Management of the geriatric patient and chronic disease
Long-term care of a senior animal with one or several chronic diseases: treatment plan, check-ups, diet, pain management and support with decisions.
What it involves
An older dog or cat rarely has just one disease. More often it is a combination: kidneys plus hypertension, heart plus joints, thyroid plus weight loss. Managing a geriatric patient means that one veterinarian sees the whole picture, combines the results, agrees medications that do not clash with one another, and plans check-ups so that the animal is not tested unnecessarily.
The aim is not to “cure old age” but to maintain a good quality of life: so that a cat eats and is not nauseous, so that a dog gets up without pain and sleeps peacefully at night, and so that you know what to watch for and when to call.
We use our own laboratory (monitoring of kidneys, liver, thyroid, electrolytes) and ultrasound (heart, abdomen) — follow-up tests are done on site during a single visit, usually with the result the same day.
When it is used
We begin geriatric care when a senior is diagnosed with its first chronic disease or when signs of “old age” appear: stiffness, slowing down, weight loss, increased thirst, disorientation at night, incontinence. Check-ups take place every 3–6 months, more often when there are several diseases.
Management also covers periods of flare-up: dehydration in a cat with kidney disease, decompensated heart failure in a dog — the patient then goes in for a short hospital stay and afterwards returns to ongoing care.
Indications: symptoms that should prompt a visit
- An older dog has difficulty getting up and climbing stairs, and is restless at night.
- A senior cat is losing weight, eating less well and its coat is getting worse.
- The animal takes several medications from different vets and it is unclear whether all of them are still needed.
- A dog with diagnosed heart disease has started coughing and breathing faster.
- A cat with kidney disease vomits from time to time and refuses food.
- An older dog has started pacing around the house, getting stuck in corners and waking at night.
- You would like an honest assessment of how the animal feels and what its prospects are.
Conditions for which we use it in particular
Diagnostics beforehand
The starting point is a geriatric panel: clinical examination, blood count and biochemistry, urine, blood pressure, and ultrasound and X-ray as needed. At check-ups we repeat only what is needed to manage the particular disease — e.g. creatinine, phosphorus and blood pressure for kidney disease, T4 for thyroid disease.
Please keep a simple diary at home: weight every 2 weeks, amount of water drunk, number of breaths during sleep (in heart disease), appetite and activity. This information tells us more than a single test in the consulting room.
How it proceeds
A monitoring visit lasts 30–45 minutes. We go through the diary and any changes since the last visit, examine the animal with a pain assessment (scale), take blood and urine, measure blood pressure and, if needed, carry out an ultrasound. We review the medication list: what to stop, what to add, whether the doses are still right for body weight.
You leave with an up-to-date written plan: medication with times, diet, exercise or restrictions, the date of the next check-up and a list of warning signs. In a flare-up we decide whether hospitalisation is needed (fluid therapy, oxygen) — usually short, 1–3 days, followed by a return to home care.
Aftercare
Care takes place at home: regular medication, diet, adapting the home (non-slip mats, a lower entry to the litter tray, a warm bed). We encourage you to phone between visits if something worries you — it is easier to adjust treatment early.
We also talk openly about quality of life and how to assess it. When the time comes for difficult decisions, we do not leave you to face them alone. Please call immediately if there is breathlessness, loss of appetite for more than a day, vomiting, seizures or a sudden inability to stand.
Frequently asked questions
Is my dog just old, or ill?
Old age is not a disease — slowing down, stiffness and weight loss almost always have a specific, often treatable cause. That is why it is worth checking rather than putting it down to age.
How often should we come for check-ups?
With a stable disease, every 3–6 months. While treatment is being set up or with several diseases at once — every 4–8 weeks. We decide this individually.
Can a senior take painkillers long term?
Yes, with monitoring of the kidneys and liver in blood tests. Untreated chronic pain shortens life more than appropriately chosen medication.
How can I tell whether my animal is suffering?
We use simple quality-of-life scales: appetite, hydration, hygiene, mobility, enjoyment of contact, whether there are more good days than bad. We go through them together at visits.
We manage every case individually. The scope, indications and course described above are indicative; we agree the exact diagnostic and treatment plan during the consultation. This content is for information only and does not replace a veterinary consultation.
Have questions about managing the geriatric patient and chronic diseases?
Call us or book a consultation. We will set out the diagnostic and treatment plan in writing, before you decide.