Senior dogs and cats can develop a syndrome equivalent to dementia or Alzheimer's in people (currently called Cognitive Dysfunction Syndrome). It is typically age-specific, chronic, and slowly progressing and it affects perception, recognition, memory, and learning. The cause is an abnormal build-up of certain proteins in and around the brain. Dementia is becoming more common because our pets are now reaching extreme old age due to living in safe environments, having improved nutrition, and receiving regular veterinary care. Researchers estimate that the disease affects 36% of cats aged 11+, 28% of dogs aged 11-12, and a surprising 68% of dogs aged 15-16. The disease remains underdiagnosed both because pet owners often assume the symptoms are a part of normal aging, and because many of the symptoms of dementia overlap with other conditions.
The main symptom is a change in the pet’s normal behavior over time: Your dog or cat may simply not behave like himself or herself anymore. The form of dementia that affects dogs frequently causes them to feel agitated, confused, irritable or anxious, and less motivated to play. They develop new fears, stop responding to familiar commands, forget what they learned, and have difficulty learning new things. Cats with dementia may either neglect their self-grooming or lick themselves excessively. They may also stop eating or eat far more than normal because they forget that they have already eaten. The acronym DISH spells out the most common behaviors of a pet suffering from this disease:
Disorientation, such as walking aimlessly and becoming confused even in settings that should be familiar to them; staring blankly; losing balance and falling; getting ‘stuck’ in a corner or trapped in a room in your house because they have forgotten how to get out.
Interactions with people change over time. The dog or cat that once greeted you at the door and loved sitting on your lap and being petted can become more withdrawn or depressed, forget family members and other pets, ignore you, and sometimes even hide under the bed. They can also go from the extreme of avoiding interaction to becoming increasingly clingy.
Sleep habits are altered. Your pet may start sleeping a lot during the day and be awake more at night howling, barking, or meowing, often for no clear reason. An increase in vocalization at night is especially common in cats.
House-training deteriorates. Your pet might have accidents indoors or want to go out at unusual times to relieve themselves. Dogs might forget how to use the pet door to go outside. Cats might forget where the litter box is.
If you suspect your pet has dementia, the first thing you need to do is to rule out other medical conditions (such as arthritic pain, cancer, hearing or vision loss, hypertension, and chronic kidney disease) that could be confused for dementia, and that may be successfully treated with medication or simple environmental changes.
Loss of house training can be due to aching joints. By the time they are 11 years old, 90% of cats have some degree of osteoarthritis which affects their ability to get into and out of the litter box. The same thing can be true for dogs. A dog with arthritic hips might not be able to squat down and will not want to use a pet door because it may cause pain when it hits his rear end.
Urinary tract infections can contribute to the loss of house training because your pet is in pain or cannot control the flow of urine. A UTI can cause leakage of pee even after they have gone to the bathroom. And pets with kidney disease or diabetes drink more water causing them to urinate frequently which can result in house soiling.
High blood pressure is another issue facing older pets, especially if they have other ailments such as kidney disease or Cushing’s disease (a condition caused by too much adrenal hormone). Just as in people, hypertension takes a toll on blood vessels in the brain.
How to support pets with dementia
A pet with dementia can enjoy an excellent quality of life for years, but, unfortunately, there is no cure for the syndrome in any species, nor are there any medications that target the underlying causes of the condition. However, vets now have medications they can prescribe to help reduce some of the symptoms.
If your pet has dementia, you can limit their confusion and distress by making it easier for them to find everything they need: Maintain a single area with all your pet’s belongings (bed, food and water bowls, toys, and litter box). Improve their environment with ramps to avoid stairs, mats, or rugs to avoid a slippery floor, keep a radio on to help them find their way, etc. Create a daily routine by feeding them and going to bed at regular times. It's particularly important to engage with your pet to give them as much mental and physical stimulation as possible (such as gentle training or puzzle games). Keeping them up during the day can also help them sleep through the night. Avoid dramatic changes to their environment, such as rearranging furniture or redecorating. Any changes need to be introduced slowly to allow them to adjust gradually. Do not get angry with your pet if they get confused or have an accident - it is not intentional.
Your vet may prescribe supplements and diets that include antioxidants (which are believed to support brain health and may help delay the progression of the disease), and medications. The FDA recently approved one drug: Selegilene(Anipryl) which can reduce symptoms of cognitive dysfunction in dogs, and there are other drugs currently being tested to see if any of them can help to prevent, slow, or reverse dementia in animals.
The best thing you can do for your older pet is to be alert to changes in behavior and seek treatment as soon as possible. The earlier you start with medication the better, to try to get the illness under control. The only prevention advice from vets, so far, is to make sure your pet gets plenty of exercise and the healthiest diet you can afford. Both are good for brain health.