What Is Inappropriate Mentation in Cats? Signs, Causes, and Treatment

Cats, unlike dogs, are discerning and less eager to please their owners. A cat probably won't come when called and rarely will even respond to its name. And while a rare forgotten trip to the litter box or food bowl shouldn't be cause for concern, when a cat seems unusually confused, disoriented, or uncoordinated, a visit to the vet is warranted. It could be suffering from acute sickness, a seizure disorder, or could have been exposed to an environmental toxin, causing a temporary lapse of normal behavior. Any abnormal behavior that continues for more than 24 hours or several times per week could be the result of a serious health issue. Note that a neurologic anomaly can only be diagnosed by a vet.

What Is Inappropriate Mentation?

Inappropriate mentation in cats refers to a host of disorders that can lead to disrupted cognitive functioning. This type of brain misfiring can result in memory loss, incoordination, and basic malfunctioning in everyday cat life. Sometimes these issues are small and acute, caused by temporary injury or inflammation. And sometimes brain disorders can be major, resulting in a compromised quality of life. Assessing the signs and discussing your concerns with your vet are the initial steps in the diagnosis and treatment of mentation disorders in cats.

Signs of Inappropriate Mentation

Cats learn by remembering, but a kitten who suffered an head injury early in life may have damaged the portion of the brain that affects short-term memory. A traumatic brain injury could account for difficulty remembering the location of food bowls or litter boxes. It can also explain an unsteady gait, incoordination, and balance issues. Traumatic injuries can also cause stunted growth. A new pet that seems to be on the smaller side for its age and breed, or a kitten who fails to grow, may have previously succumbed an injury. Seizure disorders can also cause disorientation, pacing, and confusion just following an episode. And old age can result in senility, presenting as forgetfulness, anxiety, and uncoordinated behavior. When witnessed over and over again, this could be confused for a more serious brain injury. Some infections (e.g. feline infectious peritonitis) cause damage to the portion of the brain that controls balance and walking. Affected kittens show severe trouble walking, but can otherwise live a normal and happy life.

Causes of Inappropriate Mentation

There is much debate over whether or not a cat can have a mental illness. If your cat's behavior seems off, it could be ill or could have a more serious problem with its nervous system. "Slowness" can be the result of brain damage due to injury, infections, environmental toxins, seizure disorders, genetic mutations, and even cognitive dysfunction in older cats. In the case of brain injury or infection, a functioning cat is a happy cat. If its setback doesn't interfere with your cat's daily functions, there's little you need to do about it. Get a firm diagnosis so you can take appropriate measures to prevent further seizures and neurological damage.

Cognitive dysfunction (or feline dementia) occurs most frequently in cats greater than 9 years old. If you adopt an older cat and feel like its personality is "off," it could be suffering from senility. In addition to general uncoordinated behavior, cats with dementia can also show unnecessary aggression and may display incontinence.

Diagnosis

At the vet's office, any potential brain injury is treated as an emergency, especially if it was a result of head trauma. So in addition to stabilizing your pet, the vet will perform an exam specifically looking at your cat's neurological system. The vet may determine an MRI or CT scan is needed. In the case of environmental toxin exposure—most specifically lead ingestion (which can cause a slew of neurological issues)— your vet will perform a blood test. If you cat has a seizure disorder, bloodwork is also recommended to rule in/out metabolic causes of seizures. MRI scans are done to rule out inflammatory conditions or tumors. Severe seizure cases require an EEG to measure the electrical activity in your cat's brain. For feline dementia, a vet will discuss your cat's full health history and, if necessary, perform blood tests to rule out other health conditions such liver or kidney disease.

Treatment

Any cat that suffers a potential head injury needs to be examined by a veterinarian. A vet will first stabilize the injured kitty using IV fluids and oxygen. However, a full recovery is not always guaranteed. After the injury, your cat may act different, lose its laser-sharp coordination, or have a change in personality. If this happens, the best you can do is provide a loving and supporting environment, reduce stressors, and eliminate unpredictable events as much as possible. Observe your cat's limitations and provide a lifestyle that works within them. Your veterinarian is an excellent resource for options.

Cats exposed to environmental toxins also need to be inspected by a vet, as the extent of exposure could be fatal. Treatment by a vet may include inducing vomiting, feeding your cat charcoal to absorb the toxin, administering IV fluids and medication, and time to process the toxin. If your cat has a full recovery, any neurological signs should eventually subside.

For seizure disorders (brought on by genetic conditions or other), a vet will prescribe medications to control the seizures. Most cats go on to live happy and healthy lives and any post-seizure temperament disorders should be alleviated.

There is currently no cure for feline dementia. Maintaining a good routine, providing options for exercise, and feeding your cat a high-quality food will help treat further decline. Supplements like omega-3 fatty acids, SAMe, and melatonin may improve brain function in older cats and aromatherapy with essential oils can ease anxiety.6 However some oils can be toxic to cats so you must seek your veterinarian's advice before exposing your cat to these products.

If you suspect your pet is sick, call your vet immediately. For health-related questions, always consult your veterinarian, as they have examined your pet, know the pet's health history, and can make the best recommendations for your pet.

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Cat Health

Head Tilt and Disorientation in Cats

Idiopathic Vestibular Disease in Cats

Head tilt is a medical condition that may be indicative of a serious underlying disorder, usually of the vestibular system. If a cat is tilting its head frequently to either side of the body (away from its orientation with the trunk and limbs), this is an indication that the cat feels imbalanced. The cat may even struggle to retain a balanced posture and fall.

A common cause of head tilting in cats are disorders of the vestibular system, a sensory system located in the inner ear which provides information needed to hold the body in an upright position and move about confidently. In essence, the vestibular system "tells the body where it is in relation to earth— whether it is upright, up-side-down, moving, being still, etc.

Symptoms and Types

• Abnormal head posture

• Head tilt to either side

• Stumbling, lack of coordination (ataxia)

• Constantly falling over

• Eye movements erratic, apparent inability to focus

• Circling (turning in circles)

• Nausea, vomiting

Causes

Although the underlying cause for vestibular disease is unknown, the following factors may contribute to the condition:

• Ear injury

• Brain disease

• Metabolic diseases

• Neoplasia (abnormal tissue growth)

• Nutritional deficiencies (e.g., thiamine deficiency)

• Toxicity (e.g., use of toxic antibiotics in the ear)

• Inflammation of the central and inner ear canal due to bacterial, parasitic, or other type of infection

Diagnosis

Your veterinarian will perform a complete standard physical exam, including a blood chemical profile, a complete blood count, a urinalysis and an electrolyte panel. You will also need to give a thorough background history of your cat's health leading up to the onset of symptoms. The results of the blood tests are usually normal, though changes may be present depending on whether there is an existing disease, such as an infection. Further tests will be required to diagnose underlying systemic diseases like thyroid problems, and infections.

Nutritional status will be evaluated, and you will need to recount your cat's normal diet, along with supplements or additional foods you may have fed to your cat. Thiamine deficiency, for example, can be the result of feeding your cat food that does not have B1, the source for thiamine, in its ingredients. Thiamine deficiency can also result from over consumption of raw meats and fish.

To determine if an ear infection is present, your veterinarian will thoroughly examine your cat's ear canal and will take a sample of the material present within the ear canal for further testing. Visual diagnostic tools, X-rays, computed tomography (CT), and magnetic resonance imaging (MRI) may be required to confirm a middle ear disease. Another important test used to diagnose this disease is a cerebrospinal fluid (CSF) analysis. (CSF is a clear, watery liquid that surrounds and protects the brain and spinal cord.) The results of a CSF analysis is useful in the diagnosis of inflammation and/or infection within brain. A bone biopsy may also be performed is an advanced test to confirm the involvement of the bone due to tumor or infection.

Treatment

In case of severe disease, your cat may need to be hospitalized for treatment and supportive care. Fluid replacement therapy is required in patients with fluid deficits due to frequent vomiting. These patients don’t require a special diet except in those cases where some nutritional deficiency is present. For example, thiamine supplements are often required in patients with head tilt due to thiamine deficiency.

In some cases, surgery is required to treat the underlying disease. If an ear infection is present, your veterinarian will prescribe broad-spectrum antibiotics that can enter and eradicate the infection in the brain and middle ear.

Living and Management

The prognosis is highly variable depending on the underlying disease. If the head tilt is due to involvement of the ear, chances for complete recovery are fairly high. In some cases, head tilt may persist. You will bring your cat to your veterinarian for regular follow-up examinations. Follow treatment guidelines strictly and give medications at proper doses and time. Incorrectly medicating your animal is one of the most preventable accidents with pets. In addition, do not use any drug of your own, or any drug that has not been approved by your veterinarian, especially in the ear, as it may complicate symptoms further.

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Senior Dementia in Dogs: Symptoms & Treatment

Senior dementia is a common problem seen in older dogs just like it is in older humans. Similar to Alzheimer's in people, dementia in dogs often results in altered behaviors and memory loss. These changes may affect the quality of life of both the dogs as well as the dog owners but by better understanding what is really occurring, owners may be able to lessen the negative effects of this issue.

What Is Senior Dementia in Dogs?

Senior dementia is formally known as canine cognitive dysfunction (CCD) but is often also referred to as doggy dementia or doggy Alzheimer's. Dementia isn't a disease but rather a collection of symptoms that result in major changes in mood, behavior, and memory. It usually negatively affects the everyday life of a senior dog and is commonly seen to varying degrees as dogs age. The Behavior Clinic at the University of California states that 28% of dogs aged 11 to 12 years display signs of dementia and that likelihood increases to 68% of dogs when they reach ages 15 or 16.

Leticia Fanucchi, DVM, PhD, director of Veterinary Medicine Behavioral Services at Washington State University's Veterinary Teaching Hospital categorizes CCD into four main types:

• Involutive depression: This form is similar to chronic depression in people and results in anxiety.

• Dysthymia: This form results in confusion, disorientation, and sometimes a loss of conscious awareness of the body.

• Hyper-aggressiveness: This form involves the serotonin, or "happy hormone," levels in the brain and usually results in an aggressive dog.

• Confusional syndrome: This form is similar to Alzheimer's in people where a major decline in cognitive function occurs.

Signs

The signs of senior dementia in dogs revolve around the brain changes that occur as a dog ages. These changes may be gradual and worsen as the dog continues to age or they may seem more drastic in nature. Some symptoms also easily go unnoticed until the dog owner is affected by them.

Signs of Senior Dementia in Dogs

• Soiling in the house

• Getting lost in the house/disorientation

• Barking without reason

• Going to the wrong side of the door

• Lack of interaction with people or other pets

• Decrease or lack of appetite

• Lower threshold for aggressive behavior

• Anxiety

• Irregular sleeping patterns

• Staring at the walls

• Pacing/repetitive behaviors

One of the biggest concerns that dog owners who have dogs with dementia note is the loss of house training. As some dogs develop senior dementia they get confused and may start urinating or defecating in the house. This causes frustration for the owner who may in return get upset with their pet. This affects the human-animal bond and ultimately the quality of life of both the pet and the owner.

Other signs of confusion due to senior dementia include disorientation in the home, staring at walls, and going to the hinged side of a door when the dog has known for years which side of the door opens to go through it. Senior dementia can cause a dog who has known its home environment for years to suddenly get lost in rooms or corners of its house.

Vocalizations, including barking, whining, and crying for no apparent reason, are also often seen in dogs with senior dementia. This may be an indication of stress, fear, or anxiety due to the confusion.

Aggressive behaviors may be more common in dogs with dementia due to their lowered threshold of tolerance and patience. Normally patient and willing dogs may suddenly exhibit signs of aggression such as growling and even biting at people and other pets.

Irregular sleeping patterns, repetitive behaviors such as licking and pacing, a decrease in appetite, and even not wanting to interact with other pets or their owners can be additional signs of senior dementia in dogs. These, along with other behaviors, can all put a strain on the relationships owners have with their dogs.

The most common signs of CCD can be remembered with the commonly used acronym DISHA: disorientation, interaction changes, sleep changes, house soiling, and activity level changes.

Causes

The symptoms are a result of changes or damage in the brain but different symptoms and types of dementia may arise from different brain issues. No one entirely understands the complete causes of dementia. However, there are some things that are known due to the similarities between humans and dogs with dementia. Certain proteins that accumulate in the brain around neurons and the breakdown of neurons are two things that disrupt the normal transmission of information in the brain and therefore contribute to senior dementia in dogs.

Getting a Diagnosis

Your veterinarian will rule out other medical issues with your dog before diagnosing CCD. The Quality of Life Scale (or HHHHHMM Scale) is often used to aid owners in determining whether or not their dog has changed as it ages. This scale goes through the signs of dementia and includes a review of the dog's behaviors. Hurt, Hunger, Hydration, Hygiene, Happiness, Mobility and More good days than bad are assessed in the HHHHHMM scale. This scale also helps an owner decide whether or not a pet's quality of life is still good as dementia progresses and may also help an owner decide when euthanasia should be considered.

Treatment and Prevention

There is, unfortunately, no way to reverse the signs of dementia in dogs but there are some nutritional aids that can be administered to help potentially delay brain changes as a dog ages. Antioxidants, omega-3 fatty acids, and medium-chain triglycerides (MCT's) are the main dietary components that are often discussed for brain health. Some experts recommend supplementing dogs before they begin to show signs of senior dementia but there is no specific treatment or preventative regimen. If you are concerned with CCD developing in your senior dog, talk with your veterinarian about possible preventative measures.

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