The Heartbreaking Truth. How Long Cats with Dementia Can Live

What is Feline Cognitive Dysfunction (Cat Dementia)?

Feline cognitive dysfunction (FCD), also known as cat dementia, refers to age-related changes in a cat’s cognitive function that result in behavioral changes. It is similar to Alzheimer’s disease in humans. FCD is caused by physical changes in the brain that occur as cats age, including amyloid plaques, cerebrovascular disease, and brain atrophy (https://www.aspca.org/pet-care/cat-care/common-cat-behavior-issues/older-cats-behavior-problems).

The signs and symptoms of FCD include (https://en.wikipedia.org/wiki/Feline_cognitive_dysfunction):

  • Disorientation, confusion
  • Altered interactions with family members or other pets
  • House soiling
  • Changes in sleep-wake cycles
  • Loss of prior litter box habits
  • Hiding and loss of interest in surroundings
  • Anxiety

The underlying causes of FCD are not completely understood but appear to involve structural and neurochemical changes in the brain as a normal part of aging. Risk factors include advanced age, diagnosis of a chronic disease like kidney disease, and less active lifestyle.

Prevalence of Feline Cognitive Dysfunction

Feline cognitive dysfunction (FCD), also known as cat dementia, is estimated to affect more than 55% of cats aged 11-15 years and more than 80% of cats aged 16-20 years (https://pubmed.ncbi.nlm.nih.gov/35536055/). The prevalence increases with age, with one study finding FCD in 28% of cats aged 11–14 years, rising to 50% in cats aged 15–17 years (https://bvajournals.onlinelibrary.wiley.com/doi/10.1002/vetr.3).

The age of onset for FCD is typically around 11-12 years of age. However, early signs can begin to appear as early as 7 years old. Most cats diagnosed with FCD are geriatric, usually over the age of 11. As cats reach the late teens and early 20s, the likelihood of developing dementia increases significantly.

In summary, FCD becomes increasingly common in aging cats, with over half of cats over 11 years old affected. Owners of senior cats should be aware of the signs and seek veterinary advice if concerned their cat may be developing age-related cognitive decline.

Progression of Feline Cognitive Dysfunction

Feline cognitive dysfunction typically progresses through four main stages:

Stage 1 – Early Cognitive Decline

In the early stages, symptoms are often subtle and intermittent. Cats may seem slightly confused or disoriented at times. Early signs include wandering or getting lost in familiar places, changes in interactions with family members, or disrupted sleep-wake cycles.

Stage 2 – Mild Cognitive Impairment

In stage 2, symptoms become more noticeable. Cats may start vocalizing at night or seem anxious and restless. Appetite changes, house soiling, and altered social relationships are also common. Cats may seem distant or not recognize family members.

Stage 3 – Moderate Cognitive Dysfunction

By stage 3, significant personality changes emerge. Cats may seem confused, irritable, or fearful. Disorientation and reduced interest in play or pets are typical. Cats often develop disrupted sleep cycles and wander aimlessly vocalizing or crying. Lack of grooming and house soiling accidents also increase.

Stage 4 – Severe Cognitive Decline

In the final stage, dementia impacts all aspects of daily living. Cats lose normal abilities like using the litter box and have trouble navigating. They may seem lost in their own home. Drastic personality changes, anxiety, restlessness, and night-time vocalizing are most severe in stage 4. Cats require constant monitoring and assistance.

Diagnosing Feline Cognitive Dysfunction

Diagnosing feline cognitive dysfunction usually starts with a veterinary exam to rule out other medical conditions that could cause similar symptoms. The veterinarian will take a full health history and perform a physical exam. They may look for signs like disorientation, decreased grooming habits, decreased interest in play, or failure to recognize family members.

There are no definitive diagnostic tests for feline cognitive dysfunction. However, blood work and urine analysis can help rule out issues like kidney disease, thyroid disease, and diabetes which can cause behavioral changes. Imaging tests like X-rays or MRI may also be recommended to evaluate the brain and look for tumors or vascular issues. While these tests are not specific for dementia, normal results can make the diagnosis more likely.

Veterinarians may also perform cognitive or memory tests during the office visit to assess the cat’s awareness and responses. For example, they may evaluate the cat’s ability to navigate obstacles or recognize familiar faces. Declining performance on these observations over time can aid diagnosis.

Ultimately there is no single test to confirm feline cognitive dysfunction. Veterinarians make the diagnosis based on the presence of symptoms, ruling out other conditions, and monitoring cognitive decline. Keeping detailed records of your cat’s behaviors can help your veterinarian make an accurate diagnosis.

Treatment Options

There are several approaches to treating cognitive dysfunction in cats, with the goal of slowing the progression of symptoms and improving quality of life. Key treatment options include:

Medications

Certain medications may help manage cognitive dysfunction in cats. According to the Cornell Feline Health Center (https://www.vet.cornell.edu/departments-centers-and-institutes/cornell-feline-health-center/health-information/feline-health-topics/cognitive-dysfunction), the most commonly prescribed drugs are selegiline hydrochloride (Anipryl®), propentofylline (Vivitonin®) and nicergoline. These medications aim to enhance blood flow, protect nerve cells and increase neurotransmitter levels in the brain. However, response varies between individual cats.

Environmental Enrichment

Providing mental stimulation through play, exercise and an enriched home environment can help engage the cat’s mind and slow cognitive decline. Strategies include food puzzles, new toys, daily interactive playtime and access to perches or scratching posts. Keeping food bowls, litter boxes and resting areas consistent also helps older cats navigate their surroundings (https://icatcare.org/advice/senility-dementia-or-cognitive-dysfunction-syndrome/).

Dietary Changes

Some research indicates that dietary modifications may benefit cats with cognitive dysfunction. According to PetMD (https://www.petmd.com/cat/conditions/neurological/dementia-cats), increased antioxidants from fish oils and vitamins C and E could help reduce oxidative damage to the brain. Prescription diets designed for mature cats may also be recommended. Consulting a veterinarian is advised when making dietary changes.

Prognosis and Life Expectancy

According to research published in the Journal of Feline Medicine and Surgery, the median survival time after diagnosis of feline cognitive dysfunction (FCD) is 20-22 months. However, several factors can affect the prognosis and life expectancy of a cat with FCD.

The severity of the cognitive decline plays a major role in determining prognosis. Mild to moderate cases of FCD have a better prognosis and longer survival time compared to severe cases. Cats that maintain some independence in everyday activities tend to live longer than those with severe impairment. Additionally, age at the time of diagnosis impacts lifespan. Older cats tend to have reduced survival times compared to those diagnosed younger.

Providing proper medical care and management of any comorbid conditions can prolong survival time. Studies show treating hypertension, starting medications like selegiline and anipryl, maintaining good nutrition, and providing environmental enrichment can slow the progression and improve quality of life. However, on average most cats live about 1.5-2 years after an FCD diagnosis. With dedicated care, some cats can survive 4-5 years before the condition becomes debilitating.

It’s important for owners to monitor their cat’s cognitive and functional decline, overall quality of life, and consult a veterinarian to determine the most humane and ethical approach once their pet’s condition significantly worsens. While the prognosis varies for each cat, providing attentive medical care and keeping the pet comfortable can maximize remaining life expectancy with this progressive neurodegenerative disorder.

Sources:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8470385/
https://www.purina.co.uk/articles/cats/senior/behaviour/cat-dementia

Improving Quality of Life

While there is no cure for feline cognitive dysfunction, there are ways to help improve your cat’s quality of life. Focus on providing a predictable routine, managing other medical conditions, and providing mental stimulation.

Establishing a consistent daily routine with regular feeding times, play time, and sleeping schedules can help create a sense of normalcy and security for your cat. Try to stick to the same order of events each day.

Manage any other age-related health issues your cat may have, like arthritis, high blood pressure, or thyroid disease. Getting these conditions under control can help minimize unnecessary discomfort and confusion.

Engage your cat’s mind by providing interactive toys like puzzle feeders or treat balls. Rotate different types of toys to keep them interesting. Consider installing a bird feeder outside a window for your cat to observe. Place comfortable perches near windows with activity.

Use synthetic feline pheromones like Feliway to help induce a sense of security and calmness. Limit rearranging of furniture or possessions. Play calming music designed for pets.

While you cannot control the progression of feline cognitive dysfunction, implementing these measures can help sustain your cat’s quality of life. Focus on providing comfort, reducing stressors, and maximizing enjoyment during this stage of your cat’s life.

Source: https://www.aspcapetinsurance.com/resources/cat-dementia/

Caring for a Cat with Dementia

Caring for a cat with dementia requires making adjustments to keep your feline friend safe, comfortable, and able to enjoy life for as long as possible. Here are some tips for caring for a cat with cognitive dysfunction:

Safety considerations are extremely important. Dementia can cause disorientation and confusion, so keep litter boxes in easy to access areas and keep food and water bowls in consistent locations. Use baby gates or close doors to limit access to stairs or balconies where falls could occur. Provide ramps or steps for furniture access. Place non-slip mats in slick areas and cushion hard surfaces. Keep doors and windows shut so your cat does not accidentally escape outside.

To meet basic needs, stick to regular feeding and bathroom break schedules. You may need to physically guide your cat to the litter box or food dish. Feed by hand if your cat has trouble finding the bowl. Clean the litter box more frequently as dementia can cause bathroom accidents. Groom your cat regularly if they have trouble with self-grooming.

Providing comfort and reassurance is also very important. Give your cat their own safe space, like a spare room or corner of a bedroom. Use cat appeasing pheromone sprays or diffusers to reduce anxiety. Provide steps or ramps to beds and furniture for snuggling. Pet, brush, and speak soothingly to your cat. Ask your vet about pain medication if you suspect arthritis or discomfort.

With some adjustments to your home and care routines, you can continue providing a good quality of life for your cat as the dementia progresses. Always consult your veterinarian if you have any concerns about your cat’s health or behavior changes.

When to Consider Euthanasia

It is a heart-wrenching decision to consider euthanasia for a beloved cat with dementia. However, it may become necessary if their quality of life is severely impacted, they are no longer responsive to treatment, or they are experiencing significant pain or suffering. Some signs it may be time to euthanize a cat with dementia include:

The cat is unable or unwilling to groom themselves, eat, use the litterbox, or walk. These are basic daily living activities that cats should be able to do. Inability to perform these functions often indicates the dementia has progressed significantly Buchanan, 2022.

There is no improvement with medications or treatment. If symptoms like disorientation, anxiety, pacing, and sleep disturbances continue despite trying different therapies, euthanasia may help end frustration and discomfort Vetster, 2023.

The cat is in constant pain or distress and no longer has any joyful moments. Dementia often causes anxiety, restlessness, and other distressing symptoms. If these persist despite treatment and the cat no longer seems to take any pleasure in life, euthanasia may be most compassionate Goodboy, 2022.

While difficult, euthanizing a cat with dementia may be the ultimate act of love and may be necessary to prevent unneeded suffering. Discussing all options with a veterinarian is recommended.

Takeaways

Feline cognitive dysfunction is a common condition in aging cats that causes symptoms like disorientation, anxiety, lack of litter box training, and more. While there’s no cure, various treatment options like medication, dietary changes, environmental enrichment, and routine care can help manage symptoms and improve quality of life. With proper management, cats with cognitive dysfunction can continue living happily for months or years. Key takeaways include:

  • Cognitive dysfunction often starts gradually in cats over age 11 and progresses slowly. Life expectancy depends on the cat’s overall health.
  • Veterinary exams, lab tests, and observation of symptoms are used to diagnose it.
  • Treatment focuses on managing symptoms through medication, diet, mental stimulation, and routine care.
  • Quality of life is most important – euthanasia may be considered if symptoms become unmanageable.
  • Providing a familiar routine, keeping surroundings consistent, and giving affection can help cats with dementia.

To learn more about supporting a cat with cognitive dysfunction, consult your veterinarian. Quality online resources are also available at ASPCA.org, the Cornell Feline Health Center, and the American College of Veterinary Behaviorists.

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