Age-Related Changes in Maltese Dogs: What to Expect
Maltese dogs are a long-lived toy breed that often retain puppy-like personalities into their senior years. At 8–9 years old a Maltese has entered the senior life stage (typical lifespan 12–15 years). This is the period when breed-specific conditions and age-related declines most commonly appear. Knowing which problems Maltese are predisposed to, how those conditions typically present, and what you can do at home and with your veterinarian to detect and manage them will help your dog stay comfortable and active for as long as possible.
This article focuses specifically on the Maltese: what to expect as they age, the common and breed-relevant diseases (mitral valve disease, luxating patella, cataracts, portosystemic liver shunt, [dental disease](https://seniorpet.org/knowledge/siamese-cat-dental-disease "Dental Disease in Senior Pets"), collapsed trachea, and white shaker syndrome), practical screening and at-[home care](https://seniorpet.org/knowledge/pillar/home-care-guide "Senior Pet Home Care Guide"), and evidence-based management options.
Why Maltese need breed-specific attention in older age
Small-breed, long-lived dogs show a different pattern of age-related disease compared with large-breed dogs. Maltese tend to develop dental disease, orthopedic issues like patellar luxation, and cardiovascular disease common to small breeds. They are also represented disproportionately in congenital conditions such as portosystemic shunts and neurologic syndromes like generalized tremor (white shaker) syndrome. Understanding the typical timeline and signs helps owners and veterinarians catch problems earlier, when interventions are more effective.
Routine geriatric screening for Maltese (8–9 years+)
Early detection through regular wellness exams reduces morbidity. Below is a practical screening schedule tailored for an 8–9 year old Maltese.
| Test / exam | Frequency (senior Maltese) | Why it's important | |---|---:|---| | Physical exam (including oral and cardiac auscultation) | Every 6 months | Detect early murmurs, abnormal respirations, dental disease, weight loss | | CBC + serum chemistry + electrolytes | Annually (or every 6 months if ill) | Baseline organ function, early liver/kidney changes, anemia | | Thyroid panel (T4 +/- free T4/TSH) | Annually if clinical signs | Hypothyroidism uncommon in small breeds; useful if weight gain, hair loss | | Bile acids (pre/postprandial) | Once if history/signs of hepatic disease (or persistent GI signs) | Screen for portosystemic shunt / hepatic dysfunction | | Urinalysis (incl. urine culture if indicated) | Annually | Kidney disease, infection, and metabolic disorders | | Thoracic radiographs + blood pressure | Every 12 months (or sooner if cough/exercise intolerance) | Evaluate heart size, pulmonary disease, tracheal collapse changes | | Echocardiogram by cardiologist | At detection of murmur or every 12–24 months if murmur present | Diagnose [mitral valve disease](https://seniorpet.org/knowledge/cavalier-king-charles-spaniel-mitral-valve-disease "Mitral Valve Disease Guide") and quantify severity (ACVIM guidance) | | Ophthalmic exam | Annually | Screen for cataracts, lens changes, retinal disease | | Dental exam under sedation (with scaling as indicated) | Every 6–12 months (or more frequently) | Prevent periodontal disease, tooth loss, systemic infection |
This schedule is a guideline. Your veterinarian will tailor frequency based on clinical findings and previous results.
Breed-specific conditions: signs, diagnosis, and management
Mitral Valve Disease (MVD, Degenerative Mitral Valvulopathy)
What it is: MVD (also called myxomatous mitral valve disease) is the most common [heart disease](https://seniorpet.org/knowledge/cavalier-king-charles-spaniel-mitral-valve-disease "Heart Disease in Senior Pets") in small-breed dogs and a frequent cause of heart-related illness in older Maltese. Valve degeneration leads to mitral regurgitation, cardiac enlargement, and eventually congestive heart failure (CHF).
Typical age of onset in Maltese: Often middle-age to senior years; many Maltese show a murmur by 8–9 years, though progression varies.
Common signs: Soft-to-loud left-sided systolic murmur, cough (especially at night), decreased exercise tolerance, fast or labored breathing, fainting in advanced cases.
Diagnosis: Clinical auscultation, thoracic radiographs to assess heart size and pulmonary edema, and echocardiography to evaluate valve structure and measure cardiac dimensions. The ACVIM consensus recommendations guide diagnosis and treatment thresholds. The EPIC trial demonstrated that pimobendan delays onset of CHF in dogs with cardiomegaly from preclinical MVD (ACVIM/EPIC evidence).
Management and owner actions:
- If a murmur is detected, get an echocardiogram for staging.
- Dogs with cardiomegaly in preclinical stage (B2) may benefit from pimobendan; discuss this with a cardiologist or your veterinarian.
- Once CHF develops, standard therapy includes diuretics (furosemide), pimobendan, and ACE inhibitors as indicated.
- Monitor body weight, respiratory rate at rest (home monitoring of resting respiratory rate is a validated early CHF detection tool), appetite, and activity level.
- Limit strenuous exercise during CHF; maintain a consistent, moderate exercise routine when stable.
Luxating patella
What it is: Medial patellar luxation (kneecap that intermittently slips out of place) is common in small breeds including Maltese. It ranges from mild (intermittent skipping) to severe (permanent luxation impairing gait).
Signs: Intermittent hind-leg “skipping” or sudden non-weight-bearing lameness that often improves with movement, reluctance to jump, decreased activity, muscle atrophy with chronicity.
Diagnosis: Orthopedic exam (manipulation to grade luxation I–IV), radiographs to evaluate bone alignment. In older dogs, concurrent osteoarthritis is common.
Management and owner actions:
- Weight management and controlled low-impact exercise help reduce joint stress.
- Physical therapy, underwater treadmill, and muscle-strengthening exercises can improve function.
- Pain control with NSAIDs (short-term or long-term under veterinary supervision) and joint nutraceuticals (omega-3 fatty acids, glucosamine/chondroitin) as adjuncts.
- Surgical correction is recommended for persistent Grade II–IV luxations affecting [quality of life](https://seniorpet.org/knowledge/siamese-cat-quality-of-life "Quality of Life Assessment"); surgical techniques include trochleoplasty, tibial tuberosity transposition, and soft-tissue realignment. Prognosis is generally good when surgery is done before severe degenerative joint disease.
Cataracts and age-related ocular disease
What it is: Cataracts (lens opacity) and lenticular sclerosis are eye conditions seen in aging Maltese. Small breeds can develop cataracts from hereditary causes, [diabetes](https://seniorpet.org/knowledge/[beagle](https://seniorpet.org/knowledge/breed/beagle "Senior Beagle Health Guide")-diabetes "Diabetes Management in Senior Pets"), or age-related changes.
Signs: Cloudy or gray appearance of the lens, decreased vision, bumping into furniture, hesitation on stairs, dilated pupils, or signs of lens-induced uveitis (red eye, squinting).
Diagnosis: Ophthalmic exam, potentially with an ophthalmologist (ACVO diplomate). Dilated fundoscopy and measurement of intraocular pressure when indicated.
Management and owner actions:
- Distinguish cataract from nuclear sclerosis (lenticular sclerosis), which causes a bluish haze but usually not significant vision loss.
- If cataracts impair vision or cause uveitis, referral to a veterinary ophthalmologist for phacoemulsification (surgical cataract removal) is appropriate. Surgery in small breeds requires experienced surgeons.
- Medical management includes topical anti-inflammatories for uveitis and environmental modifications for a visually impaired dog (consistent furniture placement, non-slip rugs, verbal cues).
Portosystemic liver shunt (PSS)
What it is: Congenital portosystemic shunts are abnormal vascular connections that bypass the liver, allowing toxins to circulate systemically. Small breeds, including Maltese, are predisposed.
Signs: In puppies and young adults it commonly causes growth delay, poor appetite, intermittent vomiting/diarrhea, neurologic signs (disorientation, seizures, lethargy), and urinary stones. In older Maltese, subtle signs like cognitive changes or intermittent GI signs may appear if a shunt was undiagnosed.
Diagnosis: Elevated pre- and post-prandial bile acids, ammonia testing, abdominal ultrasound, CT angiography for surgical planning.
Management and owner actions:
- If suspected, request bile acids and imaging. Early identification is important: medical management (protein-restricted or hepatic-support diet, lactulose, antibiotics) can control signs, but surgical attenuation of the shunt often offers the best long-term outcome.
- Work with a surgeon experienced in shunt attenuation (ameroid constrictor, thin film banding, or gradual occlusion).
- If surgery isn’t possible, strict medical management and frequent monitoring are necessary.
Dental disease (periodontal disease)
What it is: Maltese are particularly prone to periodontal disease due to small mouths and tooth crowding. Periodontal disease is the most common condition in small-breed dogs and is associated with systemic inflammation that can affect heart, kidneys, and liver.
Signs: Halitosis (bad breath), red or bleeding gums, tartar accumulation, loose or missing teeth, reluctance to chew, decreased appetite.
Diagnosis: Sedated dental exam with periodontal probing and dental radiographs to assess bone loss and hidden disease below the gumline.
Management and owner actions:
- Home dental care: daily tooth brushing with canine toothpaste is the gold standard. If daily brushing is not possible, aim for several times per week.
- Professional dental cleaning under anesthesia with scaling and polishing, and dental radiographs as indicated. Small breeds often require more frequent professional cleanings (every 6–12 months) depending on disease severity.
- Use dental diets, dental chews validated by the VOHC, and water additives as complementary measures.
- Early extraction of severely diseased teeth prevents ongoing infection and pain.
- Regular monitoring by your veterinarian for periodontal disease progression.
Collapsed trachea
What it is: Tracheal collapse is a progressive weakening of the tracheal rings causing dynamic airway narrowing, most commonly in small and toy breeds. Maltese can be affected, often presenting with a characteristic “goose-honk” cough.
Signs: Chronic honking cough, exercise intolerance, cough triggered by excitement or airway pressure (collars), worsening in hot/humid weather, audible breathing, sometimes respiratory distress.
Diagnosis: Thoracic radiographs (may show tracheal narrowing), fluoroscopy to assess dynamic collapse, and tracheoscopy for definitive diagnosis.
Management and owner actions:
- Avoid pressure on the neck: use a well-fitted harness rather than a collar for leash walks.
- Weight management and environment control (avoid smoke, dust, heat) reduce cough triggers.
- Medical therapy includes cough suppressants, anti-inflammatories, bronchodilators, and sometimes antibiotics if secondary infection present.
- In severe cases, surgical options include extraluminal rings (typically in cervical tracheal collapse) or endoluminal stenting (for intrathoracic collapse); these carry risks and require referral to a specialty surgeon.
White shaker syndrome (Steroid‑responsive tremor syndrome)
What it is: White shaker syndrome (also called generalized tremor syndrome or steroid-responsive tremor syndrome) is an inflammatory condition causing tremors and other neurologic signs. It is more commonly reported in small, white breeds—Maltese, West Highland White Terrier, and others.
Signs: Rapid, whole-body tremors (worse when excited), ataxia, circling, head tilt, and sometimes behavioral changes. Onset can be acute to subacute.
Diagnosis: Clinical neurologic exam, CSF analysis, MRI to rule out structural disease. Diagnosis is often presumptive, based on compatible clinical signs and rapid response to corticosteroids.
Management and owner actions:
- Prompt veterinary attention is important if tremors or neurologic signs are noted.
- Treatment typically consists of high-dose corticosteroids (e.g., prednisone) to control inflammation, often followed by a taper and sometimes additional immunosuppressive drugs if relapses occur.
- Most dogs show rapid and dramatic improvement with steroid therapy; long-term prognosis is generally good but relapses can occur, requiring ongoing treatment adjustments.
Practical day-to-day senior care for Maltese
- Dental home care: Brush daily if possible; use finger brushes and enzymatic toothpaste made for dogs. Schedule professional cleanings based on your veterinarian’s recommendation; many senior Maltese require cleanings every 6–12 months.
- Use a harness, not a collar: To protect the trachea and neck, use a padded harness for walks and in-car restraint.
- Maintain ideal body condition: Keep a lean body score (BCS 4–5/9) to reduce orthopedic and cardiac workload. Small weight gains in toy breeds translate into proportionally larger strain on joints.
- Moderate, consistent exercise: Short daily walks and supervised indoor play maintain muscle mass and joint mobility without over-exerting a senior heart.
- Environmental safety for vision or mobility decline: Non-slip rugs on hardwood floors, pet gates on stairs, nightlights for vision-impaired dogs, and ramps for beds or cars.
- Joint support and physiotherapy: Ask your vet about joint supplements (omega-3 fatty acids, glucosamine) and consider physical rehab for dogs with patellar luxation or osteoarthritis.
- Home respiratory monitoring: Monitor resting respiratory rate and pattern. A consistent increase in resting respiratory rate or coughing at night warrants immediate veterinary attention.
- Record keeping: Keep a folder of past veterinary records, imaging, and dental charts to help future providers detect disease progression.
When to seek immediate veterinary care
- Sudden onset of severe cough, difficulty breathing, or blue/pale gums
- Collapse, fainting, or seizures
- Marked lethargy, inappetence, or continuous vomiting/diarrhea
- Acute neurologic deficits (worsening tremors, inability to walk)
- Uncontrolled bleeding from the mouth or severe facial swelling
End-of-life and quality-of-life considerations
Maltese are companion dogs, and decisions about advanced interventions (cardiac medications, orthopedic surgery, cataract surgery) should balance the expected benefit against anesthesia risk and recovery in a small, senior patient. Regular discussions with your veterinarian about progressive disease, pain control, and quality-of-life scoring tools help owners make informed choices.
Summary and action checklist for owners of senior Maltese (8–9 years+)
- Schedule wellness exams every 6 months.
- Arrange baseline bloodwork, urinalysis, and annual thoracic radiographs.
- Have a cardiology workup (echocardiogram) if a murmur is detected.
- Maintain strict dental home care and professional cleanings as recommended.
- Use a harness instead of a collar to protect the trachea.
- Watch for orthopedic signs (skipping, limping) and consult about physical therapy and surgical options for luxating patella.
- Be prepared to refer to specialists: veterinary cardiologist for MVD, surgeon for PSS or patellar repair, ophthalmologist for cataracts, and neurologist for atypical tremor syndromes.
References and further reading (selected):
- ACVIM consensus statements on myxomatous mitral valve disease and clinical cardiology guidelines.
- EPIC trial evidence for pimobendan in delaying onset of CHF in dogs with preclinical MVD.
- WSAVA Global Dental Guidelines for small animal dental care.
- Veterinary textbooks and peer-reviewed case series describing portosystemic shunts, tracheal collapse, and steroid‑responsive tremor syndrome in small-breed dogs.