What you might notice
Drinking and urinating more, drinking from the tap or the toilet when they never used to, weight loss, a dull coat, reduced appetite, occasional vomiting. Colorado's dry air increases the water a pet loses just by breathing, which is worth accounting for in a cat already struggling to conserve it — multiple water stations, wet food, and a fountain are sensible here.
What we do about it
CKD is staged 1 through 4 using the IRIS system, from fasting creatinine and/or SDMA measured on at least two occasions in a hydrated, stable patient — not from one blood draw on a dehydrated pet. In cats, Stage 1 is creatinine under 1.6 mg/dL, Stage 2 is 1.6 to 2.8, Stage 3 is 2.9 to 5.0, and Stage 4 is above 5.0; the canine thresholds start slightly lower. Each stage is then sub-staged twice more, by urine protein:creatinine ratio and by blood pressure, because proteinuria and hypertension change the plan. SDMA matters because it rises earlier than creatinine and is less affected by lost muscle mass, which is the exact trap in a thin old cat whose creatinine looks reassuring. In one study, 80.9% of cats aged 15 to 20 had kidney disease — and the great majority of affected cats were Stage 1 or 2. Most of what screening finds is early, which is the whole argument for screening.
What you might notice
Drinking more, urinating more, eating more, and losing weight anyway. Owners often describe a pet that seems ravenous and is still getting thinner.
What we do about it
Diagnosis, a treatment plan, and — for cats — a diet strategy: high protein, above 45% of dry matter, and low carbohydrate, under 15%, fed in small frequent meals to blunt the post-meal glucose spike. Continuous glucose monitoring sensors can track a diabetic pet for up to 14 days, which shows far more than a single stressful in-hospital glucose curve. Ask us whether that is the right approach for your pet. The thing to know before you need it: diabetic ketoacidosis is a life-threatening emergency. A diabetic pet that is vomiting, refusing food, weak, or has sweet-smelling breath needs an emergency hospital immediately, including on a Saturday.
What you might notice
Weight loss despite a good or ravenous appetite, increased thirst and urination, vomiting, restlessness or night vocalizing, and a coat that has gone unkempt.
What we do about it
Diagnosis is generally a total T4 above the laboratory reference interval, run at a reference lab rather than in-house and ideally at the same lab each time. Options are methimazole, radioiodine, a prescription iodine-restricted diet, or surgical thyroidectomy. Here is the nuance that matters most, and the one owners are most often not told: hyperthyroidism artificially raises kidney filtration and can hide concurrent kidney disease. Somewhere between 15 and 50% of hyperthyroid cats have masked CKD, and roughly 20 to 25% become azotemic after treatment regardless of which treatment is chosen. That is not a treatment failure and not a mistake — it is the mask coming off. It is why we check bloodwork, urine, and blood pressure before starting, and why reversible methimazole is often trialed before committing to permanent radioiodine. Radioiodine requires a specially licensed facility and is not something a general practice can provide; we refer.
Canine cognitive dysfunction
What you might notice
DISHAA is the framework: Disorientation, altered social Interactions, disrupted Sleep-wake cycles, loss of House training and other learned behaviors, changed Activity levels, and increased Anxiety. In dogs it usually looks like sleeping through the day and pacing at night, less interaction, getting stuck in familiar rooms, and new anxiety. Cats tend the other way — more vocalizing, more clinging.
What we do about it
Roughly 14 to 22.5% of dogs over eight have age-related cognitive impairment. About 1.9% are diagnosed. That gap is not a diagnostic failure; it is that owners file the changes under old age and never mention them, which is why we ask directly at every senior visit. Cognitive dysfunction is also a diagnosis of exclusion, and the workup is the point rather than a formality: night pacing may be arthritis pain, house-soiling may be a urinary tract infection or kidney disease or diabetes, and disorientation may be high blood pressure or an intracranial tumor. Selegiline is the only FDA-approved drug for canine cognitive dysfunction, with improvement reported in up to 70% of dogs, and it is paired with enrichment, dietary support such as medium-chain triglycerides, and anxiety medication where anxiety is a genuine component. None of it reverses the condition. It slows and softens it.
What you might notice
Bad breath that everyone in the house has normalized. Chewing on one side, dropping food, pawing at the face, more drooling, or simply hiding more — cats in particular conceal oral pain well.
What we do about it
By age three most dogs and cats already have periodontal disease, with reported prevalence in dogs over three of 80 to 89%. Seniors carry a specific risk worth naming: tiny and small senior dogs can have significant periodontal bone loss and a higher incidence of pathologic jaw fracture, which is why full-mouth dental radiographs are not optional — they show the extent of bone loss and confirm which extractions are appropriate. Anesthesia is required to do any of this properly, and there is no legitimate anesthesia-free alternative. Our standard dental is $999; extractions and oral surgery are separate and quoted before we do them.
What you might notice
A new cough, tiring sooner on the same walk, or a resting breathing rate that has crept upward. In cats, heart disease is frequently silent until the day it is not.
What we do about it
Canine mitral valve disease is staged A through D by ACVIM consensus, and the distinction that changes treatment is B1 versus B2: a murmur with normal-sized heart chambers, versus a murmur with left atrial and ventricular enlargement. Stage B1 dogs get no cardiac medication. Stage B2 dogs get pimobendan, which in the EPIC study delayed the onset of congestive heart failure by a median of about 15 months. Telling B1 from B2 requires echocardiography, or at minimum radiographs — and echocardiography is a referral service, not something we perform in-house. One of the most useful things you can monitor at home costs nothing: count your pet's breaths for 30 seconds while they sleep and double it. Dogs and cats generally sleep at 15 to 30 breaths per minute, and a sleeping rate consistently above about 30 is abnormal and can mean fluid accumulating in the lungs.
One caution that applies across all six: senior presentations overlap heavily. Increased drinking may be kidney disease, diabetes, or thyroid disease. Night pacing may be arthritis, dementia, or high blood pressure. Nothing on this page diagnoses your pet, and it is not meant to — it is meant to get the right things onto the table at the exam. Where anxiety is a genuine part of what you are seeing, our behavioral management page covers how we assess it; a lifelong itch that has followed a dog into old age is covered on our allergy testing and treatment page. For the dental side of senior care, see our dental page; for cats specifically, our cat clinic explains how the feline side of the building works.