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Citaat:

Thank you for your question. I haven’t heard back from you and appear off line. Therefore, I do want to leave my thoughts on her situation with you. If you can answer my questions, this will give me a better idea of her situation and hopefully help us narrow down her differential list. If she has become restless, pacing, mentally lost, and vocalizing, there are a few issues we do need to consider.

The main ones would be hypertension (high blood pressure), a behaviour issue (less likely if she appears to be confused/not all there), or a brain based disease. First, it isn’t uncommon to find older cats demonstrating disorientation with vocalizing when they are suffering from hypertension (high blood pressure). High blood pressure can be an old age change but can also be precipitated by underlying kidney issues, heart issues, or metabolic conditions like hyperthyroidism. Humans with this condition often report dizziness, headaches, confusion and disorientation, and it is suspect that these symptoms also feature in the feline version of this condition (though they cannot tell us). To rule this out, you do want your vet to check her blood pressure, as well as rule out those primary instigating conditions. The former is quite non-invasive (quite similar to how we take blood pressures in people) and the latter can be determined via examination and blood sample (or you can also rule out kidney troubles with a urine sample). Depending on the findings, your vet can medically manage high blood pressure and support any of the differentials that can trigger it.

Now since she is older and there is potentially a compulsive pacing issue here, I cannot rule out brain based disease. Now there are a range of intracranial issues that can cause cats to appear less responsive, disoriented and can cause them to circle (usually in one particular direction, but not always). The kind of issues of this nature we have to consider can be divided into two categories: solitary lesions (masses, brain bleeds, clots, focal trauma, parasitic cysts, etc) and diffuse lesions (brain swelling, metabolic diseases –hormonal or organ disease causing toxin build up, toxins, etc). Some of these conditions can induce more specific signs that can give your vet an idea where it is in the brain and what it is causing the issue. Specifically, they can cause seizures, but can also head tilts, head turns, circling, and nystagmus (often the fast phase of the flickering will be in the direction opposite the lesion).

For brain differentials, a veterinary neurological examination can usually help localize the lesion. (taking a video at home on your phone or camcorder can also help the vet see what you are seeing with her). If a bleed or swelling is to blame, anti-inflammatories can be helpful. If a tumor is to blame, the associated swelling should also be treated, but removal of the mass or chemo would be indicated. If she is clear from hypertension (and its related diseases) and we are able to remove brain based disease from our worries, then we can focus on the 'harder to diagnose' conditions that can be associated with old age. In older cats, the change in environment, loss of feline company, and coping with her own older age (ie. sight deterioration, mental confusion, etc), can sometimes be daunting for kitties. And if she is a stressy cat historically, she may be struggling to get used to all the change. And there are things we can do to help support her, with this situation. To give her the feeling of a peaceful safe environment, you might want to consider some de-stressing tools. Feliway, (also known as Comfort Zone in the US pet stores) is a synthetic cat pheromone that helps to soothe kitty anxiety. This can be used as a spray (that can be used on furniture or her cat bed) or a plug-in diffuser (that can be used in the room she is in most often). This may just be enough to soothe her and help her cope with being in this living situation. As well, there is also a diet on the market called Calm by Royal Canin. This contains a number of supplements that have been found to provide stress relief to cats.

As well, there are nutritional supplements like Zylkene (which you mix into their food), which use a casein protein to soothe anxious cats. Overall, I would say that it is a good idea to get her vet involved at this point and identify what the underlying issue is for these changes before they can progress. If she is due a booster soon, then moving up that appointment would be an option. Overall, it would worth having your vet perform a neurological examination to rule out brain issues, potentially check her blood pressure (and the back of her eyes since we can see changes caused by high blood pressure), and possibly a blood sample (if kidneys/thyroid function/etc are suspected in her case). Depending on the findings, your vet will be in the position to help you determine what is causing her signs and what can be done to treat them effectively. I hope this information is helpful. Please do let me know if you have any further questions. If you have no further questions, feedback is always appreciated. All the best, Dr. B