of effect of age on digestibility of protein, fat and dry matter in beagle dogs. In: Burger I, Rivers J, eds. Nutrition of the dog and cat. 1st ed. New York: Cambridge University Press; 1989:397.
  33. Kim KH, Seo K, Cho HW, et al. Age-related digestibility of nutrients depending on the moisture content in aged dogs. J Anim Sci Technol 2021;63(6):1355–61.
  34. Laflamme DP. Nutritional care for aging cats and dogs. Vet Clin North Am Small Anim Pract 2012;42:769–91.
  35. Kealy RD. Factors influencing lean body mass in aging dogs. Comp Cont Educ Pract Vet 1998;21:34–7.
  36. Cupp CJ, Kerr WW. Effect of diet and body composition on life span in aging cats. Proc Nestle Purina Companion Animal Nutrition Summit: Focus on Gerontology. Clearwater Beach (FL), March 26-7, 2010:36–42.
  37. Schauf S, Stockman J, Haydock R, et al. Healthy ageing is associated with preserved or enhanced nutrient and mineral apparent digestibility in dogs and cats fed commercially relevant extruded diets. Animals (Basel) 2021;11(7):2127.
  38. Gough A, Murphy KF. Differential Diagnosis in Small Animal Medicine. 2nd ed. Oxford (UK): Wiley-Blackwell; 2015.
  39. Dewey CW, Davies ES, Xie H, et al. Canine cognitive dysfunction: pathophysiology, diagnosis, and treatment. Vet Clin North Am Small Anim Pract 2019;49(3):477–99.
  40. Salvin HE, McGreevy PD, Sachdev PS, et al. Under diagnosis of canine cognitive dysfunction: a cross-sectional survey of older companion dogs. Vet J 2010;184(3):277–81.
  41. Ozawa M, Inoue M, Uchida K, Chambers JK, Takeuch Y, Nakayama H. Physical signs of canine cognitive dysfunction. J Vet Med Sci 2019;81( 12):1829–34.
  42. Sordo L, Gunn-Moore DA. Cognitive dysfunction in cats: update on neuropathological and behavioural changes plus clinical management. Vet Rec 2020;188(1):1–12.
  43. Fast R, Sch€utt T, Toft N, et al. An observational study with long-term follow-up of canine cognitive dysfunction: clinical characteristics, survival, and risk factors. J Vet InternMed 2013;27(4):822–9.
  44. Hasegawa D, Yayoshi N, Fujita Y, et al. Measurement of interthalamic adhesion thickness as a criteria for brain atrophy in dogs with and without cognitive dysfunction (dementia). Vet Radiol Ultrasound 2005;46(6): 452–7.
  45. Schutt T, Toft N, Berendt M. A comparison of 2 screening questionnaires for clinical assessment of canine cognitive dysfunction. J Vet Behav 2015;10:452–8.
  46. Salvin HE, McGreevy PD, Sachdev PS, et al. The canine cognitive dysfunction rating scale (CCDR): a data-driven and ecologically relevant assessment tool. Vet J 2011;188(3):331–6.
  47. Madari A, Farbakova J, Katina S, et al. Assessment of severity and progression of canine cognitive dysfunction syndrome using the CAnine DEmentia Scale (CADES). Appl Anim Behavior Sci 2015;171: 138–45.
  48. Campbell S, Trettien A, Kozan B. A noncomparative open-label study evaluating the effect of selegiline hydrochloride in a clinical setting. Vet Ther 2001;2(1):24–39.
  49. Pipan MZ, Mihevc SP,štrbenc M, et al. Treatment of canine cognitive dysfunction with novel butyrylcholinesterase inhibitor. Sci Rep 2021;11:18098.
  50. Landsberg G. Therapeutic agents for the treatment of cognitive dysfunction syndrome in senior dogs. Prog Neuropsychopharmacol Biol Psychiatry 2005;29(3):471–9.
  51. Araujo JA, Studzinski CM, Head E, et al. Assessment of nutritional interventions for modification of age-associated cognitive decline using a canine model of human aging. Age (Dordr) 2005;27(1):27–37.
  52. Khalid S, Sambamoorthi U, Umer A, Lilly CL, Gross DK, Innes KE. Increased odds of incident Alzheimer’s disease and related dementias in presence of common non-cancer chronic pain conditions in Appalachian older adults. J Aging Health 2022;34(2):158–72.
  53. Landsberg GM, Deporter T, Araujo JA. Clinical signs and management of anxiety, sleeplessness, and cognitive dysfunction in the senior pet. Vet Clin North Am Small Anim Pract 2011;41(3):565–90.
  54. Cacabelos R. Pharmacogenomics of cognitive dysfunction and neuropsychiatric disorders in dementia. Int J Mol Sci 2020;21(9):3059.
  55. Fox SM, Millis D. Multimodal management of canine osteoarthritis. 1st ed. London: Manson Publishing; 2010.
  56. Letko A, Minor KM, Friedenberg SG, et al. A CNTNAP1 missense variant is associated with canine laryngeal paralysis and polyneuropathy. Genes 2020;11(12):1426.
  57. MacPhail, CM. Laryngeal disease in dogs and cats: an update. Vet Clin North Am Small Anim Pract 2020;50(2):295–310.
  58. Pop V, Head E, Hill MA, et al. Synergistic effects of long-term antioxidant diet and behavioral enrichment on beta-amyloid load and nonamyloidgenic processing in aged canines. J Neurosci 2010;30:9831–9.
  59. Hall JA, Tooley KA, Gradin JL, et al. Effects of dietary n-6 and n-3 fatty acids and vitamin E on the immune response of healthy geriatric dogs. Am J Vet Res 2003;64:762–72.
  60. Hayek MG, Massimino SP, Burr JR, et al. Dietary vitamin E improves immune function in cats. In: Reinhart GA, Carey DP, eds. Recent advances in canine and feline nutrition. Vol. 3. Iams Company; 2000:555–563.
  61. Hansen RA, Harris MA, Pluharc GE, et al. Fish oil decreases matrix metalloproteinases in knee synovia of dogs with inflammatory joint disease. J Nutr Biochem 2008;19:101–10.
  62. Bauer JE. Therapeutic use of fish oils in companion animals. J Am Vet Med Assoc 2011;239:1441–51.
  63. Lascelles BDX, DePuy V, Thomson A, et al. Evaluation of a therapeutic diet for feline degenerative joint disease. J Vet Intern Med 2010;24: 487–95.
  64. Vandeweerd JM, Coisnon C, Clegg P, et al. Systematic review of efficacy of nutraceuticals to alleviate clinical signs of osteoarthritis. J Vet Intern Med 2012;26(3):448–56.
  65. Pan Y, Landsberg G, Mougeot I, et al. Efficacy of a therapeutic diet on dogs with signs of cognitive dysfunction syndrome (CDS): a prospective double blinded placebo controlled clinical study. Front Nutr 2018;5: 127.
  66. Laflamme D, Gunn-Moore D. Nutrition of aging cats. Vet Clin North Am Small Anim Pract 2014;44(4):761–74.
  67. Ross SJ, Osborne CA, Kirk CA, et al. Clinical evaluation of dietary modification for treatment of spontaneous chronic kidney disease in cats. J Am VetMed Assoc 2006;229(6):949–57.
  68. International Renal Interest Society. IRIS Guidelines. Available at: http:// Accessed September 19, 2022.
  69. Loftus JP, DeRosa S, Struble AM, et al. One-year study evaluating efficacy of an iodine-restricted diet for the treatment of moderate-to-severe hyperthyroidism in cats. Vet Med (Auckl) 2019;10:9–16.
  70. Smith AJ. Perspectives on feeding and nutrition. Vet Clin North Am Small Anim Pract 2019;49(3):501–17.
  71. Bishop G, Cooney K, Cox S, et al. 2016 AAHA/IAAHPC end-of-life care guidelines. J Am Anim Hosp Assoc 2016;52(6):341–56.
  72. Amir Shanan A, Pierce J, Shearer T. Hospice and palliative care for companion animals; principles and practice. 1st ed. Ames (IA): Wiley Blackwell; 2017.
  73. Gaertner J, Siemens W, Meerpohl JJ, et al. Effect of specialist palliative care services on quality of life in adults with advanced incurable illness in hospital, hospice, or community settings: systematic review and metaanalysis. BMJ 2017;357:j2925.
  74. Belshaw Z, Asher L, Harvey ND, Dean RS. Quality of life assessment in domestic dogs: an evidence-based rapid review. Vet J 2015;206(2):203–12.
  75. Stoewen DL, Coe JB, MacMartin C. Qualitative study of the communication expectations of clients accessing oncology care at a tertiary referral center for dogs with life-limiting cancer. J Am Vet Med Assoc 2014;245: 785–95.
  76. Adams C, Kurtz S. Skills for communicating in veterinary medicine. 1st ed. New York: Dewpoint Publishing; 2016.
  77. Cox S, Dodd C, Evans B, et al. 2021 AAHA/AVMA telehealth guidelines for small-animal practice. Available at: 02-guidelines/telehealth/2021-aaha-avma-telehealth-guidelines.pdf. Accessed September 19, 2022.
  78. Klein TM, Augustin M, Kirsten N, et al. Attitudes towards using electronic health records of patients with psoriasis and dermatologists: a cross-sectional study. BMC Med Inform Decis Mak 2020;20(1):344.
  79. Embrey JR Jr. How physicians can protect themselves from litigation risk from virtual care. Medical Economics Journal. September 8, 2021. Available at: protect-themselves-from-litigation-risk-from-virtual-care. Accessed September 19, 2022.
  80. Gardner M, McVety D, eds. Treatment and care of the geriatric veterinary patient. 1st ed. John Wiley & Sons; 2017.
  81. Goldberg ME, Tomlinson JE. Introduction to physical rehabilitation for veterinary technicians/nurses. In: Physical rehabilitation for veterinary technicians and nurses. Hoboken (NJ): Wiley Blackwell; 2018:1–10.

The 2023 AAHA Senior Care Guidelines for Dogs and Cats are generously supported by Boehringer Ingelheim Animal Health, CareCredit, IDEXX, and Zoetis.

Boehringer Ingelheim
Care Credit logo