Maltese Health Screening Timeline: When to Test at Every Age

Maltese Health Screening Timeline: When to Test at Every Age Category: prevention Breed: Maltese (dog) Senior age: 8–9 years | Lifespan: 12–15 years

Introduction ------------

The Maltese is a small, long‑coated toy breed with several breed-specific health tendencies — early and severe [dental disease](https://seniorpet.org/knowledge/[siamese](https://seniorpet.org/knowledge/breed/siamese "Senior Siamese Cat Health Guide")-cat-dental-disease "Dental Disease in Senior Pets"), a predisposition to luxating patella and collapsed trachea, congenital portosystemic shunts in some lines, and neurologic disease such as White Shaker Syndrome. As Maltese reach “senior” status (commonly considered 8–9 years), the emphasis of veterinary care shifts from vaccination and growth checks to proactive screening, early disease detection, and quality-of-life preservation.

This article gives a practical, veterinary‑accurate screening timeline for Maltese from puppyhood through old age, explains why each test is recommended for the breed, and offers clear, actionable steps owners can take to detect and manage common Maltese conditions early.

Why breed-specific screening matters -----------------------------------

Small toy breeds do not age in the same way as large breeds. Diseases that affect small breeds — degenerative [mitral valve disease](https://seniorpet.org/knowledge/cavalier-king-charles-spaniel-mitral-valve-disease "Mitral Valve Disease Guide"), luxating patella, dental disease, collapsed trachea, congenital liver shunts, and immune‑mediated neurologic conditions like White Shaker Syndrome — have higher prevalence or breed associations in Maltese. Tailoring screening to the Maltese’s risks improves early detection and can change outcomes (for example, appropriate timing of cardiac imaging and starting medications in mitral valve disease).

Screening timeline at a glance -----------------------------

The table below summarizes recommended screenings by life stage for Maltese. Timing is adjusted for breed risks (congenital shunts in puppies, dental disease early, and cardiac/orthopedic/ocular surveillance as the dog ages).

| Age range | What to screen/test | Why for Maltese | |---:|---|---| | Puppy (8–16 weeks) | Full physical exam, baseline CBC/Chem/UA if clinically indicated, fecal, vaccination plan, orthopedic palpation, initial dental check, abdominal palpation; bile acids if neurologic signs or poor growth | Identify congenital issues such as portosystemic shunt (PSS) which is overrepresented in small breeds; establish dental baseline | | Young adult (6–12 months) | Orthopedic exam for patella grading, ophthalmic baseline (particularly if breeding lines), spay/neuter discussion, dental plan | Patellar luxation often apparent by this age; early orthopedic intervention improves outcomes | | Adult (2–5 years) | Annual physical, dental scaling as needed, monitor body condition, blood pressure if indicated | Dental disease often progresses early in small breeds; establish adult baseline | | Mature (5–7 years) | Annual cardiac auscultation, baseline thoracic radiographs if murmur found, ophthalmic exam | Early cardiac murmurs may appear; cataracts may begin to develop | | Senior start (8–9 years) — “senior Maltese” | Annual to semi‑annual: CBC/Chem/UA + bile acids if liver signs, thyroid profile if indicated, blood pressure, chest radiographs +/- echocardiogram if murmur, dental radiographs and cleaning, orthopedic recheck, ophthalmology exam, neurologic assessment if tremors/collapse | Highest risk period for mitral valve disease progression, cataracts, worsening patellar luxation, collapsed trachea symptoms, and exacerbation of chronic dental disease; white shaker syndrome can appear at any adult age but is often recognized in young‑to‑middle‑aged small white breeds | | Geriatric (12+ years) | Quality‑of‑life assessment, repeat diagnostics guided by clinical signs; consider more frequent lab work and BP monitoring | Tailor frequency to the individual’s health and owner goals |

Breed‑specific screening and action plans ----------------------------------------

Below are common Maltese conditions, when and how to screen for them, and practical owner actions.

Mitral valve disease (MVD) --------------------------

What it is and why Maltese are at risk:

• Degenerative mitral valve disease (myxomatous mitral valve degeneration) is the most common acquired cardiac disease in small breeds. While [Cavalier King Charles](https://seniorpet.org/knowledge/breed/cavalier-king-charles-spaniel "Senior Cavalier King Charles Spaniel Health Guide") is the prototype, many toy breeds including Maltese develop MVD as they age.
• MVD is progressive. Detecting a murmur early allows staging and timely treatment. The ACVIM consensus and the EPIC trial inform when to start therapy for asymptomatic dogs with cardiac enlargement (Keene et al., ACVIM Consensus 2019; EPIC Study, 2016).

When to test:

• Annual cardiac auscultation starting at 5–6 years; earlier if a murmur or cough is noted.
• If a murmur is detected (any grade), obtain thoracic radiographs to assess heart size and pulmonary status and consider echocardiography (cardiac ultrasound) to stage disease and guide treatment.
• In senior Maltese (≥8 years), perform at least annual auscultation and echocardiogram if any murmur or cough is present.

What tests do:

• Thoracic radiographs: evaluate cardiac enlargement and pulmonary edema.
• Echocardiogram: definitive diagnosis, measures valve structure and chambers, guides staging (ACVIM stages B1/B2/C/D).
• Blood pressure and routine bloodwork to evaluate co‑morbidities and pre‑treatment status.

Actionable owner steps:

• Learn to recognize early signs: exercise intolerance, cough (especially at night or when excited), fainting, or decreased activity.
• Maintain lean body condition — [obesity](https://seniorpet.org/knowledge/golden-retriever-weight-management-obesity "Weight Management for Senior Pets") worsens [heart disease](https://seniorpet.org/knowledge/cavalier-king-charles-spaniel-mitral-valve-disease "Heart Disease in Senior Pets").
• If echocardiogram shows stage B2 changes, discuss [pimobendan](https://seniorpet.org/knowledge/pimobendan-vetmedin-heart-failure-guide "Pimobendan Heart Failure Guide") therapy (EPIC trial showed delayed progression to heart failure and improved survival in dogs meeting B2 criteria).
• Keep regular rechecks: staging determines monitoring frequency (often every 6–12 months).

Luxating patella ----------------

What it is and why Maltese are at risk:

• Patellar luxation (kneecap slipping out of place) is common in small breeds and frequently seen in Maltese. It ranges from intermittent and mild to persistent and severely lame.
• Early grading and management improves comfort and prevents secondary joint damage.

When to test:

• Orthopedic exam and patella grading as a puppy (6–12 months) and recheck annually or with any limp.
• Radiographs if persistent lameness or planning surgery to evaluate alignment.

Tests and interpretation:

• Physical exam grading (I–IV) determines conservative vs surgical approach. Grade III/IV or painful, lameness-causing luxations are typically surgical candidates.
• Pre‑anesthetic bloodwork and imaging are standard before surgery.

Actionable owner steps:

• Avoid high-impact jumping from furniture; use ramps/steps.
• Maintain appropriate weight — even 1–2 lbs matter in a toy breed.
• If your Maltese limps or bunny‑hops, seek an orthopedic evaluation; early repair gives better outcomes.

Cataracts and ocular disease ----------------------------

What it is and why Maltese are at risk:

• Cataracts and early lens changes can occur in small breeds, sometimes earlier than owners expect. Maltese may develop cataracts that impair vision.
• Early ophthalmic exams identify lens opacities and other ocular conditions such as dry eye or lens subluxation.

When to test:

• Baseline ophthalmic exam in young adulthood, then annually starting around 5–6 years; sooner if visual deficits, cloudiness, or eye irritation appear.
• Pre‑surgical ophthalmic evaluation (by a veterinary ophthalmologist) with electroretinography (ERG) as indicated for cataract surgery candidacy.

Actionable owner steps:

• Watch for cloudiness, bumping into objects, or changes in pupil size.
• Keep eyes clean — Maltese often have tear staining and hair that irritates the ocular surface; clip hair around the eyes and use saline rinses as directed.
• Prompt referral to a DACVO (veterinary ophthalmologist) if cataract is vision‑limiting — phacoemulsification can restore vision in appropriate candidates.

Portosystemic liver shunt (PSS) -------------------------------

What it is and why Maltese are at risk:

• Congenital extrahepatic portosystemic shunts are more common in small breeds, including Maltese lines. PSS diverts blood away from the liver, causing toxin buildup and neurologic signs, poor growth, and abnormal behavior.
• Many PSS cases are diagnosed in puppies, but mild shunts can be subtle.

When to test:

• If puppy shows stunted growth, gastrointestinal signs, intermittent neurologic signs (disorientation, head pressing, ataxia), or urine that is unusually dark or smelly, request pre‑ and post‑prandial bile acids and a chemistry panel.
• If bile acids are abnormal, abdominal ultrasound (or CT angiography) to locate and characterize the shunt is next.

Actionable owner steps:

• Early detection is key: puppies with vague neurologic signs should have bile acids checked (cheap screening test).
• Medical management (low‑protein diet, antibiotics/lactulose) can control signs short‑term; surgical attenuation of the shunt offers the best long‑term outcome for many dogs.
• Consult a board‑certified surgeon or internist for imaging and surgical planning.

Dental disease --------------

What it is and why Maltese are at risk:

• Small breeds, including Maltese, have crowded teeth and a high incidence of early periodontal disease. Periodontal disease is nearly ubiquitous in small dogs by a young age without [home care](https://seniorpet.org/knowledge/pillar/home-care-guide "Senior Pet Home Care Guide").
• Left untreated, periodontal disease causes pain, tooth loss, and contributes to systemic inflammation affecting heart, liver, and kidneys.

When to test/assess:

• Dental check from puppy stages; professional dental scaling with probing and dental radiographs when indicated. Many Maltese need anesthesia‑based dental cleaning every 12–24 months beginning in early adulthood.
• Annual oral exams; dental radiographs at least every 1–2 years depending on disease.

Actionable owner steps:

• Brush daily if possible using canine toothpaste and a soft brush — the single most effective preventive measure.
• For dogs intolerant of brushing, consider dental gels, chlorhexidine rinses, or approved dental chews designed for small dogs. Discuss products with your veterinarian (some chews are a choking risk for tiny dogs).
• Maintain a regular professional cleaning schedule; avoid “hand scaling” without radiographs — periodontal disease is largely below the gumline.

Collapsed trachea -----------------

What it is and why Maltese are at risk:

• Toy breeds often develop weakening of tracheal cartilage leading to tracheal collapse; signs include a honking cough, exercise intolerance, and worsening cough with excitement or pressure on the neck.
• Chronic coughing can mimic bronchitis or cardiac cough, so diagnosis matters.

When to test:

• If your Maltese has a chronic cough, particularly the classic “honking” sound, request thoracic radiographs and consider fluoroscopy (dynamic imaging) or tracheoscopy.
• Baseline chest radiographs may be part of workup for any cough in older Maltese.

Actionable owner steps:

• Use a harness rather than a neck collar to reduce tracheal pressure.
• Weight control and avoidance of irritants (smoke, dust) can reduce coughing episodes.
• Medical therapy may include cough suppressants, airway anti‑inflammatories, and bronchodilators; severe, refractory cases may need stenting (weigh risks carefully with a specialist).

White Shaker Syndrome (Generalized Tremor Syndrome) --------------------------------------------------

What it is and why Maltese are at risk:

• White Shaker Syndrome is an immune‑mediated inflammatory condition characterized by full‑body tremors, hyperesthesia, and sometimes altered mentation. It has a predilection for small white breeds such as Maltese, West Highland White Terriers, and bichons.
• Response to corticosteroids is typically very good, but relapses can occur.

When to test:

• Any acute onset whole‑body tremor or marked neurologic signs should prompt immediate veterinary evaluation.
• Diagnostics often include CBC/Chem/UA, brain MRI and CSF analysis to rule out infectious or structural causes; in practice, a strong clinical suspicion and rapid steroid response may guide treatment.

Actionable owner steps:

• Seek prompt veterinary attention for sudden tremors.
• If White Shaker Syndrome is diagnosed, follow the tapering steroid protocol prescribed and report relapses quickly.
• Keep a seizure/tremor log with dates, duration, triggers, and treatment response.

Practical screening checklist for senior Maltese (8–9 years) -----------------------------------------------------------

• Every 6–12 months: full physical exam with emphasis on cardiac auscultation, orthopedic palpation (knees), and neurologic assessment.
• Annually: CBC, chemistry panel, urinalysis, blood pressure, dental exam +/- cleaning with radiographs every 1–2 years.
• If murmur or cough: thoracic radiographs and echocardiography.
• If chronic GI or neurologic signs in younger dogs: pre/postprandial bile acids and abdominal ultrasound for PSS screening.
• Annual ophthalmic exam for cataracts and tear film issues.
• Maintain weight logs and activity notes to discuss with your vet.

Communicating with your veterinarian ------------------------------------

Be proactive and specific when discussing your Maltese’s health:

• Document signs: coughing, exercise intolerance, tremors, appetite changes, stool/urine changes, grooming changes (coat/tears).
• Ask for staging tests if a murmur is heard — staging influences whether to start medications such as pimobendan.
• Request dental radiographs whenever periodontal disease is suspected; visual tooth inspection under sedation underestimates disease below the gumline.
• If genetics/lineage are known, mention them when discussing congenital disease risk (some breeders screen for PSS).

When to see a specialist ------------------------

• Cardiology: echocardiogram if murmur grade ≥ II or radiographic cardiomegaly.
• Dentistry: for severe periodontal disease, persistent oral pain, or complex extractions.
• Neurology: persistent or unexplained tremors, seizures, or MRI/CSF needs.
• Surgery/Interventional radiology: PSS planning; tracheal stenting or patellar stabilization procedures.
• Ophthalmology: cataract surgery evaluation or complex corneal disease.

Owner lifestyle and at‑home care tips ------------------------------------

• Daily gentle tooth brushing and at least yearly professional dental care.
• Use harnesses, not neck collars, to protect the trachea.
• Maintain a stable, lean body condition; even small weight gains matter in a 7–8 lb dog.
• Keep a quiet, low‑stress environment for dogs prone to tremors; sudden excitement can trigger signs.
• Keep scheduled rechecks and ask for baseline imaging when indicated — baselines are powerful for detecting change.

Summary and outlook -------------------

Maltese are a beloved toy breed with some predictable health risks that lend themselves to effective screening and preventive care. For an 8–9‑year‑old Maltese — the typical senior threshold — prioritize annual labs, dental care with radiographs, cardiac evaluation (auscultation ± echo), ophthalmic checks, orthopedic rechecks for patellar luxation, and vigilance for signs of tracheal collapse or neurologic disease. Early detection and breed‑specific monitoring preserve comfort and quality of life; many conditions that appear daunting at first (MVD, White Shaker Syndrome, cataracts, PSS) have effective interventions when caught early.

References and further reading (select) ---------------------------------------

• ACVIM consensus statement on degenerative mitral valve disease (Keene et al., ACVIM Consensus, 2019).
• The EPIC Study — pimobendan in asymptomatic MVD with cardiomegaly (Brown et al., 2016).
• Veterinary dentistry guidelines and position statements (American Veterinary Dental College).
• Reviews in veterinary neurology describing generalized tremor syndrome (White Shaker Syndrome) in small breeds.

(Ask your veterinarian for copies of these articles or for specific references tailored to your Maltese’s condition; many clinics maintain library access to these consensus statements and major clinical trials.)

Final practical checklist for your senior Maltese -----------------------------------------------

• Schedule an “senior wellness” visit every 6–12 months.
• Keep a dental home care routine; arrange professional cleanings as recommended.
• Report any coughing, exercise intolerance, fainting, or changes in behavior immediately.
• Use harnesses, maintain ideal weight, and clip eye hair to reduce irritation.
• Get cardiac imaging when murmurs are heard; early staging changes management.

Your Maltese ages like a small engine: regular maintenance and early problem detection will keep that engine running happily for as long as possible. Work with your veterinarian to create a screening schedule tailored to your dog’s health, activity, and any hereditary concerns from the breeder or previous history.