• • Read more details
  • Normal physiology
  • • Overview of calcium homeostasis
    • Calcium distribution within the body
    • Extracellular Calcium
    • Intracellular Calcium
    • Parathyroid hormone
    • Structure
    • Synthesis and secretion
    • Set-Point for PTH Secretion
    • Inhibition of PTH Synthesis and Secretion
    • Clearance and metabolism of parathyroid hormone
    • Actions of parathyroid hormone
    • Parathyroid Hormone C-Terminal 7-84 as PTH Antagonist
    • Parathyroid Hormone Receptor
    • Parathyroid hormone-related protein: a polyhormone
    • Parathyroid hormone-related protein in the fetus
    • Vitamin D
    • Vitamin D metabolism
    • Synthesis
    • Actions of Calcitriol
    • The calcitriol receptor
    • Effects of Calcitriol on the Intestine
    • Effects of Calcitriol on Bone
    • Effects of Calcitriol on the Kidneys
    • Effects of Calcitriol on the Parathyroid Gland
    • Calcitriol in cancer therapy?
    • Calcitonin
    • Normal homeostatic response to hypocalcemia
    • Normal homeostatic response to hypercalcemia
    • Diagnostics
    • Total calcium
    • Analytical Methods
    • Normal Values
    • Adjusted Total Calcium
    • Ionized calcium
    • Analytical Methods
    • Sample Handling Techniques
    • Normal Values
    • Fractionation of Serum Calcium
    • Parathyroid hormone
    • Parathyroid hormone-related protein
    • Vitamin D metabolites
    • Bone biopsy and bone marrow aspiration
    • Hypercalcemia
    • Toxicity of hypercalcemia and clinical signs
    • Renal Effects of Hypercalcemia
    • Effects of Hypercalcemia on Other Organs
    • Mechanisms and differential diagnosis of hypercalcemia
    • General approach to diagnostic workup of patients with hypercalcemia
    • Nonpathologic hypercalcemia
    • Transient or Inconsequential Hypercalcemia
    • Hypoadrenocorticism
    • Chronic Renal Failure
    • Pathologic or consequential hypercalcemia
    • Cancer-Associated Hypercalcemia
    • Primary Hyperparathyroidism
    • Hypervitaminosis D
    • Granulomatous Disease
    • Idiopathic Hypercalcemia of Cats
    • Uncommon Causes of Hypercalcemia
    • Treatment of hypercalcemia
    • Philosophy of Treatment
    • Definitive Therapy
    • Supportive Therapy
    • Initial Considerations for Treatment
    • Future Considerations
    • Additional Specific Treatments for Hypervitaminosis D
    • Hypocalcemia
    • Introduction
    • Consequences of hypocalcemia and clinical signs
    • Approach to hypocalcemia
    • Differential diagnosis and mechanisms of hypocalcemia
    • Hypoalbuminemia
    • Renal Failure
    • Emergency and Critical Care
    • Small Intestinal Diseases
    • Alkali Administration
    • Acute Reversal of Chronic Hypercalcemia
    • Tumor Lysis Syndrome
    • Nutritional Secondary Hyperparathyroidism
    • Secondary Hyperparathyroidism Associated with Hyperadrenocorticism
    • Effects of drugs
    • Hypoparathyroidism
    • Miscellaneous Causes of Hypocalcemia
    • Treatment of hypocalcemia
    • Acute Management of Hypocalcemia Causing Tetany or Seizures
    • Subacute Management of Hypocalcemia
    • Subacute and Chronic Maintenance
    • Clinical follow-up and potential complications
    • References

Chapter Outline

• Glucose
• • Hypoglycemia
  • Hyperglycemia
• Protein
• • Albumin
  • Globulins
  • Hypoproteinemia
  • Hyperproteinemia
• Lipids
• • Hypolipidemia
  • Hyperlipidemia
• Liver
• • Alanine Aminotransferase
  • Glutamate Dehydrogenase
  • Alkaline Phosphatase
  • γ-Glutamyltransferase
  • Aspartate Aminotransferase
  • Lactate Dehydrogenase
  • Bilirubin
• Muscle
• • Creatine Kinase
• Exocrine Pancreas
• • Amylase
  • Lipase
  • Trypsinogen
  • • Decreased Pancreatic Enzyme Activity
    • Increased Pancreatic Enzyme Activity
• Renal Parameters
• • Urea Nitrogen/Blood Urea Nitrogen
  • • Decreased BUN
    • Increased BUN
  • Creatinine
  • • Decreased Creatinine
    • Increased Creatinine
• Minerals
• • Calcium
  • • Hypocalcemia
    • Hypercalcemia
  • Phosphorus
  • • Hypophosphatemia
    • Hyperphosphatemia
  • Magnesium
• Electrolytes
• • Electrolyte Imbalances
• Suggested Readings

Key Points:

• Routine monitoring of clinicopathologic data is a critical component in the management of

older patients.

• Serial data evaluations on an individual animal can prove to be a highly objective effective

means of characterizing developing disease.

• The complete blood count provides a broad overview of the general health status of the

patient.

• The minimum canine geriatric database includes the CBC, biochemical profile (with

electrolytes), complete urinalysis.

• The minimum senior feline database includes the CBC, biochemical profile (with electro-

lytes), complete urinalysis, total T4.

• Important geriatric conditions in dogs cats include chronic renal disease, hepatobilliary

disease endocrine metabolic disorders.

The American College of Veterinary Nutrition recommends a three-step approach to patient assessment that includes assessment of patient factors, dietary factors, and feeding factors.  After the assessment phase, a nutritional treatment plan is developed and instituted, and serial monitoring and adjustment ensue (an iterative process).

This chapter focuses on the nutritional management of feline disorders.

Cardiovascular Diseases
Dental and Oral Diseases

Skin Disorders

Gastrointestinal Diseases

Hepatic Diseases

Endocrinologic Diseases - Obesity, Diabetes Mellitus, Hyperthyroidism

Musculoskeletal Diseases - Osteoarthritis

Oncology

Ophthalmologic Diseases - Herpesvirus Infection

Pulmonary and Thoracic Medicine:  Chylothorax

Toxicology

Critical Care

Urinary Tract Disorders:  Chronic Renal Failure, Urolithiasis, Idiopathic Cystitis 

Aging is associated with a wide variety of physiological changes that compromise the ability of the body to respond to stress or change, and ultimately contribute to morbidity and mortality.  Much research has been done on the aging process in humans and experimental animals, and the impact of diet, but there is relatively little data from companion animal studies.  However, although many of the aging changes are likely to be similar between different mammals, it is known that there are some differences with cats. 

In contrast to dogs and humans, elderly cats experience an increase in their maintenance energy requirements rather than a continued decline, which may be mediated partly through a better-maintained basal metabolic rate but also through progressive compromise in fat and protein digestion.  Old age is also associated with a progressive loss of lean body mass that may be mitigated in part by feeding higher protein levels.  Diets designed for healthy elderly cats should therefore concentrate on being energy dense, highly digestible and with an increase in the proportion of protein calories, and being fed with the aim of supporting optimal body weight.  There is also strong evidence emerging that dietary manipulation in cats may be able to modify aspects of the aging process, with a long-term longitudinal study of cats demonstrating both survival and health benefits from feeding a diet supplemented with antioxidants, fatty acids, and a prebiotic source.

Proteinuria is a general term that describes the presence of any type of protein in the urine (e.g., albumin, globulins, mucoproteins, and Bence-Jones proteins); however, albumin is the predominate protein in urine in healthy dogs and cats as well as dogs and cats with renal disease.  Proteinuria can arise from several different physiologic and pathologic causes, but persistent proteinuria associated with normal urine sediment is consistent with kidney disease.  
The urine dipstick colorimetric test is the usual first-line screening test for the detection of proteinuria, but false-positive reactions are common.  When proteinuria of renal origin is suspected, the next diagnostic steps are quantitation and longitudinal monitoring via the urine protein/creatinine ratio.  The recent availability of a species-specific albumin enzyme-linked immunosorbent assay technology that enables detection of low concentrations of canine and feline albuminuria has both increased diagnostic capability and stimulated discussion about what level of proteinuria/albuminuria is normal.  

Beyond being an important diagnostic marker, proteinuria is associated with kidney disease progression in both dogs and cats: the greater the magnitude of the proteinuria, the greater the risk of renal disease progression and mortality.  Treatments that have attenuated proteinuria in dogs and cats have also been associated with slowed kidney disease progression and/or improved survival.  For these reasons, screening for renal proteinuria and longitudinal assessment of renal proteinuria has recently received renewed interest.

• • Acetylcholine Receptor Antibody
  • Activated Coagulation Time (ACT)
  • Activated Partial Thromboplastin Time (APTT)
  • Adrenocorticotropic Hormone (ACTH), Endogenous
  • Adrenocorticotropic Hormone (ACTH) Stimulation Test
  • Alanine Aminotransferase (ALT, Formerly SGPT)
  • Albumin
  • Alkaline Phosphatase, Serum (SAP or ALP)
  • Ammonia
  • Amylase, Serum
  • Anion Gap
  • Antinuclear Antibody (ANA)
  • Arterial Blood Gases
  • Evaluate PaO₂
  • Potential causes of hypoxemia
  • Evaluate pH
  • Assess acid-base status
  • Aspartate Aminotransferase (AST, Formerly SGOT)
  • Basophil Count
  • Bicarbonate (HCO₃⁻)
  • Bile Acids
  • Bilirubin
  • Blood Urea Nitrogen (BUN)
  • Buccal Mucosal Bleeding Time (BMBT)
  • Calcium (Ca)
  • Cerebrospinal Fluid (CSF)
  • Chloride (Cl)
  • Corrected Hyperchloremia (elevation of chloride disproportionate to elevation of sodium):
  • Corrected Hypochloremia (loss of chloride relative to sodium)
  • Cholesterol (CH)
  • Cholinesterase
  • Cobalamin
  • Complete Blood Count (CBC)
  • Coombs Test
  • Cortisol
  • Creatine Kinase (CK, formerly CPK)
  • Creatinine
  • Cytologic Criteria of Malignancy
  • General Criteria
  • Nuclear Criteria
  • Cytologic Features of Discrete Cell (Round Cell) Tumors
  • Discrete Cells (Round Cells)
  • Specific Discrete Cell Tumors
  • Mast Cell Tumor
  • Lymphoma
  • Canine Cutaneous Histiocytoma
  • Malignant Histiocytosis/Histiocytic Sarcoma/Systemic Histiocytosis
  • Plasmacytoma
  • Transmissible Venereal Tumor
  • Melanoma
  • Cytologic Features of Mesenchymal Cells
  • Cytologic Features of Normal Epithelial Cells
  • Cytology of Ear Canal Swabs
  • Bacteria
  • Fungi
  • Mites
  • Neoplasia
  • Miscellaneous
  • Cytology of Nasal Swabs or Flush Specimens
  • Normal Findings
  • Infectious Agents
  • Noninfectious Conditions
  • Dexamethasone Suppression Tests
  • Low-Dose Dexamethasone Suppression Test (LDDST)
  • High-Dose Dexamethasone Suppression Test
  • Disseminated Intravascular Coagulation (DIC), Diagnostic Tests
  • Eosinophil Count
  • Erythrocyte Count (Red Blood Cell [RBC] Count)
  • Folate
  • Fructosamine
  • Gamma Glutamyltransferase (GGT)
  • Globulin
  • Glucose
  • Glucose Tolerance Test
  • Glycosylated Hemoglobin
  • Heartworm Antibody, Feline
  • Heartworm Antigen, Canine
  • Heartworm Antigen, Feline
  • Hematocrit (Packed Cell Volume, PCV)
  • Hemoglobin
  • Hemolysis, Prevention in Laboratory Samples
  • Steps to Prevent Hemolysis:
  • Immunoassays
  • Insulin
  • Iron-Binding Capacity (Total, TIBC)/Ferritin
  • Joint Fluid (Arthrocentesis)
  • Lipase
  • Lymphocyte Count
  • Magnesium (Mg)
  • Mean Corpuscular Volume (MCV)
  • Methemoglobinemia
  • Methods of Sample Collection for Cytology
  • Fine-Needle Biopsy (Aspiration or Nonaspiration Method)
  • Impression Smear
  • Scraping
  • Swab
  • Monocyte Count
  • Myoglobinuria
  • Neutrophil Count
  • Osmolality
  • Packed Cell Volume
  • Parathyroid Hormone (PTH)/Ionized Calcium
  • Phosphorus (P)
  • Platelet Count
  • Polymerase Chain Reaction
  • Potassium (K)
  • Protein, Total (TP)
  • Prothrombin Time (PT)
  • Red Blood Cell (RBC) Count
  • Reticulocyte Count
  • Sodium (Na)
  • Thoracocentesis Fluid
  • Eosinophilic Effusion
  • Thrombocyte Count
  • Thyroid Function Tests
  • Toxoplasmosis Antibody Titer
  • Triglycerides
  • Trypsinogen-Like Immunoreactivity (TLI)/Pancreatic Lipase Immunoreactivity (PLI)
  • Urinalysis
  • Appearance
  • Specific Gravity
  • Chemical Properties
  • Urinary Sediment Examination
  • Urine Cortisol/Creatinine Ratio
  • Urine Protein/Creatinine Ratio
  • von Willebrand Factor
  • White Blood Cell (WBC) Count