Part X — Senior care (7 years and beyond)

10.1 Recognising senior status

• Toy and small breeds — 10+ years is senior.
• Medium and large breeds — 7+ years.
• Giant breeds — 5+ years.
• First observable senior changes: reduced exercise tolerance, grey muzzle, slower to rise, altered sleep patterns.

10.2 Senior wellness examinations

• Twice-yearly veterinary examinations for seniors — many conditions progress meaningfully in 6 months.
• Baseline senior workup — CBC, biochemistry panel, urinalysis, blood pressure, chest x-ray. Repeat every 6–12 months.
• Dental examination — dental disease and its cardiac / renal consequences are the most-missed senior issues.
• Ophthalmological screen — cataracts, dry eye, glaucoma.
• Cognitive assessment — screen for cognitive dysfunction annually.

10.3 Canine cognitive dysfunction syndrome (CCDS)

Behavioural analogue of human dementia. Prevalence ~14% at 8 years, rising to ~40% by 15 years.

• Signs (DISHAA acronym): Disorientation (getting lost in the home); altered Interactions with family; altered Sleep-wake cycle; House-soiling; altered Activity level; altered Anxiety.
• Environmental interventions: predictable routine, night lights, gentle stimulation, avoid rearranging furniture.
• Nutritional interventions: senior diets fortified with antioxidants, medium-chain triglycerides, omega-3 fatty acids.
• Medication class (available on veterinary prescription) can slow progression in some individuals.

10.4 Osteoarthritis management

• Weight control — the single most impactful intervention.
• Structured low-impact exercise — swimming, controlled walking.
• Physical rehabilitation therapies where available (hydrotherapy, range-of-motion work).
• Environmental — orthopaedic bedding, ramps to bed / car, non-slip flooring.
• Nutraceuticals — omega-3 fatty acids, glucosamine-chondroitin (modest evidence); green-lipped mussel (some evidence).
• Pharmacological options — NSAID class (veterinary prescription; human NSAIDs are DANGEROUS to dogs); gabapentin class; monoclonal-antibody class (newer); adjunct classes as advised by vet.

10.5 Nutritional adjustments for seniors

• Calorie density typically reduced 15–20% due to reduced activity.
• Protein — historically restricted; modern consensus favours adequate high-quality protein unless CKD advanced.
• Sodium — restricted in cardiac or renal cases.
• Phosphorus — restricted in renal cases.
• Fibre — increased for GI motility and satiety.
• Omega-3 (EPA/DHA) — anti-inflammatory benefit.

10.6 Quality of life and end-of-life care

The hardest owner conversation the vet has is when to say goodbye. Quality-of-life scales help make the decision less isolating.

• HHHHHMM Quality of Life scale (Villalobos): Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility, More good days than bad. Score each 1–10; total < 35 warrants a serious conversation.
• Hospice care — palliative pain management; environmental adjustments; family time; a vet-guided plan.
• Euthanasia — humane and merciful when suffering outweighs quality of life. Discuss location (clinic, home), timing, aftercare (cremation, burial per local rules).
• Home euthanasia — increasingly available in many areas; reduces stress for the pet.
• Grief support — pet loss is real bereavement. Some vet clinics provide grief resources; online communities exist.