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USING DIET AS THERAPY FOR YOUR SENIOR PET
What are some things that come to mind when you think of dietary changes recommended for older people? Low sodium to help blood pressure, calcium to keep bones strong, etc may come to mind. Diet is also extremely important to maintaining good health in older pets – the nutritional needs of a geriatric dog or cat are very different from those of a growing puppy or kitten. Fortunately there has been a large amount of scientific research, including feeding trials, by some companies that make pet food and there are many choices that are particularly suited depending on the needs of your senior pet, based on their overall health or even specific condition(s). These may include prescription foods or non-prescriptions diets that are specially formulated and balanced to meet your senior pet’s needs. In this blog I will go over some diets and supplements that I recommend for my hospice patients, which I hope will be helpful if you are thinking about what you feed your older pet.
COGNITIVE FUNCTION
Many older pets struggle with declining cognitive dysfunction (see our previous blog on doggy dementia), and in fact this can be a terminal condition as their owners struggle to keep them happy and safe. Cognitive dysfunction can manifest in many ways, including getting lost in their usual environment, getting stuck around furniture, aimless wandering or restless pacing, and vocalization, and symptoms are often worse at night (similar to "Sundowners" in people with dementia). In recent years many diets have come to market that aim to decrease severity of these symptoms through nutritional management. So what are the important aspects to focus on¹?
- Antioxidants – these degrade quickly, so it is important to seal the bag well between feedings and buy the smallest bag possible.
Reducing free radicals is a cornerstone of slowing down brain-aging, and antioxidants are a major player in accomplishing this reduction. Senilife is an excellent supplement (I recommend it frequently) that has antioxidants and vitamins and may lessen behavior changes in older pets.
- Omega 3 fatty acids
Fish oils are a good ways to increase levels of these for your pet, provided their GI tract tolerates it. DHA and EPA are the forms of O3-FA’s most usable by pets’ metabolisms. Welactin is one choice for supplementing these for senior dogs and cats.
- Vitamin E
A fat-soluble antioxidant.
- L-theanine
One of the major problematic aspects of cognitive dysfunction in many older pets is anxiety. Some herbs may be considered to help, but you should consult with a veterinarian before treating your pet with an herbal supplement, and you should ALWAYS let your vet know any herbal supplements your pet is currently or has recently taken. Ginkgo biloba and valerian are two herbs that have been shown to reduce anxiety in animals² (note: ginkgo has been shown to affect bleeding through inhibiting platelet aggregation, and should be stopped at least 1-3 weeks prior to any surgery, and valerian has been shown to affect anesthetic recovery times). You may consider a supplement that blends several ingredients, including herbs, such as Senior Wellness Quiet Moments Calming Aid.
Some diets that are particularly helpful for dogs with cognitive decline include Hill’s b/d, Purina Bright Mind, and Purina Neurocare (rx only), because they include balanced amounts of the components listed above. Unfortunately the options for cats are fewer, but Hill’s j/d for cats with arthritis is supplemented with fatty acids and antioxidants.
The following handout is an excellent resource if you are looking to learn more about canine cognitive dysfunction:
CARDIAC DISEASE
Did you know that from the time of diagnosis of congestive heart failure, most pets will survive less than 1 year (although some can be managed well for many years)? Heart function requires a tremendous amount of energy and diet is an essential part of managing a patient with heart disease. The ACVIM (American College of Veterinary Internal Medicine) has a classification system for describing the severity of a heart failure patient’s condition, and you will need to work with your primary and/or specialist veterinarian to stage your pet appropriately³.
- Pets with risk factors and structural changes but no clinical signs should start having mild sodium restriction in their diet. It is important for these pets to receive adequate protein and caloric intake to maintain a good body condition.
- Pets with clinical signs (coughing, increased respiratory rate, etc) should have moderate sodium restriction, adequate protein and caloric intake, and omega 3-fatty acid supplementation. Electrolytes including potassium and magnesium should be monitored.
- Pets in end stage heart failure should have the above, with further restriction of sodium if there is fluid accumulation.
It is important these diets be highly palatable (tasty) because anorexia and cachexia (weakness and wasting of the body due to severe chronic illness) can be severe and very challenging to manage in these patients. It can also be beneficial to supplement amino acids (especially arginine and taurine), anti-oxidants, and carnitine⁴.
Some examples of cardiac diets include Purina CardioCare, Royal Canin Cardiac, and Hill’s h/d.
RENAL DISEASE
Your primary and/or specialist veterinarian will need to begin by staging your pet’s renal disease using the IRIS system to most effectively make dietary recommendations.
- In Stage 1, it may benefit your pet to start supplementation with omega 3-fatty acids (EPA and DHA in particular may slow the progression of chronic kidney disease). Antioxidants such as Vitamin E, Vitamin C, and beta-carotene may also be helpful⁵.
- In Stage 2, a renal diet should be started. These diets include reduced amounts of protein and phosphorous, moderate potassium, are alkalinizing (to counteract metabolic changes with kidney disease), and have increased fatty acids, antioxidants, and caloric density. Examples are Hill’s Kidney Care and Purina NFKidney Function. Use of a renal diet beginning with this stage has potential to double survival time from less than 300 days to over 600 days⁵.
- At Stage 3 the prognosis for median survival time in cats is about 26 months and for dogs it is about 11 months⁵.
- At Stage 4, disease is severe and pets may start having secondary health problems such as build up of toxic wastes and metabolic byproducts in the body (uremia) as the kidneys quit doing their job adequately. High blood pressure may be a problem as well. Your pet may need fluid therapy (we can teach you how to do this and manage it in hospice care starting with a quality of life assessment), anti-hypertensives (your pet will need to see a primary care veterinarian for routine blood work including chemistry and blood pressure measurements), and if warranted more aggressive care such as placing and using a feeding tube⁵.
Some tips to help encourage a good appetite in pets with renal disease include heating up food (increases aroma, which is very important to our pets), offering different textures of food (many senior pets have dental disease and certain foods are more painful to eat as well), and speaking with your primary veterinarian about appetite stimulants as needed. Sarcopenia, or muscle and tissue wasting, is a poor prognostic indicator in renal failure patients and should be prevented as much as possible!
MOBILITY
We have some previous blogs that discuss pain and mobility and discuss diets and supplements in those too. Some examples of prescription diets for mobility include Purina Rx JM and Hill’s j/d. I strongly encourage any owner of a middle-aged or senior dog or cat to start their pet on a proven, high quality glucosamine supplement such as Cosequin (can be found at Walmart) or Dasuquin (supplements aren’t regulated! - these have been tested by independent laboratories and do have the ingredients they list in them). Fatty acid supplementation can be anti-inflammatory and can help manage pain as well.
I hope you have found this blog informative and helpful. I do not have any monetary association with these products or foods. I feed my own senior dog Purina JM (my elderly Pugapoo) and she gets Adequan injections as well (I can go over Adequan with owners including showing how to administer it at an in home assessment for hospice and palliative care). She was on Carprofen, a prescription anti-inflammatory medication, but pre-dental bloodwork showed elevated liver enzymes this year – this highlights the importance of regular bloodwork on seniors, especially pre-anesthesia and in patients on an NSAID medication such as carprofen! If your pet has concurrent conditions, such as heart disease and renal disease, it can be very challenging to manage, including with nutrition. There are veterinary nutritionists who specialize in most effectively managing diet in any patient.
REFERENCES
1. PetHospice.com. The Pet Hospice Newsletter: The Cognitive Dysfunction Issue. Cognitive Dysfunction in Dogs and Cats (and what you can do about it!). June 2019.
2. Alramadhan E, Hanna M, Hanna M, et al. Dietary and botanical anxiolytics. Med Sci Monit 2012, 18(4): RA40-48.
3. Cline, Martha G (DVM, DACVIM) & Roark, Andy (DVM). Purina Webinar: Heart Smart - Nutritional Interventions For the Canine Cardiac Patient. March 30, 2022.
4. Li Q, Heaney A, et al. Dietary intervention reduces left atrial enlargement in dogs with early preclinical myxomatous mitral valve disease: a blinded randomized controlled study in 36 dogs. BMC Veterinary Research 15: 425 (2019).
5. Yanik, Doug (DVM, MBA). “Nutritional Management of Renal Disease”. Upstate Vet Spring 2022 Symposium. April 3, 2022. (Note – this is a vet with industry ties – he works for Royal Canin).
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