Your senior cat may be just as affectionate or mysterious or silly as ever, but you’ve probably also noticed some changes in them over the years. Older animals are more susceptible than younger ones to a number of health conditions, so changes in your senior cat’s behavior may actually point to underlying health issues. The good news is that by noticing and managing those issues, you can help your cat stay healthy and happy as they age.
We asked Dr. Shea Cox, National Medical Director for BluePearl Pet Hospice, about the most common health issues for senior cats, what pet parents can do to accommodate an older cat’s changing needs, and how to decide when it’s time to say goodbye.
When Does a Cat Become a “Senior”?
The average lifespan of a domestic cat is 12–18 years, though many cats now live into their twenties. Cats are considered “mature” at 7–10 years and “senior” after 10. Hospice and palliative care specialist Shea Cox, DVM, CHPV, CVPP, considers a cat “geriatric” at 14 years.
The Most Common Health Issues in Older Cats
Is your senior cat sleeping more? Playing, climbing, or grooming less? Sometimes changes in a senior cat’s behavior are misinterpreted as normal signs of old age, when they’re actually the effects of one or more health problems. Dr. Cox says the most common issues for senior cats involve mobility, cognitive function, and oral health.
Changes in Activity or Mobility
According to Dr. Cox, changes in behavior and mobility are one of the top issues pet parents notice as a cat gets older: “I often hear from families the comment, ‘He’s just slowing down because he’s getting old,’ when in fact, the reason for a pet’s change in activity or behavior is because they are in discomfort.” For example, many older cats become less agile or move more slowly because they suffer from arthritis, which causes stiffness and pain in the joints.
“Pain plays a huge role in your pet’s quality of life,” says Dr. Cox; “however, it can be challenging to know if it exists when you are not sure what signs to look for. Each individual pet may express signs of discomfort differently, making it important to tune into their language and look for signs of pain through changes in their activity and behavior.”
That’s why Dr. Cox designed the BEAP Pain Scale, which helps pet parents use observations of an animal’s day-to-day behavior to estimate the level of discomfort they may be experiencing.
“The good news is that there are so many things you and your vet can do to help with pain, and in doing so, vastly improve quality of life.” (We’ll talk about some of the ways you can keep your older cat comfortable later in this article.)
Decline in Cognitive Function
As a pet gets older, their cognitive function can begin to decline,” says Dr. Cox. In a human context, we talk about dementia; in cats and other animals, this condition is called cognitive dysfunction syndrome (CDS).
CDS affects more than 55% of cats aged 11–15 years and more than 80% of cats aged 16–20, according to the ASPCA. It can cause deterioration of a wide range of brain functions, including memory, the ability to learn, awareness, sight, and hearing.
Here are some possible signs of cognitive decline in cats:
- increased vocalization
- increased anxiety or agitation
- confusion
- startling easily
- uncharacteristic aggression
- accidents outside the litter box
Every cat is different. If you notice any behavior that isn’t normal for your cat, talk to your veterinarian. “Although CDS is a progressive disease that can’t be cured,” says Dr. Cox, “early diagnosis and intervention can help slow decline and ensure our geriatric pets continue to live a good quality of life. Providing forms of mental stimulation is one way to help.” Food puzzles, for example, use a cat’s hunting instinct to keep them actively engaged in searching or chasing.
Certain supplements may also help cats with CDS, according to Dr. Cox: “Nutritional therapy and supplements such as omega-3 fatty acids and antioxidants can help reduce the bad effects of free radicals, which are thought to contribute to the progression of disease.”
Oral Health Problems
Dr. Cox calls dental disease “one of the most common but preventable diseases in geriatric pets.” When plaque builds up on your cat’s teeth, it can lead to gingivitis (inflammation of the gums), loose teeth, and bone loss.
“If left untreated, dental disease can impact other areas of your pet’s health, such as contributing to heart valve disease (endocarditis) and significant oral pain when eating due to inflamed gum tissue.” Read more about the importance of your cat’s oral health.
Your Cat’s Gut Microbiome Changes with Age
In cats and humans alike, many health conditions are connected to the gut microbiome—the complex community of thousands of different kinds of bacteria and other microorganisms that live in the lower gastrointestinal tract (GI tract). That’s because about 70%–80% of the body’s immune cells live in the gut. A diverse, well-balanced gut microbiome is crucial to a strong immune system. But an animal’s gut microbiome changes as they age.
Defining the Core Bacteria
AnimalBiome was the first to describe the core gut microbiome of healthy pet cats, and their results were published in the journal Veterinary Sciences. The core microbiome specifies which kinds of bacteria are found in most healthy individuals. AnimalBiome’s study identified 30 different groups (taxa) of bacteria that make up the core of a healthy cat’s gut microbiome.The bacteria that were most common across all the healthy cats in the study were Bacteroides, Blautia, Lachnoclostridium, Sutterella, and Ruminococcus gnavus. The bacteria with the biggest populations in the guts of these healthy cats were Prevotella, Bacteroides, Collinsella, Blautia, and Megasphaera.
How Age Affects the Gut Microbiome
AnimalBiome’s study also looked at the effects of age on the feline gut microbiome. In the older cats they studied, the composition of the gut microbiome (that is, which kinds of bacteria are present in the community) remained relatively stable: the total percentage of the gut microbiome that was made up of those 30 core taxa didn’t change much. Diversity (the number of different kinds of bacteria in the community) also didn’t change much.
But the number of core bacteria types that were present decreased significantly. In other words, as cats get older, they lose some of the 30 kinds of bacteria that make up the core of their gut microbiome. In particular, AnimalBiome found reduced populations of Fusicatenibacter, Subdoligranulum, and Megasphaera bacteria in older cats.
Subsequent analyses performed by AnimalBiome’s researchers supported these findings and revealed that the species Peptacetobacter [Clostridium] hiranonis (which is involved in bile acid conversion) and Megasphaera elsdenii (a propionate producer) both decrease significantly with age.
When the numbers of one kind of gut bacteria go down, the numbers of other kinds of bacteria go up, as those growing populations take over the resources (food and space) freed up by the shrinking populations. So as a cat ages and loses some core gut bacteria, the populations of the other bacteria may grow bigger as a result, potentially leading to an imbalanced microbiome.
In addition, many of the 30 core bacteria are known to produce beneficial postbiotics called short-chain fatty acids (SCFAs, like acetate, butyrate, and propionate) and branched-chain fatty acids (BCFAs, like valerate, isobutyrate, and isovalerate) through the fermentation of carbohydrates, protein, and fiber in the GI tract. Postbiotics, including SCFAs and BCFAs, are molecules produced by bacteria when they “eat” the prebiotics they use as fuel.
So if older cats don’t have a healthy representation of the core bacteria types, they may be missing out on some of the benefits of the postbiotics those bacteria normally produce.
Immune system function tends to weaken as animals (including humans) get older, and systemic inflammation tends to increase. Both of these effects are directly connected to age-related changes in the gut microbiome.
As a cat ages, imbalances in the gut microbiome can lead to dysfunction of the immune system, resulting in chronic low-grade inflammation. And chronic inflammation contributes to many of the diseases seen in older cats, such as chronic kidney disease (CKD), diabetes, inflammatory bowel disease (IBD), cancer, and cognitive decline.
So good gut health is especially important for senior cats. By supporting your older cat’s gut microbiome, you can promote healthy digestion, help maintain a strong immune system, prevent skin problems, and protect many other aspects of their overall well-being.
The primary way to manage your cat’s gut health is through diet. AnimalBiome’s study of the core feline microbiome found that diet has an even bigger effect than age on a cat’s gut microbiome.
Your Older Cat’s Changing Nutritional Needs
Since diet is the best way to support your cat’s gut health, it’s important to understand how a cat’s nutritional needs can change as they get older.
Digestion Becomes Less Efficient
Like most of the body’s other systems, the digestive system undergoes numerous changes as an animal ages. In addition to age-related shifts in the gut microbiome itself, changes in the liver, kidneys, and endocrine system tend to reduce the efficiency of digestion.
With age, the intestines become less able to absorb nutrients. The GI tract of an older animal also tends to move material along more slowly. As a result, your senior cat may be more likely to suffer from such signs of reduced gut motility as constipation or hairballs.
Nutritional Needs Shift
Cats are obligate carnivores, which means they have to consume animal meat in order to get all the proteins and other nutrients they need to thrive. But the ability to digest protein tends to decrease in older animals. One way to support your older cat is by simply feeding more protein. For cats with a waning appetite, a digestive enzyme supplement can help them to efficiently break down the protein they are already consuming.
A high-quality, easily digested, high-protein diet is typically best for a senior cat. Their food should contain at least 40% protein on a “dry matter” basis. Avoid “senior” formulas, since these products tend to be too low in protein.
It’s also important to make sure your older cat’s diet includes plenty of moisture. The thirst impulse is often decreased in older animals, so your senior cat may not be drinking as much water as they used to. Adequate moisture is important for digestion and helps prevent constipation. Feeding wet food rather than dry can help ensure your senior cat is getting enough moisture. Most cats are attracted to moving water, so a water fountain designed for pets may encourage more frequent drinking.
Supplements Can Make a Big Difference
Since an older animal’s digestive system doesn’t absorb nutrients as efficiently as a younger one’s, your senior cat may benefit from one or more dietary supplements.
Vitamin B12 deficiency, for example, is common in older cats. The body needs B12, also called cobalamin, for a number of important functions, including red blood cell production, DNA synthesis, and the creation of myelin (the outer layer of nerve cells).
Possible symptoms of B12 deficiency in cats include weight loss, vomiting, diarrhea, changes in mobility, and anemia. The good news is that a little supplemental B12 (typically in the form of weekly injections under the skin) can have a significant positive effect on an older cat’s overall health.
Prebiotics (particular kinds of dietary fiber) can also make a big difference by promoting a cat’s beneficial gut bacteria and boosting the immune system. The probiotic S. boulardii (a kind of yeast) has also been shown to promote good gut health by feeding beneficial bacteria and reducing inflammation.
If your cat isn’t taking in enough moisture, talk to your vet about giving them subcutaneous fluids. Receiving additional moisture and electrolytes this way can often help a sick or older cat feel better almost immediately.
Accommodating Your Older Cat’s Changing Needs
In working closely with pet parents as a palliative and hospice care provider, Dr. Shea Cox focuses on the best ways to keep geriatric pets as healthy and happy as possible. We asked her for some advice about accommodating an older cat’s changing needs.
Weight Management
“Diet, exercise, and an appropriate weight are so important to health,” says Dr. Cox. In providing your geriatric pet with “regular, gentle exercise,” she says, “go at your pet’s pace and never push them past their comfort levels.”
Obesity
Reduced activity—or “slowing down”—as a result of arthritis is a common cause of weight gain in older animals. And more weight on the joints increases the pain of arthritis, which in turn causes an animal to move around less. In addition to making arthritis worse, obesity increases an animal’s risk of multiple other health issues, such as insulin resistance or diabetes, heart disease, high blood pressure, skin problems, and cancer.That’s why preventing or reducing obesity through exercise is so important for any pet. If additional weight reduction is necessary for your cat’s health, their daily servings of food may need to be reduced, but only very gradually. Always consult with your veterinarian before reducing a cat’s caloric intake.
Weight Loss
In older cats, weight loss is just as common a problem as weight gain. A senior cat may eat less because of a dulled sense of smell or taste, or because of decreased digestive function overall. Eating less can also be a sign of certain health conditions, including cancer, diabetes, kidney disease, and depression. It can also be an indicator of discomfort: the BEAP Pain Scale notes that appetite typically decreases with pain.
To encourage your older cat to eat more, try warming their wet food (very gently) in the microwave to increase its smell. Food puzzles often increase a cat’s interest. You can also enhance your cat’s usual food with an enticing “topper,” like a pinch of parmesan cheese, a spoonful of unsalted chicken broth, or a commercial cat food topper.
Oral Health
Like humans, animals tend to have more dental and oral health issues as they get older. Since sore gums, loose teeth, and other oral health problems can prevent a cat from eating enough, it’s especially important to watch your senior cat for any signs of mouth discomfort.
Regular veterinary dental cleanings continue to be important for your cat’s oral health, but because they require anesthesia, these procedures may not be recommended for older cats with certain conditions. Consult your veterinarian.
Joint Health
Osteoarthritis (OA, often just called arthritis) is a big factor in the lives of most older animals. This degenerative joint disease affects about 90% of cats over the age of 10. Arthritis causes inflammation and pain in the joints that can interfere with many of a cat’s usual activities.
You can avoid extra strain on your cat’s aging joints by helping them maintain a healthy weight. Preserving muscle tone is also important for supporting the joints. A high-protein diet will help, since plenty of protein protects against muscle wasting. Play and exercise will also help to keep your cat’s muscles strong and limber.
Cats with arthritis may groom themselves less frequently or may be unable to reach everywhere. You can help them keep their skin and fur healthy with regular, gentle combing or brushing.
Heated cat beds will reduce joint pain and help your cat sleep more comfortably. (Avoid human heating pads, which are not necessarily safe for animals.)
More Frequent Veterinary Care
“Geriatric pets are vulnerable to aging-related issues and disease,” says Dr. Cox. “Because of this, it is recommended that geriatric pets be seen by their veterinarian twice yearly, allowing for early detection and intervention.” Senior cats are also much more likely than younger animals to have multiple health issues.
Here are some of the health conditions that are more likely to affect older cats:
- kidney disease
- arthritis
- hyperthyroidism
- cancer
- heart disease
- liver disease
- diabetes
- high blood pressure
- cataracts, blindness
- conjunctivitis
- hearing loss
- periodontal disease
- B12 deficiency
“If your geriatric pet has mobility issues, or if there are other challenges in bringing your pet to a clinic, consider an in-home vet who specializes in older pets and offers hospice or palliative care.” See the list of resources at the end of this article.
Advice for Helping Your Senior Cat Age Gracefully
Your older cat may develop one or more age-related limitations, but by making small adjustments in their environment, you can do a lot to keep their day-to-day life easy and happy.
Make Your Home More Senior-Cat-Friendly
We asked Dr. Cox about some simple changes pet parents can make around the home to accommodate the special needs of an older cat.
- “Arthritis can make navigating wood floors and stairs more challenging. Using yoga mat runners in hallways or beneath food and water bowls can provide improved traction.”
- “Lowering litter boxes can help geriatric cats more easily get in and out.” Providing multiple litter boxes is also helpful, especially in homes with more than one level.
- “Raising food and water bowls to elbow level can reduce the strain of bending down to eat or drink.”
- “Ramps and stairs can assist pets getting onto furniture or beds.”
- “Baby gates can be placed to protect pets from falling down the stairs.”
- “Nightlights in the sleeping area can help geriatric pets who are beginning to experience cognitive decline.”
- Older cats are best kept indoors, especially if they have any loss of hearing or vision that makes them more vulnerable to outdoor hazards.
- It’s important to minimize stress in an older cat’s life. A senior cat is more likely to be stressed by any change in their routine or environment, startled by unexpected noises, or anxious about new people or pets in the household. And stress can make existing health problems worse. Always make sure your senior cat has quiet places they can retreat to for a feeling of security.
Consider Palliative or Hospice Care
The field of veterinary hospice care, focused on helping an aging or sick pet enjoy the best possible quality of life, has grown enormously. As Dr. Cox points out, this kind of support helps pet parents by giving them a range of personalized, realistic options:
The most important work we do in BluePearl Pet Hospice ties directly back to our mission: making the end-of-life experience as meaningful as the life lived. Hospice and palliative care is not just for “the final days.” It is specialized medical care for senior or geriatric pets, as well as for pets living with serious illness. Palliative care helps enhance a pet’s current care by focusing on improving comfort and quality of life. It also provides an additional layer of support to families, helping them to reach goals of care that are possible.
How to Know When It’s Time to Say Goodbye
As much as we want to keep our pets with us as long as possible, we also don’t want them to suffer. How do you decide how long to support an aging cat’s health (with more supplements or medication or procedures) and when to let them go?
Taking care of an older pet often involves a significant commitment of resources—not just money but also time and emotional energy. Hospice care specialists like Dr. Cox work with pet parents, both in person and virtually, to help them make decisions about what’s possible for the family and what’s best for the pet. She says:
The decision to euthanize is arguably the most difficult decision we must make as a pet parent, and knowing when to say goodbye is not always clear. Two fallacies I often hear are, “You’ll just know” and “When your pet stops eating, it’s time.”
Although the timing of euthanasia is a personal decision, there are resources to help you navigate. Your veterinarian can help with questions or concerns you may have, including understanding your pet’s current quality of life. BluePearl also offers free resources found here. Our “Understanding Quality of Life” is a video series containing 20 short but informative videos to help pet parents better understand their pet’s quality of life.
We also offer virtual Quality of Life evaluations, where our highly skilled nurses and veterinarians spend an hour with families answering questions that are specific to their situation and their pet’s needs. While never an easy decision, it is one you don’t have to make alone.
BluePearl Pet Hospice: Founded by Dr. Shea Cox, this nationwide organization provides in-home and virtual quality-of-life consultation and end-of-life care.
- In-Home Pet Directory: This website connects pet parents to local providers of in-home palliative care, hospice, and euthanasia services.
- BEAP Scale: Dr. Cox developed this system of eight pain indicators to help pet parents observe and evaluate an older animal’s daily behavior in order to judge how discomfort may be affecting their quality of life