Heartworm Life Cycle
Why Dental Care Is Important
AAHA Guidelines
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Pre-anesthetic exam–Your veterinarian should examine your pet to ensure it is healthy enough to go under general anesthesia. This examination may include:
- Blood tests
- Urine tests
- Electrocardiography
- X-rays
- Anesthesia monitoring–When your pet is under anesthesia, its vital signs (such as body temperature, heart rate, and respiration) should be monitored and recorded. This helps ensure your pet’s safety while under anesthesia.
- Dental radiographs–X-rays of your pet’s teeth are needed periodically to evaluate your pet’s oral health. X-rays also help veterinarians detect abnormalities that cannot be seen through physical examination alone. They can also confirm the need for tooth extraction when teeth are loose or badly infected.
- Scaling and polishing–Using instruments much like human dentists, veterinarians remove plaque and calculus from your pet’s teeth. Polishing with a special paste smoothes out scratches to the tooth enamel.
- Fluoride/sealants–By applying an anti-plaque substance, such as a fluoride treatment and/or a barrier sealant, the veterinarian helps strengthen and desensitize teeth and discourage the development of future plaque.
FAQ
Q. | Is there a physical sign that my pet has a dental problem? |
A. | Pets’ breath isn’t normally great smelling, but if it becomes particularly offensive, it could be a sign of a serious oral problem. Other signs include excessive drooling, loose teeth, tumors on the gums, and cysts beneath the tongue. |
Q. | What’s the best way to brush a dog’s teeth? |
A. | Use a brush or wrap your finger in gauze and hold it at a 45-degree angle to the teeth. Using small, circular motions, work in one area of the dog’s mouth at a time. Be sure to lift the dog’s lip if necessary to reach the teeth. Since the most tartar builds up on the tooth surfaces that touch the cheek, concentrate there and finish up with a downward stroke on the teeth to remove tartar. Your dog may not let you clean the backside of its teeth, but don’t worry about it because very little tartar builds up there. |
Q. | Is there anything else I can do to help my dog’s oral health? |
A. | Provide chew toys that help massage your pet’s gums and keep their teeth clean. Ask your veterinarian to recommend toxin-free chew toys. An added benefit of chew toys is their ability to reduce your dog’s stress level, eliminate boredom, and give pets an outlet for their desire to chew. |
Dear Scholl Animal Hospital,
First, I want to thank you for your help finding homes for our kittens. Bella has a wonderful home because of you. You can now take Jumper and Gremlin off your website, they have found good homes also. Here’s the update I’ve been sending everybody.
Sue and I were able to find good homes for all the kittens. As you know, we kept Smudge. At 9 weeks of age Alpha went to a friend of Susan’s, so we know he’s in a good home.
Scholl animal clinic in Hyde Park helped us find a wonderful home for Bella. Bella went at 12 weeks to a young lovely couple with a 10 year old cat named Henry. We met with them and it became obvious that they were animal lovers. There are no fears of declawing, etc, with these people. They keep in touch also and they just love Bella. Apparently she teaches at Western.
Then Animal Outreach helped us find a home for Jumper and Gremlin. Again I was able to screen the lady. She’s married and has 2 boys, a three year old and six year old. Jumper and Gremlin went to their home together, so that was fantastic. Also, Animal Outreach makes the new owner sign a contract where it is promised that there will be no declawing and they even physically ‘check up’ on the kittens. Jumper and Gremlin left us at 13 weeks of age.
We heard from Bella’s new owner that Bella’s new vet was very impressed by how healthy and socialized Bella was. And I know that Jumper and Gremlin are the same, so I guess Molly, myself and Sue did a good job raising the little guys.
I just wanted to thank you for doing all that you could to help the kittens (and me).
I hope you had a good Christmas and a sincere Happy New Year to you and your loved ones.
Joe
This is an e-mail from Joe and Susan.
Hello.We are animal lovers; cats in particular. For
quite a while we were being
visited by a stray, feral cat.
She was a beautiful looking
cat whom we named Molly.
Molly would visit us
seemingly whenever she
pleased. Sue and I noticed
that she was getting bigger
and was undoubtedly
pregnant. Then, for the
longest time, a much
skinnier Molly would visit us
less frequently and she seemed quite exhausted. She would come in the house, eat, and have a long nap. Then she would leave again. Sue and I figured she had her kittens outside somewhere and was visiting us for some food and a rest. Molly knew Sue and I had a kind heart and one day she tried to lead me to her kittens, but she would cut through backyards and fences and there was no way I could keep up. As time passed, Molly was at our house quite a bit, but there was no sign of her kittens. Given the harsh weather, wild animals and other factors…Molly’s kittens didn’t stand a chance.
As time passed we noticed Molly getting bigger. Yes, she was pregnant again. Sue and I decided that there was no way we were going to let Molly have her kittens outside. We set up a nesting box and put it in the spare bedroom. She was going to give birth soon, and if necessary, I wasn’t going to let her out of the house. I wasn’t going to take any chances this time. But it wasn’t necessary. Molly knew what the nesting box was for, and she knew that her litter had a greater chance of surviving if she had her kittens in our house. Having survived outside on her own for what we think was about two years, it’s was obvious that Molly was an extremely intelligent cat.
When the time came, Molly
literally came and got me
and took me into the spare
room. At about 3:00 pm on
September 20, 2013, Molly
gave birth to five healthy
kittens: Alpha, Smudge,
Gremlin, Jumper, and Bella.
In the passing weeks it has
been absolutely amazing to
see Molly perform her
mothering skills. I
witnessed her teaching the
kittens how to use the litter
box, how to drink out of a
water dish and glass, how
to eat hard food, how to
talk…the whole nine yards.
These kittens have been
using the litter box after
about 2 weeks of age.
There has not been a single ‘accident.’ There has not been a single case of diarrhea or anything like that. This mom has done such a good job that these kittens all use their scratching posts.
Based on the markings of the kittens, Sue and I believe that this guy here is the father. We named him Junior. Unfortunately, we haven’t seen him in a couple weeks and we fear that something has happened to him. The life of a feral cat is a hard one. Needless to say, Molly is scheduled to get fixed soon. We are not going to let this happen to her again. The vet did blood work on Molly and everything turned out fine. The vet was actually amazed at the beautiful condition Molly was in.
We have all the vet records for you, if you decide you want a kitten or two. Sue and I are not asking for payment. This is our charity.
In order to receive a kitten you must promise that he or she will not be declawed. We would prefer if they went to a home with children. Retired or semi-retired people would also be a good option. Of course the important thing is that you love animals.
Like I said, Mom is healthy. She has been tested for feline leukemia, etc, and she is fine.The kittens are also healthy. On November 26 they had two sets of shots and are due for their final set around Christmas time.
Many vets say it is ok to adopt out a kitten at 8 weeks, but my research has shown that the 8 to 12 week period with the mom is extremely important. It is during this time that the kittens learn much more subtle things like social interaction with other cats and humans. I am witnessing it with my own eyes…these kittens are learning how to talk! The difference is something like this: these kittens are being lovingly weaned from their mother, by their mother, and are learning to be independent yet well adjusted, as opposed to being ‘yanked’ from their mother where possible personality issues may occur. These kittens will be twelve weeks old on Friday December 13, 2013.
Alpha has already been adopted and Sue and I are keeping Smudge, so that leaves Jumper, Gremlin and Bella. Remember, if genetics has anything to do with it, these kittens are extremely intelligent. Also, they are above average in social skills. They eat hard food and are litter trained. If you are interested in one or two of the remaining three kittens, please contact Scholl Animal Hospital.
What is chocolate toxicity?
- Chocolate toxicity (poisoning) is caused by excessive intake of the methylxanthine alkaloids in chocolate, coffee, tea and caffeinated sodas. The active ingredient in chocolate is theobromine. The poisoning affects many organ systems and animals of all ages are susceptible.
- Poisoning is common in dogs because of their habit of rapid consumption, particularly puppies and young dogs as they may be more likely to ingest large amounts of unusual foods. Although dogs are the most susceptible, the toxin has been known to affect or kill cats, birds, rodents and reptiles as well.
-
Clinical signs
- The clinical signs include vomiting, diarrhea, hyperactivity, restlessness, excessive urination, muscle tremors, tachycardia, bradycardia, arrhythmias, hyperthermia (high temperature), seizures, coma and death. Vomiting and diarrhea can occur 2 to 4 hours after intake. Advanced signs (seizures, heart failure, coma and death) can occur 12 to 36 hours after intake.
Diagnosis
- The patient may have a history of exposure to a methylxanthine. The clinical signs are important, but chocolate toxicity can look similar to many poisonings such as that caused by strychnine, amphetamines, pesticides and some rodenticides. The stomach contents, serum, or urine can be analyzed for the presence of methylxanthine alkaloids (caffeine, theophylline, and theobromine).
Treatment
- If your pet has just ingested chocolate, induce vomiting with hydrogen peroxide. Emetics (medications that induce vomiting) are contraindicated if the pet is twitchy, unaware of his/her surroundings or seizuring. Induction of vomiting in dogs can be performed with 3% hydrogen peroxide 1 ml/lb by mouth (max dose is 45 ml or 3 tablespoons). If the patient does not vomit within 15 minutes, give the same dose again. If this is not effective, a veterinarian may choose other drugs to induce vomiting.
- Take your pet to an emergency facility immediately.
- Supportive treatment: There is no antidote for chocolate poisoning. The patient needs to be hospitalized for supportive treatment and observation.
- Activated charcoal may be administered every 3-4 hours to reduce the serum half–life of methylxanthines.
- Intravenous fluid therapy may be used to help flush out the toxins.
- In some cases oxygen therapy may be needed.
- Sedation is necessary for some patients that are very hyperactive.
- The patient’s cardiovascular system function may require monitoring with ECG, blood pressure, oxygen saturation and/or blood gases.
- Medication may be required to treat a slow, very fast, or irregular heart beat.
- Insulin administration may be beneficial to treat caffeine poisoning, as insulin has been shown to be antagonistic to caffeine.
Potential complications
- If a 50 mg/kg dose of theobromine is ingested, cardiotoxicity (heart complications) can be seen. At 60 mg/kg, seizures are possible. Any dose over 40 mg/kg should be considered life-threatening. 100mg/kg is the LD50 meaning that at this dose half of the animals will die. Animals can die from exposures well below the LD50. Pregnant or nursing animals are at risk for teratogenesis of newborns or stimulation of nursing neonates.
Aftercare (home care)
- It is important to remember to keep chocolates, chocolate cakes and chocolate-coated goodies safely away from your pets.
Prognosis
- Patients usually recover with aggressive supportive therapy under the direction of a veterinarian. If the ingestion and the treatment are performed in the first 4 hours, the prognosis is good. Heart failure, weakness, seizures, coma and death can occur 12 to 36 hours after ingestion and the prognosis may be guarded.
Milk Chocolate (60 – 66 mg/oz or 2.12 – 2.33 mg/gram of methylxanthines)
WeightMild ReactionModerate to Severe Reaction5 lbs 2.27 kg 0.75 oz 21.26 gm 1.5 oz 42.53 gm 10 lbs 4.5 kg 1.5 oz 42.53 gm 3.0 oz 85.05 gm 20 lbs 9.1 kg 3.0 oz 85.05 gm 6.0 oz 170.10 gm 30 lbs 13.6 kg 4.5 oz 127.58 gm 9.0 oz 255.15 gm 40 lbs 18.2 kg 6.0 oz 170.10 gm 12.0 oz340.20 gm 50 lbs 22.7 kg 7.5 oz 212.63 gm 15.0 oz 425.25 gm 60 lbs 27.3 kg 9.0 oz 255.15 gm 18.0 oz 510.30 gm 70 lbs 31.8 kg 10.5 oz 297.68 gm 21.0 oz 595.35 gm 80 lbs 36.4 kg 12.0 oz 340.20 gm 24.0 oz 680.40 gm Semi Sweet Chocolate (150 mg/oz or 5.29 mg/gram of methylxanthines)
WeightMild ReactionModerate to Severe Reaction5 lbs 2.27 kg 0.3 oz8.51 gm0.6 oz17.01 gm10 lbs 4.5 kg 0.6 oz17.01 gm1.2 oz34.02 gm20 lbs 9.1 kg 1.2 oz34.02 gm2.4 oz68.04 gm30 lbs 13.6 kg 1.9 oz53.87 gm3.6 oz102.06 gm40 lbs 18.2 kg 2.1 oz59.54 gm4.2 oz119.07 gm50 lbs 22.7 kg 2.5 oz70.88 gm5.0 oz141.75 gm60 lbs 27.3 kg 3.8 oz107.73 gm7.6 oz215.46 gm70 lbs 31.8 kg 4.2 oz119.07 gm8.5 oz240.98 gm80 lbs 36.4 kg 4.8 oz136.08 gm9.6 oz272.16 gmBaking Chocolate (~450 mg/oz or 15.87 mg/gm of methylxanthines)
WeightMild ReactionModerate to Severe Reaction5 lbs 2.27 kg 0.1 oz2.84 gm0.2 oz5.67 gm10 lbs 4.5 kg 0.2 oz5.67 gm0.4 oz11.34 gm20 lbs 9.1 kg 0.4 oz11.34 gm0.8 oz22.68 gm30 lbs 13.6 kg 0.6 oz17.01 gm1.2 oz34.05 gm40 lbs 18.2 kg 0.8 oz22.68 gm1.6 oz45.36 gm50 lbs 22.7 kg 1.0 oz28.35 gm2.0 oz56.70 gm60 lbs 27.3 kg 1.2 oz34.05 gm2.4 oz68.04 gm70 lbs 31.8 kg 1.4 oz39.69 gm2.8 oz79.38 gm80 lbs 36.4 kg 1.6 oz45.36 gm3.2 oz90.72 gmNOTES:
* Mild reactions may be seen at ~ 20 mg/kg
* Moderate to severe reactions may be seen at doses over 40 mg/kg
* Cardiotoxicity may be seen at ~ 50 mg/kg
* Seizures are possible at doses over 60 mg/kg
* Any dose over 40 – 45 mg/kg should be considered potentially life-threatening
* 100 mg/kg is the LD50, meaning that at this dose half of the animals will die; animals can die from exposures well below the LD50

Provide choices: Just like you, pets prefer comfortable sleeping places and may change their location based on their need for more or less warmth. Give them some safe options to allow them to vary their sleeping place to adjust to their needs.
THIS IS AN EMERGENCY!!
|
Recognizing the Emergency
Male cats are at risk for an especially life-threatening complication of this syndrome: the urinary blockage.
Mucus, crystals and even tiny bladder stones can clump together to form a plug in the narrow male cat urethra. The opening is so small that it does not take a lot to completely or even partially obstruct urine flow. Only a few drops of urine are produced or sometimes no urine at all is produced.
It is hard to tell when a cat is blocked as the inflammation, urgency, and non-productive straining also accompany cystitis whether or not there is a blockage. The easiest way to tell is by feeling in the belly for a distended bladder. It is often the size of a peach and if there is an obstruction the bladder will be about as hard and firm as a peach. (Normal bladders are usually soft like partly filled water balloons, and non-obstructed inflamed bladders are usually very small or empty). Still, while this size and texture difference is obvious to the veterinarian, most pet owners are not able to feel for the bladder correctly. If there is any question about whether a male cat is blocked, he should be taken to the vet for evaluation as soon as possible.
If the blockage persists 3 to 6 days, the toxin build up will result in death.
DO NOT PUT OFF HAVING THE CAT CHECKED!
Confirmation and Assessment
The veterinarian will feel the bladder in the abdomen and attempt to express urine. Sometimes gentle pressure will actually expel the obstruction but usually the cat will require more aggressive means of relief. The blocked cat will be assessed for dehydration and toxin build up. The urinary toxins that build up in obstructions commonly cause vomiting, nausea, and appetite loss. They can also cause life-threatening heart rhythm disturbances. Your cat is assessed for all these complications as they will need to be addressed.
A partial blockage can be just as serious as a complete blockage. Treatment is usually the same.
Initial Treatment
The single most important thing for the obstructed cat is to have the blockage removed. This is done by placing a urinary catheter through the urethral opening and either through the obstruction itself, or using pulses of flushing solution to move the plug back into the bladder where it can be dissolved. This procedure is often painful and sedation will most likely be needed. Some cats are unblocked with great difficulty only. Some cats cannot be unblocked and must have an emergency perineal urethrostomy to re-establish urine flow .
Fortunately, most cats are successfully unblocked. The urinary catheter is sewn in place and will stay in place for a couple of days. Often a urinary collection bag is attached to the catheter so that urine production can be measured. Sometimes, the bladder is filled with sterile fluid and flushed out to remove crystals, inflammatory debris, and blood.
When the blocked cat has filled his bladder to capacity, his kidneys stop making urine as there is nowhere for it to go. Once urine flow returns, the kidneys quickly begin to correct the metabolic disasters that have been taking place. Often an extremely sick blocked cat can be snatched literally from the jaws of death by having proper fluid support and by re-establishing urine production. It is amazing how efficient the working kidneys can be in restoring the body’s balance; still, it is important to realize that this is a serious condition and not every cat can be saved.
Occasionally a cat is brought in soon after blocking and achieves an excellent urinary stream immediately after unblocking. These cats may be able to proceed with treatment without having to spend a few days in the hospital or without having to have the catheter sewn into place. Most blocked cats do not fit into this category but is important to realize that some cats are able to avoid more aggressive treatment
What Happens during Hospitalization?
The kidneys do most of the work during the recovery phase. The cat must wear a type of collar that prevents biting at or removing the crucial urinary catheter. Urine production is monitored closely as after the obstruction is relieved often dramatic urine volumes are produced. (This is called post obstructive diuresis and if the cat is not drinking on his own, it is crucial that his fluid therapy matches the volumes produced as urine. If they do not, he will dehydrate.) Fluid therapy is given either intravenously or under the skin, depending on the degree of support needed by the cat. Medications are given to relieve pain and relax the irritate urethra.
After a couple of days of catheterization, the catheter is removed and the patient is observed for re-blockage. He will not be allowed to go home until his urine stream seems strong and relatively easy. Some cats will leak urine at this point as it is painful for them to engage in normal pushing; this is generally a temporary problem. Once he seems to be urinating reliably on his own, he will be released for home care.
What to Watch for at Home after Discharge from the Hospital
In an ideal world, owners can learn how to feel the abdomen for a firm obstructed bladder. This is hard to teach at discharge mostly because at this point, the cat is pretty sore. There will usually be medications and dietary recommendations to go home with the cat.
It is crucial to realize that the cat is at risk for re-blocking for a good week or two from the time of discharge.
This is because the irritation syndrome that led to blocking in the first place is still continuing and as long as the episode continues, blocking is a possibility.
At home, the same straining and possibly bloody urine will still be produced. It is important for the owner to be aware of urine volume being produced and of bladder size, if possible. Any loss of appetite or vomiting should be reported to the veterinarian at once. If there is any concern about reblocking, the veterinarian can determine fairly easily if the cat has re-blocked.
Most cats recover uneventfully and most do not need continuing medication after they have recovered. Some cats, especially if they have blocked before, will require on-going treatment. Once the cat is no longer obstructed, management is the same as for any other cat with feline idiopathic cystitis that is not obstructed.
Occasionally the bladder over-stretches while it is blocked and is permanently damaged. Such cats require medication to help them contract and empty their bladders normally. This is unusual but one should be aware of the possibility.
Have you noticed that your dog or cat has become lethargic? Is your pet extremely thirsty, or does it eat often, but still seem to be losing weight? Dogs and cats can develop diabetes just like people, and it’s important to recognize these and other signs of the disease. Although it is treatable, you should seek out veterinary care for your pet sooner rather than later if you suspect it has diabetes.
Early Warning Signs
These early warning signs are all directly related to excess glucose (blood sugar) and your pet’s inability to produce or use insulin in order to process it. These symptoms include:
-
Weight loss in spite of an increased appetite
-
Excessive thirst (known as “polydipsia”)
-
Excessive urination (known as “polyuria”)
-
Lethargy
Complications That Often Arise
In the earlier stages of the disease, a pet often remains active and alert with few signs of illness. As the diabetes progresses, however, complications often appear, such as:
-
Frequent infections of the skin, bladder and kidney.
-
Cataracts (in dogs).
-
Weakness, abnormal gait and muscle loss, especially in cats, caused by neuropathy.
-
Dehydration and vomiting due to ketoacidosis (high concentrations of ketones in the body). This can lead to coma and death.
Your Vet’s Evaluation
Early detection of a diabetic condition by a veterinarian is important for your pet’s continued health. Your vet will likely check your pet’s blood and urine for high levels of glucose, as well as look for other clinical signs. An initial evaluation for diabetes in a dog or cat typically includes:
-
Checking the overall health of the pet through a health history, diet review and physical examination.
-
Identifying any immediate complications associated with the disease, such as cataracts (in dogs) or neuropathy (in cats).
-
Identifying common problems often associated with the disease such as urinary tract infections.
The laboratory tests that may be indicated include:
-
A complete blood count (CBC) which measures and evaluates cells in the blood.
-
A serum biochemical analysis plus electrolytes. This test evaluates various organ function as well as checks sodium, potassium and chloride levels. The blood glucose level is also included.
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Urinalysis (UA). This is both a chemical and visual analysis of a sample of your pet’s urine.
-
Urine culture (UC). If there is evidence of a urinary tract infection, your vet will order a urine culture to identify any bacteria that may be present.
-
T4, a blood test to check thyroid hormone (T4) levels.
-
Blood pressure.
-
For cats: FeLV/FIV which is a blood test for Feline Leukemia Virus and Feline Immunodeficiency Virus (if the cat has not already been checked).
-
For dogs: Serum progesterone which is a blood test to check the levels of progesterone.
Further blood tests can be done to check the levels of certain vitamins, hormones and enzymes. These tests help determine the health of the pancreas, thyroid, and adrenal glands, and include:
-
Thyroid panel.
-
Trypsinlike immunoreactivity (TLI): For testing exocrine pancreatic insufficiency (this means the pancreas is not producing the enzymes necessary to break down food and may not be making the insulin).
-
Pancreatic lipase immunoreactivity (PLI): For testing acute necrotizing pancreatitis (inflammation of the pancreas).
-
Cobalamin/folate (for cats): If your cat is vomiting and has diarrhea and a pancreatic problem has been ruled out through other testing, your vet may run these tests to evaluate intestinal function.
-
Low dose dexamethasone; ACTH stimulation: Both used to check adrenal gland function.
More specific labwork may be recommended if pancreatitis, hyperadrenocorticism (Cushings disease), hyperthyroidism (in cats) or hypothyroidism (in dogs) is suspected. Your veterinarian may also recommend additional diagnostic tests such as an abdominal ultrasound or chest radiographs.
Recognize the Signs, Maintain a Healthy Lifestyle
Scholl Animal Hospital is emphasizing Senior Wellness during the month of November. The program will include a comprehensive physical examination, fecal analysis, urinalysis and geriatric blood test. Call the office to schedule an appointment and we will help to optimize the health of your senior pet.
What is “Senior”
The term “senior” has been chosen to describe the aging and older pet. The number of years considered to be “senior” may vary, and one must keep in mind that organ systems, species, and breeds of dogs age at different rates. Several papers have suggested specific ages at which pets should be considered “old,” depending on breed and size, although few recommendations are evidence-based.2-12 Some studies of brain aging in beagles have shown that memory and learning deficits may be found as early as 6 to 7 years of age, with brain pathology found at ³12 years of age.8-11 Many books and articles consider cats to be senior at 7 to 11 years of age.2-5
In humans, 56 to 60 years of age is considered to be the start of the senior years. Middle age begins at 42 to 45 and is the time when senior wellness screening generally starts. Middle age would equate to approximately 7 to 8 years of age for most dogs and cats (except for large-breed dogs that may reach middle age a year or two earlier). As the pet enters its senior years, more frequent testing and more extensive examinations are recommended than for younger pets. Rather than attempt to calculate age equivalents to humans, for practical purposes, this task force suggests that practitioners apply these guidelines to dogs and cats that are in the last 25% of the predicted life span for their species and breed.
Approach to the Apparently Healthy Senior Pet
The purposes of clinical screening of healthy pets are to establish a baseline assessment for future comparison and to detect subclinical abnormalities at a time when preventive and therapeutic intervention may have the most benefit. To illuminate such conditions, there is no substitute for a thorough and complete history and physical examination. A wealth of scientific literature documents the presence of subclinical disease in some healthy-appearing animals; to illuminate such conditions, there is no substitute for a thorough and complete history and physical examination. In addition, subtle changes in laboratory test results may give an indication of the presence of underlying disease.
Elements of a Thorough History
Construct questions that extend beyond the client’s presenting concern and that include physical and behavioral signs.13 Use of both closed (yes/no) and open-ended questions helps to elicit all possible information about quality of life, physical health, specific behavioral changes, and medications (e.g., prescription, over-the-counter, dietary supplements). When possible, to better ensure an accurate and thorough baseline for future comparison, have the client record historical information on a printed form prior to the appointment.
Elements of a Complete Examination
Observe the pet prior to handling, in an open carrier and/or on the floor. Perform a complete physical examination with special attention to the areas of increasing concern in the senior pet. Such areas may include, but are not limited to:
- Risk factor analysis: signalment, breed, lifestyle/use14,15
- Physical condition: weight gain or loss (that may not have been observed by the client); obesity; changes in body condition or conformation
- Evaluation of skin, coat, claw, and nail bed character; detection and assessment of lumps and bumps
- Presence of lymph node enlargement
- Presence of thyroid nodule (cats)
- Hydration status
- Abdominal palpation, especially the size and shape of kidneys and liver
- Vital signs: temperature, pulse, respirations, and pain assessment16
- Cardiopulmonary evaluation: auscultation of heart sounds; heart rate and rhythm; pulse rate and quality
- Evaluation of the central nervous system: mentation; cranial and peripheral nerve reflexes, especially conscious proprioception; vision and hearing
- Orthopedic examination: mobility, gait, range of motion, weakness, pain, crepitation, muscle mass
- Rectal palpation (dog)
Elements of a Minimum Laboratory Database
Tests to be included in the minimum laboratory database for the healthy-appearing senior animals are listed in Table 1. Additional testing is based on breed, age, sex, previous medical history, and ongoing medications.17,18
Preventive Care
Preventive care is directed at making recommendations prior to the onset of disease in order to prevent or temper the effects of disease or adverse health conditions. This task force recommends that “senior” wellness tests begin for pets at middle age, to establish baseline values and to insure that there are no clinically silent health abnormalities. During middle age, retesting is recommended at least once a year (equivalent of 4 to 5 human years). Routine health care visits, including a minimum laboratory database, are recommended for senior animals (i.e., those in the last 25% of their predicted life span) every 6 months (equivalent of every 2 to 3 human years).
Focused Areas of Client Education
Such areas include, but are not limited to:
- Increased veterinary attention to dental/oral care and to home dental prophylaxis
-
Diet and nutrition
- Digestibility, caloric content, quality of ingredients
- Discussion of any new developments in the use of stage-of-life diets, food supplements, or food additives (e.g., omega-3 fatty acids, nutraceuticals)
- Attention to ingredients that might affect disease in older pets
- Weight control: monitoring of weight gain (especially in the dog) or loss (especially in the cat)
- Parasite control: following published guidelines for fecal examination and parasite prevention19,20
- Maintaining mobility via exercise or therapeutic intervention
- Vaccination only as appropriate for lifestyle, management factors, geographic region, and local jurisdiction21-23
- Mental health: importance of routine and predictable environment; environmental enrichment; companion pets and social interaction; discussion of brain aging; monitoring signs of cognitive decline
- Environmental considerations: housing; indoor/outdoor lifestyle; accommodation of disabilities; avoidance of smoke and toxin exposure
- Potential reproductive disease in nonneutered pets: pyometra, mammary or testicular neoplasia, prostatic disease24
Even during routine exams, when there are no obvious signs of injury or illness, your pet will be evaluated for pain. It is considered the fourth vital sign, following body temperature, pulse, and respiration.
Your veterinarian will measure your pet’s pain using a three-step observation process. First, when entering the exam room, the doctor will watch your pet’s movement and behavior without interacting. Next, your veterinarian will observe your pet while interacting verbally but without making physical contact. During the third and last step, your veterinarian will touch your pet, concentrating on the areas where injury or disease are suspected or already known.
During each observation, the doctor will score the level of discomfort by comparing your pet’s behavioral responses to responses that are listed and scored on a pain scale. The highest of the three scores becomes your pet’s overall pain score.
Jennifer Trembley, DVM, at AAHA-accredited Community Pet Hospital in Thornton, Colo., says that any pet with a pain score of 3 or higher is given medication immediately. If your pet’s score is 2 or less, your veterinarian will discuss treatment options with you, which may include medications, supplements, and physical therapy and rehabilitation.
At AAHA-accredited hospitals, pain assessment is considered part of every patient evaluation, so whether it is a trip to the veterinarian for a routine examination and vaccine appointment or an emergency, you can be assured that appropriate pain management will be provided for the anticipated level and duration of your pet’s pain.
What Is a Pain Scale? Pain scales used by veterinarians are adaptations of scales developed to assess pain in young children, explains Jennifer Trembley, DVM, of Community Pet Hospital in Colorado. Typically they are based on a scoring grade of 0-4 or 1-5. ![]() Step 1: Non-interactive behavior scoring Grade 0 — no pain or hint of discomfort Grade 1 — seems in comfortable position in room Grade 2 — shifting positions but quiet Grade 3 — restless, anxious, and unsettled Grade 4 — vocalizing / becomes stiff / guards with body parts or thrashingStep 2: Interactive behavior scoring Grade 0 — shows greeting behavior / wagging tail / approachable Grade 1 — curious / approaches but hesitates with movement Grade 2 — hesitates to approach / restricted interaction / not moving comfortably Grade 3 — wary / slow movement usually away from person / guarding Grade 4 — unaware of surroundings / not moving / vocalizingStep 3: Palpation / touching patient Grade 0 — can palpate or touch — no negative response Grade 1 — can palpate or touch — no resistance / may look at or sniff area Grade 2 — may slightly object to gentle palpation / may lick lips or affected area / holds body still Grade 3 — withdraws immediately / mild vocalization / tense or guarding / stiffness Grade 4 — tries to escape / bites / grinds teeth or grimaces / ears are back / hides affected area / loud vocalization |