Photo courtesy by Heidi Lobprise, DVM, DAVDC.
A recent study debunked the age-old credo that 1 year in the life of a dog is equivalent to 7 years of human life.1
As veterinary professionals, we certainly recognize that the rate of aging depends on the size of the dog. But whether it’s a 5-year-old Great Dane or 10-year-old Chihuahua, certain ailments are more common in senior dogs. Here are the top 5 conditions to talk to your clients about.
1. Osteoarthritis and degenerative joint disease
Although joint disease and pain can occur in younger dogs, they’re more common in seniors. A combination of underlying orthopedic issues, years of use/overuse, and obesity can contribute to discomfort associated with osteoarthritis. Owners may think their dog is “just getting old” when they start slowing down or are reluctant to jump, climb stairs, and exercise. These indicators occasionally can be acute—making them much more obvious to owners. More typically, the slow, gradual alteration may go unnoticed until the dog becomes clinically lame. Changes in behavior, from decreased activity to increased irritability, may be the primary indicator of pain.
A complete physical exam, body condition assessment, palpation of the skeletomuscular system to elicit discomfort, and thorough history can help determine if focal or generalized discomfort is present. Additionally, radiographs can reveal specific osseous structures and causative lesions. Management of degenerative joint disease is directed at pain relief and can include a combination of pharmaceuticals such as nonsteroidal anti-inflammatory drugs, supplements, therapeutic diets for both weight control and mobility, rehabilitation, appropriate exercise regimens, and complementary methods such as laser therapy, acupuncture, and targeted pulsed electromagnetic field therapy.
2. Cardiac disease
Cardiac diseases can impact dogs of all ages, but the most common (especially in smaller, older dogs) is myxomatous mitral valve disease. Clinical signs of congestive heart failure (CHF) can develop 3 to 4 years after hearing that initial mitral murmur. Age-related degeneration of the valve structures allows a backflow of blood through the valve, causing the murmur. This can lead to inefficient outflow and eventual dilation of the heart chambers (atria and ventricles). The first clinical sign of CHF that a pet owner may observe is coughing. This can be due to the enlarged chambers pushing on the bronchi or, in more severe cases, a buildup of fluid in the lungs.
Initial diagnostics may include the following:
- Pro–B-type natriuretic peptide levels (heart muscle stretch)
- Thoracic radiographs to determine cardiac enlargement (measuring vertebral heart score)
- Blood pressure
- Electrocardiogram
- Echocardiogram
Owners can measure the resting respiratory rate (RRR) when their pet is sleeping and should be concerned when the RRR exceeds 25 breaths per minute. Additionally, the ABCDs of canine cardiology help with classifying the level of disease and making treatment recommendations. Once mild changes such as heart enlargement start to occur, therapy is focused on managing blood pressure with pimobendan and angiotension-converting enzyme inhibitors.
Once clinical signs of CHF (eg, coughing, exercise intolerance, shortness of breath, and syncope) are present, diuretics are administered to remove excess fluid, either with oral medications in chronic cases or with intravenous diuretics and oxygen therapy in emergencies. Typically, the life expectancy is about 12 months after presenting with clinical signs.
3. Cancer/neoplasia
Many types of cancerous lesions are possible, from those in the skin or dermis to those hidden in the mouth, thorax, abdominal cavity, osseous structures, or another systemic form. Ask owners to monitor any visible masses (tumor map) by taking sequential pictures. Internal lesions, however, sometimes aren’t identified until the disease has advanced enough to cause significant changes in the patient. Early detection can be enhanced through semiannual physical examinations, radiographs, and regular diagnostic testing.
4. Behavioral changes and cognitive Issues
Almost any type of body system deterioration can impact an animal’s actions and behaviors, but often one of the toughest to accept and manage is cognitive dysfunction syndrome. Dog owners may compare this condition to dementia or Alzheimer disease in people and may be all too familiar with the challenges associated with dementia in an otherwise healthy individual. The impact on the relationship and the human-animal bond can be devastating.
Certainly, a complete medical workup needs done to rule out or to identify and manage other, often concurrent issues. Consider an assessment of that dog’s cognition when incontinence, restlessness, lack of interaction, or sleep disruptions are present.
Assessing mental acuity in dogs with DISHAA
DISHAA is a tool to help assess mental acuity in dogs.2 Owners score their pet in the areas listed in the acronym. The newly added “A” at the end recognizes the increase in anxiety that many dogs experience, especially separation anxiety.
- D—Disorientation
- I—Social Interactions
- S—Sleep/wake cycles
- H—House-soiling, learning, and memory
- A—Activity
- A—Anxiety
Early detection of cognitive dysfunction provides the best probability that management may help. Pharmaceuticals such as selegiline may be paired with supplements and diets to help support cognition, as well as anxiety medication when necessary and environmental enhancement.
Thoroughly and carefully reviewing medications and supplements is essential when treating senior patients because issues with polypharmacy can cause additional problems, many of which are not well defined in dogs at this time.
5. Oral and dental problems
Studies show that the incidence of periodontal disease increases as the size of the dog decreases and their age increases. That means we have a lot of small, older dogs with significant periodontal problems. Many studies in human dentistry have shown that, in direct relation to aging, a significant inflammatory process such as ongoing periodontal disease can directly impact the health of the patient’s organ systems beyond bacteremia. Other than periodontal disease, the incidence of oral tumors also increases in older dogs of all sizes.
Yes, there are anesthetic risks for these senior patients with concurrent diseases, such as cardiac, renal, or hepatic problems. However, when patients are well managed pre- and perioperatively, the benefits of treating dental disease often far outweigh the risks. Anyone in general practice has seen the positive results—when that dog comes back 2 weeks after extensive extractions feeling like a puppy again!
References
- Wang T, Ma J, Hogan AN, et al. Quantitative translation of dog-to-human aging by conserved remodeling of the DNA methylome. Cell Syst. 2020;11(2):176-185. doi:10.1016/j.cels.2020.06.006
- Cognitive dysfunction syndrome evaluation tool. Purina Institute. Accessed November 5, 2020. https://www.purinainstitute.com/sites/g/files/auxxlc381/files/2018-08/DISHAA.pdf