How to look after an old cat – comprehensive page focusing on health issues

As domestic cats are living longer thanks to better nutrition and veterinary care together with better educated cat caregivers, there are going to be more elderly cats requiring specialist care from their human caregiver.

This page is in two parts as it has been updated, upgraded, checked and added-to as at January 9, 2022, at which stage it has also been republished.

Pops an elderly rescue cat
Pops an elderly rescue cat
Until September 7th I will give 10 cents to an animal charity for every comment. It is a way to help animal welfare without much effort at no cost. Comments help this website too, which is about animal welfare.

Health and the senior cat – the focus on caretaking

Domestic cats over 10-years-of-age make up one third or more of the owned cat population. Dr. Bruce Fogle DVM (Complete Cat Care) says that at his practice cats over 10 years of age make up over 50% of all the cats that he sees. Clearly, we are in the age of elderly cats. This is mirrored somewhat in the human population.

Elderly or senior cats are, like humans, much more predisposed towards contracting chronic illnesses such as arthritis, chronic kidney disease, heart disease, overactive thyroid glands, cancers and senility. There are other diseases which affect older cats such as lower urinary tract problems, tooth and gum disease, perhaps diabetes caused by obesity or by a permanent dry cat food which is high in carbohydrates.

Dr. Fogle says that looking after an elderly cat can be like looking after a “cross between a little child and an elderly relative”.

Arthritis

A common complaint with senior cats is arthritis. Studies indicate that radiographs of older cats reveal that 90% of them over the age of 12 have evidence of degenerative joint disease. Osteoarthritis is therefore very common in senior cats. It is perhaps under-diagnosed.

Thomas a 26-year-old rescue cat
26-year-old Thomas. Photo: Laura.

Some breeds such as the Maine Coon are predisposed to develop arthritis in specific joints such as the hip in Maine Coon cats because they can develop hip dysplasia. Arthritis of the knee apparently is not that uncommon in elderly Abyssinian cats. And Scottish Fold cats are prone to arthritis in many joints. Burmese cats cats can suffer from arthritis of the elbow more than other breeds.

Arthritis in a cat
Arthritis in a cat. Picture by Annie Mole

Bearing this in mind, it’s important to watch a senior cat carefully to look out for signs of discomfort when moving and jumping. If they suffer from a joint that hurts them, they will reduce their physical activity. They become more passive and they hide their pain.

You should watch out for:

  • Hesitation when jumping up or down;
  • An unwillingness to jump up or down from furniture;
  • A general reduction in physical activity;
  • Playing less or going outside less, if allowed outside;
  • Less hunting and exploring;
  • Licking more at specific joints in an effort to reduce discomfort and pain;
  • Self-grooming less often;
  • More matted hair especially those areas that require the body to be contorted to get to them;
  • Sleeping in more accessible places;
  • Difficulties using the cat flap;
  • Mistakes in using the cat litter especially when it is high-sided;
  • Increased irritability particularly when being stroked or touched;
  • A reduction in the enjoyment of being patted and stroked and
  • Ingrowing claws due to reduced activity.

A caregiver can do specific things to help alleviate the difficulties that an arthritic domestic cat has to endure. They can provide medication, and dietary advice can be provided by a veterinarian. Soft, warm and comfortable beds that are easily accessible will be appreciated. An arthritic cat may particularly enjoy an igloo bed. You can buy microwaveable warmers to make it cosier. You may provide steps up to a radiator hammock. Higher places can be made accessible with carpeted steps or a carpeted ramp. A small ramp on both sides of a cat flap may make it more usable. The litter tray should have low sides and should be indoors if they used one outdoors. The litter substrate might be softer to make it more comfortable.

The litter tray, food and water should all be on the same floor. Grooming your cat should be done with gentleness and the paws should be checked for ingrowing claws. It is likely that they will be ingrowing and it can be painful for a cat to have these trimmed. It’s a question of doing it very gently and precisely. Sometimes in growing claws puncture the paw pads.

As for diet, there is a plethora of customised foods for elderly cats on the market. And you can buy nutritional joint supplements which are specifically formulated for senior cats with joint problems. They normally contain essential fatty acids which reduce inflammation and glucosamine and chondroitin which help to improve cartilage quality. Antioxidants help to reduce free radical damage. These dietary supplements may help but there have been no studies on cats on this topic but there have been studies on people and they’ve been shown to be helpful.

Most cats with arthritis are over 12-years-of-age. They may have other medical conditions such as kidney failure which is very common.

There is an anti-inflammatory non-steroid drug called meloxicam which may help but it should be used with caution and under experienced veterinary care. Please do your research on this before using it. If the drug is provided the cat should be encouraged to drink more water. Perhaps a switch to wet cat food is appropriate.

You might consider acupuncture. This will definitely be a personal choice because some people don’t believe in it but it is worth a try.

Weight

Like humans, cats can put on weight when they become elderly. A good cat caregiver will watch their cat’s weight and that they are overweight, weight loss should be conducted with care. It should be a slow process to avoid hepatic lipidosis in which fat accumulates are dangerously high levels in the liver.

Kidney failure

Chronic kidney failure is a massive issue in elderly cats. One of my late cats died of kidney failure. You can watch out for this by observing how much water they drink and how often they drink. The water simply passes through them when the kidneys fail. There a question mark in my mind as to whether cats with kidney failure feel pain. They must at least feel discomfort. The cause of kidney failure in elderly cats is stated to be unknown. 20% of cats over 15 years of age have chronic kidney failure. It is three times more common in cat than it is in dogs. And it’s worth noting that up to 3/4 of all kidney tissue has been destroyed by the time you see visible signs of kidney failure.

Other signs of kidney failure are: weight loss, a lowering of interest in food, increased thirst and drinking as mentioned above, peeing more often and a dull coat. Action needs to be taken. Failure to act will lead to more dramatic signs such as vomiting, foul-smelling breath, mouth ulcers and perhaps convulsions.

Cats with kidney failure may also be anaemic and have high blood pressure.

You can buy specially formulated commercial kidney and renal diets. They are low in phosphate which helps to protect the kidneys from further damage. And they contain potentially beneficial fibre and unsaturated fatty acids.

Warming up food is a great trick to help make the food more palatable and interesting to a cat who has lost his appetite.

HCM

Senior cats are also more likely to suffer from hypertrophic cardiomyopathy (HCM) and high blood pressure. This is called hypertension and is common in older cats and can damage blood vessels. The signs of heart disease are loss of appetite, breathlessness and lethargy. If you think that your cat has been hit by a car, it may be that she has suffered a complication of cardiomyopathy in that blood clots have formed and become trapped in smaller arteries which supply the hind legs.

Freddie a Maine Coon who carries a mutated gene causing HCM. This is Kathy Janson's husband Michael and Freddie
Freddie a Maine Coon who carries a mutated gene causing HCM. This is Kathy Janson’s husband Michael and Freddie. Photo: Credit: University of Cincinnati.

An overactive thyroid causing hyperthyroidism is a very common disease in older cats. It’s caused by an overproduction of thyroid hormones from enlarged thyroid glands. It is rarely seen in cats less than seven years of age. You will see increased activity, restlessness and irritability. I have a page on hyperthyroidism. Please click on this link to read it. Elderly cats also more likely to suffer from cancers and tumours.

Senility

As in humans, dementia in domestic cats in old age is increasingly common. The signs of senility are subtle. Below is a list of some possible signs.

  • A blank expression;
  • Stereotyped placing;
  • Lack of grooming;
  • Disorientation as shown in a delay in recognising familiar people or places;
  • Becoming lost in familiar places;
  • Increased daytime sleeping;
  • Less sleeping at night;
  • More disturbed sleep;
  • Howling at night due to confusion;
  • Less enthusiasm when greeting you;
  • Response rate is decreased;
  • Playing less with their human caregiver or other companion animal;
  • Irritability;
  • Ending social interactions prematurely.

Feline senility is also referred to as cognitive dysfunction or CD. It’s a gradual process. Treatment in the early stages can be useful. CD can be confused with arthritis because of a cat’s reduced activities and chronic pain.

The brain is susceptible to damage from free radicals. Chronic free radical damage can lead to senility and Alzheimer’s disease in cats. Free radical scavengers include special enzymes, and vitamins A, C and E together with the mineral selenium and zinc.

Pain

Pain in senior cats can be reduced with non-steroid anti-inflammatory drugs when used properly and safely under veterinary supervision. Also, Dr. Fogle tells me that anti-anxiety drugs such as amitriptyline and diazepam (Valium) may reduce apparent pain 10% of senior cats. The same effect takes place on people.

Environmental enrichment and stimulation

Environmental enrichment, of which a lot is spoken, can also benefit the senior cat. It includes playing, stroking and talking to your cat and giving them new toys. Interactive feeders may be useful. Introducing a more exciting environment may help because it helps to increase nerve connections between nerves and therefore less dementia.

Diet supplement such as antioxidants, chicory root and essential fatty acids resulted (in research) cats living longer and healthier than un-supplemented cats. Most pet food manufacturers provide supplemented diets for senior cats. They may be useful in delaying the onset of CD.

However, changes to an elderly cat’s environment should be resisted at a fundamental level because it will cause stress and disorientation. Changes to the environment should be to make it easier and more exciting within the existing framework.

Off-label drugs

To the best of my knowledge there are no drugs licensed for cats with senility. Off-label drugs are sometimes prescribed by veterinarians including selegiline, propentofylline and nicergoline. These drugs are available in the UK. I don’t know about the USA. However, the American Association of Feline Practitioners supports the use of selegiline. Sometimes diazepam is used as is amitriptyline and buspirone.

Nighttime howling

To reduce night-time howling (mentioned above in the table) an idea is to provide a relatively small and secure area for your senior cat. Perhaps the bedroom where the cat caregiver sleeps or the kitchen. Replace the cat’s bed in a warm spot and make it very comfortable and warm. Feed your cat four meals a day and the last meal just before bedtime. Place your cat in their bed and then leave her and don’t respond to yowling. The idea is that responding to yowling encourages yowling. Personally, I would allow my cat to sleep on my bed with me for both reassurance and warmth. It can reduce night-time yowling as well.

Other tips to improve the life of your scene are:

  • Discuss the issues with your veterinarian if you feel up to it! You can work out a plan including health checkups;
  • Provide two litter trays in locations convenient for your cat;
  • Use nonslip rugs on slippery floors;
  • Feed more frequently but smaller amounts, for example 4 times a day;
  • Trim the claws to avoid them penetrating the paw pad;
  • Provide at least two beds in accessible locations within fleece bedding;
  • Play and try and stimulate your cat for a few minutes at least two times per day;
  • You might consider getting another cat but this is considered to be a bad idea for a senior cat with possible dementia;
  • Stick to routines and rhythms to reassure your cat;
  • If you go on holiday it’s best that you have a cat sitter because going to a boarding cattery can be stressful especially for senior cat with dementia causing confusion;
  • On warm days you can both sit outside and allow him or her to enjoy the warmth and the outdoors.

Early post (2009) on how to look after an old cat – there will be an overlap with the above

Well, some people think that there are things we can do and I’ll list them. But they all really simply translate to being aware of our cat’s health and diminishing abilities and accepting that old age brings change. One of those changes is the coat. And another is being less active, which can mean a tendency to put on weight. But (and this is my personal viewpoint) we should not try and “shoe horn” an older cat into a young cat’s body. We change shape as we get older and so should a cat. It is natural.

Sometimes I feel that we tend to treat cats as robots and think of them as all the same. That said, being overweight is to be resisted. These are the conventional thoughts on how to look after an old cat:

  • Regular vet visits and blood work are recommended. This can pick up health problems early. Trouble is money doesn’t grow on trees especially at this particular time.
  • Be aware of our cats gradual change by making mental comparisons to the way it was.
  • Buy senior cat food. I am personally a bit skeptical about the benefits of senior cat food. It is more a marketing ploy but I am sure there is an intended benefit to the cat as well.
  • As usual always renew her water bowl. Water should be fresh and in a clean bowl.
  • Sometimes certain drugs can help such as glucosamin and chondroitin, which are good for healthy joints; plus non-steroid anti-inflammatories. I would always treat drugs with caution though. Minimize drugs for obvious reasons.
  • Getting older can mean that the cat becomes more nervous and this can mean more aggression that can be misconstrued by us.
  • Old age can bring on cognitive dysfunction syndrome. This is the same for humans e.g. Alzheimer’s. This might lead to symptoms such as disorientation etc. A vet can advise.
  • The coat becomes dryer making grooming (always important) even more important.
  • Play is also always important for mental and physical activity. Regular sessions are best but I realise that in practice finding time can be factor.
  • Maintain an interesting environment.
  • Watch for dental hygiene. My cat has good teeth (lucky) but some are predisposed to bad teeth.
  • Watch for ingrowing claws. These occur in elderly cats because they are less active and their front claws do not wear down. In fact, this problem will occur at least potentially in awful-time indoor cats.
  • Above all love her or him unconditionally and gently. This will keep them relaxed and feeling secure. That, bottom line, is how to look after an old cat.

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