Feline Your Age: Comorbidities in Old Cats

Aging in cats has become complex. With the advancement in veterinary medicine cats are living longer and over time things “wear out.” To put it simply with aging comes disease. In cats, comorbidities appear to be the ‘new norm’ with the aging process. The following are known diseases that have an association, specifically in cats:

• Chronic kidney disease (CKD) and hyperthyroidism
• CKD and degenerative joint disease (DJD)
• CKD and heart failure
• CKD and periodontal disease (PD)
• Hyperthyroidism and diabetes mellitus (DM)
• DM and obesity
• DM and CKD
• DM and lower urinary tract disorders
• DM and urinary tract infections + hyperthyroidism + CKD
• Obesity and DJD/DM/cardiac disease/respiratory illness
• Triaditis
• Hypertension and hyperthyroidism
• Hypertension and CKD
• Hypertension and hyperaldosteronism

It is likely that some coexisting conditions may not have direct relationships and may be coincidental. For veterinarians, the challenge is to recognize when these comorbidities may be occurring before cats become clinical for these diseases. For this to occur we, as clinicians, must be vigilant in assessing and screening cats regularly for developing diseases to provide earlier identification of problems. As part of the screening process, serial thorough histories, performance of a comprehensive physical exams, and clinicopathologic testing (e.g., CBC, serum chemistry, urinalysis) are all essential to identify these diseases before cats become clinical. During this lecture we will discuss common comorbidities that occur in cats, how we recognize when these may be occurring, the diagnostics testing associated with these common comorbidities and their limitations. Finally, we will discuss the therapeutic strategies to manage contrasting diseases.