Amanda Steffen: You are listening to Senior Pet Talk, the show where we combine Western and Chinese medicine to give senior dog and cat parents the knowledge, the clarity, and the confidence to make sure that your pets' senior years are their best years yet. I'm Dr. Amanda Stefan. Let's get started. Hi, welcome. Thank you for joining. This is the Senior Pet Talk Podcast. I am Dr. Amanda Stefan. And today I am really excited about what we're going to be talking about because I want to go over something that I feel like a lot of senior dog and cat parents miss. Okay. We are talking about these very subtle changes. I want to talk about these signs that are so minimal that we Can't even see them a lot of times. It's one of those things where it changes and we're with them every day and we're taking care of them and we're doing everything in our power to give them the best quality of life that sometimes we miss these very minuscule changes because they happen over weeks or months. And they happen so quietly that we don't even realize that they've occurred. Okay. So we are gonna go through about 10 different this is normal. And this is abnormal symptoms. And I'm really excited to give you this information today because I really think it's going to change the game for you and your senior pets. I know that it has for the people that are in my program the amount that they understand now and how much smarter they are about being able to recognize these symptoms in their pets has been amazing to watch because now. They're able to pick up on a lot of different changes. And everything is not going to happen the same. Just because we're teaching you, or if I do a consult with you or something like that, I can tell you, ⁓ hey, that symptom that your pet is doing right now, that's not actually normal. But then they may have another symptom down the road. So that's where I feel very strongly about the education of pet parents. So that you can recognize it on your own and you are a key component of their care team. I am there to help you, but you are gonna be a huge component of that because you live with it every day, right? So I really love this part of things where I get to do some education and maybe a light bulb moment for everyone. I'm gonna teach you how to count respirations. I'm gonna teach you about muscle wasting, all of those things today. So get ready. And you may need a pattern paper for this one, but if you have any questions, please always find me on social media, send me a DM on Instagram, and I would love to chat more. Okay, let's get into it. So 90% of cats over the age of 12 have arthritis somewhere in their body. 80% of dogs over the age of eight have arthritis somewhere in their body. Almost none of these guys are going to actually limp. They are not going to cry out in pain. They are going to have the most minuscule changes because they don't know that they're not supposed to feel this way now. And as someone who also suffers from chronic pain, I have rheumatoid arthritis and I'm not going to dwell on that every day because does my body hurt? Yeah, sometimes. But is it something that I'm going to let impact me living my life? No. And I think our pets do that to a very high degree. So we are going to look at more of these subtle changes. And I'm going to look over 10 different body systems. We're going to talk about clear, like normal versus abnormal comparisons so that you can walk away with like an actual checklist. And if you guys are not already, make sure that you sign up for my email flow. It has A free Asian gracefully checklist on day one, some pain calculators, quality of life calculators, things like that. So you get a lot of the extra information. All right. So one of the hardest things about having our senior pets is not knowing whether something is wrong. And I think, especially the women listening, I am getting very into intuition and trusting yourself. And I think we need to do that. If you guys don't know or have not heard this before, my senior dog Floyd, he had a brain tumor. And it wasn't anything in particular. It was just a lot of very tiny things. I was also pregnant with my first kid and I had a lot of emotions and things because I was watching him deteriorate. And I was trying to grow a human and I just knew something was wrong. And I took him to the neurologist. He had seen probably three specialists at that point. And I took him to the neurologist and I said, I know. I know. I know he has a brain tumor. I know. I just need you to find it and I need to help him. And I can't explain why I knew. It has nothing to do with my medicine. I just knew. So trusting our intuition when you feel like something is wrong and blood work may be normal, ultrasound may be normal, Floyd's blood work and his ultrasound weren't perfect. It was in his brain. And when you have that feeling, look, yes, it may be expensive. An MRI is not cheap. I am very blessed that I was able to do that. However, if you feel like something is amiss, I want you to bring that to your veterinarian. And make sure that we're talking about that because I believe you. There is something going on. If you feel it, there is something. And we need to get to the bottom of it. It may be something simple, it may be something complicated, but trust that intuition. Okay. Dogs and cats, cats especially, are really good at hiding illnesses. They, it's survival instincts, and looking weak means that you look like prey. They are not going to show that. they don't feel good or that something is going on, especially cats. I noticed that they will come into the emergency room and there will be heart failure, there will be kidney failure, there will be a UTI, there'll be like four things in one. And the owners will tell me, well, she was fine two days ago. And although her body probably wasn't technically fine, I believe that you didn't see any clinical signs until two days ago. Because that's just how they operate. You're not gonna always see these very minimal changes when they pop up until they're something glaringly obvious, like vomiting or trouble breathing or urinary accidents, things like that. So there is an integrative component of this. I'm gonna go through each of these normal versus abnormal with you. And then I'm gonna talk about like the Western protocol and things that we would go through. And then we're gonna talk about the Chinese. meaning of these things and what we would go through in Chinese medicine because this is an integrative veterinary podcast. I am a firm believer in mixing Chinese and Western medicine to give pets a personalized plan that fits them and what their pet parents are comfortable with. So we're gonna talk about it all here. Okay. There's a component of it you don't believe in, just feel free to kind of tune that out until we get there. Okay. One of the easiest ones that I feel like is seemingly easy to mix up, I would say, is I will have probably 80% of senior pet parents come in to me and I'll say, Do you have any concerns? And they'll say, Well, no. I know that he has cataracts in his eyes, but you know, I think that's just normal. And we look and I say, Well, I have good news for you. What he has going on is actually called nuclear sclerosis or lenticular sclerosis. And this is a normal aging change of the eye. The lens of the eye lays down continuous layers over time. And eventually, those layers, if you put enough clear coats on something, it is likely going to look a little filmy and thicker, right? So what we start to notice is that they start to get this like white blue haze over the black part of the eye in the middle. But this isn't usually a cataract. Cataracts only happen at about 10% of senior dogs. That is still a decent amount, right? But not as much as the nuclear sclerosis, which happens in 100% of dogs over the age of eight and cats over the age of 10 to 12, right? It's not as noticeable in cats, I will tell you that, because the black part of their eye tends to be very small. But it is something that we do see in cats as well. So a normal change will be over a series of time, you're gonna notice very minimally in the beginning, like, ⁓ hey, it looks a little milky in that part of the eye. Not a lot, just very minimal. It's gonna be in both eyes. The same, and there's not any irritation to the eye. There's not any, you know, redness or squinting or bulging or anything abnormal like that going on. We're just seeing this kind of normal milkiness in that part of the eye. That is nucleoscoriosis, and it is normal. Now, what we don't want to see is symptoms of like a cataract. or a corneal ulcer or a mast in the eye or something along those lines because those things can't happen. That is cataracts are truly going to obstruct their vision and make them blind. And this can often be linked to diabetes, it can be a genetic disorder, and it can cause glaucoma, which is this swelling that happens or increased pressure in the eye. And this increased pressure in the eye causes pain. It makes them feel like they have a headache. So glaucoma will look more like a bulging of the eye almost. And that can be helped with medications, but it is in a medical emergency because it can cause them to go blind. With nuclear sclerosis, there is always going to be a human ophthalmologist who is going to comment on this and say, Nucleoslerosis is a cataract. In humans, it is considered a cataract. In our pets, it is not. If you have any questions, I recommend going to the vet eye guy, who is a wonderful friend of mine, and he gives a really good explanation on why. I don't get too deep and dirty into that because I'm not a veterinary ophthalmologist, but I can tell you that in veterinary medicine, we do not consider them the same thing. Okay. However, It is important to know that with nuclear sclerosis, as it progresses over time, we can start to notice that our pets will have some difficulty seeing at night. So adding nightlights around the house can be helpful. And we can also notice that they have some difficulties with shadows. A shadow may look look like a cliff to them or something. So they may kind of jump or seem uncomfortable with shadows. And they may also have some issues seeing right in front of their face. So we can have these guys that can potentially fall down the stairs or things like that. That's why I always recommend baby gates on stairs with seniors and making sure we're trying not to move furniture a whole lot. From a Western standpoint, with this, we are going to do a really good ophthalmic exam to be able to distinguish the two. It's a pretty easy way to do this. And Another thing that sometimes pet parrots can see and we can see is with nuclear sclerosis, they're still going to have a tapedal reflection, which is that green, bright green reflection that you see sometimes when you shine a a light on their eye just right. With cataracts, we're not gonna see that tappedal reflex. So that's a interesting way to tell the difference between the two. In traditional Chinese veteran medicine, so the eyes are connected to the liver system. When we're talking about liver in traditional Chinese veterinary medicine, we don't truly mean the organ that's inside of our body. It is everything in Chinese medicine is more abstract than that. But the liver system in traditional Chinese veteran medicine is where the eyes are connected to. So supporting the liver and yen through things like diets and herbs is going to be part of helping these guys have a healthier. Aging plan and then also, you know, just just making sure we're evaluating everything appropriately. Next up, we're going to talk about muscle. This is extremely important, in my opinion, because so many, I don't have percentages on me, but I would probably say in what I see, I see 50 to 100 clients at a time any given month, and I see a lot. Of muscle wasting. And this can detriment our senior pets in a lot of ways. This can cause incontinence issues. This can cause ambulation issues. This can cause general quality of life issues. So I want to talk about muscle. It is quote unquote normal for us to have a mild, gradual muscle softening. Just like your grandparents, right? Over time. So we're talking over months to years. We're seeing this slightly less what I call meaty, but like muscly changes to their spine, their head, their hind limbs, especially. We're going to see those changes over a large amount of time. And it is going to be symmetrical. So it's going to look the same on both sides. What we do not want to see would be like rabid muscle wasting. Can we see the top of their head or their back legs or their stapula, so like their shoulder blade very prominently on their front limbs over a period of weeks? And if we're getting to that severe muscle wasting point even over time, there are things we can do to intervene. That's the really cool part about this: is that we don't have to just say, Okay, well, muscle wasting is happening and there's not much we can do about it. I have improved so many senior pets with muscle wasting just by doing things like changing their food or increasing their rehab or adding a muscle builder or things like that. There's a lot we can do to help with muscle wasting. So, in a Western medicine standpoint, we're going to look at body condition scoring and the muscle condition scoring. We want to make sure that our senior pets are an ideal body condition score, which means that they are not overweight and not too terribly underweight, because we want to make sure that they're not putting too much strain on their joints, right? And then we also, very important, and I feel like not enough of us as veterinarians do this during vet visits is a muscle condition score. We really need to grade their muscle and know, are we having any muscle breakdown? And then knowing that over time and where that's located at to be able to help pet parents a lot more. We can also do things like blood work to rule out underlying diseases driving the loss. So there are a lot of diseases like diabetes and kidney disease and thyroid disease that can cause that muscle wasting to accelerate, as well as a Cancers, so we can have cancer cocaxia, which is like a cancer muscle wasting, or we can have heart disease that causes a muscle wasting as well. So it's important to rule out other key factors involved with that. And to me, muscle wasting is so important, not only because it affects their quality of life, it affects their lifespan. We know that senior dogs and cats have a smaller, a shortened lifespan. If they have muscle wasting. So the earlier that muscle wasting starts and deteriorates, the shorter their lifespan is going to be on the other side of that. So, in a respect of keeping our pets around as long as possible, keeping their muscle mass up is extremely important. Okay. In an integrative standpoint, again, I talk a lot about high-quality protein in these scenarios. Western medicine also We know that senior dogs and cats both need more protein typically as they get older, and they need a protein that's easier for the body to break down. So even if they handled beef their whole life, they may not be able to handle beef as a senior in a way that efficiently helps their muscle. We may need to look at something that's easier for the body to break down. We're talking about things like rehabilitation. Acupuncture. ⁓ again, I love using acupuncture and electrical stimulation. This is kind of like a tens unit. It sounds really scary when you say electrical stimulation, but it's really just like a tens unit for the body and for those muscles. And it helps to ramp up healing and nerve function and those types of things. I really enjoy that. I have a patient that I'll talk about here probably a lot, named Fonzi. Fonzie. He's a 15-year-old cat and he does like rehab and acupuncture and estime and muscle building. And he looks five years younger and he's a year older. We started acupuncture on him at 14, and the pictures of him at 14 are starkly different than the pictures of him at 15 and what he looks like now. He looks amazing. And he also has diabetes. So on top of all of that, we're you know, combating that diabetes very efficiently with an integrative approach for him. Next talking point we're going to talk about is arthritis. So mobility and joints. What we can notice that is normal for senior dogs and cats, we know they are going to have arthritis, right? Again, 80% of dogs over the age of eight, 90% of cats over the age of 12, they have arthritis. It's going to happen, which means They are going to be a little slower to get up. They're going to probably have a slower pace overall. It might take them a little while to warm up their joints first thing in the morning. And they may take a little bit longer to recover after certain activities. But what we don't want to see, and what would be signs of that arthritis causing substantial pain, would be things like. hesitating at the stairs or not jumping anymore are decreased in our dogs standing up on their hind legs to greet you. Cats, instead of jumping straight up onto the counter, now we are seeing our cat is jumping onto the stool and then onto the counter or just onto the stool because the counter's slippery and they don't want to get up there and it bothers them. Or maybe they're not climbing the cat tree as high as they did previously. Maybe they're having some litter box accidents outside of the box because they're not able to climb it into their box anymore. These things can all happen with arthritis that is causing significant chronic pain in our senior dogs and cats. We don't want the name pain, right? So there are plenty of things we can do to combat this. The next episode, I'm going to talk about all of the different things that we can do to help with pain and arthritis. It is an overwhelming amount of things. I think a lot of times. Pet parents think there's one or two things to do and that's it, or everything's really expensive and they can't afford to do anything else. And that's just not true. There's so much that you can do that is low cost or no cost. And there's so many other options for senior pets. So it's really important for us to make sure that we talk through all of those things, which we will do in the next podcast episode. It is crazy to know that. Dogs between the age of eight months and four years, forty percent of them already show osteoarthritis changes. Not even a year old. Under the age of four, forty percent of dogs are already gonna show signs of arthritis on x-rays. And often we're not picking up those symptoms until they're six plus years old because we just don't think about them having arthritis at that young of an age. So if you have younger pets, Please look out for these things as well. It's never too early to start thinking about all of these things and asking the right questions. The earlier that we find answers, the more efficiently that we can help them and the more options that we have to help them. X-rays are kind of the only way in Western medicine that we diagnose and treat osteoarthritis. However, a lot of the conversations I have with pet parents is. Are we really gonna radiograph their whole body? Like if we know that Fluffy is limping on his left back leg, or mom says, hey, he's not standing on his back legs anymore, or we're having difficulty going up the stairs or jumping up on the couch, then I know it's probably the back end. And we can say, Okay, well, let's x-ray his like lower spine and hips and knees and kind of get an idea there. We can also feel a lot of this on a good physical exam. So anytime I see patients, I'm going to do a Chinese exam, which means checking trigger points and checking for heat and checking their tongue color and checking their pulses. But I'm also going to do a Western exam where I'm lifting and extending all the legs, pushing along the spine to try to locate is there anywhere that they seem uncomfortable? Is there anywhere that I can feel crepitus or like that crunching type of feeling or the popping that would indicate to me that there's some arthritis in those areas? So I think a good physical exam can give us a lot of information. And overall, if we want to get some definitive answers, we're gonna talk about x-rays. And the reason that we still talk about doing and recommend x-rays is because if it's not arthritis, it could be something scarier, like a tumor or like nerve degeneration or something like that. So it is still something I talked to pet parents about, you know, if we want to definitively know, we would need to do these x-rays. But if you decline them, I am still going to talk to you about how to help your pet with pain control because my number one is that they're not in pain. So we're still going to touch on those things. In Integrative medicine or in Chinese medicine, arthritis is considered B syndrome, usually from cold, damp, stagnant patterns in the joints. So we talk about things like acupuncture, laser therapy, pulse electrical magnetic frequency therapy, or PEMFs. All of these types of things. Also, herbs can help with this. We're also going to there's a lot more information now happening with ozone therapy, which is Very interesting to me. It's something I want to pursue a little bit more and learn more about and helping with ozone therapy and stem cell therapy to help with those joints and things like that. So it is a whole new world and there's always so much to learn. I am extremely grateful that I am in a profession where I want to learn more about this every day. And I've found my happy place in veterinary medicine with senior pet care that I just want to every day I want to set up for a new program and I want to learn something new. And I've been able to open my mind to Western Chinese medicine so that I'm able to help my my patients even more, which is just really exciting. Have you ever left the vet with more questions than answers? And then you drive home and you go straight on to Google. Yeah, I hear that a lot. And honestly, it's exactly why I created my senior pet virtual consultations. Imagine we have 45 minutes where we go through everything, your pet's full history, their specific challenges, their daily life, no rushing. We're gonna cover nutrition, integrative options, whole modifications, and quality of life. And I send you a personalized plan after so that nothing slips through the cracks here. But don't just take my word for it. Chelsea called it a senior pup therapy session and said she felt so much better afterwards. Adiba got recommendations her own vet had never thought to suggest, and Denise said that the consult was incredibly informative and helpful, giving her many options to help her dog Loki feel better. This is the conversation that your senior pet deserves. And honestly, The one you deserve too. The link is in the description. I'd love to help you. So again, very important. Most of our patients that have arthritis are not going to limp as an early symptom. Okay. They're not hardly ever going to cry out in pain. They're going to stop going up and down the stairs as well. They're going to hesitate. They're going to not greet you at the door anymore. They're not going to want to get up and go on the walks. They're going to be lagging pretty far behind on the walks. They're going to go from making it two miles to making it two blocks. These are symptoms and signs that I want you to be aware of and bring up to your vet and say, Hey, I really want to know what's going on and how to help. Another little snippet I will give you is I always recommend for people to have a couple days or a week of a pain medication at home from their vet. So whenever you go in for your vet visit next, say, hey, I know he's a senior. I know he could slip on the floor or down the stairs and hurt himself on a Friday afternoon. Is there something safe I can have at home as a pain medication? If this were to happen, we may be out of town, or if, you know, we're not close to an emergency room or I can't get him in somewhere, then is there something I can have on hand to give him until we're able to get back here for a couple of days? I feel like most veterinarians can find something to give you. I always like to have a couple days of an anti-inflammatory as long as it's okay, but There's always gonna need to be a protocol for that because I do not want you going to the pet store and buying aspirin. Aspirin does not have good pain qualities in pets, and it just there's so many better things we can use. The next thing I want to talk to you about is the brain. So when we're talking about cognition and behavior, normal things that we would see is maybe they are sleeping a little bit more than they used to. Maybe they are slightly less interested in learning new tricks and performing new tricks and things like that. What is abnormal, and we'll go over this in another podcast, the whole dish-ee that I talk about as far as all the symptoms of cognitive decline. But in general, like if they're disoriented or they're pacing, especially night waking or sundowning, people are still surprised when I tell them sundowning happens in pets. Vocalizing cats, especially like to wander aimlessly at night yowling. And that can be a sign of cognitive decline or dementia. If they seem like they're getting lost or stuck places, having ⁓ house soiling when they used to be pretty well house strained, like they would never be in the house and now they're having that happen. All those things are abnormal symptoms and things we definitely need to be aware of. Cognitive dysfunction changes from Almost 30% of dogs at the age of 11 to 12, and that number goes up to almost 70% of dogs over the age of 15 have dementia to some caliber. However, only about 2% of these guys ever come to a veterinarian and talk about those symptoms and actually get treated for it. For cats, we are seeing about 28% of cats. 11 to 14 showing at least one sign of cognitive decline, that number goes up to 50% of senior cats over the age of 15. So we have a pretty substantial epidemic of dementia in senior dogs and cats that is almost not even being touched by most of vets and pet parents. There's a lot of things to be done about dementia. One of my favorite stories is a dog who I really improved his son downing with just acupuncture. It was an amazing. I hope to write a paper up on him. But his parents had slept on the floor with him for a year before I saw him. And he just would not sleep in the bed. He would wake up all hours of the night. So they just put a mattress on the floor and slept downstairs on the floor with him. And after two sessions, he was sleeping in the bed fifty percent of the time. with them, they were able to sleep in bed again and improved his quality of life substantially. So there are a lot of things we can talk about with cognitive decline. So it is a rule out diagnosis, which is a little bit difficult, right? So when we talk about that, rule out diagnosis means that we rule out everything else first, which means it can get a bit expensive because we're talking about we need to make sure that they don't have high blood pressure. We need to make sure that they don't have kidney disease. We need to rule out pain. So dental pain is a really common reason and can actually make dementia worse. I again suffer from chronic pain, and I can tell you, I can see where chronic pain would make dementia worse because it makes you just a little crazy sometimes. And if what they think about half the time is just being uncomfortable, it can definitely make. you not be able to do as many things that open your brain up and help improve your cognitive function and can lead to cognitive decline. So I a hundred percent see where that could be something. We have to rule out all these other things first, but in general we do know some of the most c most common clinical signs. And there are some easy things we can do over the counter that are fairly safe for dementia and helping puzzle games are super simple to add in, you know, sniff boxes, those types of things. So there's a lot we'll talk about in another Episode about that. But I just want you to know that we can help dementia and noticing these symptoms early is extremely important because it is a progressive disease. It is going to worsen over time. And if we're able to get ahead of it earlier before these substantial signs occur, then hopefully we can help prevent conversations of end of life or quality of life because of dementia, which do happen fairly frequently, unfortunately. The next thing that I want to talk to you about is weight. So in dogs, we may see some small weight changes, especially with seasonal changes. You know, in the summer they tend to get a little thinner. The winter, they tend to put on a little more pounds, whether that's from just not walking as much or staying in anything more, we do the same thing. So, you know, that can be somewhat normal. Depending on the size of pet, though, you want to make sure if an 80-pound dog changes one to two pounds each direction, I am not worried. If a six-pound chihuahua lost two pounds, like that's a big deal. So we have to think about it in percent of their body weight. That being said, for cats, we definitely need to make sure if we notice any weight loss, then it is a significant thing. We do not have a lot of wiggle room with cats. And once they start losing things like muscle or losing weight, it can just spiral. So it's really important for us to stay on top of cat weights. That can be even harder because it's not as easy to just pop your cat on a scale and weigh them. So if you're able to get some sort of a baby scale, those are typically what we use in veterinary clinics anyways, to get weights on your cat once a month, once every few months. If you feel like you're noticing weight changes, then do it more frequently. But Keeping an eye on that is extremely important for cats and is one of the ways that we catch disease early. Because again, cats don't show us symptoms hardly at all. So noticing those subtle things like weight changes can be something that catches kidney disease or thyroid disease earlier than it would have once they're already in failure or something like that. So ideally we're weighing them monthly. That would be the best thing if you're able to. If you have a scale at home, you can kind of weigh yourself and then weigh yourself with your pet and subtract whatever that may be. But trying to get weights on them monthly is going to be extremely important. And then ideally we're also checking things like blood work and thyroid screening. So dogs tend to become hypothyroid, which means they can often gain weight and cats. often become hyperthyroid, which means they can lose weight fairly rapidly because of an overactive thyroid or an upped metabolism essentially and they're not maintaining what they need to. So those things are important to check as well. From a Western standpoint, we talk about like spleen chi deficiency would show up as things like poor appetite or weight loss, but we always want to look at the whole picture, right? All right. The next thing that I want to talk to you about is thirst and urination. This is something that gets overlooked a lot. And it is one of the most important early symptoms that we can see in senior dogs and cats. So it's something I want you to be very familiar with. It is normal for them to have we know that Callie goes to the litter box usually three times a day in peas. And that's normal for her. We know that we have to fill up that water bowl once every two days. That's normal. Well, now we're starting to have to fill up the water bowl every day. Or it's staying there for three or four days. Now we're noticing that she's going to load her box seven times a day. Or she's going in there and she's yelling and making changes and things like that. That is concerning to us. If we're noticing that our dog is now having accidents in the house, or they're asking to go out more frequently, or they're drinking more water. Any of those things make me concerned. 30% of cats over the age of 10 have kidney disease. That hops up to 80% of cats over the age of 15. So at this particular moment, we need to catch these things early. Catching kidney disease early can be substantially altering to their lifespan. I have seen cats that catch kidney disease early on lab work. And they can live two years without ever changing stages of kidney disease. They can be perfectly healthy, stable for years before they ever actually progress into another stage of kidney disease. So it's extremely important for us to catch these types of things early. And these very minimal changes in their thirst and their urination can be one of the earliest signs. It can also be signs of things like a urinary tract infection. It could be signs of things like bladder stones. Can also be a symptom of endocrine diseases like cushions or Addison's, things like that as well. So it's important for us to keep an eye on those things and do bring them up to your veterinarian when they occur because we do want to get ahead of that and we want to check on those things early. Cats that are diagnosed with kidney disease Can often live another two to three years with good management. Okay. So it is extremely important to make sure that we're keeping an eye on those things. And with dogs, things like cushions, they're able to live a normal life with that if we diagnose it early and we get them treated for that. Same thing with Addison's. So in a Western standpoint, we're probably going to talk about doing blood work. We're probably going to talk about doing a urine sample. And these are going to be the mainstays of kind of checking on that. In a Chinese medicine standpoint, we talk about kidney yen or kidney qi support. So comparing that with conventional treatments, we're going to talk about like conventional things like diet, fluids, medication. And then also I help a lot of patients with acupuncture for chronic kidney disease and things like that, as well as herbal therapy. So very important. All right, the next thing I want to talk to you about, these are some daily habits. So I want to talk to you about things like appetite. We're gonna start there. Appetite kneading. It is normal. I see very frequently senior dogs, especially, don't really want breakfast anymore. And this can get worse in the summertime, I feel like, but anytime they can I have again 50 to 100 clients on rotation at a time in my local practice and I get this complaint frequently of he just won't eat his breakfast anymore. And I say, okay, well, let's feed him more at dinner time and then feed him a lunch if you can. And as long as they're still eating the same amount in that time frame, then I'm happy with that. But what we don't want to see is if they're starting to have some things like they're dropping food that look like they're chewing on a particular side of their mouth or something. We're noticing I've seen cats with pain in their mouth actually walk up to the food, look like they want to eat it, and then they hiss at it because it hurts when they eat. So that can be more of a telltale sign. We have some drooling that happens. If we're noticing they're really just not eating as much anymore, or I'm really having to provoke their appetite. I'm having to add toppers onto this all the time. I'm having to do all these different tricks to get them to eat. That does concern me a little bit. And it can be one of the earliest signs of certain cancers, certain endocrine diseases and metabolic diseases and things like that. So it's very important to notice those mild changes and bring them up, no matter how mild they are. I'd rather people be over worried. And then we can tell them that it's okay and try to find some remedies for that as opposed to. Just pushing it off and saying it's nothing and then we don't catch it until it's something big, right? So especially with cats, if they stop eating, we can see a pretty substantial problem that happens with their liver, where they get some big hepatoglibidosis that can actually kill them. So it's it's really important to not wait when we're talking about major diet or appetite changes in our pets, because that can cascade very quickly. And then with our seniors, there's often not a lot of reserve that they have to go off of. And those organs are not going to bounce back as well. So we want to make sure that we're hopping on top of these things quickly and getting them remedied. Okay. So normal would be like, hey, we're not eating as quickly. Maybe we have some mild changes off and on. But abnormal things would be like major changes, consistent changes, those types of things. With coat and grooming. This is something that I talk a lot about with cats, but also can happen with dogs. We can often see their coat becomes a little coarser over time. So their very soft fur becomes a little like terrier like, you know, more coarse like. And if you've never touched horse hair, something more along those lines. Not quite that bad, but it can become more like that than it is soft. We definitely start to notice what I love so much. They're beautiful. Sugar face, the gray that starts to happen. There is actually some research that graying happens earlier and faster in patients that have anxiety, which I think is very interesting. But that normal graying change can happen starting around the muzzle, but anywhere. I had a 17-year-old chow named Molly, and she was all black when I got her. She looked like a little black bear. And then as she got older, Her feet were gray, her face was all white, she she kind of turned mostly white. It was she was precious. So those things can be normal. Abnormal things that we don't want to see would be: are they, especially for cats, not grooming, or are they over-grooming one spot? I see this with dogs too. They start to lick at painful joints. So they're licking at their wrists more frequently, or Chewing at like their hocks or their ankles essentially more. This can often be a sign that they're actually having some arthritis pain and they're doing their best to try and remedy that. So keeping an eye on those things. If we are having like a matted, greasy coat, interestingly enough, a greasy coat and dandruffy coats are more of something I think about in Chinese medicine because they have some more indications with Chinese medicine. But We have some spleen changes associated with that. But it's also important for us to know if we're starting to have some matted fur on the back end or we're starting to have some grooming difficulties or some dandruff. A lot of times that in a cat, that means they can't groom themselves appropriately in their back end. It hurts to turn around and get to that area. So they're not able to do it as much. If your cat will let you brush them, this is a wonderful time to start doing that. Obviously, soft. It does usually help with your bonding with them as well. So it's something that you can help them feel more comfortable and also help with your bonding. Another thing is breathing. This is something I'm gonna teach you today. Okay. So get ready, maybe write this down. It is normal for our senior dogs and cats to need a little bit longer recovery after a walk or play. Maybe they're panting a little bit longer, those types of things. It is not normal for us to have things like coughing. To have complete exercises intolerance. So they're not able to exercise at all anymore, or they're getting way more winded than they had previously, especially if that happens abruptly. Like, hey, two months ago they were able to run around the backyard and they seemed fine afterwards. And now they aren't even trying to run around in the backyard and they're still panting. That is alarming to me. If we're having labored breathing, so if we're panting when we're resting. That can be a concern if our gums are starting to change colors or our tongue is starting to change colors like to a purple color, we may be having some difficulty oxygenating appropriately. It is a fact that about 10% of dogs have heart disease. That number goes up to as much as 75% of senior dogs. So a lot of it can go undetected for quite a few years and then it just continues to get worse. If we catch it earlier, there are things we can do to help with that. Again, like Sen cell therapy or herbal therapy or medications and things like that to help. So panting at rest can signal either heart disease or respiratory lung disease, and they're important things for us to keep a very close eye on. Could also, I do struggle with evaluating panting in senior pets a lot because we don't always know what it means. It could mean pain, it could mean respiratory or cardiac disease. Could just mean they're a little less tolerant to the weather changes, things like that. So that's always something to it's harder to navigate and figure out, but it is something we want to keep a close eye on. Now, respiratory rate. This is the thing I'm gonna teach you. There are Cardallis, I think, is one. There's a couple of different apps that you can use to measure respiratory rate. If your pet has heart disease, this is a must. But regardless, this is still one of the things to put on your monthly check just to see if you're noticing changes. So you can either do timing for 30 seconds and double that, or you can just count for a minute. I think it's easier and you're gonna get a more accurate number if you just watch them breathe for a minute. This is when they're resting. So you want them to be laying on the couch, laying on their bed, you know, taking a nap, whatever it may be. You're going to set a timer for one minute and you're going to watch how many times their chest rises and falls in that time frame. We want something under 30 as a normal breaths per minute respiratory rate. If we're talking about something consistently over 40, or there's a lot of like belly breathing associated with that, that is a symptom that I want you to definitely bring to your veterinarian sooner rather than later. Okay. GI symptoms. This is another one that I feel like in cats we disregard and we definitely should not. A normal thing could be, hey, one off, my dog threw up or my cat threw up, they had an upset stomach, they got some diarrhea, maybe they had something different, a new treat or something like that. Maybe that can be normal. Abnormal symptoms. If we are vomiting or having diarrhea more than a couple of times, or it's happening recurringly once a week. Catch the vomit once a week, it's not normal. It's important to know that. If they're hiding or they seem like they can't get comfortable, a lot of dogs, especially with belly pain, do a very extended downward dog pose. So where they put their butt up in the air and they're they're staying like that for an extended period of time. If that is a normal thing for your dog to do, do not stress that. Okay. But if it is something new that they're doing, along with some other gastrointestinal signs like vomiting diarrhea, decreased appetite, anything like that, then that is something to bring up to your okay. There's a lot of organs that sit right up next to the diaphragm, the liver, the pancreas, the gallbladder, stomach, the small intestines, all those things are right up in that area, that core area, that they can be trying to stretch out because something's uncomfortable in one of those areas. Okay. Cats, especially, again Vomiting is not normal. If they get hairballs, there are things we can do to help with that. If they have appetite changes and things like that, this is something we need to look into. A cat that's having vomiting episodes off and on, I do worry especially about kidney dysfunction. So something I really want to keep an eye on. And in Chinese medicine, and actually becoming a little bit more common in Western medicine now, we have some really amazing ways that we can help. With the gastrointestinal tract. For a long time, we used to just say, I guess Western medicine always said, ⁓ well, we're going to put you on this low fat diet. We're going to put you on antioxid, something like that. And you only get to eat this one food for the rest of your life. And I personally don't agree with that. I think that a pet should not only be able to handle one food. They should be able to handle variety. And because of that, I think the gut microbiome is extremely important. We know the gut microbiome is linked to all the other organs, the brain, the cognitive stuff, all of that. And I think tracking their gut microbiome can be extremely helpful for senior dogs and cats and fixing that if it needs to be. So that's another episode we'll talk about as well. All right. I hope this helps. I'm gonna recap these for you guys really quickly. Okay. So Nuclear sclerosis, a normal aging change in the eye, normal, cataracts, not normal, bulging eyes, pain, quick, rapid changes, just one side changes, that type of stuff. Muscle loss. A very minimal amount of muscle loss over a period of time can be normal, but it still doesn't mean that there's not things we can do to intervene. We can definitely still intervene with diet changes and muscle builders and rehab and acupuncture and things like that. But if we are noticing a very quick muscle wasting or It's only happening in one spot on the body. That is definitely something to bring up quickly. Arthritis, a normal amount of like slowing down can happen, but what we want to make sure we're keeping on top of with arthritis is pain control. Only about 12% of senior cats actually get any sort of arthritis pain control. And again, 90% of them have arthritis. So there's a big gap there. Same with dogs, 75% of them have arthritis. And only about 25% get treatment. So a little bit better, but still that's 50% of dogs that are suffering. And, you know, we we can do things about this. We can help them. So there's a lot of things that we can do to help. You are not helpless. You're not out of options. I promise you. So weight loss is very important to monitor as well. Any weight loss in a cat definitely is something you need to worry about. If you can try to do monthly weight check-ins for your dog and cat. You are A plus. Perfect. Vomiting, increased thirst, grooming changes, those are all signals that we need to take as an early symptom and talk about and try to get some answers for. Okay. All right. If anything that you heard today you have questions about, please reach out to me on my messages. Instagram is where I'm the most active, but Facebook, places like that as well. You can also find me at my website, senior petconnection.com. I often do a variety of webinars that go a little bit more in depth with these things, answers more questions for you. I have a lot of freebies I give away. I try to make as much as I can free to help people. And if you have any interest in being in my program or doing a consultation with me, those things are available as well. I just want you to know that you are doing a good job with the information that you have. I am just here to give you more of it because I truly believe that you are one of the biggest components of your senior pets care team. Have a beautiful day. That's it for today. If this episode helped you, please leave a review or rate this podcast so we can get the word out to more pet parents who need to hear that they are doing a good job. And if you're interested in working more with me, you can find me on social media or at senior petconnection.com because we all need to stay connected. Remember that you are doing a great job with the information that you have in this moment. And I am just here to give you more of it. See you next week.