Top 5 Considerations in Caring For Geriatric Patients

5 TOP 5 Rachel V.
Poulin, RVT, VTS (SAIM)

Coral Springs Animal Hospital
Coral Springs, Florida
TOP
Medical and nutritional advances are allowing companion animals to live
longer; according to the Banfield State of Pet Health 2013 report, the
average lifespan of a cat was 12 years, a 10% increase from 2002, and
the average lifespan of a dog was 11 years, a 4% increase.1
Geriatric medicine is defined as “the branch of medicine that deals with the
problems of aging and diseases of older animals, usually companion ani-
mals.”2 The population of geriatric pets that require special knowledge and
care is at its highest.3 Although old age itself is not a disease, the aging process
involves changes in physiologic function that the health care team and the cli-
ent need to understand to ensure the geriatric patient is as comfortable and
happy as possible (see Average Life Stages for Dogs & Cats).
Following are the top 5 considerations in caring for older patients.
Special Nutritional Needs

As animals age, their metabolic rate and activity decrease, which leads to
a decrease in caloric need by as much as 30% to 40%.4 Older animals
also may need specific diets for health reasons (eg, osteoarthritis, kidney
or liver disease, neoplasia). Commercial dietary formulas that attempt to
address geriatric patients’ needs are available, but finding a single product that
addresses all their nutritional needs can be difficult. The veterinary team should
ensure an aging patient has proper nutrition, as it can impact quality of life.
Importance of Early Disease Detection

CONSIDERATIONS As animals age, metabolic changes occur and immune competence
IN CARING FOR
decreases, despite normal numbers of lymphocytes.4 Also, phagocytosis
and chemotaxis decrease, resulting in less ability to fight infection and
GERIATRIC allowing for autoantibodies and immune-mediated diseases to develop.4
Top 5
PATIENTS
Early signs of a disease state may be
masked by what the client considers
signs of the normal aging process (eg,
Considerations
decreased appetite, lethargy, change in in Caring for
hair coat). Therefore, when taking a Geriatric Patients
patient’s history, team members should
• Special Nutritional Needs
focus on any changes that the client
• Importance of Early
has observed, even if the client does Disease Detection
not consider the changes problematic. • Special Anesthesia Requirements
Some conditions can be expected in • Importance of Oral Health
geriatric patients (eg, arthritis), and • Need for Comfort.
36 veterinaryteambrief.com November/December 2015

PEER
REVIEWED
Average Life Stages for Dogs & Cats4
Cats Dogs (small & medium-sized breeds) Dogs (large & giant breeds)
• Pediatric: Birth-6 months • Pediatric: Birth-6 months • Pediatric: Birth-6 months

• Young adult: 7 months-6 years • Young adult: 7 months-5 years • Young adult: 7 months-2 years
• Mature adult: 7-10 years • Mature adult: 6-9 years • Mature adult: 3-5 years
• Senior: 11-14 years • Senior: 9-12 years • Senior: 6-9 years
• Geriatric: 15 years and older • Geriatric: 12 years and older • Geriatric: 9 years and older
As animals age, early diagnosis allows more treat-

ment options. Identifying diseases
vigilant when monitoring geriatric
patients and adjust the anesthesia pro-
their metabolic earlier also allows the team to man-
age conditions that come with aging
tocol based on recent diagnostics and
the physical examination.
rate and activity and preserve quality of life for as
long as possible. Importance of
decrease, Oral Health
Special Anesthesia Periodontal disease in ani-
which leads Requirements mals has been linked to
to a decrease Geriatric patients respond
differently than younger
many systemic diseases (eg, kidney
and liver disease, heart failure and
in caloric need animals to anesthetic procedures,
and the anesthetist must be aware of
heart attacks, lung disease, adverse
pregnancy effects, cancers, complica-
by as much their special needs.5 These patients tions of diabetes6) because of the
also have a lower tolerance for some consistent bacterial load in the mouth
as 30% to 40%. medications, possibly the result of entering the blood stream through
the normal aging process or a dis- bleeding or inflamed gums. Many of
ease process, which may result in a these conditions improve with proper
deeper plane of anesthesia than ini- dental treatment; therefore, keeping
tially anticipated and a prolonged patients’ mouths clean and healthy
recovery time. The team should be increases their chances of staying
November/December 2015 Veterinary Team Brief

37
5 TOP 5
to protect thinning paw pads from

hot asphalt; provide extra bedding
to reduce or eliminate the frequency
of pressure sores; and slow down
and walk at the patient’s preferred
pace.
Conclusion
Geriatric patients present their own
unique set of challenges, but with
understanding, the veterinary team
can help them age gracefully and give
them excellent quality of life.
Editor’s note: Rachel Poulin has more than 12 years

of experience as a veterinary technician, with a
specialty in internal medicine. She is currently the
supervisor of the small animal medicine department
Geriatric patients healthy and decreases disease risk
throughout their life.
at her practice. She also speaks regularly at national
conferences about animal health, the veterinary
technician's role, and client education.
present their All clients should be aware of the References
own unique set importance of good oral health. More 1. Banfield State of Health Pet Health Report,
2013. Banfield. http://www.stateofpethealth.
than 70% of dogs and cats are esti-
of challenges, mated to have some form of peri-
com/content/pdf/banfield-state-of-pet-health-
report_2013.pdf. Published 2013. Accessed
October 2015.
but with odontal disease by 2 years of age,6 so

it is important to educate clients
2. Studdert VP, Gay CC, Blood DC. Saunders
Comprehensive Veterinary Dictionary. 4th ed.
Philadelphia, PA: Elsevier Saunders; 2007.
understanding, about at-home dental health options

(eg, teeth brushing, chews, sprays)
3. Bassert JA, Thomas JA. Geriatric and hospice
care: Supporting aged and dying patient. In:
Bassert JA, Thomas JA, eds. McCurnin's Clini-
the veterinary and inform them that full anesthetic
dental cleanings will likely still be
cal Textbook for Veterinary Technicians. 8th ed.
St. Louis, MO: Elsevier Saunders, 2014:1356.
team can
4. Bassert JA, Thomas JA. Geriatric and hospice
recommended to ensure complete care: Supporting aged and dying patient. In:
Bassert JA, Thomas JA, eds. McCurnin's Clini-
cleaning and decrease future risk for
help them decay and disease.
cal Textbook for Veterinary Technicians. 8th ed.
St. Louis, MO: Elsevier Saunders; 2014:1358.
5. Hollingshead KW. Anesthesia problems and
age gracefully Need for Comfort

emergencies. In: Thomas JA, Lerche P, eds.
Anesthesia and Analgesia for Veterinary Tech-
nicians. 4th ed. St. Louis, MO: Mosby Elsevier;
and give them Older patients’ comfort is as

important as their health. Use
2011:324.
6. Niemiec BA. Treating and preventing dental dis-
excellent quality
ease in geriatric pets. Veterinary Practice News.
a sling while walking a geri- http://www.veterinarypracticenews.com/
October-2012/Treating-And-Preventing-Dental-
atric osteoarthritis patient to increase
of life. the patient’s comfort; provide booties
Disease-In-Geriatric-Pets. Published September
2012. Accessed October 2015.
38 veterinaryteambrief.com November/December 2015

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5 TOP 5 Rachel V.

Poulin, RVT, VTS (SAIM)

Following are the top 5 considerations in caring for older patients.

Special Nutritional Needs

Importance of Early Disease Detection

GERIATRIC allowing for autoantibodies and immune-mediated diseases to develop.4

36 veterinaryteambrief.com November/December 2015

Average Life Stages for Dogs & Cats4

• Pediatric: Birth-6 months • Pediatric: Birth-6 months • Pediatric: Birth-6 months

As animals age, early diagnosis allows more treat-

November/December 2015 Veterinary Team Brief

to protect thinning paw pads from

Editor’s note: Rachel Poulin has more than 12 years

but with odontal disease by 2 years of age,6 so

understanding, about at-home dental health options

age gracefully Need for Comfort

and give them Older patients’ comfort is as

38 veterinaryteambrief.com November/December 2015

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