March 24, 2026
Feline Cognitive Dysfunction Syndrome
Senior cat with nighttime vocalization, litter box issues, and disorientation.
When the 18-year-old cat starts yowling at 3 AM.
🐱Feline⚖️3.8 kg🩺Neurology / Geriatrics📋Routine
18yo FS DSH, 3.8kg. Yowling at night, staring at walls, missing the box, seems lost. T4 normal, renal stable on k/d. CDS?
OpenVet
Moderate EvidenceBased on 5 clinical references
🧠LIKELY FELINE CDS — Classic DISHA signs with medical causes ruled out. Multimodal management needed.
DISHA Assessment
- Disorientation — staring at walls, getting lost ✅
- Interaction changes — many cats withdraw or become clingy
- Sleep-wake disruption — nighttime vocalization ✅
- House soiling — missing litter box ✅
- Activity changes — aimless wandering or reduced play
Rule Out Differentials
- Hyperthyroidism — T4 normal ✅ | CKD — stable on renal diet ✅
- Check blood pressure — hypertension causes vocalization and disorientation
- Pain assessment — OA very common at 18; causes vocalization and box avoidance
Management Plan
- SAMe 90 mg PO q24h (Novifit/Denamarin) — neuroprotective
- Environmental changes — nightlights, extra low-entry litter boxes, consistent routine
- Selegiline 0.5 mg/kg PO q24h — if supplements fail after 4–6 weeks (off-label)
- Gabapentin 25–50 mg PO at bedtime — helps nighttime restlessness
💬For the Owner
This is similar to dementia in people — a real brain change, not just 'old age.' We have supplements, environmental changes, and medications that help. Most cats improve within a few weeks.
Sources
📚AAFP Senior Care Guidelines 2021🔬J Feline Med Surg: Feline Cognitive Dysfunction
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