Maintaining Geriatric Cats at a Healthy Weight

By Jenny Alonge, DVM, FFCP

Improvements in veterinary care and disease prevention strategies and cat owners’ increased awareness about the importance of wellness care have led to about 40% of cats reaching 7 years or more of age. Mature adult and senior cats have unique dietary needs, and the appropriate nutrition can help them maintain good health, prevent disease, and manage underlying disease. However, determining the best diet for your feline patient can be difficult, because of each cat’s individual needs. Keep reading for our guidelines that will help your geriatric feline patients maintain a healthy weight. 

Geriatric Feline Nutritional Requirements

Mature adult cats 7 to 10 years of age may have daily energy requirements (DER) equal to their resting energy requirements (RER), while for senior cats (i.e., older than 10 years of age), RER must be multiplied by 10% to 25%, depending on their condition. Age-related changes can affect nutritional requirements, but a cat who has no underlying disease may do well eating a high-quality commercial diet designed for adult cats, so long as they receive the appropriate amount. Senior feline foods vary depending on the manufacturer, but common factors include:

• Reduced protein — Healthy adult and senior cats should receive a minimum protein allowance of 30% to 45% on a dry matter basis to prevent lean muscle mass loss. However, senior feline diets often have reduced protein amounts, because many senior cats experience chronic kidney disease (CKD) and need a reduced protein diet.
• Reduced phosphorus — High phosphorus foods are not considered ideal for senior cats, especially those with CKD.
• Reduced sodium — Sodium restriction is not necessary for healthy senior cats, but may benefit those affected by hypertension or cardiac disease.
• Reduced calories — Since many cats tend to gain weight once they reach 7 years of age, senior feline foods are often lower in calories than foods for mature adult cats and may not be appropriate for cats 10 years and older who need more energy.
• Increased fiber — Senior feline diets are often high in soluble or insoluble fiber, since older cats are prone to decreased intestinal motility and constipation, but may not be appropriate for cats who have trouble maintaining weight.

Managing the Overweight Geriatric Feline

Feline obesity is a common nutritional disorder, especially in neutered cats 3 to 10 years of age. Overweight cats tend to have a shorter lifespan than normal weight cats and are at increased risk for conditions such as diabetes mellitus, arthritis, CKD, various gastrointestinal (GI) disorders, and feline lower urinary tract disease. On a nine-point scale, cats with a body condition score (BCS) of six to seven are considered overweight, while those with an eight to nine BCS are considered obese. An appropriate feline weight loss plan should include the following steps:

• Estimate the target body weight — If available, use data from the cat’s medical history to determine a body weight when their BCS was ideal, or use their BCS, with each unit above five representing a 10% increase in body weight. For example, a cat with a BCS of seven is about 20% above their ideal weight. For an extremely obese cat, you may need to initially set the target body weight above the cat’s ideal weight.
• Address underlying health problems — Diagnose and treat underlying health issues, such as diabetes and osteoarthritis (OA), that may contribute to weight gain.
• Determine necessary energy restriction — In overweight cats, energy restriction can lead to lipid mobilization and hepatic lipidosis, but restricting their energy to 50% of the cat’s metabolic energy requirement (MER) is considered safe. 
• Select an appropriate diet — Diets formulated for weight loss, which are typically high in protein and fiber and low in fat and carbohydrates, minimize the cat’s nutrition risk, but may not be appropriate if the cat has CKD or another complicating health issue. The diet should be transitioned gradually to improve the cat’s acceptance of the new food.
• Establish feeding management and activity plan — Advise your clients to accurately measure their cat’s meal portions with a kitchen scale, since measuring cups are often inaccurate, particularly when measuring small portions. In addition, encourage daily activity by recommending that your client change their cat’s food bowl location and use food puzzle toys and interactive toys. 
• Schedule follow up visits — Schedule rechecks every two to three weeks and make adjustments as needed to facilitate weight loss.

Managing the Underweight Geriatric Cat

Fifteen percent of cats over 12 years of age are considered underweight, and felines older than 14 are at 15 times greater risk for a low BCS, but inadequate nutrient intake can prevent disease management and be life-threatening. Geriatric cats have a reduced digestive ability and they are also at increased risk for diseases that can cause weight loss. The first step is to determine why the cat is losing weight. Steps include:

• Obtain history — A thorough history can help you identify changes that may indicate an underlying disease. Ensure your client knows that small weight changes can be significant to help them focus. Ask open-ended questions that do not allow the client to answer briefly and that help them express their concerns in more detail. You should also ask specific questions to help clarify missing or unclear information. 
• Assess weight — Assess the cat’s BCS and muscle condition score (MCS) to determine if they have lost lean muscle mass. Muscle wasting is caused by imbalances between synthetic and degradative protein pathways along with increased programmed cell death, and is associated with increased morbidity and mortality rates in cats.
• Rule out disease — Determine if an underlying disease is contributing to the cat’s low BCS. Diseases associated with weight loss include cancer, diabetes mellitus, hyperthyroidism, CKD, cachexia, chronic oral pain, OA, cognitive dysfunction, and constipation.
• Meet the cat’s nutritional needs — Anorexic cats do not ingest enough protein and can shift into a catabolic state. They also are at risk for hepatic lipidosis, so their diet should be well balanced and palatable. Other factors to consider include:
  • A wide, flat bowl to avoid whisker fatigue
  • A non-threatening environment
  • Ensuring no other cats or household pets are competing for their food

• Stimulate the cat’s appetite — Appetite stimulants may be helpful to jumpstart a cat’s interest in food, but you must still monitor their caloric intake, because they may need further assistance if they still aren’t eating enough.
• Assist the cat’s feeding — If the cat can’t or won’t eat enough, you can syringe feed them, or place a feeding tube to provide appropriate nutritional support. Start by feeding one-third to one-half the calories needed for the cat’s current weight. On the second day, feed two-thirds to three-quarters of this amount, and on the third day, the full calories needed. Once the cat is stable, gradually increase the calories to meet their ideal weight. 

When choosing a diet for a senior or geriatric cat, the first consideration should be their overall health. If you would like more information about this topic, check out our RACE approved webinar at VetandTech.com.