Pete the Vet: The seven ways to spot dementia in elderly cats and dogs

70% of dogs over the age of 15 are affected.

Just as dementia is common in people, so it is in pets. Over 50% of cats and almost 70% of dogs over the age of 15 are affected, with signs starting from 10 years of age onwards. Vets tend to use the term “cognitive dysfunction syndrome” to describe what’s happening, but the bottom line is that the brain just isn’t working as well as it used to.

It’s easy to put dementia down to simple wear and tear: just as joints, skin, teeth and hair suffer from ageing changes, so does the brain. However, a number of specific changes in brain structure have been identified that are not necessarily directly linked to advancing age.

There’s often an increased accumulation of b (beta) amyloid, which is a neurotoxic protein that accumulates in plaques in the frontal cortex and other important parts of the brain. There are many other factors, but it has been proven in dogs that errors in learning tests are strongly associated with this increased b amyloid deposition, similar what is seen in people with Alzheimer’s disease.

Increased levels of a substance called tau protein have also been noted in demented pets, another feature that is seen in human Alzheimer’s patients.

It has also been shown that vascular changes take place in demented pets’ brains, including mini strokes caused by tiny bleeds and blood clots. Finally, there are altered levels of neurotransmitters in the brain.

Detailed studies are continuing: the ageing brain is complicated and we still have much to learn.

So how do you know if a pet is developing dementia? You can’t quiz them about what they were doing earlier in the day, and you can’t ask them if they remember who you are. Instead, you need to observe their behaviour carefully.

There are seven key areas where elderly pets are known to demonstrate changes when they are suffering from cognitive decline.

1. Spatial disorientation and confusion is often the first sign. Pets start to wander around aimlessly, sometimes staring into the distance at nothing in particular. Sometimes they go to unusual places, like a far corner of the room, where they never used to go.

2. A loss of memory and learned behaviour means that pets start to to to the toilet in inappropriate places, losing the knowledge of where they are supposed to urinate and defecate.

3. Alterations in activity may occur, such as increased random or repetitive activity, or sometimes a decline in activity, with pets sleeping for longer or just lying around more. Often owners notice that their pets are more difficult to wake up. I know people who even think that their pets have passed away and it’s only after a big nudge that they actually stir.

4. Changes in social relationships are often seen, with pets becoming more distant and less responsive to people they used to be close to. Sometimes they can be uncharacteristically restless, irritable or even aggressive. These changes are an area where it’s easy to see parallels with people with dementia.

This can be most distressing for owners: it’s as if their pets don’t know them anymore and they no longer have the same personalities.

5. Changes in sleep-wake cycles are common, with pets waking up in the middle of the night and becoming active (and noisy) as if it’s time for breakfast. This can be very distressing for owners: sleep deprivation is a challenge for us humans. It can be difficult to continue to be loving and caring to an elderly pet who is waking us up night after night.

6. Other common changes in behaviour include excessive vocalisation (dogs barking and howling, cats yowling loudly) and decreased self-grooming (especially in cats).

7. Reduced responsiveness to people engaging with pets can lead to less interest in activities that used to be enjoyable, such as eating, playing or going for walks.

It’s important to remember that there are other possible causes of these types of behavioural changes. For example, cats with high blood pressure (a common problem) often start to vocalise more and this can be effectively treated with a daily tablet.

Painful dental disease or arthritis can stop cats from grooming themselves and urinary incontinence in dogs is a common problem that can often be treated very successfully.

So the first stage of dealing with a suspected case of dementia in a pet is to visit the vet so that other illnesses can be ruled out. This will involve a detailed physical examination, as well as blood and urine tests, and sometimes extra diagnostics such as X-rays and ultrasound. Once the diagnosis has been confirmed, your vet will talk to you about treatment.

I’d love to report that there’s a ground-breaking, dramatically successful treatment for dementia in pets, but sadly this is not the case. There’s no specific therapy to reverse or cure dementia. The best that can be done is to use supportive therapy to keep pets comfortable and perhaps to slow the progression of the problem. Diets containing extra anti- oxidants, vitamins and essential fatty acids may help, and some prescription-only medication may improve the blood flow to the brain or alter the balance of neurotransmitters. As in older humans, it can help to engage the brain more by focussing on regular exercise, the introduction of new toys and games, and more social interactions.

Eventually, pets with advanced dementia lose all pleasure in life and this is an area where vets do have an advantage over doctors: we are allowed to carry out painless euthanasia to put an end to their pain, confusion and distress.