Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.
I agree that Amber's signs do sound to be related to confusion induced by older age. Dementia in out elderly animals is not uncommon but is a condition that is difficult to diagnose (since it is a diagnosis of exclusion and there is no test for it) and often people just cope with the resulting behaviors. Now even though her signs are quite suspicious of dementia, I would suggest that if her vocalizing has been excessive (not just associated with forgetting how to use the cat flap) or you have noticed a change in her appetite, thirst, or weight; then it'd be prudent to consider having a blood sample and blood pressure checked by her vet. These will just ensure that you aren't missing any underlying health disease (ie high blood pressure, kidney disease, hyperthyroidism, etc) that could be contributing to her mental confusion. (Especially as high blood pressure on its own or alongside these diseases notoriously causes excessive unprompted howling in cats).
Now in regards XXXXX XXXXX dementia in the elderly cat, we can take a few steps to make life easier for them. First, since change is stressful to cats at the best of times, we do tend to want to keep their environment as stable as possible. If she struggles particularly at night, you can place night lights in her usual haunts (ie by her food/water and litterbox). Furthermore, to keep her tensions and anxiety levels in the face of her mental confusion low, 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 aged 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. Also there are nutritional supplements available from the vets, like Kalmaid (LINK) or Zylkene , that we often use to soothe the anxiety cats will have secondary to their mental confusion.
As well, you may want to discuss medical management with her vet. There are several medications that can be used for treating dementia in our pets. They are all licensed for dogs but can be used off label for cats. Specifically, we use these medications to enhance the brain's overall function (ie selegiline) and increase brain blood flow (ie nicergoline, propentofylline). Doing so, can settle her signs and help improve her mental clarity. When using these drugs, they can be used on their own or in combination with one another. Usually, treatment is for life and which to use tends to depend on the individual cat's response to the treatment.
Further to all of this, we do want to keep her as mentally stimulated as possible (ie play, food puzzles, treats, interaction, etc). Because just like people, if their minds aren't stimulated then they are more prone to getting lost in the fog of confusion.
Overall, dementia in the elderly cat is very common and Amber's signs are suspect. Still if you have noticed any of those aforementioned health changes, I would advise making sure there is nothing underlying increasing her mental confusion. If that is all clear, then we want to support her with a stable environment, mental stimulation, keep her tension levels low, and consider medical management to increase her enjoying her older years and not being so lost in her mental confusion.
I hope this information is helpful.
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All the best & happy holidays,
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