Cognitive Decline in Cats – Feline Cognitive Dysfunction Syndrome (CDS)

Written By Dr. Arnold Plotnick; Originally published on Catster.

Cats are living longer than ever.  When I began my veterinary career, a 20-year-old cat was a rarity.  Now, I see at least a dozen every year.  It’s wonderful that we get to spend additional years with our beloved companions, but increased longevity is a double-edged sword.  A longer lifespan also means more time for cats to develop disorders associated with aging.  Advances in veterinary diagnostics and therapeutics have allowed for improved management of age-related medical conditions such as cancer, arthritis, and kidney disease, however, there’s another age-associated ailment for which there is still no definitive treatment: the decline in cognitive ability as a cat grows older.  

Cognitive Dysfunction Syndrome (CDS) is a slow, degenerative condition of the brain that leads to impairment of a cat’s cognitive ability.  Affected cats show difficulty with learning, memory, and awareness.  People often use lay terms like feline dementia, senility, and even “kitty Alzheimer’s” (as a client of mine used to call it), and I have no issue with this, as most people can relate to these terms and understand their implications.  

A number of behavioral changes can be seen in cats with CDS, the most common being disorientation. Cats may appear lost or confused despite having lived in their environment for years.  Many years ago, I adopted a ten-year-old cat named Ethel who lived, impressively, for additional ten years.  Around age seventeen, her behavior began to change.  One morning, I placed a bowl of canned food on her placemat, and she wandered over to eat.  Five steps before arriving at the bowl, she slowed to a halt, sat down, and stared blankly around the room. After a minute, I picked her up and carried her the remaining few steps to the bowl.  She saw the bowl, bent down, and began eating as usual.  Apparently, she had forgotten, in mid-stride, why she was walking toward her placemat! Cats with CDS may wander behind furniture and get trapped, get stuck in the corner of a room, or sometimes just stare off into space.  

Changes in social interaction may be another sign of CDS.  Some cats may become very clingy.  Others may get cranky, irritable, or anxious with their owners. I’ve had a few clients tell me that their cat no longer seems to recognize them.  (Ethel became very clingy, which I didn’t mind at all.) Less frequent grooming and decreased appetite are also possible symptoms of feline CDS.

Altered sleep-wake cycles have been described in cats with CDS.  Cat who previously slept through the night may now wake up in the middle of the night and pace or wander, sometimes vocalizing loudly.  Inconsistent use of the litterbox is another commonly reported symptom of CDS, possibly because they can’t always remember where their litterbox is located.   

Diagnosing CDS can be tricky because many of the signs may be subtle.  Mild changes in mood, grooming behavior and appetite are often dismissed as being a normal part of aging, when in fact they’re part of the syndrome. In addition, some of the medical conditions seen in older cats can mimic behavioral changes in CDS. For example, cats with hyperthyroidism often vocalize loudly, and cats with arthritis may have trouble getting in and out of their litterbox, resulting in them seeking alternative places to eliminate. It is important to have a veterinarian examine your cat to rule out medical causes for the behavioral changes.   

There are no FDA-approved treatments for feline CDS.  The goal of treatment is to support the cat’s current cognitive function, relieve any anxiety, and improve the cat’s welfare as best as possible.  Maintaining a stimulating environment to keep the cat’s mind engaged can slow the progression, and perhaps even improve cognitive function.  This can be achieved through a regular exercise schedule, use of interactive toys, placing a bird feeder outside the cat’s favorite window, etc.  Adjusting the environment to make it more “senior friendly” may make the cat more comfortable.  For example, important resources like food, water, and the litterbox should be readily accessible; elderly cats should not have to walk up and down a flight of stairs to access these resources.  Using nightlights to illuminate dark areas and hallways will help the cat locate their food and litterbox more easily. Adding another litterbox to the household may help reduce accidents in the house.  Litterboxes with low sides are preferable, as they are easier for the cat to enter and exit. Bear in mind that any alterations to the environment should be gradual and discreet; predictability and consistency take on increased importance as cats age. Now is not the time to renovate the house, rearrange the furniture, or introduce a new pet to the household.  

Pharmaceutical options for feline CDS are lacking.  The drug selegiline (brand name Anipryl) is FDA-approved only for canine CDS, not feline CDS. Use of this drug in cats is considered to be “off-label”.  Large, controlled studies are lacking, however, a small open trial using selegiline showed a positive effect in cats, and the American Association of Feline Practitioners supports the use of this drug for feline CDS.  S-adenosylmethionine (brand name Novifit) has shown some benefit in cats with mild to moderate cognitive dysfunction, suggesting that this drug may be most useful if given in the early stages of CDS.  A number of other products and supplements have been suggested as being potentially beneficial (antioxidants, vitamins, omega-3 fatty acids), and there are many nutritional supplements that are marketed as being cognition-enhancing, but controlled studies of their efficacy are lacking. Diets rich in vitamin E and antioxidants may slow the progression of CDS, and many prescription diets for seniors contain increased amounts of these substances.  For cats whose main symptom of CDS is heightened anxiety, anti-anxiety medication may provide some relief. A little extra love and attention is something all cats enjoy, but it may be especially beneficial for cats with CDS.  

Although CDS is progressive, affected cats usually have a good quality of life, especially if the owner is aware of the condition and provides the cat with the emotional and environmental support it needs.  

[Sidebar: According to one study, approximately 28% of cats aged 11 to 14 will show at least one behavioral sign related to CDS.  This increases to 50% for cats over the age of 15.]  

Check out more published feline articles by me on Catster!

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