Puppies and kittens are adorable, but I can’t help loving another group—geriatric pets. There’s something about the weak and the wobbly, the skinny and the stinky. When I meet a dog with grayed eyes, a sunken head, and shaky spaghetti legs, my heart just melts. With a long and established legacy, the geriatric pet typically has been a part of its family for more than a decade, witnessing many life events and playing an integral part of its family’s story. The families of these pets are a group of dedicated, devoted clients—and they’re greatly in need of our help. Unfortunately, despite comprising the demographic that most benefits from your expertise, geriatric pets are even worse than elusive cats when it comes to being seen in your clinic. In my role as a veterinarian who exclusively helps families manage end-of-life care, I’ve seen my fair share of geriatric pets. What saddens me the most is that many are not seen enough during the last, crucial phase of their lives. In this three-part series, I will delve into the uniqueness of caring for geriatric pets and outline ways to increase visits from patients in this group. In part one, I will explore the differences between senior and geriatric pets and review the statistics illustrating how often these age groups are examined by their primary care veterinarians. Senior or geriatric? I currently have two dogs: Sam, a female 10-year-old Anatolian shepherd, and Duncan, a male 13-year-old Doberman. While both technically are classified as senior pets, they are worlds apart in terms of daily care and management—but what makes them different? As veterinarians, we are taught any dog older than age 7 can be classified as a senior, but have you ever tried to tell the owner of a 7-year-old Labrador without obvious health problems that their pet is a senior? There’s a high probability the client might challenge this label and assume you’re upselling them on some diagnostic testing. However, when a 12-year-old Labrador wobbles into your exam room, accompanied by an owner with a laundry list of problems they are dealing with at home, this is no longer simply a senior pet—this is a geriatric pet. What differentiates the two? It’s simple—degrees of fragility and differences in management. Geriatric humans versus animals The idea of geriatric, in regard to both humans and animals, has always intrigued me. Early in my career, however, I realized defining the term in the context of the veterinary world posed a challenge. To clarify my own misconceptions, I attended a human geriatric conference and was amazed by what I learned. For humans, a senior is someone who is older than 65 years of age. This classification does not take into account a person’s body composition, ailments, struggles, disease, or ability to care for oneself; age is the only factor. However, being labeled geriatric is almost a state of being—and that state occurs when you are fragile. Classifiers of fragility in humans include various combinations of the following indicators: Weakness (including grip strength) Fatigue or exhaustion Weight loss Impaired balance Decreased physical activity Slowed motor performance (gait speed) Social withdrawal Mild cognitive dysfunction Increased vulnerability to physiological stresses Regardless of whether a person is 65 or 85, it’s been proposed that, in order to be classified as geriatric, an individual should exhibit at least three of the following criteria on a chronic basis: Weakness Weight loss Slowed mobility Fatigue As such, the geriatric label in humans reflects a person’s biological status, health space, and general need for assistance. This phase typically occurs in the years comprising the last 10 percent of a person’s lifespan. Taking this idea into account, I can easily identify advanced-aged pets as either senior or geriatric, as, like humans, geriatric pets typically are in the last 10 percent of their lifespan. My Anatolian, Sam, has mild arthritis and a few lipomas, but she’s generally very healthy and happy. She gets her bloodwork done every six months and has X-rays and ultrasounds performed to ensure nothing’s happening beneath the surface. Duncan the Doberman, however, is a hot mess. Three years ago he had a tie back for laryngeal paralysis and now has peripheral neuropathy. While he won a battle with oral melanoma last year, he’s now challenged with dilated cardiomyopathy and symptoms of early heart failure. To manage his changing needs, my home is covered in bath mats so he can keep his footing. There are night-lights everywhere to help him get around, as well as signs posted on my front door asking visitors to not ring the doorbell. He wears a harness around the house, all the dog beds have baby mattress covers in case he has an accident at night, and someone has to be available every four hours to let him outside. Looking after Duncan isn’t just a chore—it’s a nightmare—but I will gladly be his caregiver as long as he’s happy and has a good quality of life. That being said, it’s still a struggle. Dealing with Duncan’s symptoms and managing the care of an aging, 100-pound dog isn’t a role suited for everyone. Now more than ever, I can appreciate what families go through as caregivers for a geriatric pet. I feel for them. The anticipatory grief is immense and the guilt is looming. You continually pray for good days—or, alternatively, a day so utterly awful that the final decision becomes clear. However, life and death isn’t easy; in these cases, it’s a string of so-so days, dotted with great ones and sprinkled with scary ones. Geriatric pets and the clinic During my eight-year career as an end-of-life veterinarian, I uncovered a dark statistic: Frequently, pets nearing euthanasia have gone years without seeing their primary care veterinarian. This trend bothers me deeply. Oftentimes, end-of-life care for a geriatric animal consists of a veterinarian advising a family of how to modify their home and alter care practices in order to keep that pet healthy and happy. It was upsetting to think of how often I might have missed out on helping pets and families who were suffering. Curious to see if this was an anomaly in my business or representative of something larger, I reached out to Martin Traub-Werner, CEO of VetSuccess, a data intelligence company that analyzes and normalizes data from veterinary practices across the country. VetSuccess reviewed data from 300 clinics from across the U.S. and uncovered data I found shocking. First, VetSuccess broke down the percentage of pets within each life-stage category: puppy/kitten (younger than 1 year), adult (2 to 7 years), senior (8 to 10 years), and geriatric (older than 11 years). The data determined the largest group of pets fell into the geriatric category, but I had to wonder if these animals were seeing their veterinarians regularly. Next, VetSuccess looked at pets that had been euthanized in these clinics. For this data, I was interested in the percentage of pets that had visited that clinic within 18 months of euthanasia. Cats The data looked at cats aged 12 years or older. Of this group, only 23 percent were seen by their primary care veterinarian within 18 months prior to euthanasia; 77 percent were not seen. That said, many veterinarians would argue this is not earth-shattering news, as cats are often infrequent visitors at most clinics. Dogs When looking at cases of dogs aged 10 years or older, the data showed only 31 percent were examined by veterinarians within 18 months prior to euthanasia. Nearly 70 percent did not receive veterinary care during the last phase of their lives. To illustrate this statistic, let’s assume a three-doctor practice has a total of about 3,000 active patients. If 40 percent of those patients are geriatric, 1,200 pets fall into this category; of those, 70 percent—840 pets—are not being seen. If just 25 percent of this group came to the clinic, this would amount to 210 “gray muzzles” receiving veterinary care that could greatly enhance their lives. While veterinarians aren’t always able to increase a patient’s quantity of life, we have so much to offer in regard to improving quality of life. This presents a huge opportunity for veterinary clinics. While many have strategies for targeting senior pets, most do not market specifically to geriatric pets, despite this group comprising the greatest number of patients. When appealing to clients with geriatric pets, there are a number of questions to consider: How do we get geriatric pets to the clinic? How can we help? What are the struggles that families encounter when caring for geriatric pets? In next month’s installment, I will examine specific challenges faced by geriatric pets and offer practical solutions veterinarians can offer their owners for at-home management. To read part two, click here.
