Senior Care/Geriatric Workups, Part 3: “He’s been so healthy until today.”

Three times in the last week I have been presented with a pet who was gravely and terminally ill, and the people felt the illness had come on suddenly.  I looked at the pet and saw things like being twenty percent underweight, bones "sticking out", dehydration, sunken eyes, swollen abdomen.  These are things that didn’t happen overnight. 

It is certainly true that animals have a tendency to conceal their illnesses to whatever extent possible.  It’s a survival thing: you don’t want to advertise what a helpless target you are.  It is also true that a long hair-coat sort of fills in the gaps, concealing early weight loss (like someone wearing a bulky sweater: you don’t know if they’re fat, thin or what).

Also, the body has a lot of reserve capacity built in.  Your heart normally beats at about half-speed, resting the other half of the time.  You have two lungs, but could get by with one.  Two kidneys, but you could get by with half of one.  The liver has lots of excess capacity.  This means that long-term, chronic, ongoing destruction of the organ’s function can go on for quite a while, and you still look okay.  It’s only when the reserve is all gone and you’re down to losing the nitty-gritty that you start looking sick.

On the other hand, when questioned, these owners readily volunteered things like "Oh, yeah, he hasn’t been eating well for a long time.  He doesn’t move around much either.", or "She has been eating everything she could find and still was losing weight.  She drinks a ton of water, too, way more than she used to." , or  "We had been noticing that big belly for a few weeks."

Does that sound like some of the things on yesterday’s checklist?  You bet it does!  Even though the pets had been operating at a level the owners had come to consider "normal" just a few days before, there was nothing normal about it.  They had been sick for weeks or months, but it had been dismissed as (you guessed it) "just getting older".

Many veterinary hospitals (including KVC) have "Senior Care" packages.  When your older pet (or younger one, for that matter) is showing some of the clinical signs on yesterday’s checklist, we bundle a wide array of screening tests into a package that saves you about twenty percent over the cost of running them separately. [The savings derive from getting a package deal from an outside lab, and from only having to handle the patient and the paperwork one time.]  It’s not a bad idea for older pets to have periodic screenings, even if they don’t have obvious clinical signs of disease.  As a dog or cat ages, one calendar year really does equate to seven "human  years".  A lot can change in that time for an aged pet.

What difference can it make?  It’s a tale of two dogs.

"E" had high liver enzymes when she had her senior check-up, leading to an ultrasound exam showing a tumor.  The tumor went to surgery, but could not  be completely removed.  However, at 13 years old, she is 18 months past surgery, leading a happy life with oral chemotherapy at home. 

"K" came in at 12 years old with a really swollen abdomen.  It had been a couple of years since her last check-up.  It seemed to her owners that she had just "suddenly become sick".  Her ultrasound exam showed her liver riddled with tumors, with practically no normal tissue left.  Her owners felt that euthanasia was the only practical and humane choice.

You don’t have to invest a lot of money in diagnostic testing for your pet.  If you have an older pet, why not invest a little time in reviewing that checklist?  You might be able to add years (good years) to your friend’s life.

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