Identifying signs of cat dementia is not always straightforward. In the hubbub of daily life, behavior changes can be subtle and go unnoticed until they are more severe.

Changes in behavior can indicate if your cat’s mental state has changed. The acronym VISHDAAL summarizes the behavior changes we need to observe to care for our senior cats.

V = changes or increase in vocalization
I = changes in interaction with us and other pets
S = changes in sleep-wake cycle: restlessness, night time activity
H = housesoiling
D = disorientation and confusion
A = changes in activity
A = anxiety
L = learning and memory

Three cats – three outcomes


rupert, 18 year old neutered male siamese

Cat on sailboat


I had two senior Siamese cats when I had my first child.  A first-time mom, I was frazzled, dealing with the completely new experience of parenting and was not paying as much attention as I should have to my cats.

One day, an acquaintance asked why one of the cats, Rupert, was sitting on the kitchen counter, in a corner, facing the wall. I had been aware that he did that sometimes but when I paid closer attention, I found that he would eat in the morning, use his litter box and then spend the day on the counter, facing the wall. He would come down to eat, drink, and use the litter box but always returned to the counter.

Behavior Changes – signs of cat dementia?

  • I – Rupert was no longer interacting with us.
  • D – He seemed confused and “out of it” – sitting on the counter all day
  • A – His activity had changed – he did not move much from the counter

Diagnosis:

Rupert had lost quite a bit of weight, although he was eating well. My vet diagnosed him with hyperthyroidism, which was a new disease in cats at that time.

Outcome:

Use of radioactive iodine to treat the disease was pioneered about 10 years earlier but it was not commonplace. Surgery was an option but at 18 years of age, Rupert was not a good candidate for surgery and we elected euthanasia due to his declining Quality of Life.

The Takeway:

I suspect that Rupert had moderate to severe cat dementia. The symptoms were most likely apparent earlier and I just did not recognize them. Nowadays, drug therapy for hyperthyroidism is readily available – methimazole is an FDA approved treatment for hyperthyroid cats. Perhaps treatment of the hyperthyroidism would have reduced the symptoms of cat dementia enough for Rupert to have had some more time with us.

Athena, 16 year old spayed female


Athena had been slowing down over the past year, was not eating as well and was spending most of her time sleeping. We had provided her with steps to access window perches and our bed; we also provided her with a heated bed.

Behavior Changes – signs of cat dementia?

  • I – Although still willing to play, Athena was interacting less with us; she had previously been a “nosy, busybody” kind of cat.
  • A – Athena no longer went on her daily walk and was less active in general

Diagnosis:

Diagnostic blood work did not show any significant changes over the past year. Athena did not show other signs of cat dementia and would still learn new tricks when hungry for treats.

X-rays showed moderate to severe arthritis in one of her hips and knees. We decided to treat her arthritis pain with the drug gabapentin.

Outcome:

Treatment for her arthritis pain has been a game changer for her; her activity level has increased, her appetite has increased, and she is back to “being in your face” when she wants something.

The Takeaway:

Regular checkups and treatment of chronic conditions can make you and your cat happier! Some symptoms typical of dementia may be due to treatable, medical conditions.

Marley, 15 year old neutered male

cat with food puzzle
Marley works the Poker Box, a food puzzle.

Marley is a friendly, affectionate cat with good health overall. In the past several months, Marley showed some of the behavior changes that we need to monitor in senior cats.

Behavior Changes – signs of cat dementia?

  • I – Marley had become more clingy than usual and more interactive
  • D – He seemed confused when playing the nightly game of “treat toss” – he seemed to forget that he was chasing a treat!
  • A – He did not want to walk outside with us (which he has been doing for years).
  • A – He seemed anxious and a little fearful. His interactions with the other cats became timid.

Diagnosis

Marley’s senior exam and blood work did not reveal any abnormalities other than a slight decline in kidney function which could be expected at his age.

Marley appears to have some mild cat dementia. Since these changes were mild, we decided to try SAMe, a dietary supplement. SAMe has been shown to be effective at reducing symptoms of dementia in cats in the early stages of cat dementia.

Outcome

About 2 months have gone by with daily supplementation. Marley is taking his daily walk again and is not as clingy with his humans. He is no longer stand-offish with the other cats and is “catching” his treats again when we play the nightly treat toss.

A Final Word…


Cat dementia cannot be cured but it can be managed. With early diagnosis, appropriate environmental modifications, dietary supplements, therapeutic diets, and medication can help can reduce the symptoms of dementia and improve Quality of Life for both you and your cat.

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Elevated feeding station for a cat
Athena’s microchip feeder raised up on a platform.

My oldest cat, Athena, is 16 1/2 years old now. She was diagnosed with Chronic Kidney Disease (CKD) and osteoarthritis a few years ago.

Signs of CKD

  • Weight loss
  • Poor appetite
  • Lethargy
  • Increased thirst
  • Increased urination
  • Vomiting

 Kidney disease can result in reduced appetite and weight loss due to underlying nausea. As the kidneys become less efficient, cats drink more and more water to compensate for the reduced filtration, but they just can’t drink enough. One side effect of this draw on the body water by the kidneys can be constipation. And constipation can also result in reduced appetite.

Athena was losing weight, seemed depressed, did not want to eat and was not very active. Her quality of life seemed to be declining.

My vet recommended:

  • a laxative
  • an appetite stimulant

I added the laxative to Athena’s moist cat food. When she ate things were good.

If she did not eat:

she did not get the laxative >>she would become constipated >> she would not eat even with the appetite stimulant.

I felt we were trapped in a downward spiral.

It is important to treat the whole cat when managing an older cat with multiple disorders.

treat the whole cat


medical treatment


In addition to kidney disease, Athena also suffers from arthritis. Having been a fairly active cat who went on daily walks, it was disheartening to see her decline her walk and stay at home. Her gait became stiffer, in spite of a heated bed and daily exercise in the form of play.

So, I wondered, what if the pain due to arthritis was a bigger player than we thought?

What if stiff and painful>>not moving as much>> bowels don’t move as well>> constipation >>drop in appetite?

I asked my vet “What if we treat the arthritis pain?” Athena moved fairly well in the vet clinic but x-rays showed quite a bit of arthritis in one hip and one knee. The vet prescribed gabapentin twice daily for Athena.

dietary changes


To reduce the constipation, Athena needed more fluid and a laxative. I decided to try a hydration supplement, Purina Hydracare, and added the laxative to the Hydracare. Fortunately, she liked the Hydracare so down went the laxative in a little Hydracare!  This way I knew she got the laxative without stressing about her eating her entire meal.

environmental changes


Because her hips are painful, it occurred to me that “maybe crouching down is painful” so I elevated the feeding station. While she eats, she puts weight on her back legs, helping strengthen her back legs, which are most likely weaker from her previous lack of activity.

eureka!


  • Athena has responded well to the gabapentin – it does affect her balance a bit but she has become more active again and we have resumed our daily walks.
  • Increased activity combined with the hydration supplement and laxative seem to have have eliminated the constipation.
  • Athena accepted the elevated feeding station right away – I guess being more comfortable encourages her to eat more.

the takeaway


It is important to “treat the whole cat”. Treating Athena’s arthritis pain seems to have been a game changer. Although reduced appetite and constipation often accompanies kidney disease, reducing the pain of arthritis has balanced this out, increasing mobility and appetite.

She is still an old cat but her quality of life has improved dramatically with these changes.

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