Approach to the apparently healthy senior pet

The purposes of clinical screening of healthy pets are to establish a baseline assessment for future comparison and to detect subclinical abnormalities at a time when preventive and therapeutic intervention may have the most benefit. To illuminate such conditions, there is no substitute for a thorough and complete history and physical examination. A wealth of scientific literature documents the presence of subclinical disease in some healthy-appearing animals; to illuminate such conditions, there is no substitute for a thorough and complete history and physical examination. In addition, subtle changes in laboratory test results may give an indication of the presence of underlying disease.

Elements of a thorough history

Construct questions that extend beyond the client’s presenting concern and that include physical and behavioral signs.13 Use of both closed (yes/no) and open-ended questions helps to elicit all possible information about quality of life, physical health, specific behavioral changes, and medications (e.g., prescription, over-the-counter, dietary supplements). When possible, to better ensure an accurate and thorough baseline for future comparison, have the client record historical information on a printed form prior to the appointment.

Elements of a complete examination

Observe the pet prior to handling, in an open carrier and/or on the floor. Perform a complete physical examination with special attention to the areas of increasing concern in the senior pet. Such areas may include, but are not limited to:

  • Risk factor analysis: signalment, breed, lifestyle/use14,15
  • Physical condition: weight gain or loss (that may not have been observed by the client); obesity; changes in body condition or conformation
  • Evaluation of skin, coat, claw, and nail bed character; detection and assessment of lumps and bumps
  • Presence of lymph node enlargement
  • Presence of thyroid nodule (cats)
  • Hydration status
  • Abdominal palpation, especially the size and shape of kidneys and liver
  • Vital signs: temperature, pulse, respirations, and pain assessment16
  • Cardiopulmonary evaluation: auscultation of heart sounds; heart rate and rhythm; pulse rate and quality
  • Evaluation of the central nervous system: mentation; cranial and peripheral nerve reflexes, especially conscious proprioception; vision and hearing
  • Orthopedic examination: mobility, gait, range of motion, weakness, pain, crepitation, muscle mass
  • Rectal palpation (dog)

Elements of a minimum laboratory database

Tests to be included in the minimum laboratory database for the healthy-appearing senior animals are listed in Table 1. Additional testing is based on breed, age, sex, previous medical history, and ongoing medications.17,18

Preventive care

Preventive care is directed at making recommendations prior to the onset of disease in order to prevent or temper the effects of disease or adverse health conditions. This task force recommends that “senior” wellness tests begin for pets at middle age, to establish baseline values and to insure that there are no clinically silent health abnormalities. During middle age, retesting is recommended at least once a year (equivalent of 4 to 5 human years). Routine health care visits, including a minimum laboratory database, are recommended for senior animals (i.e., those in the last 25% of their predicted life span) every 6 months (equivalent of every 2 to 3 human years).

Focused areas of client education

Such areas include, but are not limited to:

  • Increased veterinary attention to dental/oral care and to home dental prophylaxis
  • Diet and nutrition
    • Digestibility, caloric content, quality of ingredients
    • Discussion of any new developments in the use of stage-of-life diets, food supplements, or food additives (e.g., omega-3 fatty acids, nutraceuticals)
    • Attention to ingredients that might affect disease in older pets
  • Weight control: monitoring of weight gain (especially in the dog) or loss (especially in the cat)
  • Parasite control: following published guidelines for fecal examination and parasite prevention19,20
  • Maintaining mobility via exercise or therapeutic intervention
  • Vaccination only as appropriate for lifestyle, management factors, geographic region, and local jurisdiction21-23
  • Mental health: importance of routine and predictable environment; environmental enrichment; companion pets and social interaction; discussion of brain aging; monitoring signs of cognitive decline
  • Environmental considerations: housing; indoor/outdoor lifestyle; accommodation of disabilities; avoidance of smoke and toxin exposure
  • Potential reproductive disease in nonneutered pets: pyometra, mammary or testicular neoplasia, prostatic disease24