“Sharifa” is a girl’s name from the Middle East, meaning “honoured”. Barbara took Sharifa on as a kitten, back in 1996, never expecting that twenty one years later, she’s still be alive and well.
For the past few years, Sharifa has lived a quieter life: she now spends most of her time sleeping, only getting up at meal times or to use her litter tray. It’s natural to slow down in this way at such an advanced age.
A  couple of weeks ago, Barbara had noticed that Sharifa had started to drink more water than before. She also had begun to be a fussy eater, and had lost weight. Then she started to walk unsteadily, even staggering from time to time. Barbara decided that it was time for a thorough check over from the vet.

When I examined Sharifa, I wasn’t surprised that she was so thin: it’s normal for very elderly animals to lose weight. But as I checked her over, there were a few other aspects of her health that concerned me.
The most significant physical finding was her heart: when I listened with a stethoscope, it was racing along, at around 250 beats per minute, and there was a loud heart murmur. A healthy cat’s heart beats at around 150 beats per minute, with no heart murmur.   There’s a long list of possible causes of a rapid heart, and it was important that we discover the reason, so I admitted her to our cat-only clinic for the day, to carry out a full work-up.
The first task was to measure her blood pressure. High blood pressure is very common in older cats, and it’s easy to treat with a daily tablet. Blood pressure in cats is measured in a similar way to humans, using a cuff around her front leg, and listening to her pulse with a special type of stethoscope. The inflatable cuff is pumped up until the pulse stops flowing, and at that point, the blood pressure can be measured as being equal to the air pressure in the cuff. Sharifa’s blood pressure was around 20% higher than normal: this partly explained her rapid heart rate, her heart murmur, and the way that she had started to stagger (she must have been feeling dizzy from time to time). She would also have been at risk of developing sudden onset blindness: when cats have high blood pressure like this, there’s a serious chance that the back of the eye will undergo permanent damage.
The second diagnostic test was to analyse a urine sample. The results told me that Shafira’s urine was healthy (no sign of a urinary tract infection), but that it was far too dilute. Her kidneys had stopped concentrating her urine, which is often a key sign that the kidneys are not working properly.
The third and final set of diagnostic tests of the day involved a blood sample. Shafira sat quietly while I collected half a teaspoonful of blood from her leg, and I then ran this through the automatic blood analyser at our clinic. I measured three important parameters.

First, I checked her thyroid hormone levels. Elderly cats often develop tiny tumours on the thyroid gland, and these produce excessive quantities of thyroid hormones, often leading to high blood pressure and other signs of illness.Affected cats need specific drugs to dampen down thyroid hormone production. I was surprised to find that Shafira’s thyroid levels were normal: there must be another underlying cause of her high blood pressure.
The second part of her blood test involved counting and assessing her red and white blood cells. These were mostly normal, but the results did show that she was anaemic, with a low red blood cell count. This would also make her feel weak and staggery, but the question remained: what was making her anaemic?
Conclusive confirmation of her diagnosis came with the final set of blood tests. I measured a range of chemicals and enzymes in her blood that told me about a wide range of her internal metabolic goings-on. She had elevated levels of chemical markers linked to kidney function. This confirmed that her main underlying illness was kidney failure, the most common serious health challenge for all elderly cats.
As the kidneys fail, the results are dilute urine, higher levels of toxins in the blood stream, high blood pressure, and anaemia (healthy kidneys produce a hormone that boosts red blood cell production: if kidneys aren’t fully functional, this hormone ebbs away, and anaemia follows).
Nobody knows exactly why so many elderly cats suffer from failing kidneys: it’s partly just an “old age” problem. However we do know how to help cats with this problem: if they are fed a special type of diet, designed to ease the daily stress on the kidneys, they can live for twice as long as they would otherwise do. Sharifa generally has a good appetite, so she has been sent home on a range of sachets containing special food. It comes in flavours from salmon to chicken to tuna to beef, so she has plenty to choose from.
Sharifa may be in her early twenties, but one thing is certain: there is life in this old cat yet.