Golden Oldies – What Should You Keep in Mind for Senior Cats?

Thanks to major advances in feline medicine, the overall health of our feline patients has improved significantly over the past 15 years. As a result, we are pleased to see an increasing number of older cats being brought to us today.

I see these wise seniors as “golden oldies” who need a great deal of loving care, understanding, and attention. The focus should not only be on living longer, but above all on ensuring the highest possible quality of life.

How should veterinary care for senior cats change?

As a general rule, every cat should be taken to the veterinarian for a health checkup once a year. Even younger cats can develop serious conditions, such as severe dental disease or heart defects, which should be detected as early as possible.

Starting at around nine years of age, but no later than eleven, cats should undergo a thorough examination at least once a year. Older cats often benefit from two to four checkups a year to help maintain their quality of life as much as possible.

Particular attention is paid to muscle condition, nutritional status, and weight trends. Changes in activity, behavior, and general well-being are also specifically assessed.

Depending on the patient, a senior health checkup may also include blood and urine tests as well as a blood pressure measurement. Teeth, claws, and fur should also be carefully examined. At the same time, regular vaccinations and deworming remain important, as the immune systems of older cats become increasingly less effective with age.

What health issues are commonly seen in senior cats? Can they be prevented?

Aging itself is a slow, gradual process: metabolism slows down, muscles and bones weaken, and vision, hearing, and cognitive function decline. Some seniors also develop difficulty swallowing. The skin loses its elasticity, the coat becomes drier, and sleep patterns often change.

Along with gradual cognitive decline—that is, a form of dementia—some cats become restless at night, seem disoriented, or meow more frequently. Their immune system also weakens, and their susceptibility to infections increases. However, aging itself is not a disease.

However, as people age, they are more likely to develop various health conditions that can be detected early through proper preventive care and often successfully treated or at least significantly improved.

Cognitive impairment (dementia)

Between the ages of 11 and 14, about 30 percent of cats develop at least one symptom of age-related brain aging. In cats over 15 years of age, this percentage rises to over 50 percent.

Typical symptoms include confusion, forgetfulness, wandering around the house, a vacant stare at the walls, reduced grooming, or soiling. Many cats lose their usual day-night rhythm, sleep poorly at night, and appear lost or uncertain.

Often, these cats also become more affectionate and seek out their owners’ company more frequently. Another typical behavior is that they forget which side a door opens on and therefore wait in front of the hinges instead of by the doorknob.

Unfortunately, just as in humans, there is no cure. However, the progression of the disease can be slowed with medications that improve blood flow to the brain, as well as special dietary supplements containing tailored vitamins and trace elements.

Establishing a consistent daily routine can also be helpful, as can using small night lights to help them find their way around. In cases of severe dementia, allowing the cat to go outside should be carefully considered, as some cats may become disoriented outdoors.

Chronic kidney disease

Along with hyperthyroidism, chronic kidney disease is one of the most common conditions in older cats. It causes gradual and irreversible damage to the kidney tissue.

About 30 to 40 percent of cats over the age of ten are affected; among cats over the age of 15, the percentage is as high as 80 percent.

Among other things, the kidneys are responsible for excreting toxic metabolic waste products through urine, retaining fluids and essential proteins, and producing hormones involved in blood formation. Unfortunately, symptoms usually do not appear until very late in the disease—often only after about 75 percent of kidney function has already been lost.

Typical symptoms include increased thirst and urination, weight and muscle loss, nausea, vomiting, dehydration, bad breath, loss of appetite, fatigue, and high blood pressure.

Regular checkups are particularly important here: Modern laboratory tests often allow for early detection long before any obvious symptoms appear. Making dietary changes early on can significantly reduce the strain on the kidneys and slow the progression of the disease.

Hyperthyroidism

Hyperthyroidism is also one of the typical age-related conditions in cats. Over ten percent of cats over the age of ten eventually develop nodular changes in the thyroid gland, which are usually benign tumors.

These produce too much thyroid hormone, regardless of normal regulatory mechanisms. As a result, the entire metabolism runs at full speed constantly: heart rate and blood pressure rise, organs work faster, and energy consumption increases dramatically.

Cats often appear restless, stressed, or more irritable than before. Despite having a good appetite, they lose weight, and diarrhea or vomiting often occur as well. Over time, the disease can damage the heart, liver, and kidneys.

If the condition is detected early, it can usually be treated very effectively—either with medication, special diets, or, in some cases, radioiodine therapy.

Heart disease

Many older cats develop a thickening of the heart muscle over the course of their lives, a condition known as hypertrophic cardiomyopathy. This condition can be congenital, hereditary, or acquired.

Since symptoms often do not appear until the disease has reached an advanced stage, it is important to carefully auscultate the heart at every checkup. Any suspicious findings should be further investigated using ultrasound or blood tests.

Affected cats may develop shortness of breath, pant, or form blood clots that affect, for example, their hind legs or other organs.

Unfortunately, this condition is more difficult to treat than many common heart diseases in dogs. Nevertheless, medications and supportive care are available to relieve the strain on the heart and reduce complications.

Dental diseases

We see painful dental conditions very frequently, especially in senior cats. So-called resorptive lesions (FORL) are particularly common in cats; in these cases, the tooth structure breaks down and the gums become severely inflamed.

In addition, periodontitis or other inflammatory conditions often occur. Many cats suffer in silence, without showing any obvious signs of pain. Therefore, the fact that a cat is still eating does not necessarily mean that it is not experiencing tooth pain.

Owners often don't notice the changes until after their cat has had dental work done: the cat suddenly seems more active, better groomed, and generally much happier.

Untreated dental diseases not only cause pain but can also put a strain on the heart, liver, and kidneys. That is why a thorough examination is almost always worthwhile—even for older cats. Modern anesthesia techniques can now be tailored very specifically to the patient’s health condition.

High blood pressure

High blood pressure is relatively common in older cats and is often associated with kidney or thyroid disease. In some cases, however, it can also lead to further organ damage.

Very high blood pressure can lead to serious complications such as retinal detachment, stroke, or damage to the heart and kidneys.

Measuring blood pressure is straightforward, but it is important to do so in a calm, stress-free environment, as stress can cause a sharp, temporary rise in blood pressure. Treatment is usually successful with medication.

We know that dogs often have significantly poorer vision and hearing as they get older. Is that also true for cats?

To some extent, yes—vision in particular changes as cats age, though in a slightly different way than in dogs. Dogs often suffer from slowly progressive retinal degeneration. This also occurs in cats, but is usually less severe. Typical symptoms include pupils that gradually become larger and difficulty seeing, especially at dusk or in low light.

In addition, older cats, like humans, develop a certain degree of presbyopia. This means they have more difficulty focusing on nearby objects. For most cats, however, this is hardly a problem in everyday life.

However, it is important to note that sudden blindness is always a medical emergency and should be evaluated by a veterinarian on the same day. Older cats can develop retinal detachment as a result of high blood pressure. These cats often go completely blind overnight, have severely dilated pupils, bump into objects, and appear frightened.

If action is taken quickly, vision can sometimes recover surprisingly well. However, this requires immediate treatment of the underlying cause, particularly high blood pressure. Unfortunately, the prognosis worsens significantly after several days.

Hearing also declines with age. This often happens gradually and initially affects specific frequencies. In some cases, however, severe hearing loss can occur relatively suddenly. There is little that can be done to prevent this. Owners should therefore approach older cats calmly and gently, especially when they are sleeping, so as not to startle them.

If a dog’s hearing is significantly impaired, allowing it to roam freely should be carefully reconsidered, as it may have difficulty detecting hazards such as cars. A fenced-in yard can be a sensible alternative in this case.

In addition, a cat’s sense of smell tends to decline with age. Since cats have a much keener sense of smell than taste anyway, this often makes food less appealing to them. Slightly warming the food can help intensify the smell and improve their appetite.

What changes in terms of hygiene and grooming as cats age—and what can owners do?

As cats age, their skin becomes drier and less elastic. At the same time, many older cats develop stiffer joints or back pain, which makes it difficult for them to groom themselves thoroughly—the lower back is particularly prone to this issue.

Owners can help their senior dogs by regularly brushing their coats and removing matted areas early on. In addition, appropriate grooming products can help moisturize the skin and improve coat quality.

If the underlying cause is pain or osteoarthritis, these conditions should be treated specifically. This often leads to a significant improvement in the cat’s coat condition.

I’ve read that up to 80 percent of all senior cats suffer from osteoarthritis. How can cat owners help their cats?

That's actually true. Osteoarthritis is extremely common in older cats, but it is often overlooked for a long time because cats are very good at hiding their pain.

The typical symptom is not so much obvious limping as a loss of the cat’s usual agility. Cats are less inclined to jump, hesitate before jumping, or sleep significantly more. Some seem more irritable or withdraw. Changes in sleeping position or small patches of matted fur can also be signs of pain and limited mobility.

As a general rule, cats in pain often appear calm, tired, or withdrawn rather than visibly distressed.

Cat specialists sometimes refer to this as “asking the cat.” What this means is that if osteoarthritis is suspected but there are no clear symptoms, a suitable osteoarthritis medication can be administered on a trial basis for a few weeks. If the cat’s quality of life visibly improves, this often confirms the suspicion.

Modern anti-inflammatory medications specifically approved for cats can be of enormous help to many senior cats and significantly improve their quality of life. Studies also show that cats whose conditions are well managed often remain more active and enjoy a good quality of life for longer overall.

Even in cases of chronic kidney disease, certain medications can often still be used, though they must be individually tailored and carefully monitored. It is important to understand that these medications are not primarily traditional pain relievers, but rather anti-inflammatory drugs. By reducing joint inflammation, they alleviate pain and slow the progression of joint damage.

In addition, dietary supplements such as glucosamine or chondroitin can be helpful. Some cats also benefit from special joint diets or CBD products—provided they are guaranteed to be free of THC and terpenes.

In addition, modern antibody therapies have been available for several years now; these are administered as a monthly subcutaneous injection. They specifically block certain inflammatory mediators and are often very effective at reducing pain—while being very well tolerated.

Even small adjustments to daily life can be a huge help to senior cats: warm, soft sleeping spots, heating pads, or heat lamps are often gratefully accepted. Small steps or risers make it easier for them to reach their favorite elevated spots. Litter boxes should have a low entrance and be large enough for the cat to turn around without discomfort. In addition, the path to the litter box should be as short as possible and accessible without stairs.

Regular, gentle exercise also helps keep your joints flexible.

Are there any other health issues that owners should be aware of when it comes to their senior cats?

One topic that is often overlooked is claws. While older cats usually continue to sharpen their claws, the outer keratin sheaths often do not shed as easily. As a result, the claws become thicker and longer.

They can grow into the pads of the paws, causing pain, especially on the front paws. That’s why owners should check their cats’ claws regularly—including the so-called dewclaws.

If the claws become too long, they can be carefully trimmed. The hind claws should also be checked: although they usually grow less curved, they can still interfere with walking and further impair mobility.