This article was originally published in the October 2015 issue of Feline Focus and is reprinted with permission from International Cat Care. Feline Focus is the online veterinary nursing journal of the International Society of Feline Medicine. Subscription is free for all veterinary technicians. Find out more at icatcare.org/nurses/membership.
Half of the cats in the United Kingdom are over 8 years old, and it is not uncommon for cats to live into their early 20s. This aging cat demographic is likely representative of cat populations in other countries. Veterinary nurses and technicians can play a key role, through clinics and nurse consultations, in assisting owners of older cats to manage their changing needs and monitor for the subtle signs of disease to ensure early identification and treatment. Environmental modifications for older cats can be easily made and improve the quality of life for older cats.
There is no specific age at which cats become elderly, as the aging process is very individual, but 3 older life stages have been identified1:
- Mature (7–10 years)
- Senior (11–14 years)
- Geriatric (15+ years)
This article discusses the changes that come with aging, common behavioral problems in this group of cats, and how veterinary nurses and technicians can educate owners on caring for their cat during their advancing years.
How Does Aging Affect a Cat?
With increasing age there are many physical changes that take place, all of which potentially impact on a cat’s normal patterns of behavior, including2:
- Ability to smell and taste food
- Ability to digest fat and protein
- Immune function (making the elderly more vulnerable to infections)
- Skin elasticity
- Heart and lung function
- Tolerance to distress (chronic stress)
- Changes to eyes, such as iris pigment changes and nuclear sclerosis
- Brittle nails
Common behavior patterns observed in the elderly may all be attributed to these physiologic changes; these include:
- Reduction in hunting
- Reduction in general activity levels
- Less time spent outdoors
- Sleeping for longer periods
- Reduced appetite; fussier about food
- Playing and grooming less
- Altered sociability
- Increased insecurity
- Lack of adaptability to change
- Increased vocalization
- Increased dependency on, or attachment to, the owner
It is important that owners appreciate that behavioral changes can occur as a direct result of illness. For example, increased thirst and appetite are commonly seen in cats suffering from diabetes mellitus. Other signs that may indicate a physical problem include:
- Stiffness, lameness, or difficulty in jumping up
- Lumps or swellings
- Balance problems
- Toilet accidents
- Difficulty passing urine or feces
- Disorientation or distress
- Weight loss
- Uncharacteristic behavior (e.g., hiding, aggression, excessive vocalization)
General Tips for Elderly Cat Maintenance
This is the time, more than any other, when a cat needs essential care and regular monitoring at home. As cats get older they will find it more difficult to maintain their own cleanliness. The owners can assist them by regularly trimming claws (FIGURE 1) and grooming gently in areas that the cat can no longer reach. Early identification of problems leads to improved healthcare if owners check their cat’s teeth regularly, monitor their toilet habits, and check for general warning signs such as loss of appetite, weight loss, excessive drinking, etc.
Stimulating the Older Cat
Caring for an elderly cat is not all about monitoring for signs of disease. Many owners believe that physical and mental exercise is no longer beneficial, yet encouraging activity can maintain and prolong good health. It is arguably more important at this age as time spent hunting and patrolling territory will decrease, often resulting in more sleep to fill the void. Regular activity helps to retain muscle mass (which can decrease pain from osteoarthritis) and aids circulation; it is also useful to assist bladder and bowel function in the elderly.
Exercise can be interactive or solitary and take the form of predatory play, exploration of new objects, patrolling, or foraging for food. The nature of the activity undertaken should be appropriate for the cat’s age and mobility;3 gentle and regular playtime for short periods is the most suitable regimen. Large toys for self-play can be useful to encourage the elderly cat to grab and kick, giving important “range of movement” exercise for stiff hindlimbs (FIGURE 2).
Cardboard boxes, a favorite for many cats, can be adapted for the elderly to take into account lack of flexibility. Larger boxes on their side, or those with a shallow entrance, will be easier to access. If part or all of the cat’s diet consists of dry kibble, then they may enjoy a challenge to acquire some of their daily ration. Placing kibble or biscuits inside cardboard egg boxes, tubes, or paper bags requires some paw dexterity to remove them.
Making the Home and Garden Elderly Cat Friendly
Small adaptations to an elderly cat’s existing resources can make a significant difference to quality of life. If they are finding stairs difficult to negotiate, then they may be spending prolonged periods on one level, either up- or downstairs. Ensuring that all their needs are met on that one level will avoid any risk of being unable to access important resources.
Many cats become increasingly insecure as they get older, and this may lead to greater demands of the relationship with their owners. Routine activities and predictable social contact will help the older cat feel more secure.
Food and Water
Food bowls should be located well away from litter trays, thoroughfares, full-length glass windows, and cat flaps. Ideally, they should be placed so that the cat can approach the bowl from any direction, thereby avoiding the need to have their back to any other cats that may be in the household. If the bowl is positioned on a raised platform, the cat will not need to lower its head in order to drink or eat and this will make it easier to do so for those with stiffness or discomfort in the neck, shoulders, or forelimbs. Elderly cats are more likely to become dehydrated, so the availability of attractive sources of water is essential. Water bowls should be placed away from the feeding areas.
Many behaviorists recommend that litter trays be provided in the formula of one per cat (or one per identified social group) in the household plus one extra.4 They should be located in different areas so that it is not possible for one cat to prevent another from having access to a litter tray. In the case of a single-cat household, two trays can be positioned in close proximity to each other. For the very elderly, or those cats suffering from cognitive dysfunction, it is appropriate for all of the cat’s resources to be located in easy reach of the cat to avoid confusion.
Covered trays (those with hoods and flap entrances) can be difficult to negotiate. Open trays with low sides are ideal,5 and they should be firmly fixed to prevent them from being tipped up if the cat is clumsy when using a tray. Polythene litter tray liners should be avoided as they can catch in a cat’s claws. Indoor trays should be cleaned regularly (BOX 1).4
Elderly cats are less likely to use vertical scratching posts, so alternative surfaces must be provided that enable the cat to scratch and exercise on horizontal surfaces. Activity centers may still be appealing as high perches, but gradual steps should be placed alongside for ease of access.
Laminate, wood, or tile floors can be slippery and loop pile carpet may get caught in a cat’s claws. Cut pile carpets are less problematic, so strategic use of runners for those cats having difficulty will be helpful.
Cats love to view outdoors, and most enjoy sitting on high windowsills. Jumping up can prove difficult if not impossible for some, so provision should be made for easy access up to and down from these favorite lookouts. A series of shallow steps offers the best solution.5 If steps are built to reach a particular area, the distance should be measured and the height of each step calculated based on a 3-step unit (usually the device becomes bulky if there are any more than 3 steps). The steps should be constructed in such a way that they will support the cat’s weight and be comfortable to use (FIGURE 3).
In the 1995 Elderly Cat Survey, owners reported that most of their cats (79.1%) had a favorite place to sleep; and when asked where their cat liked to sleep, almost all owners reported that it was somewhere warm and comfortable (BOX 2 and TABLE 1).
TABLE 1 Favorite Places to Sleep from the Elderly Cat Survey
|FAVORITE PLACE TO SLEEP||No. (%)|
|Warm (e.g., in the sun; airing cupboard;
by the radiator, boiler, or fire; on lap)
|Owner’s bed||340 (26.5)|
|Soft furnishings (e.g., chair, sofa)||273 (21.2)|
|“Cat” bed/basket/cradle/hammock||87 (6.8)|
|Garden or outside||83 (6.5)|
|Varies with the weather/cat’s mood||53 (4.1)|
|Box/cardboard box||39 (3.0)|
If a cat uses the owner’s bed, chair, or sofa, it is useful to provide a thermal blanket that is warm and washable. If a cat likes to sleep on window sills or other narrow platforms, it is advisable to place a soft padded object on the ground underneath to prevent injury, as many older cats have impaired balance and could easily fall; ideally, elderly cats should be encouraged to use secure or wider surfaces for sleep. Heated pads or beds may be beneficial to those elderly cats that are underweight or arthritic.
Cats need to be able to have uninterrupted rest, and occasionally this needs to be in a place well away from children, family, and other pets in the household. These areas should be kept accessible and new ones created if lack of mobility prevents a cat from using those previously favored. Private places, like beds, should be warm and padded, and the cat should not be approached when it is there unless the owner has any concerns about its well-being.
Some elderly cats will reduce the frequency of excursions outside purely as a result of difficulty negotiating the cat flap. It may be helpful to build a step, inside and outside (FIGURE 4), to make it easier to use the flap, but eventually the cat flap may be replaced by escorted trips into the garden. When this occurs, if no other cats in the household are using the flap, it would be advisable to block off or remove it to prevent invasion from other cats outside, which can distress the elderly resident.
Other cats in their territory may deter the older cat from going outside. If the garden can be secured, it will exclude other cats and contain the resident cat within the safety of its own property.
Most systems for securing a garden require 6-foot fencing or boundary walls of an equivalent height to be present along the entire perimeter (FIGURE 5). Trees and sheds may also be an issue as many are positioned in close proximity to boundary fences, and this can provide an entry route for cats from outside. There are several commercially available systems that may be suitable for the elderly.
With any securing system, gates that give access to the garden will have to have similar treatment to ensure the area really is cat proof. Gaps below the fence, holes in fencing, and holes that are dug under fencing by wildlife all represent possible escape or entry routes and must be identified and blocked accordingly.
Once the owner is satisfied that their garden is secure, or they wish to escort their cat outside and supervise excursions, they can then concentrate on ensuring that the area provides everything the cat needs. Positioning a selection of pots and tubs near the exit and entry point to the house (e.g., near the cat flap or door) provides immediate protection for an elderly cat to allow it to survey the area before moving away from the safety of the home. Borders should be stocked with a variety of plants and dense shrubbery to provide the cat with private areas, shade in hot weather, and protection from rain.
A weatherproof container can be left outside to collect rainwater, which the cat can use as a water bowl. Any fishponds should be protected with cat-proof netting and, ideally, a small fence around its perimeter. If the garden does not have a lawn, then grass can be grown in pots. In good weather conditions, the elderly cat may appreciate an attractive outdoor toilet near to the house (BOX 3).
Common Behavioral Problems in the Elderly
Over a quarter of cats aged 11 to 14 and half of cats over 15 develop at least one age-related “problem behavior.”6 Those behaviors that, in the author’s behavior referral practice, are seen most commonly in elderly cats include:
- Urination and defecation outside of any provided litter facilities (house soiling)
- Excessive night-time vocalization
- Attention-seeking behaviors motivated by or resulting from over-attachment
- Abnormal/unusual/unacceptable behavior associated with disease
Most behavioral problems seen in elderly cats have a physical origin and, therefore, a thorough veterinary examination is essential to rule out disease before referring the patient to a suitably qualified behaviorist with a particular interest in cats.
The elderly cat population has specific requirements, for both preventive and general health care, that take into consideration the physical and emotional changes that take place as a result of the aging process. Veterinary nurses are well equipped to provide their clients with support and guidance regarding the best way to care for these cats.