ABSTRACT: Ageing is part of life and, as veterinary care improves, we can expect to see increasing numbers of elderly pets being presented at veterinary practices. Care of the geriatric pet has become a major part of the veterinary nurse's role, with many practices running nurse-led geriatric clinics. Despite this, owners remain reticent to present the older pet – concerned that any visit to the practice may be the last – leading to many elderly pets living in discomfort and depleted welfare. As in so many cases, behavioural changes can be the first signs of physical problems and the veterinary nurse plays a vital role in identifying the elderly dog that requires support.


Dogs of 14 years plus and 18-year-old cats used to be considered remarkable, but they now form part of the daily case load in most practices. Despite the inevitability of old age in humans and pets, it is still a poorly understood process.

One thing, however, does seem clear: as ageing occurs, the body becomes less capable of coping with physiological and environmental stressors. Yet many owners delay requesting veterinary support for their ageing pet, convinced that the associated behavioural and physical changes are inevitable and that presenting the animal at a surgery will only result in euthanasia, leading many to telephone the practice for advice, rather than visit it.

By knowing the age of the patient, the veterinary nurse can anticipate potential problems and initiate sympathetic and positive discussions with the owners of elderly pets; creating the reassurance that enables owners to present pets in the confidence that their pet will return home and in a state of improved welfare.

But he’s only eight years old!

Although the owners of larger breeds of dogs are aware that they rarely make old bones, few seem to realise that this may have a knock on effect on the ageing process – convinced that there are seven canine or cat years to every human one. Surely if they are eight years old that equates with 56 – and that’s not old?

Of course, many factors are involved in the ageing process and many smaller breeds mature much more slowly. But we shouldn’t be surprised that owners sometimes find the concept of pet ageing so difficult, particularly as we find it so hard to remember ourselves! Some pets seem to age prematurely, with grey muzzles and a tummy paunch, and these are easy to spot – but others appear youthful and athletic and it can be far more difficult to counsel the owners of such pets.

Exercise tolerance and mobility

Obesity, orthopaedic, respiratory and cardiac problems are often present in elderly pets and all reduce exercise tolerance. If exercise tolerance isn’t revised, then mobility problems will be significantly increased, and if exercise stops, mobility issues will be accelerated. Ask about dog owner lifestyles, what part the dog takes in exercise, and then advise accordingly.

As the dog gets older, frequent, shorter outings will not only decrease wear and tear on joints, but will also increase interest levels in the environment. Increased resting in older cats and dogs doesn’t always indicate contentment, but may be a clear indicator of pain or a reduction of interest in the surroundings.

Social stress created by other household pets may also lead to inactivity in older cats. Encourage the family to look at the wider picture and to investigate the reason behind inactivity – and then rectify it.

Use it or lose it

Some pets initiate play throughout their lives, but others have to be encouraged. Just because a pet requires encouragement and only plays for a short period, we shouldn’t assume that it does not enjoy the period of engagement. All pets need mental stimulation, and as their environment begins to shrink, the elderly pet needs it more than any, particularly if they have reduced their exploration of their environment as a consequence of anxiety or discomfort.

Advise owners to encourage several, short play sessions each day. Long games will tax even the keenest of pets, and elderly collies may be willing to chase a ball for hours, but they will pay the price after resting – so make sessions stimulating, but short!

Many older pets lose interest in people and games, but food will often become an even greater focus in their day – an ideal opportunity to encourage brain activity through ‘puzzle feeding’ and food searching activities. Owners may have never encountered these, so keep some examples available to show them and demonstrate how they are used. However, it is important that owners understand that this food is an alternative to normal meals – not an addition!

Physical exercise can become problematic for older pets as their exercise tolerance decreases. It can be difficult for owners to understand that the pet that is keen to go out for a long walk may not be benefitting from it. Reduced distance but increased frequency of exercise can make a lot of difference to the older pet, but reduced exercise may also affect the pet’s waistline! Feeding regimen and diet may have to be reassessed.

There are a number of specific diets available for geriatric pets, as well as some that support the pet in cognitive decline. However, not all pets will find these diets palatable or enjoyable – in such cases owners may wish to consider one of the excellent dietary supplements that have been designed to be added to the normal diet of the elderly pet, enabling it to continue to enjoy its normal food.

Accidents will happen

As pets get older, many will experience toileting problems, ranging from forgetting the ground plan of the house and not being able to get to the correct door in time, to having to struggle too much to lift themselves out of their bed. With patience and lateral thinking owners can, if not eradicate, at least reduce this problem.

Normally, as a nurse you would be trying to convince owners that cats should never have to tolerate the stress of finding their food, drinking water, latrine and bed in close proximity – but this is the exception. As gut transition is increased through the effort of getting out of bed and of eating, this is the time when both cats and dogs may benefit from having these resources closer together and near to the back door!

Making sure that beds are cosy, secure, peaceful, made from disposable or easily cleaned material and of a shape and angle that enhances easy entrance and exit, can make all the difference to elderly pets. As physical stress may initiate bladder and bowel emptying, home-made or purchased ramps may be useful, but pets may need a little encouragement during initial use.

What to expect?

Confusion, disorientation and cognitive changes are common in elderly pets following alteration in brain physiology, and possible toxicity issues associated with cardiac, digestive/excretory and endocrine problems. This may lead to pets not recognising familiar people or things – often becoming anxious or fearful and using distance-creating communication, including aggression (Figure 1).

Figure 1: Elderly pets may increase their use of distance-creating behaviours, such as aggression

Alteration in the sleep/wake cycle is a common partner of old age, leading to owner distress, particularly if their rest is also disturbed.

Not surprisingly, older pets may be either unable,
or slow, to learn new associations, so any changes in domestic arrangements – social or environmental – will create challenges to their ability to cope. However, re-training of basic commands and associations is usually possible; and it will just take more time, patience and tasty rewards!

Particularly distressing for owners are the changes in social relationships that can occur in the older pet, especially amongst con-specifics – with the possibility of the pet becoming subject to aggression.

Older pets are also prone to becoming aggressive towards other family pets and family members. The younger pet can choose to walk away from potential threat, conflict or pain. But with reduced sensory awareness, increased discomfort from conditions such as arthritis or toxicity caused by organ malfunction (added to possible confusion), the elderly pet is no longer able to avoid potential problems and is often forced to use distance- creating communication – aggression.

Elderly pets need ‘warning’ regarding human approach and handling, and handling techniques should be less robust and more respectful of areas of discomfort. Children and elderly people should be particularly careful regarding their approaches and handling techniques.

Old age doesn't come alone

Anxiety and increased fearfulness often accompany old age. These and the pain, discomfort and toxicity associated with unresolved organ malfunction will inevitably increase restlessness, panting and the need for social support, particularly from the owner. This, in turn, may precipitate associated separation issues.

In addition, many older pets develop a reduction in exploratory behaviour (with associated decreased interest in their environment, lethargy and weight gain), personality changes and difficulty coping with any changes in or outside the home (Figure 2). This can then lead to irritability and a reduction in the pet’s ability to cope without using aggression to create a safe space around it.

Figure 2: Increased anxiety may lead to reduced social and environmental interaction

Many owners have also noted that a pet’s normal behaviours may change in frequency (barking, for instance) or be performed out of context and these and other uncharacteristic, old-age and anxiety induced behaviours may initiate aggression towards the older pet from younger con-specifics. Basic advice about recognising the signs of anxiety and assisting the pet in feeling more secure can be invaluable.


The untreated elderly pet can lead a miserable existence of pain and distress, yet with a full physical and behavioural assessment their final years can be comfortable and fulfilled. Ignorance regarding the type and level of veterinary and behavioural support available for elderly pets can often lead to misery for owners, who watch their pet’s decline while trying to cope with house-soiling and other disturbing symptoms.

Gentle, yet persistent, intervention from the veterinary nurse can make all the difference. 


Claire Hargrave BSC MSC PGCE CCAB

Claire is a Certified Clinical Animal Behaviourist and a Member of the Association of Pet Behaviour Counsellors who has worked in veterinary practice in numerous capacities for over 30 years.

Claire runs a specialist referral practice for companion animal behaviour cases and is located in South West Wales. www.petbehaviourwales.co.uk

To cite this article use either

DOI: 10.1111/j.2045-0648.2011.00099.x or Veterinary Nursing Journal Vol 26 pp 410-412.

• VOL 26 • November 2011 • Veterinary Nursing Journal