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Diagnostic Testing for Each Life Stage

Recommended Diagnostics Based on Life Stage*

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These recommendations are intended for apparently healthy cats and do not extend to preanesthetic laboratory work. Although specific data documenting benefits are not available, the Task Force concluded that regular preventive healthcare examination and collection of associated medical data can be valuable, allowing early detection of disease or trends in clinical or laboratory parameters that may be of concern. Examples include increasing creatinine, symmetric dimethylarginine, total thyroxine (T4), or blood pressure and decreasing urine specific gravity. Additionally, these diagnostic results provide a baseline for interpretation of data recorded at subsequent visits.

Diagnostics for Each Life Stage

/

Kitten (Birth up to 1 Year)

+, consider based on individual patient; ++, recommended; +++, strongly recommended.

Complete blood count: hematocrit, red blood cells, white blood cells, differential count, cytology, platelets

 

Serum biochemistry panel: at a minimum include total protein,albumin, globulin, alkaline phosphatase, alanine aminotransferase, glucose, blood urea nitrogen, creatinine, potassium, phosphorus, sodium, calcium

 

Urinalysis: specific gravity, sediment, glucose, ketones, bilirubin, protein

 

T4

 

Symmetric dimethylarginine and other renal indices

 

Blood pressure

 

Retroviral testing

+++

Fecal examination

+++

Testing frequency

Single baseline, then as needed

Young Adult (1–6 Years)

+, consider based on individual patient; ++, recommended; +++, strongly recommended.

Complete blood count: hematocrit, red blood cells, white blood cells, differential count, cytology, platelets

+

Serum biochemistry panel: at a minimum include total protein,albumin, globulin, alkaline phosphatase, alanine aminotransferase, glucose, blood urea nitrogen, creatinine, potassium, phosphorus, sodium, calcium

+

Urinalysis: specific gravity, sediment, glucose, ketones, bilirubin, protein

+

T4

+

Symmetric dimethylarginine and other renal indices

+

Blood pressure

+

Retroviral testing

+

Fecal examination

+

Testing frequency

Single baseline, then as needed

Mature Adult (7–10 Years)

+, consider based on individual patient; ++, recommended; +++, strongly recommended.

Complete blood count: hematocrit, red blood cells, white blood cells, differential count, cytology, platelets

++

Serum biochemistry panel: at a minimum include total protein,albumin, globulin, alkaline phosphatase, alanine aminotransferase, glucose, blood urea nitrogen, creatinine, potassium, phosphorus, sodium, calcium

++

Urinalysis: specific gravity, sediment, glucose, ketones, bilirubin, protein

++

T4

++

Symmetric dimethylarginine and other renal indices

++

Blood pressure

++

Retroviral testing

+

Fecal examination

+

Testing frequency

Every 1–2 years

Senior (>10 Years)

+, consider based on individual patient; +++, recommended; ++++, strongly recommended.

Complete blood count: hematocrit, red blood cells, white blood cells, differential count, cytology, platelets

+++

Serum biochemistry panel: at a minimum include total protein,albumin, globulin, alkaline phosphatase, alanine aminotransferase, glucose, blood urea nitrogen, creatinine, potassium, phosphorus, sodium, calcium

+++

Urinalysis: specific gravity, sediment, glucose, ketones, bilirubin, protein

+++

T4

+++

Symmetric dimethylarginine and other renal indices

+++

Blood pressure

+++

Retroviral testing

+

Fecal examination

+

Testing frequency

At least yearly
(every 6 months recommended)

Detailed information on heartworm testing is available in the American Heartworm Society guidelines.125

*Diagnostics should be tailored to the individual cat and based on history/physical examination. These recommendations are based on the opinion of the Task Force for apparently healthy cats and do not include recommendations for preanesthetic laboratory work. In most cases, these tests are recommended to establish baseline data and to detect unapparent clinical disease.

†These tests may be done as a single baseline evaluation or at repeated intervals based on the specific needs of the individual cat.

Specific recommendations regarding frequency of laboratory testing by life stage depend on many factors. One consideration regarding testing frequency is that the incidence of many diseases increases as cats age. Although limited incidence studies have been performed to identify the age of onset of hyperthyroidism in cats, the Task Force recommends that veterinarians strongly consider T4 testing in the apparently healthy mature adult cat. More robust incidence data are needed to develop firmer recommendations.

Comorbidities are extremely common in the senior cat and can impact diagnostic, treatment, and management approaches. Additional considerations relating to diagnosis and management of diseases in mature adult and senior cats are described in the AAFP Senior Care Guidelines.12 Consensus guidelines and toolkits for the diagnosis and treatment of specific medical conditions are available for more detailed information (see “Guidelines and Toolkits” box).

For cats of all ages, timing and frequency of diagnostics may depend on lifestyle, exposure risks, and geographic location. Retroviral testing recommendations are discussed in detail in the 2020 AAFP Feline Retrovirus Testing and Management Guidelines.18 In addition to routine deworming, fecal examination should be performed regularly at intervals based on patient health and lifestyle factors.

Heartworm infection ismore difficult to diagnose in cats than in dogs because of lower worm burden, single-sex infections, and infrequency of microfilaremia. HARD, which is an asthma-like inflammatory reaction of the pulmonary tissue to immature larval stages, is an added complexity relating to heartworm exposure in cats. Interpretation of antibody and antigen test results is challenging, and a thorough understanding of the limitations of both tests is necessary.More detailed information is available in the American Heartworm Society guidelines.125 Testing does not need to be performed before starting preventive treatment.

N-terminal probrain natriuretic peptide has been investigated as a diagnostic tool for cardiac disease in cats.138 However, limited information exists about using this test as a screening tool and recommendations cannot be made on the frequency of use for the general population. The decision to use this test should be on an individual basis, and interpretation of test results should be made with an understanding of the sensitivity and specificity of the assay.

Boehringer Ingelheim Animal Health USA Inc., CareCredit, Dechra Veterinary Products, Hill's Pet Nutrition, Inc., IDEXX Laboratories, Inc., Merck Animal Health, and Zoetis Petcare supported the development of the 2021 AAHA/AAFP Feline Life Stage Guidelines and resources through an educational grant to AAHA

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