Geriatric Dogs

Possible Geriatric Syndromes

Chronic Weight Loss - Weight loss is very common in our geriatric population. The problem is that weight loss can stem from a variety of ailments or underlying diseases. A good history needs to be examined to see if we have vomiting or diarrhea as part of the problem. Or, is a lack of appetite the primary concern? If the weight loss is due to cancer, kidney disease, liver disease, or heart disease, then those specific diseases need to be treated. If no specific diseases can be found, then appetite stimulants may be appropriate.

Continuous Poor Appetite - As mentioned above under chronic weight loss, poor appetite is usually due to an underlying disease. The most common are kidney or liver disease. Additionally, heart disease and certain forms of cancer could result in poor appetite as the only obvious sign of illness. It is important to do adequate testing to investigate the true cause.

Decreased Mobility - Decreased mobility could be due to a problem in a specific leg, multiple areas of arthritis, or a neurological condition. We frequently look at our older dogs and say that they are sleeping more and laying around more due to "age", but in reality, it is usually pain or instability that causes our pets to just lay around.

Chronic Pain - We all have aches and pains from time to time, but when a dog has chronic pain it can be debilitating. That pain usually affects appetite, mobility, and general attitude. Some dogs seem to get grumpy with age. This personality change is probably due to pain coming from somewhere in the body. Sometimes the source of the pain is obvious, but frequently it will take a search by your veterinarian to locate the painful area of the body.

Chronic Vomiting - In general, dogs vomit much easier than people do. Their system is designed to reject materials that upset the stomach. We have all seen dogs vomit up some foreign material, and immediately after that, they go back and start eating again. In other words, they were not nauseous. However, when vomiting becomes more frequent, we need to go hunting for the cause. Typical causes in our older patients would include blockages caused by a growth in the stomach or intestines, chronic liver or kidney disease, drugs that are irritating the stomach, or food intolerance.

Chronic Cough - Coughing is common in dogs of any age. We frequently encounter "kennel cough" in young dogs that have been in a kennel environment or that have recently been adopted from a shelter, but our older dogs are more commonly afflicted with non-infectious causes of cough. If the cough is seasonal, we may have an allergy or just an irritant causing post-nasal drip, which frequently causes a cough. More serious coughs can come from collapse of the airways or paralysis of the larynx. Additionally, one of the more common causes of chronic coughing in dogs is heart disease, specifically from "leaky" heart valves - more appropriately called Valvular insufficiency, where fluid starts to accumulate in the lungs and stimulates a cough. Another common cough is from Chronic Bronchitis. This is a disease also seen in people. The cause is often a chronic inflammation of the bronchial tree, the underlying cause may be unknown. There is no cure - the treatment is a combination of anti-inflammatory drugs and cough suppressants. return to top

Unaware of Surroundings - No one wants to think about it, but senility does occur in dogs. The signs of senility can include the following: not recognizing the owner, loss of bathroom training, staring at things that are not there, and barking for no apparent reason. As in people, there is no cure, but there are special foods and some medications that can be tried. return to top

Inappropriate Elimination - A common ailment of our older dogs is leaking urine. This incontinence can be a result of the weakness of the urinary bladder sphincter, a mass in the bladder, or simple "overflow" from drinking too much water. If the leaking is only when the dog is sleeping or napping, the incontinence may be treatable with safe medications. A urinalysis and a good physical examination will often give us enough information to determine the cause.

Vision Loss - Vision loss can be the result of a defect anywhere along the vision pathway. Specifically, there can be a problem with the cornea, the lens, the retina, the optic nerve, or the brain. A really common ailment in older dogs is the aging of the lens where the lens becomes gray in appearance. This is called Lenticular Sclerosis or Nuclear Sclerosis and is NOT the same as a cataract. Lenticular Sclerosis is a graying of the lens and rarely affects vision. It is more like a person that has dust on their glasses - you can still easily see through them. A Cataract, on the other hand, is an opacity in the lens that you cannot see through. Cataracts can be addressed with surgery by a veterinary ophthalmologist - Nuclear sclerosis does not need to be addressed.

Possible Geriatric Diseases

Arthritis - Most older dogs develop arthritis in one or more joints. Some dogs are only mildly affected by the arthritis and others are incapacitated. It is important to know that there are many treatments available for arthritis. Once a diagnosis is made by your veterinarian, an appropriate treatment protocol can be started. Among the most important treatments are the following:

Weight Management - taking extra body weight is extremely important to reduce the stress on the joints. It does not make any sense to load a patient up with drugs and ignore the excessive weight that many of our pets are carrying around!
A good quality "Joint Supplement" should be part of all arthritis protocols. The problem with joint supplements is that their quality cannot be evaluated by looking at the label, the advertisements, or even the price! So, how do you pick the best one for your dog? Your veterinarian will have experience with these supplements. You should trust their choice as being one that will usually work on your dog. We try to use only the best supplements available. At present, the one we recommend for dogs is called Dasuquin Advanced.
A rich source of DHA and EPA are very helpful in decreasing inflammation and slowing additional degenerative changes in the joint. These essential fatty acids are found in certain fishes. Generic "fish oil" is frequently NOT a good source of EPA or DHA. Consult with your veterinarian for a good source of these Omega-3 Fatty acids.
The above three items are what we generally use for long-term support for our arthritic patients. These supplements usually take 4-6 weeks to see changes, so initially, we often use drugs to get the arthritis under control. If the supplements do not provide adequate relief, then we may use drugs either "as needed" or continually for additional relief from pain. Most veterinarians usually start with NSAIDs (non-steroidal anti-inflammatory drugs). If the NSAID is not adequate, then the addition of additional drugs like Gabapentin, Tramadol, Amantadine, or Adequan may be needed.
A "non-drug" approach is also available and very helpful for a lot of patients. This would be Laser Therapy to control the inflammation in the joints (click HERE for more information on Laser Therapy) and the use of the Underwater Treadmill to strengthen muscles (click HERE for more information on the Underwater Treadmill). Additional "non-drug" therapies could also include the Assisi Loop (click HERE for more information on the Assisi Loop).

Progressive Kidney Disease - As dogs age, their kidneys slowly start to deteriorate. No one knows the reason, but once the deterioration begins, it tends to progress. The big problem with this "disease" is that the routine blood tests that are done for our older patients will not pick up any issue until the deterioration is advanced. Symptoms of kidney disease include increased thirst and urination and eventually a decrease in appetite and perhaps vomiting. So, what can we do to try to avoid or slow down this disease process? There is no perfect answer, but having plenty of fresh water for your dog at all times is essential. Additionally, it has been shown that bad oral hygiene can directly send excessive amounts of bacteria to the kidneys. So, keeping the mouth clean and healthy with periodic dental cleanings would be a good idea. If the kidney disease is advanced, there are some special diets and drugs that may help.

Liver Disease - Multiple liver diseases can affect our older dogs. Certainly, cancer is one that we are all concerned about, but not all liver problems are from cancer. Several diseases just cause inflammation of the liver which could result in vomiting, loss of appetite, and abdominal discomfort. Hepatitis means "inflammation of the liver". Most people equate "hepatitis" with viral diseases, and indeed, people have multiple viruses that affect the liver. Dogs only have one real viral hepatitis and early puppy vaccines against this virus make viral hepatitis a rarity in dogs. So the hepatitis that we see in dogs can be from drugs, excess production of cortisol by the body, or fat storage from obesity or Diabetes. Some forms of heart disease can also cause problems with the liver by decreasing blood flow and making the liver swollen. Blockage of the bile ducts with either stones or disease of the gallbladder can also look like liver disease with elevated bilirubin making our patient look yellow!

Inflammatory Bowel Disease - This is a common ailment of middle-aged and older dogs. Most people think that this is an immune system issue, where "normal proteins" or "normal bacteria" in the food cause inflammation of the stomach, small intestines, or colon. Symptoms can include vomiting, diarrhea, or weight loss. Sometimes chronic weight loss is the only symptom. Treatments, once the diagnosis is properly made, may include diet changes or medications.

Cancer - Cancer can occur in almost any organ of the body - not something that we want to think about. There is not enough space (or time) to discuss all forms of cancer. Suffice it to say, that a good physical examination is where we always start. In our older patients, we strongly encourage a good physical examination every 6 months. If you feel or see a lump anywhere on your dog, please bring it to your veterinarian's attention.

Heart Disease - Heart disease can present in several different forms. The most common form is a valvular leak. In dogs, this is commonly either Mitral or Tricuspid Insufficiency (left and right side of the heart, respectively). Symptoms of Left-sided leak most commonly include coughing, especially at night or right after waking up from sleep. Symptoms of Right-sided leak most commonly include accumulation of fluid within the belly. Another cause of heart disease is irregular heart rhythm. Symptoms may include shortness of breath or fainting. Many cases of heart disease are treatable, but not curable. We often can initiate treatments in the office, but some pets are better served with a visit to a veterinary cardiologist.

Cognitive Dysfunction (Senility) - No one wants to think about their beloved pet becoming senile, but it can occur. The signs of senility can include the following: not recognizing the owner, loss of bathroom training, staring at things that are not there, and barking for no apparent reason. As in people, there is no cure, but there are special foods and some medications that can be tried.

Degenerative Myelopathy - Middle age and older dogs can start walking funny in the back end. Often one hind leg may bang against the other or you might notice your dog standing on his/her knuckles instead of the pads of the foot. Sometimes this disease just presents as difficulty using the hind legs and is often mistaken for arthritis, especially hip arthritis. The big difference is a complete lack of response when pain medications are given to the pet. This is because this disease does NOT cause pain! It is a degeneration of some of the nerves of the hind end and causes a lack of awareness of "where the legs are". This is a progressive disease and can eventually cause a lack of good control of urine and bowels, but more frequently it simply is a wobbly gait and progressive weakness. There have been many treatments that have been recommended over the years, but, unfortunately, none of them have been shown to work. Once again, the good news is that this is NOT a painful condition.

Lenticular Sclerosis - A really common ailment in older dogs is the aging of the lens where the lens becomes gray in appearance. This is called Lenticular Sclerosis or Nuclear Sclerosis and is NOT the same as a cataract. Lenticular Sclerosis is a graying of the lens and rarely affects vision. It is more like a person that has dust on their glasses - you can still easily see through them.