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As our cats get older, they can show a variety of signs of aging. Some, like arthritis and a graying muzzle, you probably expect. But did you know that cats (and dogs) can get dementia, just like humans? Cognitive dysfunction in cats is not uncommon in old age [4]. About 30% of cats 11-14 years old and 50% of cats 15+ have changes in behavior unrelated to another health problem [4-6]. This is called Feline Cognitive Decline or Cognitive Dysfunction Syndrome (CDS) in veterinary terms.
What Does Cognitive Dysfunction Syndrome Look Like?
Sordo and Gunn-Moore use the acronym VISHDAAL to help explain the typical indications of cognitive dysfunction in cats. The letters are in order of how common the symptoms are. [5]
- V is for Vocalization: excessive meowing or yowling, especially at night [1-5]
- I is for Interactions: changes in the way your cat interacts with members of the household, such as an increased or decreased interest in petting and attention, irritability, aggression toward people/pets, or decreased responsiveness [1, 3, 5, 6]
- S is for Sleep-wake cycle: changes in the cat’s sleep-wake cycle, particularly being awake during hours of the night when they used to sleep [1-6]
- H is for House-soiling: that is, urinating and/or defecating outside the litterbox [1-6]
- D is for Disorientation: being confused about place or time, e.g. getting lost in familiar locations, becoming somehow stuck in places they should be able to get out of easily, not remembering that they’ve just been fed, staring blankly into space [1-6]
- A is for Activity levels: either decreased activity, e.g. less grooming, lack of interest in food or play, or increased activity in the form of restlessness [1-6]
- A is for Anxiety: this can manifest in a variety of ways depending upon the individual cat and may contribute to other symptoms [1-6]
- L is for Learning and memory: forgetting routines, commands, and familiar people, pets, or places [2-6]
Not every cat will exhibit every symptom, and CTS is a condition that changes and progresses over time [5, 6]. Some of the first signs of CTS may be subtle, and many cat parents mistake them for a normal part of aging that they can’t do anything about [1, 5, 6]. However, if you notice any of these symptoms in your senior cat, you absolutely should tell your veterinarian [1, 3]. The vet can confirm a diagnosis and come up with a treatment plan to make your cat’s last years as peaceful as possible.
Cara’s Story
Cara was one of my childhood cats. She was born under our front porch when I was five or six years old, along with two sisters and a brother. We kept her and her brother, Milo, and they were with us into my college years. Cara was always sort of an odd duck. She wanted attention only rarely, stuck her head in shoes, and stared down into the floor vents for extended periods of time. But when she got to be maybe eight or nine years old, she started getting weirder.
The garage was the cats’ home base, and when they wanted out there they would stand at the door and meow. But Cara started going up to any closed door in the house and meowing to go out. She started actually rubbing against us and demanding attention. She started peeing in the bathtub. Cara had kidney problems, as many old cats do, but we never could figure out why it was just the bathtub. She became much more vocal, as well, although if she was meowing in the middle of night, we never heard it since they slept in the garage. No one in my family knew that pets could get dementia until we saw it with Cara.
Diagnosing Cognitive Dysfunction Syndrome
CDS is a diagnosis of exclusion because many of the symptoms can also be caused by medical problems that are common in senior cats [1-3, 5, 6]. For example, pain from arthritis might cause irritability or decreased activity [1, 2, 5]. Vision or hearing loss might cause a cat to become disoriented [1, 2]. It’s important to rule out other medical causes through testing [5]. Only then can your veterinarian be sure that CDS is the culprit.
What Causes Cognitive Dysfunction in Cats?
No one knows for sure what causes CDS. Just like Alzheimer’s disease in humans, it is still somewhat of a mystery. Veterinarians have a few ideas, however. As cats get older, their brains accumulate certain kinds of age-related damage [4-6]. Their brains eventually shrink and lose neural connections, just like ours do [5]. Toxic beta-amyloid plaques and abnormal tau proteins build up in the brain over time [4-6]. Impaired blood flow and oxidative damage are also age-related changes that contribute to cognitive dysfunction in cats [4-6]. The brain is expected to deteriorate with age, just like the rest of the body [3]. However, handling dementia in your elderly pet isn’t as straightforward as some of the other conditions common in senior cats because it isn’t one-size-fits all.
How is Feline Cognitive Dysfunction Treated?
There is no cure for CDS, but there are things you can do to make things easier for your cat if they are diagnosed with it [3, 5, 6]. A lot of it has to do with adjusting your cat’s environment to make things easier for them [1, 3]. Keeping to a strict routine makes everything easier to remember and less stressful [1, 5]. Avoid major changes, such as introducing a new pet, if at all possible [2, 3]. If your cat is up all night, you can make a point to keep them active during the day and play with them in the evening hours [1]. Cats that are soiling outside the litterbox may be forgetting where the litter box is or how they’re supposed to use it [1]. Add more litterboxes in easy-to-see places [1-3].
Anxiety may be helped by giving your cat more attention, playing the radio at night/when you’re not home, or using a calming pheromone diffuser like Feliway [1, 3, 5]. Every cat is different, though, so expect some trial-and-error. Ask your veterinarian for recommendations based upon your cats specific symptoms [1, 5]. It may help to consult a cat behaviorist, too [1].
A special diet can sometimes help with CDS [2, 3, 5, 6]. Vitamin E and antioxidants are believed to aid an aging cat’s brain [2, 3, 5]. There are cat foods available that are high in these nutrients [5]. Ask your veterinarian or local pet store for a recommendation. You can also buy supplements, but be careful, because they are usually formulated for dogs and may not be safe for cats [5]. Only use a supplement that is clearly labeled as safe for cats!
Medication
There aren’t any medications specifically for cognitive dysfunction in cats yet; nonetheless, there are some that your veterinarian may prescribe. Anti-anxiety medication is one option [1-3, 5]. The drug selegiline/Anipryl is approved for CDS in dogs and is sometimes prescribed for cats [1, 2, 5, 6]. Not all cats with CDS require medication, however, and their needs can change over time. Take your senior kitty into the vet for regular appointments to reassess what their needs are [6].
Sources
- American Society for the Prevention of Cruelty to Animals. (n.d.). Older cats with behavior problems. ASPCA. https://www.aspca.org/pet-care/cat-care/common-cat-behavior-issues/older-cats-behavior-problems
- Cornell Feline Health Center. (2018, July). Cognitive dysfunction. https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/cognitive-dysfunction
- International Cat Care. (2018, August 17). Senility, dementia or cognitive dysfunction syndrome. https://icatcare.org/advice/senility-dementia-or-cognitive-dysfunction-syndrome/
- Kornreich, B. (2022, September 27). Feline cognitive dysfunction syndrome (CTS). Cornell Feline Health Center Monthly Health Tips. [Email Newsletter]
- Sordo, L. and Gunn-Moore, D. A. (2021). Cognitive dysfunction in cats: Update on neuropathological and behavioural changes plus clinical management. VetRecord, 188(1), e3. https://doi.org/10.1002/vetr.3
- Stilwell, N. (2019). Unpacking feline dementia: A veterinary guide. Vetted, 115(5), 6-8. https://www.dvm360.com/view/unpacking-feline-dementia-veterinary-guide
Published October 1st, 2023
