Guest post by Ingrid R. Niesman, MS PhD 

Thanks to improvements in veterinary medicine, better nutrition, and the fact that most pet cats are indoor cats, cats are living longer than ever before, but with longer lifespans, they are also facing the inevitable issues of old age. The American Association of Feline Practitioners (AAFP) is recognizing these dramatic changes since they last published senior care guidelines in 2009. The 2021 AAFP Senior Cat Care Guidelines, created by a task force of experts in feline clinical medicine, consist of 26 jam-packed pages of health management practices for feline practitioners, stressing the importance of engaging the cat parent in all aspects of caring for aging cats.

Working as a team on behalf of cats

Healthy aging means different things to everyone. We all have our personal perspective on what is best for our cats. Under the new guidelines, healthy aging is individualized for each cat. Understanding each cat begins and ends with cat parent involvement, assessments and decision-making.

Educating cat parents is now a major push in these guidelines. You are the best judge of your cat’s subtle changes over the years. Veterinarians only see a snapshot during an examination, usually when the cat is less than relaxed and in a foreign environment. Increasing the frequency and scheduling longer appointment times are emphasized as crucial to creating a comprehensive picture of each geriatric cat.

Another key point stressed in the article is to remind us that an examination begins at home. An anxious, fearful or motion-sick cat might not present normal physiology or mental status, confounding already complex diagnoses.

Here’s where you come in

If we recognize that care of our cats is a partnership, then information should be easily shared. The guidelines recommend cat parents fill out open-ended questionnaires pertaining to four main categories before an appointment: the cat’s environment, total nutrition intake, including supplements, and fluids, elimination status, and all patterns of activity.

If paperwork isn’t your favorite activity, how about putting that phone to good use and video typical behaviors at certain intervals? The task force suggests clinicians use client videos to gain insights that might otherwise be missed, or to stretch the time intervals between appointments.

Senior author Hazel C. Carney, DVM, MS, DABVP, empathizes the need for human surveillance. “If an owner randomly takes even one minute snippets, clinicians may detect subtle changes in day to day activity.” An example she cites is an aging cat beginning to change their sleeping location from a warm blanket to a solid cool surface. This may be an early sign of hyperthyroidism.

The video below illustrates how video can aid verterinarians in observing a cat in his own environment. It shows my Mr. Spock in 2013, when he was 19 years old. His mobility issues are evident, along with a subtle head tilt.

Eusoh Community Pet Health Plan for Cats

Catching potential problems early

Stressing preventive care was a primary rationale for updating the 2009 guidelines. As an example, the 2021 report recommends inclusion of blood pressure readings for cats over ten years old. Untreated hypertension is a leading cause of disease in humans and cats. High blood pressure is also implicated in kidney and lung diseases. Treating early may stave off the more severe consequences, such as further kidney damage, blindness or stroke.

Lead author, Michael Ray, DVM, Medical Director at The Cat Clinic of Roswell, also tells cat parents to be proactive. “By being on top of senior care, your cat doctor can put out little fires.” He stresses the importance of not just leaving your cat without care due to age. “I find it helpful to remind my clients that an aged cat is very much like your 80-year-old relative.”

Another very helpful inclusion in the 2021 guidelines is a clear table of observable subtle patterns indicating the potential for pain. Since cats are masters at hiding pain, your cat needs you to recognize issues. Watch and report changes in behaviors, such as decreased scratching, altered social interactions, mobility changes typified by reduced jumping, relocating a regular sleeping location, and particularly changes in responses to human touch.


Assessing quality of life for your cat

Multiple disease processes are frequent in aging felines, leading to complex care and requiring participation of the cat parent in conjunction with the veterinarian and veterinary staff. How these conditions affect each cat’s physical and emotional states defines quality of life. The guidelines stress the importance of the caretaker when it comes to considering pain, mobility, acute illness, cognitive decline, chronic diseases, anxiety and frustration when assessing the overall health of a senior cat. True assessment only comes from you as the person who knows your cat best, so knowing what matters for your cat will help guide your veterinarian with regards to diagnosis and treatment.

Caring until the very last moment

End of life considerations go hand in hand with quality of life. Perhaps the most radical updates in the 2021 guidelines relate to the notion that as a cat parent, your decision to end your treasured cat’s life revolves around your feline-human bond. Whether you chose palliative care, hospice or euthanasia, the decision should be guided by honest conversations with your cat’s veterinarian.

Clinicians, on the other hand, are advised to look at the lifestyle and the impact an aging cat has on the owner’s quality of life when making recommendations. Does a sleepless cat keep infants awake? Can a family afford expensive medications? How will the loss of the cat affect the emotional and physical state of the owner?

Unlike previous version, the 2021 guidelines have a more enlightened approach to the final days. The Task Force strongly recommends that end of life decisions should ultimately be based on a negative impact of the existing feline-human bond. You will want to remember your friend with wonderful memories, not sadness and regret.

In my next installment, I will dive into some of the updated advice on treatment of common age-related conditions, anesthesia use and specialized nutritional needs, so you can make informed decisions for in the best interest of your cat.

You can read the complete 2021 AAFP Feline Senior Care Guidelines here.

Ingrid R. Niesman MS PhD is the Director of the SDSU Electron Microscope Imaging Facility at San Diego State University. She graduated from Utah State University and received her MS from the University of Illinois-Urbana-Champaign. After 30 years of technical electron microscopy, cell biology, neuroscience and infectious disease research, Dr. Niesman completed her PhD in the UK at the University of Sunderland. Her work experience includes time at LSU Medical School, Washington University, UAMS in Little Rock, UCSD, TSRI and a postdoctoral year at CALIBR in La Jolla, CA. She has worked for at least two National Academy of Science members and is credited with over 50 publications. She can be reached at iniesmanphd@gmail.com

3 Comments on 2021 AAFP Feline Senior Care Guidelines, Part 1: Caring for Aging Cats Begins At Home

  1. Theses are some great ideas. I wouldn’t have thought to take videos of a cat to help at vet appointments. I am good at documenting things, but might miss something where the video would come helpful.

  2. Never think about the end until you absolutely have too. Plus planning. Look forward to next installments.


  3. Thank you so much for writing about this. Should be mandatory readying for all pet parents. I’ve lost 2 older kitties in the last 18 months. One to long term disease and one to very sudden illness both ages 14 and their brother turns 15 this year. I’ve learned a lot from reading this and he will be the beneficiary. Thank you again.

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