December 28, 2012

It’s 3am and no one in the house is sleeping. Fluffy, your geriatric cat, has been up howling and screaming for the past hour. Fluffy never used to do this before, but it’s become a nightly ritual. Everyone is exhausted and you’re ready to put Fluffy out on the front porch. What could have prompted this nighttime opera?

The geriatric howling cat is a surprisingly common phenomenon in veterinary medicine. It seems to be exclusively a problem in the aged feline population and there are several things that could be causing it.

1.) Hyperthyroidism

This is the most common metabolic disease in the older cat population. Older cats can develop benign growths, called adenomas, on the thyroid glands; this results in an excess of thyroid hormone released into the bloodstream. This, in turn, can cause Fluffy to develop a hyperactive metabolism. Increased appetite, weight loss, increased water intake and increased urine production can all be symptoms of hyperthyroidism. So can nighttime vocalization. This disease is diagnosed with a simple blood test, and can be easily treated with medication, a prescription low-iodine diet, or a one-time injection of radioactive iodine (the gold standard for hyperthyroidism treatment in humans.)

2.) Vision loss

Our senior kitties can develop cataracts, which can lead to gradual vision loss. For our patients with cataracts, their vision is often worse at night, when there is minimal light. This can lead to Fluffy seeming confused or agitated at night, resulting in excessive vocalization. Cataracts can be eliminated with surgery. If surgical removal of the cataracts is not an option, providing extra light for Fluffy at night may be a good idea. Cataracts can easily be diagnosed by your veterinarian on a routine examination.

If Fluffy acutely seems blind, is stumbling around or bumping into walls, and howling, then she may have experienced retinal detachment; this is a common complication for cats with hypertension, or high blood pressure. This condition can be diagnosed with an ocular exam and blood pressure measurement; sometimes vision can be regained if proper treatment is initiated immediately.

3.) Pain

Pain in cats can be very subtle, and something easily overlooked even by the most seasoned cat owners and veterinarians. Sometimes pain is obvious- it can come in the form of a limp, a cry when Fluffy is touched in a certain area, a lack of appetite. More often, pain in cats, particularly chronic pain such as that seen with arthritis, can be exceedingly difficult to recognize. Subtle changes such as climbing the stairs more slowly, hesitation before jumping up on furniture, and defecating outside the litter box can all be indications of Fluffy’s pain or discomfort. So can nighttime vocalization. Arthritis can be diagnosed via a thorough orthopedic exam by your veterinarian; sometimes radiographs are used to confirm the diagnosis. Veterinarians are becoming more aggressive about pain management in our patients; we have a variety of options for long-term pain management in cats and dogs.

4.) Cognitive dysfunction/Dementia

The veterinary community is starting to recognize that our geriatric pet population can develop dementia, or cognitive dysfunction, as humans do. This is a difficult problem to diagnose in pets, as there are no specific tests to confirm the diagnosis. If all of the other more common causes of nighttime vocalization have been ruled out, we may assume that Fluffy has developed cognitive dysfunction in her latter years. There is, unfortunately, no real cure or specific treatment for dementia in pets. Some supplements such as vitamin E, fish oil and antioxidants may be helpful in preserving brain function. In many cases, managing a cat with dementia is really about managing their environment. Leaving lights on at night, preventing access to stairs so Fluffy can’t fall, providing multiple litter box options in various locations of the home- these can all go a long way to improving Fluffy’s safety, security and may decrease her confusion at night.

There is no need for everyone in the household to be sleep deprived from Fluffy’s nighttime howls. Have Fluffy examined by your veterinarian; with a proper diagnosis and treatment plan, everyone can get a good night’s sleep again!