Ageing in small animals
Ageing in numbers
Definition of ageing and preliminary clarifications
Physiology of ageing: why do we age?
Consequences of ageing in cats and dogs
Consequences for owners and veterinary surgeons
The owner’s perspective
Key points veterinary practitioners should bear in mind
Nutrition in elderly patients
Assessing the nutritional status of geriatric patients
Step 1: the questionnaire
Step 2: the physical examination
Step 3: the dietary assessment
Effects of age on nutritional needs
Effects on energy requirements
Effects on protein
Effects on other nutrients
Diets for nutrition-sensitive diseases
Diseases that course with overweight or obesity
Why is achieving an ideal weight so important?
Dietary treatment of obesity
Dietary treatment of diabetes
What makes a good diet for diabetes?
Dietary treatment of senior patients with weight loss
Dietary management of malabsorption
The owner’s perspective
Key points veterinary practitioners
should bear in mind
Pharmacological treatment of geriatric patients
Basic concepts in pharmacology
Dose adjustments for geriatric patients
Pharmacological changes in patients
with chronic kidney disease
Alterations in drug bioavailability and absorption.
Alterations in drug distribution
Alterations in hepatic metabolism.
Acid–base balance
Pharmacological changes in patients with liver disease
Hepatic clearance (CLH)
Pharmacological changes in patients with heart disease
The owner’s perspective
Key points veterinary practitioners should bear in mind
Anaesthesia in elderly patients
Anaesthesia: secrets, magic protocols, and other myths
How to design a personalised protocol for each case
Familiarity with the patient
Systems most affected by ageing
The preoperative visit and tests
Recognising our options and materials
Familiarity with the drugs used
Sedatives
Injectable hypnotic agents.
Agents used for maintenance
Analgesics for acute or postoperative pain.
The owner’s perspective
Key points veterinary practitioners should bear in mind
Environmental enrichment for cats and dogs
Species-specific objectives of environmental enrichment
Animate enrichment
Conspecifc social contact
Heterospecifc social contact
Inanimate enrichment
Toys
Structures
Sensory enrichment.
Sound
Odours and pheromones
Visual enrichment
When should an environmental enrichment plan be implemented?
How can we tell if environmental enrichment is working correctly?
The owner’s perspective
Key points veterinary practitioners should bear in mind
Chronic pain. Arthrosis
Introduction. Definitions and basic concepts
Pathophysiology of pain
Identifying pain.
Treatment of chronic pain
Analgesic agents
Nonsteroidal anti-inflammatory drugs
Opiates
Morphine
Codeine
Methadone
Tramadol
Drugs used for neuropathic pain (Table 4)
Gabapentin and pregabalin
Amantadine
Osteoarthritis
Treatment of osteoarthritis
Weight loss and control
Nutraceuticals
Unconventional analgesic measures
Rehabilitation techniques
New treatments
The owner’s perspective
Key points veterinary practitioners should bear in mind
Orodental problems in elderly animals
Considerations before starting
The orodental exam
Preparing patients for anaesthesia
Dental prophylaxis
Step 1: removal of supragingival calculi and assessing gum health
Step 2: probing subgingival pockets
Step 3: detecting hidden calculi and plaque
Step 4: polishing
Step 5: pocket irrigation and topical fluoride
Step 6: periodontal diagnostic tests
Step 7: recording data in the patient’s dental file
Step 8: home care measures
How to complete a patient’s dental file
The owner’s perspective
Key points veterinary practitioners should bear in mind
Chronic kidney disease
Definition and prevalence
Renal physiology
Diagnostic techniques and early diagnosis
Urinalysis
Blood test
Diagnostic imaging
Renal X-rays
Renal ultrasound
Renal biopsy
IRIS classification
Evidence-based treatment of CKD
Main therapeutic measures for CKD
Renal diet
Treatment of proteinuria
Phosphate binders
Monitor blood pressure
Treating anaemia
The owner’s perspective
Key points veterinary practitioners should bear in mind
Liver problems
in geriatric patients
Inflammatory liver diseases
Chronic inflammatory liver disease in dogs
Diagnosis
Treatment
Inflammatory liver diseases in geriatric cats
Diagnosis
Treatment
Prognosis and evolution
Infiltrative liver diseases
Canine hepatic fibrosis and cirrhosis
Diagnosis
Treatment
Hepatocutaneous syndrome
Diagnosis
Treatment
Prognosis
Liver tumours
Clinical presentation of liver tumours
Laboratory diagnosis
Diagnostic imaging
Treatment of primary liver tumours
Hepatic encephalopathy
Diagnosis
Treatment
What should a good diet for HE consist of?
The owner’s perspective
Key points veterinary practitioners should bear in mind
Endocrine problems in senior patients
Diabetes mellitus
Epidemiology
Pathophysiology
Canine diabetes mellitus
Feline diabetes mellitus
Diagnosis
History and physical
Laboratory diagnosis
Definitive diagnosis
Treatment
Insulin
Diets
Diabetic patient monitoring
Glucose curves
Urine strips for determination of glycosuria
Fructosamine
Other data to monitor
What if the diabetic patient is not well controlled?
Action protocol for patients with poorly controlled DM
Hyperadrenocorticism or Cushing’s syndrome
Epidemiology and pathophysiology
Canine HAC
Feline HAC
Diagnosis
History and physical examination
Laboratory diagnosis
Definitive diagnosis
Diagnostic imaging
Treatment
Medical treatment
Surgical treatment
Prognosis
Feline hyperthyroidism
Epidemiology
Pathophysiology
Diagnosis
History and physical examination
Laboratory diagnosis
Diagnostic imaging
Treatment
Medical treatment
Surgical treatment
Radioactive iodine treatment
Dietary treatment
The owner’s perspective
Key points veterinary practitioners should bear in mind
Reproductive diseases in senior patients
Benign prostatic hyperplasia
Pathophysiology of BPH
Clinical signs
Diagnosis
Treatment
Osaterone
Delmadinone
Deslorelin
Pyometra
Pathophysiology
Clinical signs
Treatment
Mammary tumours
Predisposing factors
Diagnosis
Treatment
Surgical treatment
Adjuvant treatments
The owner’s perspective
Key points veterinary practitioners should bear in mind
Senior cardiovascular disease
Cardiovascular physical examination
Step 1: frst, observe the patient
Step 2: evaluate the eyes, mucous membranes, and neck
Step 3: evaluate the thorax
Heart sounds
Murmurs
Arrhythmias
Step 4: palpate the abdomen
Step 5: palpate the limbs
Mitral valve endocardiosis or degenerative mitral valve disease
Aetiopathogenesis
Diagnostic protocol
Treatment of canine valvular disease
Hypertrophic cardiomyopathy (HCM) or hypertrophic cardiomyopathy phenotype in cats
Clinical signs
Physical examination
Additional tests
How to interpret a chest X-ray
Echocardiography
Treatment
Feline hypertension
Regulation of blood pressure (the underlying physiology)
Arterial baroreceptor reflex
Atrial receptor reflex
Treatment
The Owner’s perspective
Key points veterinary practitioners should bear in mind
Most frequent neurological problems in senior patients
Cognitive dysfunction syndrome (CDS)
Pathophysiology
Hypoxia
Free radicals
Deposition of β-amyloid and hyperphosphorylation of tau protein
Neurotransmitter alterations
Anatomical changes
Diagnosis
Treatment
Correct information for the owner
Medication
Vestibular system involvement in senior animals
Basic anatomy of the vestibular system
Peripheral vestibular system
Central vestibular system
Clinical signs in small animals
Idiopathic peripheral vestibular syndrome
Treatment
Degenerative myelopathy
Clinical signs
Diagnosis
Treatment
The owner’s perspective
Key points veterinary practitioners should bear in mind
Health plans in senior animals
Approach to the senior health programme
Step 1: who is it for? (internal level)
Step 2: how to inform the owner (in reception)
Step 3: how to present the health plan (during the consultation)
Step 4: take advantage of the moment
Step 5: calculate the price of the health plan
Step 6: closing the deal
Helpful advice in difficult situations
Team consensus
Clarity and transparency
The target customer
The owner’s perspective
Key points veterinary practitioners should bear in mind