Care for the aging feline patient: more than just medicine

As cats age into their early years and older, there are important considerations that can greatly increase their quality of life.

As the domestic cat continues to grow in popularity as a household pet, caregivers are getting more and more adept at providing everything their cat needs to stay healthy. cats may live Long As a result, but do they live better Quality spirits? Now more than ever, we need to shift our focus to the well-being of our elderly feline population.

What is a big cat? When are they considered old? The 2021 AAFP Senior Care Guidelines Working Group updated the geriatric categories to be patient-dependent (Table 1).1 The older and older years are a special time for caregivers and their cats. The veterinary team plays a direct role by providing support and guidance. Our big cat patients should visit us at least every 6 months, sometimes 4 months, depending on their health. With more visits, we can diagnose disease earlier, treat disease more successfully, and improve patient stability and quality of life.

Each visit should include an evaluation of the patient’s history, including behavioral changes. Any suspected or confirmed pain necessitates the use of analgesics before proceeding with the visit. An integral part of the visit is a comprehensive physical examination and minimum database, including blood pressure, clinical chemistry, total T4, CBC, and urinalysis. Body weight, body condition score and muscle condition score can be assessed at each visit. It should be noted negative trends in these parameters, often precede the onset of the overt disease.

Just as important are the conversations we had with the caregiver and how we guide them through the cat’s golden years. Our detailed history can be improved by providing caregivers with validated questionnaires for mobility and quality of life. With each passing visit, the marked directions will allow us to guide the caregiver. Accommodation and accessibility for a large cat indoors is critical to improving the quality of life. Guidance is ideally based on the five pillars of a healthy feline environment (Table 2) modified for cats’ diminished senses of age, decreased mobility, and specific health conditions.1

For example, a large cat with arthritis will likely need increased access to resources such as food, water, and litter boxes. More of each resource, on a larger scale throughout the house, is considered ideal. Resources should also be in an easier-to-use version or a patient-favorite version. Litter boxes should be either low-walled or high-walled, transparent with an easily accessible entrance (Fig. 1). Older adults may prefer flat plates and wide bowls over traditional food and water bowls (Figures 2 and 3).

Figure 1. A transparent home-made high-walled litter box that includes a low-walled entry point for elderly cats with mobility issues.

Figure 2. Elderly cats may prefer low-walled or flat-walled food and water bowls over traditional cat bowls.

Figure 3. Example of a flat food bowl that provides easy access for elderly cats.

Regular reassessment of quality of life factors can be useful in assisting the client with accommodation and making decisions at the end of life. There are several quality-of-life measures available to offer to caregivers, including the HHHHHMM scale and those provided by the Lap of Love Veterinary Hospice & In-Home Euthanasia. It helps to designate one or two people to contact the caregiver, with whom they can build a trusting relationship over the years. Providing our guidance and permission to listen to caregivers takes extra time and effort but is of high value to the family. When they remember their pet, they will also remember the support, time, and effort we put into facilitating their journey – a memory worth its weight in gold.


  1. Ray M, Carney HC, Boynton B, Quimby J, Robertson S, Denis KS et al. 2021 AAFP Senior Care Guidelines. J. Felin Med Surg. 2021; 23 (7): 613–38.


Leave a Reply

Your email address will not be published. Required fields are marked *