Guest post by Ingrid R. Niesman, MS PhD

If you start your day wondering where your car keys are, think how your cat feels when they can’t find their favorite toy anymore? Humans with cognitive decline, be it Alzheimer’s disease or any number of Lewy Body dementia diseases, have resources such as memory care facilities to aid families in care-giving. Cats with symptomatic cognitive dysfunction syndrome (fCDS) are sadly considered disposable.

Feline CDS is currently untreatable 

The first truth is that there is very little research on this disease in felines. Canine disease was recognized a few decades ago, and animal behaviorists are designing interventions for pet owners. Yet, the outcome for either dogs or cats is the same: eventual euthanasia. This condition is untreatable at the physiological level.

There is a lack of awareness by veterinarians and the public 

The second truth is that few veterinarians have encountered feline CDS routinely in their practices. With better nutrition and an increased awareness of the importance of pets in our lives, cats are living long and pampered lives. Once an anomaly, 20-year-old cats are not a rare occurrence anymore. Just like in people, the incidence of neurological issues rises with age, but distinguishing true neurodegeneration from medical background noise is creating confusion. Clinical fCDS diagnosis requires an MRI, an expensive test many cat parents will not consider for their aging cats.

Early symptoms are easily dismissed 

Early in the course of this disease, symptoms are mainly behavioral changes. As far back as 2007, a study concluded that nearly 30% of senior cats (aged 11- 14 years) and over 50% of geriatric cats (15 years and older) display at least one or more of the classical symptomology of CDS:

  • disorientation
  • altered sleep patterns
  • loss of house training
  • eating changes
  • excessive nighttime vocalizations

Each symptom by itself would not necessarily raise an alarm. Even the most vigilant caretaker can easily misinterpret the signs. It isn’t until the latter stages of the disease that the underlying pathology in the brain is apparent. Therefore many cats will go without a clinical finding and valuable medical information is lost.

There are no drugs in clinical trials for fCDS

 The incentives to develop drug therapies for cats just aren’t there for pharmaceutical companies. Until recently, the use of cats as a potential model for human neurodegenerative diseases was considered farfetched. Yet, cats, unlike dogs, are shown to have human-like neuropathological changes, suggesting therapies that work on humans will work on cats and vice versa.

Dogs have been treated with selegiline (Anipryl®, L-deprenyl) with reported significant improvements in quality of life. Selegiline is a drug that raises the concentration of the neurotransmitter dopamine and as such acts as an anti-anxiety medication.  But, this drug is not commonly prescribed or used in felines. Although recommended by the American Association of Feline Practitioners for treatment of fCDS, its use in cats is not FDA approved and is considered “off-label”. There are significant side effects and it should not be used unless a clear diagnosis of fCDS is evident, which is confounding. Again, this is a treatment, not a cure and won’t slow the progressive loss of brain cells.

Alternative treatments are few and far between

Dr. Stefanie Schwartz, DVM, MSc, DACVB, a board-certified veterinary behaviorist and owner of Pet Behavior Medicine, suggests that fCDS is uncommon. “Owners with an 18-year-old cat showing neurological symptoms will favor euthanasia over treatment,” explains Dr. Schwartz. Behavior modifications may help alleviate some of the more troubling symptoms. For example, for excessive nighttime vocalizations, Dr. Schwartz advices “keeping your cat up and stimulated with play and physical interaction during the day.”

Sadly however, few of the behaviorists I contacted had any experience treating cognitively impaired cats. Without client cats, behavioral intervention studies are scant and uncontrolled. We need more patients.

Environmental enrichment and stimulation such as play and food puzzles are routinely suggested for all cats, and may aid in prevention of cognitive decline. Studies in animals and humans have shown for decades that enrichment and exercise increase neuronal connections and stimulate growth of new young neurons. Whether or not this approach will slow the cell death in the brains of afflicted felines will require longitudinal studies and a significant number of diagnosed client cats.

Although we are still in the dark about human mild cognitive impairment, adding antioxidants and dietary supplements is one recommendation routinely suggested as a method of long-term prevention of neurological diseases. There are several nutritional products on the market sold as feline cognitive enhancing formulations that include omega-3 fatty acids, vitamin E, D, B6 and B12, L-carnitine, and amino acids in varying concentrations. Similar formulations for canines have resulted in some cognitive improvements. Client reviews seem positive for feline brands, but these recommendations are not a substitute for controlled clinical studies.

True clinical trials on a significant number of confirmed fCDS cats would provide a more definitive answer to the question whether supplementation improve cognitive performance over time.

Ivory Gould

The emotional costs of this disease linger

 When a previously loving and adventurous cat rapidly changes, the effects on a family can be devasting. Lori Gould describes her experience when her beloved Siamese-mix Ivory suddenly began to exhibit behavioral symptoms reminiscent of fCDS following a harrowing escape from major flooding. We were flooded out and rescued by helicopter in September. I carried Ivory’s crate in my arms to safety. On March 13th of the following year, I noticed that her behavior was odd…She was clingy, yet somehow distant. I couldn’t convey these changes to my vet but I knew something was different.” Her decline continued with eating disorders. “She was hungry but forgot how to feed herself,” explained Lori, “I syringe fed her until the end.” Ivory passed away on her own terms. Unfortunately, like many other cats, she was never officially diagnosed or treated specifically for fCDS, leaving not only a hole in her family’s heart but a widening gap in our understanding of this disease.

The funding for all companion animal CDS research doesn’t cover costs

The importance of increasing our funding for companion animal health should be a priority. Companion animals share our common environments, eat prepared foods, and have many similar health issues. They also have more limited lifespans, making them ideal prototypes to understand the efficacies for medical interventions. When we treat cats for similar human conditions, we treat ourselves as well.

This attitude is a paradigm shift. Instead of using animals as disposable human models, we need to use our companions as gatekeepers, unlocking the potential of new therapies and interventions that benefit both animals and people. What is lacking is money. Animal foundations have shouldered much of the costs for research, but their budgets are limited. $50,000 sounds like a lot of money, but for labs doing high-end research, that amount is supply money for maybe 6 months.

How do we fight for our feline friends?

Given the facts, prevention and early diagnosis are the best options for maintaining your cats’ mental capacity as they age. Just like the explosion of Alzheimer’s disease in humans, fCDS cases will increase as the pet population ages. Until researchers understand more about the earliest triggers for neurodegeneration, cats and humans should follow the same advice: exercise, eat a healthy diet and get plenty of mental stimulation over a lifetime. Take your aging cat for regular check-ups and observe them carefully over time for signs of cognitive decline. The more data that is collected and the more treatments attempted on diagnosed cats, the faster we can help everyone.

Ingrid R. Niesman MS PhD is the Director of the SDSU Electron Microscope Imaging Facility at San Diego State University.

13 Comments on The Sad Truths About Feline Cognitive Dysfunction Syndrome

  1. My 19 year old cat has been meowing loudly in the night over the last few weeks and I’m wondering if this might be the cause. She seems very happy when she sees someone and greets them loudly, as if she wasn’t expecting to see anyone, and then she curls up happily with them. I’m not sure if she is seeking attention but I don’t think she is doing it in the day when my husband is home and the rest of us are out.

  2. I feel at a loss. But at lleast I have found this information on CDS. All of a sudden everything went downhill with my 14 year old cat. He has a dx of either IBD or GI lymphoma. He was doing well on a special diet but now he has lost all coordination. He started walking in circles, bumping into things, getting stuck between furniture and making a mess when eating. In a matter or a week or two he is just not there anymore. No puring, pees or poops out the box or anywhere. We have found him stuck in wierd places and doesnt even meow to get out, even when upsidown. I have to feed him, put the food right in front of his mouth. Its so wierd. Doc says his lymphoma probably spread to his brain. So sad. I made changes to his environment to help him wander without getting stuck. But cant do much more.

  3. I agree with Wendy’s comment above and the best treatment may actually be easier than you think. Doctors and scientists have already found that there is a significant link between Alzheimer’s and other neurological conditions and the toxins in our water – specifically fluoride. Get a good filter which uses reverse osmosis which will remove the fluoride and you should see significant changes and prevent this condition in the first place. Remember a trace of something is not that harmful to a human but to a cat who is 1/6th the size that trace has 6 times the effect. Hope this helps.

  4. A very informative post. Interestingly my vet suggested our elder, Buddy Budd, may have had this when he was 16. He started late night vocalizations and showed a reduction in appetite. Fortunately I got him to eat again and the vocalizations seemed to be something he just did. I would call his name loudly and he would stop and come back to bed. I think his vision and hearing went a little and that was the problem then it became a habit. Thanks for good posts

  5. I recommend the two books by Dennis Crouse, who reversed his mothers Alzheimer’s with silica rich water, such as Fiji brand. Silica pulls aluminum from the body and it would make sense that cats, who are fed daily from aluminum cans and receive immunizations would accumulate an excessive amount.

  6. This is sad information. I am seeing a few signs in our 17 yr.old cat. She is already mostly blind from hyper-tension and now sometimes she seems a bit disoriented. And she is eating less. We are getting regular checks at the vet and will keep her happy and safe for as long as possible.

  7. I am seeing signs of this in Pipers. At 18 years old, she has changed her sleep patterns and is more talkative at night. I have now taken to sleeping on the couch to keep her more calm at night.

      • This is a very interesting article. We’ve noticed some symptoms in our 16yo cat – increased vocalizations, disorientation, changes in eating habits. Would be great to have therapeutic interventions to offer in order to ease symptoms.

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