Pharmacologic options to help older cats
Several medications licensed for treating cognitive dysfunction, or cognitive dysfunction syndrome—a catch-all diagnosis for
the behavioral manifestations of brain aging—in dogs are available. But none of these treatments has been licensed for use
in cats. Controlled studies also are lacking.
The available medications focus on promoting more efficient neurochemical signaling (e.g., selegiline, an MAO-B inhibitor),
improved blood flow (e.g., nicergoline and propentofylline) or some combination of these two modalities. Anecdotal extralabel
use of selegiline, nicergoline and propentofylline has been recommended in cats, generally at reduced dosages from those recommended
in dogs. Dosages (oral per day) in cats are as follows:
- Selegiline: 0.25 to 1.0 mg/kg
- Nicergoline: 0.25 to 0.5 mg/kg
- Propentofylline: 12.5 mg/cat.
Once started, if a beneficial effect is noted, treatment is likely to be necessary for life.
For age-related anxiety and distress, treatment with commonly used behavioral medications (e.g., selective serotonin reuptake
inhibitors, tricyclic antidepressants) may not only help but may be essential. When used correctly, these medications help
maintain neuron integrity through second messenger stimulation of neurotrophic factors.
Polyunsaturated fatty acids may play a role in cats as they do in dogs, and there is slight but growing evidence that supplementation
with omega-3 and omega-6 fatty acids may prevent some damage by reactive oxygen species. Certainly, there is evidence that
they help maintain neuron integrity across species. Phosphatidylserine has been shown to have some beneficial effect in aging
dogs, but data are sparse and even sparser in cats. Phosphatidylserine is one of the components of a version of Aktivait (Vet
Plus, United Kingdom; available only online in the United States) now being marketed for cats. A number of companies are currently
developing foods that may enhance brain health in cats and dogs.
What we lack in products for aging cats can be redressed by creativity in behavioral and environmental intervention. To be
maximally effective, we must retrain ourselves to stimulate cats at young ages and to keep them stimulated throughout their
lives. Kittens don't actually age out of their charming, active and clownish selves. These behaviors become more complex and
less obvious to us, so we cease to interact in the same way. We need to change this.
Cats, like all other aging mammals, have improved cognitive function if they are stimulated. Meal feeding for cats may be
mandatory for those with certain health conditions, but if the animal is healthy, we should consider feeding them with puzzle
balls or boards, mazes or anything that encourages cats to hunt, move around and use their brains. Remember the colony cat
experiments from the 1980s: Older cats were happy to problem-solve, and, once rewarded, they learned how to do so every day
for each test.
Conditioning for cats is important. Indeed, old cats that can walk planks and mazes have good muscle tone. Range-of-motion
exercises, massage, aquatic treadmills (for cats that will tolerate them) and water beds (which can help with balance and
epaxial muscle stimulation) are underexploited in feline stimulation.
Additionally, cats have an exquisite sense of smell. The health of olfactory neurons may be improved by encouraging cats to
use their sense of smell. For example, routinely dragging a sardine on a string through the grass for the cat to track may
help maintain neuron health and interest. There are creative adaptations of this paradigm for even the smallest apartment.
Cats that enjoy the outdoors as youngsters do not have to give that up as oldsters. Several buggies, carriages and bicycle
accoutrements are available that allow people to transport pets. And even if older pets no longer can see the beach or hear
the surf, they surely can feel and smell the air. The tactile and olfactory stimulation of other pets also likely plays an
underestimated role for aging cats. Providing cats with soft surfaces to rub against and bedding of varying textures and temperatures
(through judicious placement of warm gel inserts) can encourage cats to move and explore. If stimulation is important, we
need to exploit all aspects of it, providing no distress is involved.
If we want cats to age successfully, we must plan for it when they are kittens. All of the interventions that will render
healthier cognitive abilities as a cat ages will, in turn, improve the animal's welfare and the quality of its intellectual
life, regardless of age.
Dr. Overall, faculty member at the University of Pennsylvania, has given hundreds of national and international presentations on behavioral
medicine. She is diplomate of the American College of Veterinary Behavior (ACVB) and is board certified by the Animal Behavior
Society (ABS) as an Applied Animal Behaviorist.
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