CDS in Cats

Did you know cats can get “Alzheimer’s disease”?

Author: Dr. Alissa Bally (DVM)

Trinidad and Tobago Veterinary Association

There has been an increase in the elderly feline population (cats over 11 years old) due to improved nutrition, health care and changes in management systems. The expansion of the geriatric population brings with it increased numbers of cats with alteration in behavior and evident senility which can result from numerous disorders, one of which is Cognitive Dysfunction Syndrome (CDS), this is the equivalent to Alzheimer’s disease in humans. CDS is an age-related neurodegenerative (deterioration of the nervous system, especially the nerves in the brain) disorder characterized by cognitive decline and behavioral changes unrelated to any medical issue. Approximately 28% of cats aged 11-14 years old and 50% of cats aged ≥15 years old will develop behavioral problems.

Causes of Feline Cognitive Dysfunction Syndrome

The causes of feline CDS is not 100% certain, however, recent research indicates it is very similar to that of Alzheimer’s disease in people. Many mechanisms can cause brain ageing and it can occur singularly or in combination, a few examples include:

  1. Vascular changes that alters blood flow in the brain.
  2. Age-related deterioration of mitochondrial efficiency (mitochondria is the part of a cell that produces energy); this results in reduced energy generation and buildup of toxic free radicals (reactive oxygen species). There can be decreased clearance of the free-radicals due to illness, advancing age and stress. This surplus of free radicals reacts with deoxyribonucleic acid (DNA), lipids and proteins which can particularly affect the brain leading to cellular damage, dysfunction and mutation.
  3. Senile plaques can form by the accumulation of certain proteins (for example β-amyloid), that can gather around the meninges (the protective tissue covering the brain and spinal cord) and blood vessels, this plays a role in the development and progression of the disease and has been linked to altered behavior in cats.

Clinical Signs/Symptoms of Feline Cognitive Dysfunction Syndrome

The classic clinical signs of CDS in cats are referred to by the acronym DISHA. The cat may be disoriented, confused, and seem to be lost in familiar environments, there is alteration in the interactions between owners and other animals (decreased/increased desire for affection, increased aggression, irritability), sleep-wake disturbances can occur with increased vocalization especially at night, housesoiling, and changes in activity can arise for example less grooming, restlessness, pacing, and endless wandering. Some cat owners may report that their cat has increased anxiety and deficits in learning and memory; cats may forget that they were fed, also, spatial disorientation can occur where the cat would stare at a wall or get trapped in corners.

Tips for Cat Owners

Have you ever heard a strange noise coming from your car while driving, and when you go to the mechanic, the noise suddenly stops and the mechanic is unable to hear it, but, on the way back home, the strange noise starts again? Frustrating isn’t it? This example can also be used to describe cats within the environment of a veterinary clinic. Cats can become very stressed in the consultation room and behavioral signs may not be evident on presentation to the veterinarian, therefore, you should video record any changes in the cat’s behavior at home as this demonstrates a more accurate depiction of the clinical signs so the veterinarian will have a clearer picture of what is happening to your pet cat.

It is important to talk to your veterinarian about what is normal from abnormal behaviors, this would enhance your ability to recognize the early clinical signs of CDS. Always note and report any behavioral changes as soon as possible to your veterinarian for prompt diagnostic evaluation that will aid in the early detection of CDS and inform proper treatment/management of the disease.

Diagnosis of Feline Cognitive Dysfunction Syndrome

There are no specific diagnostic tests for CDS in geriatric cats, this makes the diagnosis of CDS complicated because many concurrent and interacting disorders/diseases can coexist with and worsen the clinical signs/symptoms of CDS. CDS becomes a diagnosis of exclusion prompting a thorough investigation for any underlying diseases.

Treatment and Management of Feline Cognitive Dysfunction Syndrome

Cat owners must be aware that treatment of CDS is an ongoing process and necessary for the remainder of the cat’s life because the medical treatment and environmental intervention can slow disease progression. Treatment options consists mainly of pharmacotherapy, dietary and nutritional modification and environmental management.


You may want to take your aging cat to visit the veterinarian a bit more often. Your veterinarian may prescribe a medication called Selegiline or Propentofylline to improve brain function. Always consult a veterinarian to determine the most appropriate treatment regimen for the cat.

Dietary and Nutritional Modification

Studies have shown that diets rich in vitamin E, omega-3 fatty acids, beta carotene and essential fatty acids (antioxidants) reduces oxidative damage and β-amyloid production, also, vitamins C and B12 is shown to improve cognition, therefore, always ensure that your elderly cat’s diet is plentiful in the above nutrients.

Environmental Management

All cat owners must know the importance of providing the key resources for cats such as food, water, resting places, litter boxes, and hiding places or exit routes, also, provision of environmental enrichment (toys, scratching posts etc.) produces positive effects such as mental stimulation, increased growth and survival of nerves and improved cognitive function.

Inconsistencies with the management of the environment can negatively impact the health and well-being of cats with CDS. If you have an elderly cat in your home, it will be prudent to keep your arrangement/environment consistent, for example, younger cats may find rearranged furniture intriguing, however, older felines may be disoriented by sudden changes. With this said, never move key resources from their usual place as this causes heightened anxiety and confusion in cats with CDS which consequently antagonizes any improvement sought from enrichment, therefore, changes must be done gradually with reassurance.

Tips for Cat Owners

  1. Raise food and water bowls so that your elderly cat can drink and eat more comfortably.
  2. Pet water fountains can be useful as the sound of running water can stimulate the cat to drink more, also, pet feeders can enhance feeding time (although it may add stress if introduced too late in the cat’s life).
  3. Provide warm and soft bedding for resting and hiding places and add ramps for easy access as cats prefer sleeping places that are above the floor. Never disturb cats if they are in their hiding place as it must remain a place of safety if they are stressed.
  4. Provide litter boxes with low sides for easy access and ensure there is a litter box on each level of the house, this prevents housesoiling.
  5. To promote better sleep and maintain sleep-wake cycles, owners should encourage daily interactive play sessions (this also strengthens the cat-human bond) before bed and decrease exposure to artificial light at night.
  6. Introduction of new pets is not recommended as it increases stress in elderly cats.
  7. Make your home more senior-friendly by applying nonslip padding to slippery floors.
  8. Ask your veterinarian about using Feliway sprays or diffusers which contains a pheromone that aids in decreasing anxiety and it helps to create and maintain a state of well-being and calm in cats with CDS.


It is important that cat owners (especially new/inexperienced cat owners) recognize and report behavioral changes early on in the cat’s life because this is paramount in establishing a prompt diagnosis and initiating successful treatment and management of CDS.