Old veterinary patients, new care

That frisky young feline who first visited your practice seven years ago is getting older now, and though she's still got a spark in her eye and a spring in her step, the care she needs is dynamic. Dr. Eliza Sundahl, owner of KC Cat Clinic in Kansas City, Mo., says as cats age, they are at increased risk for health issues, such as kidney disease, hyperthyroidism, arthritis, weight issues, and the hypertension that goes along with these diseases.

First, it's important for your clients to recognize that every year for them is equivalent to four years for their cat. Six months between their cat's twice-yearly visit represents a long time in the cat's life, Dr. Sundahl says. The 2008 Senior Care Guidelines from the American Association of Feline Practitioners (AAFP) outline the life stages for cats:

• Kitten—birth through 6 months

• Junior—7 months through 2 years

• Adult—3 through 6 years

• Mature—7 through 10 years

• Senior—11 through 14 years

• Geriatric—15 or more years

A key component to a senior preventive program for your feline patients is client compliance and education. First, Dr. Sundahl says, you need to teach your cat owners to show up and pursue preventive healthcare visits. As a veterinary team, you can better evaluate cats that visit regularly, and you have the perspective to identify subtle changes that might signal a health change. Next, you need to educate clients that their cats may hide signs of illness.

"People think that it's OK to slow down because you're old. And they'll frequently say, 'Everything's fine at home, my cat's just starting to show his age,'" Dr. Sundahl says. "That comment is a huge red flag. The team has to pick up on this language and use open-ended questions, such as, 'What do you mean by that?'"

You may need to act as a fact-finder to help pet owners uncover some of the signs they might not recognize as potential issues in their older cats. Some subtle signs clients may fail to notice include mobility issues or lack of interaction, Dr. Sundahl says. For example, has the cat stopped jumping on the counter? Is he not coming around for pets as much?

You may also need to re-evaluate the questions you ask to learn about the cat's health. For example, if you ask, "Is your cat urinating more?" you might get a different answer than a lifestyle-focused question, like, "Are you changing the litter box more often?"

Dr. Sundahl also recommends staff education that uses the AAFP's 2008 Senior Care Guidelines and the 2011 Feline Friendly Handling Guidelines.

"I encourage team members to read these guidelines and embrace them," she says. "And look at cats as an underserved population. Pet owners love their cats, but veterinary practices haven't done a good job of showing them what we can do for their cats. I don't think we've done a good job of connecting the dots to show that we can help improve cats' quality of life, minute to minute and day to day, with good preventive care."

Another way team members can improve senior cat care is in making veterinary visits less stressful for cats. "Be mindful. If the cat was your grandmother, what kinds of manipulations would you do for an older person to make the visit more comfortable?" she asks. "How would you modify your sampling techniques and venipuncture to make the experience more comfortable for cats?"

A calming environment is key for several reasons. First, clients are more likely to visit with their pets if they know you're going to do everything you can to make the visit a comfortable experience for the cat. Second, Dr. Sundahl says, a stressful veterinary visit can influence lab tests, including blood work, which can make it harder to interpret results.

Finally, remember one of the most important steps you can take to improve senior pets' heath is to encourage regular preventive care visits. When you help cat owners see value in preventive care, Dr. Sundahl says cat owners will take better care of their pets.