Maltese Aging Guide: How Your Toy Dog Changes Over Time

Maltese Aging Guide: How Your Toy Dog Changes Over Time ======================================================

As a small, long-lived toy breed, the Maltese often reaches “senior” status around 8–9 years old and commonly lives 12–15 years with proper care. Because Maltese have breed-specific risks (dental disease, [mitral valve disease](https://seniorpet.org/knowledge/cavalier-king-charles-spaniel-mitral-valve-disease "Mitral Valve Disease Guide"), luxating patella, cataracts, collapsed trachea, portosystemic shunts and white shaker syndrome), aging care should be tailored to these vulnerabilities. This guide explains what to expect as your Maltese ages, how to monitor for key problems, and concrete steps you can take at home and with your veterinarian to keep your little companion comfortable and healthy.

Quick senior facts for Maltese

• Senior age: 8–9 years (breed-specific)
• Typical lifespan: 12–15 years
• Common senior conditions: degenerative mitral valve disease (MVD), luxating patella, [dental disease](https://seniorpet.org/knowledge/siamese-cat-dental-disease "Dental Disease in Senior Pets"), cataracts, collapsed trachea, portosystemic shunt (PSS, usually congenital but relevant to lifelong care), and generalized tremor syndrome (“white shaker”)

How Maltese change as they age ------------------------------ Maltese are active, affectionate dogs that can maintain vitality into their teens. With aging, expect more subtle and gradual changes in energy, hearing and vision, dental health, and mobility. Because of their small size and head/face conformation (brachycephalic tendencies in the muzzle, crowded teeth), some problems appear earlier or more prominently than in medium or large breeds.

Physiologic changes to monitor

• Cardiac: small-breed dogs, including Maltese, are predisposed to myxomatous mitral valve degeneration (MMVD/MVD). Murmurs and cough may appear in middle age and progress.
• Musculoskeletal: patellar luxation (kneecap instability) is common; osteoarthritis develops with time and contributes to stiffness.
• Dental and oral: crowded teeth → rapid periodontal disease; by 3–4 years many small breeds show periodontal changes that worsen with age.
• Ocular: early cataract formation or lenticular changes; progressive cataracts may develop and impair vision.
• Hepatic: congenital portosystemic shunts (PSS) are overrepresented in small breeds and may be diagnosed in puppies but also affect lifelong health and anesthetic risk.
• Respiratory: tracheal collapse and small airway disease can cause chronic cough and exercise intolerance.
• Neurologic: generalised tremor syndrome (“white shaker”) is described in small white breeds including Maltese and may appear as high-frequency tremors that are steroid-responsive.

Common senior conditions in Maltese (what to watch for) -------------------------------------------------------

The table below summarizes onset, hallmark signs, screening tests and management principles for the key conditions Maltese owners should know.

| Condition | Typical age of onset in Maltese | Common signs you may notice | Screening / diagnostics | Management (practical owner steps) | |---|---:|---|---|---| | Degenerative mitral valve disease (MVD) | Middle age to senior (often 8–12 yrs) | Cough (especially at night), exercise intolerance, murmur, rapid breathing | Auscultation, thoracic radiographs, echocardiography; NT-proBNP blood test can aid screening | Annual cardiac exams; monitor weight; limit strenuous exercise as advised; follow vet plan (pimobendan, diuretics when indicated); earlier vet visit if cough or lethargy | | Luxating patella | Puppy to senior (often becomes symptomatic with age) | Intermittent skipping, hindlimb lameness, pain, decreased activity | Orthopedic exam, grading (I–IV), radiographs | Weight control, physical therapy, joint supplements (omega-3), harnesses for walks; surgery for persistent lameness or high-grade luxation | | Dental disease / periodontal disease | Starts young; worse with age | Bad breath, tartar, red gums, difficulty chewing | Oral exam under sedation/GA recommended, dental radiographs | Daily tooth brushing, yearly professional dental cleaning (frequency personalized), remove broken/abscessed teeth; home oral care products as recommended | | Cataracts / lens disease | Middle age to senior | Cloudy lens, bumping into objects, vision changes | Ophthalmic exam, slit lamp, ophthalmologist consult for surgery | Keep environment consistent; ophthalmology referral for phacoemulsification if vision impaired; manage secondary uveitis with vet-prescribed meds | | Portosystemic shunt (PSS) | Congenital (puppy) but lifelong impact | Stunted growth, abnormal behavior after meals, seizures, vomiting | Pre-/post-prandial bile acids, imaging (ultrasound, CT angiography) | If diagnosed: surgical correction when appropriate or lifelong medical management (diet, lactulose, antibiotics); inform vet for anesthetic planning | | Collapsed trachea | Middle age to senior | “Honking” cough, worse with excitement or pressure | Thoracic radiographs, fluoroscopy, endoscopy | Use harnesses not neck collars, avoid irritants (smoke), control weight; medications (cough suppressants, bronchodilators); severe cases: stenting/surgery | | White shaker syndrome (generalized tremor) | Young adult to middle age but may appear later | Rapid whole-body tremors, anxiety, sometimes ataxia | Clinical diagnosis after excluding metabolic causes; neurologic exam, bloodwork | Often responds rapidly to corticosteroids; sometimes long taper or other immunomodulation; emergency vet if severe or progressive |

Note: Many Maltese will have more than one of these issues. Individualized care with your veterinarian is essential.

Screening and monitoring schedule for senior Maltese ---------------------------------------------------- Because Maltese age earlier relative to large breeds, adopt a proactive screening schedule once they reach 7–9 years:

• Every 6–12 months: physical exam (including cardiac auscultation, orthopedic, ophthalmic quick screen) — at least yearly for healthy seniors, twice-yearly if chronic conditions exist.
• Annual bloodwork: CBC, chemistry panel, thyroid testing (T4/TSH if clinically indicated), urinalysis. Baseline helps detect early kidney, liver, metabolic disease.
• Cardiac checks: annual auscultation; if murmur > grade 2/6 or clinical signs, get thoracic radiographs and echocardiogram. Consider NT-proBNP if signs equivocal (see EPIC study background for medications).
• Dental: dental exam every 6–12 months; schedule professional cleaning based on oral health. Dental radiographs under anesthesia are gold standard.
• Ophthalmology: annual basic eye exam; seek ophthalmologist referral if vision changes, cloudiness, redness or discharge.
• Orthopedics: check for patellar luxation, range of motion and early osteoarthritis; radiographs if lameness.

Veterinary research & evidence (brief) -------------------------------------

• Degenerative mitral valve disease is the most common acquired cardiac disease in small-breed dogs and has been extensively studied; the EPIC trial (Boswood et al., 2016) demonstrated that pimobendan delays onset of congestive heart failure in dogs with preclinical, advanced MVD (stage B2) when criteria are met. Early detection by auscultation +/- echocardiography lets clinicians use evidence-based interventions earlier.
• Periodontal disease affects a majority of small-breed dogs by middle age and is associated with systemic inflammation. Consistent [home care](https://seniorpet.org/knowledge/pillar/home-care-guide "Senior Pet Home Care Guide") and professional cleanings reduce disease progression and tooth loss.
• White shaker syndrome (generalized tremor syndrome) is a recognized, steroid-responsive condition in small white breeds; early immunosuppressive therapy often leads to rapid improvement.

(References: ACVIM consensus literature on MVD; EPIC trial, J Vet Intern Med 2016; reviews on periodontal disease and small-breed dental prevalence.)

Daily care and environment — practical tips ------------------------------------------ Make small changes around the home to reduce risk and improve [quality of life](https://seniorpet.org/knowledge/siamese-cat-quality-of-life "Quality of Life Assessment"):

• Grooming & coat care: Regular professional grooming and weekly at-home brushing prevent matting that can hide skin problems. Clean facial folds and tear-stained areas daily to prevent irritation.
• Dental routine: Brush teeth daily with canine toothpaste; if daily isn’t possible, aim for 3–4 times weekly. Use enzymatic oral rinses or dental chews as adjuncts (check with your vet for safe choices). Schedule professional cleanings as advised by your veterinarian — many Maltese benefit from annual or biennial cleanings.
• Weight control: Keep your Maltese lean — each extra ounce increases joint and cardiac workload disproportionally. Follow portion-controlled diets, measure food, and avoid calorie-dense treats.
• Exercise: Short, consistent daily walks and low-impact play maintain muscle and joint health. Avoid high-impact jumping from furniture; use ramps or steps.
• Home adaptations: Non-slip rugs, low-entry beds, ramps to couches, and hand-rail steps help elderly Maltese with mobility and balance.
• Respiratory care: Use a harness rather than a neck collar to decrease pressure on the trachea. Avoid smoke, aerosols, and other airway irritants. During coughing episodes, keep the dog calm and seek veterinary advice promptly.
• Mental enrichment: Puzzle feeders, scent games, and routine keep cognitive function engaged.

Nutrition and supplements ------------------------- Diet is a modifiable factor that supports healthy aging:

• Choose an age-appropriate diet formulated for small-breed seniors if your veterinarian recommends. Look for high-quality protein, appropriate caloric density, and omega-3 fatty acids for inflammation management.
• For joint support: evidence supports omega-3 fatty acids and may support glucosamine/chondroitin use though responses vary. Discuss supplement choices and dosing with the vet.
• If liver disease (PSS) is present, specialized low-protein or digestible-protein diets and lactulose/antibiotics may be needed.
• Avoid overfeeding and free-choice feeding; small dogs rapidly gain fat mass on excess calories.

Dental care specifics for Maltese -------------------------------- Dental disease is one of the most predictable and preventable senior problems in Maltese.

Actionable dental plan:

• Start daily toothbrushing if not already established. Use a finger brush or small soft toothbrush and canine toothpaste.
• For dogs resistant to brushing, begin with finger rubs, then introduce toothpaste flavors and short sessions, rewarding calm behavior.
• Schedule an initial comprehensive dental exam with radiographs under anesthesia to establish the baseline and identify root disease (which is not visible externally).
• Plan regular professional cleanings based on baseline status — many Maltese need cleaning every 6–18 months.
• Consider home dental products (chews, water additives) as adjuncts — choose products with VOHC (Veterinary Oral Health Council) approval.

Mobility, joint care and luxating patella management --------------------------------------------------- Maltese commonly have medial patellar luxation. Management depends on grade and clinical effect.

At-home measures:

• Maintain lean body weight.
• Feed a joint-supporting diet or supplement if osteoarthritis present (talk to your vet).
• Apply cold packs acutely after a twisting or painful episode; use heat for chronic stiffness as advised.
• Controlled physiotherapy: short leash walks, underwater treadmill if available, strengthening exercises prescribed by a canine rehab therapist.
• Surgery: for Grade III–IV luxations or persistent lameness, surgical correction (trochleoplasty, tibial tuberosity transposition) significantly improves function in many dogs; talk to an orthopedic surgeon about timing and prognosis.

Cardiac care — setting expectations ----------------------------------- Degenerative mitral valve disease in Maltese is common and progresses at variable rates.

What you can do:

• Monitor for cough, decreased tolerance for walks, rapid breathing at rest or fainting episodes. Record episode frequency and triggers.
• Schedule cardiac evaluations — even an asymptomatic murmur warrants echocardiography if grade ≥ 3/6 or if radiographs suggest cardiomegaly.
• If your vet prescribes pimobendan or diuretics (furosemide) in heart failure, follow drug administration schedules carefully, and watch for side effects (increased thirst/urination, GI upset).
• Keep a log of activity, appetite, weight and any cough episodes for your vet.

Tracheal collapse and airway management -------------------------------------- Maltese can suffer tracheal collapse; early, conservative interventions often control symptoms.

Practical steps:

• Use a well-fitted harness for walks to avoid tracheal compression.
• Control environmental irritants, frequent dusting and humidity control can help.
• Observe for a chronic “honking” cough, worse with excitement; notify your vet early.
• Medical therapy (cough suppressants, anti-inflammatories, bronchodilators) can relieve clinical signs; stenting is an option in advanced disease but has risks.

White shaker syndrome — recognition and treatment ------------------------------------------------ White shaker syndrome (generalized tremor syndrome) typically presents with high-frequency whole-body tremors and may be accompanied by anxious behavior, but dogs remain conscious. It is classically described in small white breeds such as Maltese, West Highland White Terriers and others.

Key points for owners:

• Symptoms may appear abruptly. Tremors are often worse when excited or stressed and improve under sedation or sleep.
• This syndrome is commonly responsive to corticosteroids (e.g., prednisone) with improvement within 24–72 hours. Long tapers are often required to avoid relapse.
• Because other causes (metabolic, toxic, infectious) can mimic tremor syndromes, a veterinarian will often perform bloodwork and other diagnostics before starting long-term immunosuppression.

Portosystemic shunts (PSS) — the lifelong implications ----------------------------------------------------- Although congenital portosystemic shunts typically present in puppies, their diagnosis and management affect anesthetic risk and long-term senior care.

Practical owner guidance:

• If your Maltese was diagnosed with a PSS or you suspect liver-related signs (poor growth as a pup, neurologic signs after eating), ensure this is communicated to any veterinarian before anesthesia or surgery.
• Dogs with PSS often require special diets (low aromatic amino acids, restricted protein), lactulose and perhaps antibiotics (e.g., amoxicillin or metronidazole) to control hepatic encephalopathy.
• Surgical correction is often curative but depends on shunt anatomy and patient suitability.

Anesthesia and senior Maltese ----------------------------- Seniors with cardiac, hepatic, renal or respiratory disease require tailored anesthetic planning.

Before elective procedures:

• Pre-anesthetic bloodwork and chest radiographs or cardiac workup as indicated.
• For dogs with MVD, discuss anesthetic drug choices and perioperative monitoring (IV fluids, ECG, capnography) with your veterinarian or anesthesiologist.
• For dogs with PSS, liver function and coagulation should be reviewed; specific perioperative protocols help reduce complication risk.
• For dental cleanings, balanced anesthesia and local blocks reduce systemic anesthetic requirements. Ensure a thorough pre-anesthetic evaluation for senior Maltese.

When to call your veterinarian — red flags ------------------------------------------ Seek immediate veterinary attention for your Maltese if you notice:

• Sudden onset or worsening coughing, respiratory distress, blue gums, or fainting.
• Severe or progressive tremors, seizures, or sudden neurologic deficits.
• Collapse or inability to stand.
• Loss of appetite >24 hours, repeated vomiting, or severe diarrhea.
• Oral bleeding, broken teeth with pulp exposure, or reluctance to eat.
• Sudden blindness, rapid change in vision, or eye pain.

End-of-life planning and quality-of-life monitoring -------------------------------------------------- Because Maltese can live into their mid-teens, owners should discuss long-term quality-of-life plans with the veterinarian as chronic diseases progress. Use validated quality-of-life tools (mobility, appetite, interest in social activity, pain scoring) to guide decisions. Palliative measures (pain control, appetite stimulants, home modifications) can maintain comfort; involve your vet in end-of-life planning so decisions are informed and timely.

Putting it together — an actionable 30-day plan for the newly senior (8–9 years) --------------------------------------------------------------------------------

Schedule a senior exam and baseline bloodwork (CBC, chemistry, urinalysis).

Ask for cardiac auscultation and, if any murmur is heard, discuss thoracic radiographs and echocardiography.

Book a professional dental assessment (with dental radiographs if possible) and start a daily home toothbrushing routine.

Begin a weight/condition check and create a feeding plan to maintain an ideal body condition score.

Discuss joint supplements or a referral to physiotherapy if you notice stiffness or skipping episodes.

Swap a neck collar for a harness and check home steps/rugs for non-slip surfaces.

Summary ------- Maltese dogs have breed-specific aging risks that warrant targeted surveillance and preventive care. Regular senior exams, proactive dental care, cardiac monitoring, weight control, and environmental modifications greatly improve quality of life. Most important: early recognition and collaboration with your veterinarian (and specialists when indicated) allow evidence-based interventions that extend comfortable, active years.

Selected references and further reading

• Boswood A, Häggström J, Gordon SG, et al. Effect of pimobendan in dogs with preclinical myxomatous mitral valve disease and cardiomegaly (EPIC). J Vet Intern Med. 2016.
• ACVIM Consensus Statements on degenerative mitral valve disease and other small animal cardiovascular conditions.
• Canine periodontal disease reviews and veterinary dentistry texts (see Veterinary Dentistry, Harvey & Emily).
• Reviews of generalized tremor syndrome (white shaker) and small-breed neurology literature.

(Ask your veterinarian for copies of original papers or a specialist referral — your vet can provide the most current, practice-relevant literature.)