## The "silent drama" of senior cats

Cats are **masters at hiding pain and illness**. It’s an evolutionary legacy: in nature, a cat that shows weakness becomes prey or gets excluded from the group. So they hide.

The result: **70% of senior cat owners** do not notice the early signs of illness. Late diagnoses mean less effective therapies, reduced quality of life, and premature mortality.

Here are the 5 most common illnesses in senior cats, along with the early signs to recognize.

## 1. Chronic Kidney Disease (CKD)

The **most common illness** in senior cats: it affects about **30% of cats over 10 years old** and over **50% of those over 15 years old**.

**What happens**: the kidneys progressively lose the ability to filter toxins. They accumulate in the blood (azotemia, urea).

**Early signs** (often ignored):
- **Drinks much more** than usual (polydipsia).
- **Urinate more frequently and in larger quantities** (polyuria).
- **Slight progressive weight loss**.
- Dull coat, slightly dehydrated.
- **Variable appetite**.

**Advanced signs**:
- Repeated vomiting.
- Lethargy.
- Uremic breath (urine smell from the mouth).
- Visible dehydration.
- Anemia (pale gums).

**Diagnosis**: blood test (creatinine, SDMA, urea) + urinalysis (specific gravity).

**Therapy**:
- Specific "renal" food (reduces protein, phosphorus).
- Supplements (omega-3, antioxidants).
- Maximum hydration (water fountain, pâté).
- Sometimes subcutaneous fluids at home.
- Medications that protect the kidneys (Telmisartan).

**Prognosis**: manageable for years. With early diagnosis, **3-6 years of quality life** after diagnosis.

## 2. Hyperthyroidism

The second most common illness in senior cats: affects about **10% of cats over 10 years old**.

**What happens**: the thyroid produces excessive hormones (T3, T4), accelerating metabolism, heart rate, and anxiety.

**Early signs**:
- **Eats a lot but loses weight** (classic paradox).
- Vocalizes more, seems "hyperactive" despite age.
- Scruffy coat, shaking.
- **Polydipsia** (drinks more).
- **Diarrhea** or softer stools.

**Advanced signs**:
- Extreme weight loss.
- Repeated vomiting.
- Secondary cardiomyopathy.
- Hypertension (can cause sudden blindness).

**Diagnosis**: blood test for T4 (and sometimes T3, TSH).

**Therapy**:
- **Antithyroid medications** (Methimazole, in tablets or transdermal gel): 95% effectiveness, low cost.
- **Radioactive iodine**: definitive cure, high cost, available at specialized centers.
- **Surgery** (removal of the hyperfunctioning thyroid gland): rarely done now.
- **Low-iodine diet** (Hill's y/d): alternative only if the cat only eats that.

**Prognosis**: excellent with therapy. **3-5 more years of life** compared to untreated.

## 3. Diabetes Mellitus

Increasingly common in indoor cats: affects about **2-4% of cats**, especially **overweight neutered males over 6 years**.

**What happens**: the pancreas does not produce enough insulin, or the body does not respond well. Glucose accumulates in the blood.

**Early signs**:
- **Drinks excessively** (significant polydipsia).
- **Urinate a lot** (polyuria).
- **Eats more** but **loses weight**.
- Scruffy coat.
- Weakness in back legs (diabetic neuropathy).

**Advanced signs**:
- Diabetic ketoacidosis (emergency): vomiting, dehydration, coma.
- Cataracts (sometimes).

**Diagnosis**: blood sugar + fructosamines + glycosuria (urine).

**Therapy**:
- **Subcutaneous insulin** twice a day.
- **Specific diabetic diet** (high protein, low carbohydrates).
- Weight management.
- Home glucose monitoring.

**Prognosis**: excellent with active management. About **30% of cats go into complete remission** (no longer need insulin) if treated early with the correct diet.

## 4. Osteoarthritis

Grossly underestimated: recent studies show that it affects **70-90% of cats over 12 years old**, but is diagnosed in less than **15% of cases**.

**What happens**: progressive wear of the joint cartilage (hips, knees, elbows, shoulders, back).

**Early signs** (almost always ignored):
- **Jumps less**: difficulty jumping onto windowsills or sofas. Chooses different strategies.
- **Sleeps more**.
- **Licks specific areas** of the body insistently (painful area).
- **Hides** in smaller or quieter places.
- **Changes grooming habits** (doesn't clean entire body).
- **Less tolerant** of physical contact.

**Advanced signs**:
- Visible lameness.
- Muscle atrophy.
- Aggressive behavior if touched in painful spots.

**Diagnosis**: clinical exam + X-rays. Sometimes CT or MRI.

**Therapy**:
- **Specific anti-inflammatories** (Meloxicam in low chronic doses, Onsior).
- **Solensia (frunevetmab)**: revolutionary monoclonal antibody, one monthly injection.
- **Chondroprotectors** (Cosequin, glucosamine, chondroitin).
- High-dose **omega-3**.
- **Environmental adaptations**: ramps, low-sided litter boxes, raised bowls, soft warm spots.
- **Weight loss** (crucial: every gram less = less joint load).

**Prognosis**: well manageable. Drastically changes quality of life.

## 5. Tumors (neoplasia)

The risk increases with age. About **40% of cats over 12 years old** will develop some form of tumor during their life.

**Most common tumors in senior cats**:

- **Lymphoma**: the most common. Can affect the intestines, mediastinum, lymph nodes.
- **Squamous cell carcinoma**: skin (white cats), mouth.
- **Mammary tumors**: unspayed females.
- **Sarcoma**: soft tissues.
- **Oral tumors**: often aggressive.

**Generic signs**:
- **Unexplained weight loss**.
- **Palpable masses** under the skin (check monthly).
- **Changes in habits**.
- **Recurring vomiting**.
- **Difficulty eating** (oral tumors).

**Diagnosis**: exam + ultrasound + X-rays + biopsy + blood tests.

**Therapy**: depends on the type:
- **Surgery** (curative for many).
- **Chemotherapy** (well manageable in cats, much better than in humans).
- **Radiotherapy** (specialized centers).
- **Palliative care** (for incurable tumors: pain management, quality of life).

**Prognosis**: variable. Lymphomas manageable for 1-3 years. Aggressive oral tumors are often fatal.

## The prevention rule

To catch the conditions listed above **before** they become serious:

**1. Semi-annual veterinary visits** starting at age 7.

**2. Annual blood tests** that include: complete blood count, biochemistry, T4, blood glucose, renal SDMA.

**3. Annual urinalysis**: specific gravity, glycosuria, proteinuria.

**4. Blood pressure measurement** once a year from age 10 (hypertension is often silent).

**5. Close observation of behavior**: **70% of early diagnoses** start from owner observations, not from random tests.

## Changes to watch for

Behaviors that deserve a visit even if they "seem minor":

- Increased thirst.
- Eating too much or too little.
- Sleeping in different places than usual.
- Licking specific areas of the body.
- Jumping differently, avoiding jumps.
- Increased vocalizations (especially at night).
- Sudden apathy.
- Weight loss.

Individually they may mean nothing. **Combined**, they are often the first warning sign.

## The truth

Illnesses in senior cats are not "inevitable": **they are manageable** if caught in time. The problem is not the disease: it’s the late diagnosis. And late diagnosis is almost always due to:
- Lack of regular check-ups.
- Underestimating "small" changes.
- The idea that "they're just old".

A 15-year-old cat can enjoy another 5 happy years with the right management. Invest in regular visits: it’s the greatest gift you can give them.