Good To Know

Guest post by Ingrid R. Niesman, MS PhD 

This is the second in a two-part series that takes a closer look at the 2021 AAFP Senior Cat Care Guidelines. Click here to read Part One: Caring For Aging Cats Begins at Home.

It is a fact of life that all cats and humans age; they just age at different rates. This discrepancy can leave cat parents with difficult choices when it comes to considering veterinary care for their senior companions.

A three-way partnership

The original AAFP Senior Care Guidelines were published in 2009. Although a masterclass in clinical diagnoses and treatments for aging felines, this report was geared towards clinicians and ignored the intertwined relationships existing between veterinarians, cat parents and the feline patient. In Part 1: Caring for Aging Cats Begins at Home, I presented how the new 2021 guidelines engage you in assessing the health of your aging feline. For Part 2, I will review major changes in clinical practices designed to improved senior cat lives and how these changes revolve around you and your cat.

Measuring age-associated changes by Fragility scales

One consistent principle between 2009 and 2021 is early detection and monitoring of chronic ailments. Where this differs is in approach. In the 2021 guidelines, management of disease is viewed as a team-based effort, requiring careful observations both in the home and in the clinic. Acknowledging that we as cat parents play crucial roles in our cats’ health is an important step in maintaining quality of life for aging cats.

Fragility scales, borrowed from human medicine, provide a measurable means for determining effectiveness of treatments or physical decline through in home observations or during office visits. The Fragility scales presented in 2021 include components of feline physiology and feline psychology. Further, they are designed to be easy to implement and continue over time. For example, you can rate your cat’s activity level and social behaviors at home, while your clinician evaluates them at a single point in time. This eliminates guesswork. Your veterinarian can rely on solid, quantifiable data.

Incorporating veterinary advances into practice

2021 represented a pivotal point for human and feline medicine. Novel tests for emerging diseases, affordable genotyping, and an understanding of immune dysfunction are new even for human medicine. The 2021 guidelines incorporate many of these new tools. Evaluation of a changing metabolic state with age is foremost, with addition of thyroid stimulating hormone (TSH) assays and inclusion of amino transferases into routine chemistry panels as examples. Screening for feline hyperthyroidism and detection of immune altering viruses are now important tests for cats over 10 years old.

In 2009, being underweight was considered a major problem for aged cats. Clinicians are currently advised to watch for obesity instead. Being overweight is associated with a myriad of chronic conditions, such as diabetes, and heart and liver dysfunction.

Recognizing feline cognitive dysfunction syndrome (fCDS) as a source of distress to the affected cat and to the family is given greater attention. Although untreatable, fCDS is a manageable condition when a team approach is applied.

Recognizing and mitigating pain as a priority

If movement is medicine for people, this advice also applies to our aging felines. Degenerative joint disease (DJD) is a continuing problem for elderly humans and aging cats. The 2021 guidelines take particular care in emphasizing pain management of cats suffering from DJD. A checklist of questions for assessing pain from DJD, based on activity levels and natural feline behaviors are available on a number of different websites.

Untreated pain accelerates decline in quality of life. Management begins at home, with environmental changes such as support stairs and heated beds. Although DJD is still deemed incurable, newer clinical approaches using treatments like the first ever cat-specific monoclonal antibody treatment for cats with arthritis, as well as nutritional supplements, are designed to ease the burden to the affected cat and the family.

Veterinarians supporting people and cats

Whereas we have made strides in treatment for diseases like certain feline cancers and chronic kidney disease, the guidelines strongly support informing cat parents of all risks, costs and benefits before undertaking a course of action. Aggressive treatment isn’t always the right choice for every cat or every human.  The authors of the 2021 report get this. They strongly recommend that all interventions in the home should be positive, recognizing the importance of maintaining the bond between human and cat.

You are the critical link

As we move into 2022, remember that you as your cats’ caretaker are a critical link in ensuring their quality of life. As the 2021 guidelines suggest, your feline veterinarian works for you and for the best interest of your aging cat. Be informed. Ask questions. Use trusted sources when seeking advice on treatments or supportive care. Observe, listen, and use resources available to gauge the daily life of your cat, and share these details with your clinician regularly.

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

Photo Pixabay

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