By Teresa Garden, DVM
For years veterinarians and pet owners have been aware of cognitive dysfunction in our aging dog population. We are just now understanding and appreciating that our aged cats are vulnerable to dementia just like people and dogs. It is thought cognitive changes are common in cats greater than 10 years old. Recognizing the symptoms may be more difficult since they are subtle and may be mistaken for “normal aging”. Symptoms of dementia in cats include decreased activity and social interaction, excessive vocalization at night, and house soiling. As many as 50% of cats greater than 15 years old are afflicted. Cognitive dysfunction in cats has genetic, nutritional, and environmental components. The pathophysiology of cognitive dysfunction is thought to be similar to that in people. As we age our brain is challenged with a decrease in blood flow, chronic inflammation, oxidative damage, and inefficient free-radical scavenging. Our aged brains have decreased production and metabolism of neurotransmitters. Neurotransmitters are crucial in maintaining normal movements, mood, memory, appetite, and sleep. Chronic pain also plays a role in dementia. Chronic pain can affect behavior, sensation, cognition, and social interaction. Many of our geriatric cats have painful conditions such as arthritis, joint disease, dental disease, cystitis, and neuropathy which may put them at further risk of developing dementia.
Feline cognitive dysfunction is a diagnosis of exclusion. This means we must rule out physical or medical problems that may be causing symptoms. Excessive vocalization could be caused by dementia. But it could also be caused by pain, hyperthyroidism, or hunger. Restlessness could be caused by dementia. But it could be caused by pain or increased elimination needs due to kidney disease, diabetes, or hyperthyroidism. House soiling could be caused by dementia. But it could be caused by a variety of medical problems or environmental problems within the household. A thorough physical exam, history taking, and performing blood and urine tests are in order to obtain the proper diagnosis.
Once feline dementia has been diagnosed, a treatment plan can be implemented based on the individual cat’s needs. The goal of treatment is to slow the progression of the condition and to improve quality of life for the kitty. A multimodal approach to treatment is taken and includes environmental enrichment, dietary modification, pain management, and cognitive function support. Environmental enrichment encompasses social interaction, mental stimulation, and physical exercise. Heated beds, elevated perches, and window ledges can attract cats to desired areas of the home. Puzzle toys are good for both dogs and cats to stimulate mental and physical activity. Keeping cats groomed and free of hair mats is very important for cleanliness and comfort. Long thick toenails should be trimmed to prevent painful ingrown nails. Providing easy access to clean litterboxes with low access points is paramount for our geriatric feline friends.
Dietary supplements play a crucial role in treating dementia in people and many of the same benefits are thought to extend to cats as well. Omega 3 fatty acids have been shown to promote cell membrane health and can be easily added in liquid form to the cat’s canned food. Antioxidants Vitamin E and C can slow the progression of the disease by scavenging free radicals. Ginkgo biloba and phosphatidylserine will help to maintain normal neurotransmitter levels, scavenge free radicals, and reverse MAO-B inhibition. Senilife is a great supplement made for dogs and cats to treat cognitive dysfunction. It contains antioxidants, phosphatidylserine, and Ginkgo biloba. Other nutritional supplements to help are S-AME and L-Theanine.
There is also a place for western drugs in treatment protocols for feline dementia. Selegiline (Anipryl) is a MAO-B inhibitor that is FDA approved to treat canine cognitive dysfunction. It has been used off label to help our kitty cats as well. Selegiline restores dopamine balance and decreases free radicals in the brain. It can treat symptoms such as house soiling, pacing, vocalization, irritability, and disorientation in cats suffering from feline dementia. It can take 4 to 8 weeks of therapy to see improvement. Gabapentin can also be useful in some cases of feline dementia. It can reduce chronic neuropathic pain such as that found with osteoarthritis. Gabapentin may help decrease anxiety and stabilize mood.
Like people, our pet cats are living longer. It is a given that with increased longevity we will see more cases of dementia. Our aim as pet owners and veterinarians is to keep our geriatric cats comfortable and healthy as possible. We can work together to improve our older cats’ diets, enrich their environment, and provide supplements and drugs as they become available to accomplish these goals.
Dr. Teresa Garden is chief veterinarian/owner of Animal Health & Healing, a full-service holistic and conventional veterinary practice in the Maplewood/Richmond Heights area. AnimalHealthandHealing.com; phone: 314-781-1738.