By Dr. Becker
Cats, just like dogs and humans, undergo age-related changes as they enter their senior years. Four very common behavioral changes owners of elderly cats often report include:
- Excessive vocalization, especially at night
- Appearing confused as to where they are and why (staring off into space)
- Eliminating outside the litter box
- Loss of interest in interacting with human family members
Older kitties can develop cognitive dysfunction syndrome (CDS) – even though the condition hasn’t yet been formally documented in felines. Cats who develop CDS are typically 11 years or older. Although some signs of mental decline can be attributed to normal aging, the degree and nature of the deterioration tells us whether a kitty has CDS or simple age-related “forgetfulness.”
DISH: A Method for Evaluating Cognitive Decline in Cats
Many veterinarians and feline experts use the acronym DISH to measure cognitive dysfunction in cats.
D = disorientation. Kitties with CDS may wander aimlessly, stare at walls, and appear lost or confused at times. They may also intermittently fail to recognize family members.
I = reduced social interactions. A cat with CDS may seem confused when his guardian arrives home at the end of the day. He may also show less interest in being petted or sitting in his owner’s lap.
S = changes in sleep patterns. An affected cat may sleep more during the day but turn into an insomniac at bedtime, wandering the house and often crying out for no obvious reason.
H = house soiling/housetraining. Cats with CDS frequently lose their housetraining skills. This happens because they either forget the location of the litter box, or they are no longer terribly concerned about their own cleanliness, or perhaps a bit of both.
CDS in cats hasn’t really been studied, so no scientific explanation currently exists for what causes the problem in felines. However, in humans and dogs, the condition is thought to be caused by Alzheimer’s-related changes in the brain (the formation of beta-amyloid plaques) or cerebrovascular disease. In dogs with CDS, it is known that pathological changes in the brain are closely associated with the severity of dementia symptoms, and the same probably holds true for cats.
Diagnosing Feline CDS
Feline cognitive dysfunction syndrome is a diagnosis of exclusion. There are many conditions older animals acquire that can mimic the symptoms of cognitive decline, so it’s important to rule out all non brain-related physical reasons for a change in behavior. For example, a small seizure can cause a kitty to stand still and stare. If your cat seems detached, he could be in pain. Inappropriate elimination can be due to kidney disease. These disorders and many others can result in a change in behavior unrelated to cognitive decline. That’s why it’s so important to rule out all possible alternative reasons, especially in aging pets.
It’s also important to review any medications your cat is taking. Older animals metabolize drugs differently than younger pets.
Help for Cats with Cognitive Dysfunction
There are things you can do as the guardian of an older cat to help maintain good mental function for as long as possible, and delay the onset and progression of cognitive decline.
- Feed a balanced, antioxidant rich species-appropriate diet. Your kitty’s diet should include omega-3 essential fats, such as krill oil, which are critical for cognitive health.
- Keep your pet’s body and mind active with regular exercise appropriate for your cat’s age and physical condition, and mental stimulation (puzzles and treat-release toys can be beneficial). Think of creative ways to enrich your cat's indoor environment and if your kitty never touches the earth’s surface directly (most housecats don’t), consider a grounding pad to help reduce the buildup of EMFs.
- Provide your kitty with a SAMe (S-adenosylmethionine) supplement as a safe and effective way to stall or improve mental decline. Consult your holistic veterinarian for the right dose size. Periodic detoxification with the herbs milk thistle and dandelion can also be very beneficial.
- Medium-chain triglycerides (MCTs) have been shown to be safe for cats and can improve brain energy metabolism and decrease the amyloid protein buildup that results in brain lesions in older pets. Coconut oil is a rich source of MCTs. I recommend 1/4 teaspoon for every 10 pounds of body weight twice daily for basic MCT support, if your cat will voluntarily eat it.
- Other supplements to consider are antioxidants, including resveratrol (Japanese knotweed), which protects against free radical damage and beta-amyloid deposits, N-acetyl cysteine (NAC), vitamins E, C and B complex, ginkgo biloba, as well as phosphatidylserine and apoaequorin – nutritional supplements that can inhibit age-related cognitive deficits. Consult a holistic veterinarian for dosing guidance.
- For aging kitties who prowl the house all night and vocalize, consider melatonin, which is not only a sedative with a calming effect, but also an antioxidant. I also use Rhodiola, chamomile and l-theanine with good results. There are several homeopathic remedies that I have used with great success in calming night time vocalizations, including Aconitum and Nux Vomica. Consult with a veterinary homeopath about what specific remedy is right for your cat’s unique pattern of symptoms.
- Consider flower essences, including Green Hope Farm Senior Citizen.
- Acupuncture can also be beneficial for calming older cats.
The above recommendations will be only marginally effective for a cat in the advanced stages of cognitive decline, which is why it’s important to diagnose and begin treating the problem as early as possible. Cognitive dysfunction is a progressive disease that can’t be cured, but early diagnosis and intervention can slow mental decline and offer your aging kitty good quality of life.
There is also a drug called Anipryl® (selegiline hydrochloride), which is a monoamine oxidase B inhibitor given to dogs with CDS. It isn’t FDA approved yet for use in cats, but is being used extra-label with kitties, with mixed results. The drug prevents the breakdown of dopamine in the brain, which can help restore normal function. Based on its use with dogs, it is expected the drug will provide dramatic improvement in about one third of cats, significant improvement in another third, and the remaining third will have no response. Because all drugs have potential side effects, I prefer to use natural remedies whenever possible and would only consider using Anipryl if all other options failed.
Environmental and Lifestyle Recommendations
Housecats do best with routine and consistency in their daily life, and this is especially true for kitties who aren’t as mentally sharp as they once were.
- If your cat seems disoriented, consider limiting her access to certain parts of the house. Keep doors closed so she can’t wander into a closet or any place where she might be unable to get herself out.
- Set aside time each day to interact with your kitty. Make sure meals are provided on a consistent schedule, along with playtime and petting/lap time. If your cat tolerates being brushed or combed, work that into the daily schedule as well. Not only do many cats love to be brushed or combed, but kitties with CDS often lose their desire to groom themselves regularly.
- If your cat has turned into a midnight prowler, if possible, try gently waking him up from naps during the day. The more active you can keep him during daylight hours, the more likely he’ll be to sleep on your schedule.
- Sometimes all a vocalizing cat needs to quiet down is to hear her owner’s voice, so try calling your kitty’s name when she starts to vocalize from another room or in the middle of the night. If that doesn’t do the trick and the nighttime crying is really a problem for you, consider earplugs.
- If eliminating outside the litter box is an issue, try putting additional boxes around the house. Also insure it’s comfortable for your cat to get into and out of the box. Cats are very adept at hiding arthritis and other aches and pains, which can limit their ability to climb into high-sided boxes, or boxes kept in bathtubs or up a flight of stairs, for example.