Clinically important abnormalities are common in senior cats perceived to be healthy by owners

Objective: To describe physical examination findings, diagnostic abnormalities, and owner-reported assessments of senior cats perceived as healthy by their owners, and to evaluate agreement between owner perceptions and objective findings to inform diagnostic prioritization within a spectrum-of-care framework. Methods: Client-owned cats aged ≥ 12 years presenting to the University of Wisconsin-Madison School of Veterinary Medicine were prospectively enrolled between 2022 and 2024. Cats were included if their owners reported good health; cats with stable, chronic conditions were also eligible. Owner questionnaires, examinations, and diagnostic testing were performed. Prevalence of abnormalities and agreement between owner perceptions and findings were assessed. Results: 129 cats were included in the study. All cats had abnormalities on physical examinations, most commonly dental (129 of 129 [100%]) and orthopedic disease (63 of 81 [77.8%]). Diagnostic testing revealed a high prevalence of previously unrecognized disease, including chronic kidney disease (49 of 80 [61.3%]), hypertension (54 of 56 [96.4%]), and hyperthyroidism (11 of 17 [64.7%]). Owner-reported mobility scores were not associated with orthopedic abnormalities. Although increased urination was associated with chronic kidney disease, 75.6% (34 of 45) of affected cats had no owner-reported change and only 1.3% (1 of 78) had reported increased thirst. Physical examination, urine specific gravity, renal parameters, total T4, and blood pressure were most informative for disease detection. Conclusions: Clinically important abnormalities are common in apparently healthy senior cats. Reliance on owner-reported changes underestimated disease burden. Physical examination revealed most abnormalities, with urine specific gravity, renal values, total T4, and blood pressure abnormalities being prevalent. Clinical Relevance: These findings support routine screening and a prioritized diagnostic approach, particularly when constraints limit comprehensive evaluation.