Cat using food puzzle

At the veterinary clinic where I work, I often hear people say when I ask about their cat’s activity and play, “she sleeps most of the time and meows a lot at night. She doesn’t play – she’s an older cat”. How much of these behaviors is due to “normal” aging? How much is due to other medical conditions or a declining brain?

Cognitive Dysfunction Syndrome in cats or cat dementia refers to the decline in mental abilities associated with aging.

Cat dementia results from damage to the brain.  As your cat ages, the the numbers of molecules called  free radicals are no longer balanced out by the antioxidants in his body. These free radicals are reactive and cross the blood-brain barrier, damaging cells in the brain.

Changes in blood flow to the brain can also cause damage by starving the neurons of oxygen.  High blood pressure, heart disease, anemia – are all conditions that alter the flow of blood to the brain.

How can we tell if our cats are undergoing mental decline? Is there anything we can do about it?

VISHDAAL – behavior changes


Changes in behavior can indicate if your cat’s mental state has declined. The acronym VISHDAAL summarizes the behavior changes we need to monitor in our senior cats, from the most prevalent (vocalizing) to least frequent (changes in learning and memory).

V = vocalization
I = changes in interaction with us and other pets
S = changes in sleep-wake cycle
H = house soiling
D = disorientation
A = changes in activity
A = anxiety
L = learning and memory

How do we sort out behavior changes due to disease and those due to declining mental capacity?

Changes in behavior signal the onset of cognitive decline but they may also arise from other health issues:

  • Cats with untreated high blood pressure or hyperthyroidism may meow at night (vocalizing).
  • Cats with untreated hyperthyroidism may be restless and beg us for food (changes in interactions and sleep).
  • Kidney disease can be accompanied by increased thirst and urination which may result in house soiling (house soiling)
  • Cats with osteoarthritis may have difficulty accessing the litter box (house soiling).

behavior changes: disease vs Dementia


Regular veterinary exams and diagnostics can identify medical conditions such as high blood pressure, hyperthyroidism, and osteoarthritis.  If behavioral changes persist after treating these other medical conditions, your cat may have CDS or cat dementia. 

Cat dementia is a “diagnosis of exclusion” – it is the diagnosis that remains after all the other possible diagnoses have been eliminated. Cat dementia will usually have a slow onset and behavioral symptoms will gradually get worse.

Cognitive Dysfunction (CDS) cannot be cured but management can reduce the symptoms and improve the Quality of Life for both you and your cat.

managing cat dementia


  • environmental enrichment/modification
  • dietary supplements
  • therapeutic diets
  • medication

Environmental enrichment/modification


In the early stages of cat dementia, enrichment increases mental stimulation, leading to the growth and survival of neurons, preserving the thinking processes.  Enrichment should be tailored to the individual cat.  For example, some cats prefer high places; others are “ground dwellers”.  Arthritic cats will not have the range of motion of healthier cats but will still enjoy play that does not require lots of jumping.

Ways to enrich your cat’s environment:

  • play – interactive play and toys
  • scent enrichment – catnip, silvervine
  • food puzzles
  • motion – climbing (cat trees) and exploring (cardboard boxes)
  • supervised outdoor access

As CDS progresses…

Environmental changes become stressful and confusing. Cats with severe cat dementia need an environment that does not change much – daily routines and feeding schedules must be maintained. Litter boxes and feeding stations need to stay in the same place.

A cat with severe CDS may benefit from a “room of his own”, with easy access to his resources. Changes that need to be made must be done slowly. If you need to move a litter box or feeding station, do it gradually over a number of days so the cat can still find it.

Environmental modifications

Modifications to the environment of the cat with dementia should take into account the behavior that she is exhibiting.

  • Cats that constantly beg for food may benefit from a timed feeder at night or treat balls. 
  • Cats with house soiling tendencies may need more litter boxes and ones that are easily accessed, with a lower entry for example. 
  • Cats that become disoriented and confused may benefit from a night light and radio playing soft music.

Dietary Supplements


Dietary supplements in general seek to restore the balance between the activity of antioxidants in the body and the  production of free radicals.  Antioxidants give up electrons to the free radical, effectively “neutralizing” it so that it is no longer reactive. So, these supplements usually contain antioxidants.

SAMe: (S-adenosyl-methionine)  aids in the production of glutathione, an antioxidant. When elderly cats were supplemented with SAMe, there was improvement in cognitive tests. SAMe is best used pro-actively – it is most effective in cats in the early stages of cat dementia.

Proprietary supplements containing vitamins, resveratrol (antioxidant), and fish oils are on the market but there is no clinical data testing cats for these at this time.

other supplements


Melatonin: hormone in the body that is thought to promote sleep. It also has antioxidant properties. Melatonin declines with age.

Pheromones (Feliway), Zylkene, Anxitane (L-theanine) may help reduce anxiety in cats that are disoriented and may promote sleep.

Therapeutic diets


Therapeutic diets containing antioxidants and fish oils have been shown to help cat dementia. 

  • Feline Mature adult Hill’s Pet Nutrition
  • Purina Pro Plan Age 7+
  • Hills prescription diet j/d with fish oil for osteroarthritis

Diets that reduce anxiety may also help with cat dementia

  • RC Calm diets
  • Hill’s urinary support

Medications


Selegiline: licensed to treat dementia in dogs. Like the dietary suplements, it aims to reduce the production of free radicals.  Selegiline stimulates the production of enzymes that eliminate free radicals.

Anxiolytics: Prozac, gabapentin and clonazepam are used to treat dementia by reducing anxiety.

boxes as enrichment for cats
Boxes can be source of enrichment for senior cats.

If you feel there has been a significant change in your cat’s behaviors, keep a journal or log and make sure to mention it at her next senior exam. Start the conversation with your vet about cat dementia and how to manage it!

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You’ve stopped by the pet shelter and are interviewing the cats for adoption. You’re looking to adopt an adult cat – you feel your life is just too hectic to take on a pair of kittens. There is an orange male cat who seems friendly and rubs your outstretched hand in greeting. He is simply charming!

You find a shelter volunteer for more information. She asks you how you feel about caring for a blind cat. You do a double-take – the cat moves confidently around his enclosure, then turns and approaches you.  Nothing about him makes you think he can’t see.

Blindness in cats can arise from a number of factors:

  • genetic condition present at birth
  • trauma to the eyes
  • cataracts due to aging or diabetes
  • detachment of the retina, resulting from high blood pressure, chronic kidney disease, or hyperthyroidism
  • infectious organisms, such as FeLV, FIV, can cause inflammation in the eye and lead to blindness.
  • untreated eye infections resulting from upper respiratory infections can also cause blindness

“keep an eye” on your cat’s eyes – see your vet if:


  • your cat is squinting
  • her third eyelids are swollen
  • her conjunctiva are red and swollen
  • there is discharge from her eyes – clear to greenish-yellow
  • her pupils are not the same size
  • she starts rubbing her eyes

Caring for a blind cat


Caring for a blind cat or cat who is gradually becoming blind is similar to  caring for a “sighted” cat. Blind cats and “sighted” cats have the same environmental and emotional needs.

Blind cats adapt quickly to their surroundings. How do they do it? They rely on their other senses – smell, touch, and hearing – to get around.

The blind cat’s superpowers


superpower #1 – smell


Cats live in a landscape of odors. Cats have two ways of detecting odors in their environment:

  • the cells lining the nose and nasal cavity
  • the vomeronasal organ or VNO in the roof of the mouth

In the VNO, there are 3 types of “receptor proteins”. These receptor proteins respond to chemicals such as odors. We know more about the V1R protein than the other two.

Cats have 30 genetic variants of the V1R protein. Genetic variants refer to changes in the DNA sequence that makes up a gene. More genetic variants of the V1R protein allow cats to detect a greater variety of scents than say, dogs, who have only 9 genetic variants of this receptor protein. 

Cats can associate certain odors/scents with a particular experience, place or other animal. For example, to a cat, another animal or person has a signature scent that the cat uses to identify that individual.

superpower #2 -TOUCH :THE WHISKER POSITIONING SYSTEM


Each whisker is embedded in a cluster of nerve endings located 3 x deeper in the skin than the surrounding hair follicles. Not only do whiskers alert your cat to the piece of furniture nearby, they alert him to changes in air currents, from say an open door or window.

Cats use their whiskers to navigate – whiskers help the cat pinpoint where she is relative to her surroundings – “can I fit behind this sofa?” Needless to say, a blind cat finds her whiskers crucial to getting around.

superpower #3 – hearing


Cats have one of broadest hearing ranges of all mammals. They are able to hear the high-pitched ultrasonic squeaks of mice and also the low-pitched tones of the human male voice.

Cats’ cone-shaped ears move independently of each other. Sounds will reach each ear at different times and allow the cat to pinpoint the source of the sound.

Watch as these blind cats track a bird.

CAT FRIENDLY HOMES FOR blind kitties


Setting up a cat-friendly home for a blind or partially blind cat is much the same as setting it up for a sighted cat. He will need multiple, separate litter boxes, feeding and water stations, and safe places to retreat to.

Your blind kitty will use his incredible sense of smell and ability to discriminate between scents, to navigate his environment. His hearing and whiskers will also alert him to the presence of other animals and objects. And just like any “sighted” cat, he should be introduced gradually to a new environment. (Yes, rearranging the furniture is a “new” environment.)

Alana Miller of Blind Cat Rescue & Sanctuary has some tips for caring for a blind cat:

  • Blind cats should only be indoor pets. Make sure there are no open pet doors, windows or other ways your cat could get outside. (A secure area like a catio can give your blind kitty a safe outdoor experience).
  • Make sure the house is safe.  Keep cleaning chemicals, power cords or other potential tripping hazards out of your cat’s reach.  Be aware of spaces he could explore and get stuck in like behind washer/dryers.
  • Stairs.  Make sure you’re with your cat the first few times she uses the stairs until you’re sure…she knows where they are and is able to navigate them.
  • Know where your blind cat is. He can’t see you and may not know he’s under your feet… you don’t want to step on him by accident.
  • Let your blind cat know that you are going to touch her. A blind cat can’t see your hand coming … she might startle when you touch her.  As you approach, make sure you rub your fingers together or make a gentle noise with your hand to alert her.

Whether you adopt a blind kitty or your older kitty has vision loss, remember your blind cat has the same needs as sighted cats. With some modifications, you can provide a safe and enriching environment for your blind cat.

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