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Dr. B.
Dr. B., Cat Veterinarian
Category: Cat
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Experience:  I am a small animal veterinarian with a special interest in cats and am happy to discuss any questions you have.
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My cat is 13+ and showing signs of senility.She has just started

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My cat is 13+ and showing signs of senility.She has just started taking fortekor as her kidney results were at the high end of normal and kept getting a red eye.She now seems to have gone blind but is still eating plenty and using the litter it time to have her put to sleep? She isn't in pain just confused.

Hello & welcome, I am Dr. B, a licensed veterinarian and I would like to help you with your wee one today.

By red eye, do you mean that the eye filled with blood?

By signs of senility, can you tell me what she is doing specifically (ie vocalizing at night, getting lost in the house, etc)?

Customer: replied 3 years ago.
Yes her eye filled with blood a month ago so I put her on fortekor and it seemed to calm down her red eye.Over the last couple of days her other eye went red and now she's walking into things and is wandering around a lot eventually settling down.She has always yowled a little at night but it is getting more friend says I should put her to sleep but she is eating and still using her litter tray fine.

Thank you Heather,

Based on your history, I am a wee bit concerned about Marge may not necessarily be as senile as thought. It is quite possible at her age that she does have feline dementia, but her eye signs do make me concerned that she may also have issues with her blood pressure.

We can see elevated blood pressure in elderly cats as a primary issue but it can also be secondary to kidney disease. The reason this would be a concern here is because high blood pressure can cause increased pressure within the retinal blood vessels leading to ocular bleeds as you have seen. In these cases, the cats appear temporarily blind due to not being able to see through the blood within the eye. (That said, we do need to be careful with these cases because we can also see high blood pressure cause the retina to detach off the back of the eye to cause permanent blindness if not treated immediately. So, if you ever see blindness without the blood, we'd want her seen urgently to give her at least a chance of regaining her sight.).

Furthermore, just to note, high blood pressure in cats often presents to the vet as cats that wander the house vocalizing/screaming in the house for no reason, notoriously at night. And while this can be related to dementia as well, humans with high blood pressure report mental confusion, dizziness, and headaches. So, it is quite possible that this could be at least playing a partial role in her

Now often treating the kidney disease with medications like Fortkor can help address these signs. Still, if her signs are not resolving then I would suggest having he vet check a blood pressure. If it is high despite Fortekor, they that may want to switch her to Semintra (More Info) or consider also treating her with blood pressure medication. Hopefully, if they can get this blood pressure under control, we will see no further ocular bleeds, risks of blindness, and hopefully she will settle a bit more mentally.

Finally, if she is going a bit senile, this isn't necessarily a death sentence for them. It just depends if it is negatively impacting her ability to enjoy her twilight years. I can tell you that the cat in my icon shares Marge's issues. I diagnosed her with kidney disease a few years ago and had to treat her blood pressure as well. Mind you she does likely have dementia as well (since just as old people often the mind and body has health issues), but she putters around in the garden, eats her meals, and loves a fuss. So, as long as she is happy and enjoying her days (with more good ones then bad), then she will continue to live her life. If any of that changes, then I would use that as my guide to considering letting her go. And I would say that would be my same thoughts on Marge. These are chronic diseases that we cannot cure but we can try to manage them (there are even some medications that can be used, though I'd focus on making sure those kidneys and her blood pressure are stable first). And as long as the cat is happy, using her box, eating, and interacting with you like a comfortable kitty, then there is no reason to put her to sleep at this stage.

Overall, Marge is an old lady and does sound to potentially having a blood pressure issue that is still causing her issue. Therefore, I would advise addressing that first and then monitoring her for mental confusion. If she continues to show dementia signs but can cope, then it is fine to continue as you are. If she is struggling then you could either consider medical management for her or use that as your sign to let her go. But at the moment, it'd be worth just making sure her blood pressure isn't making this worse for her at the moment.

I hope this information is helpful.

If you need any additional information, do not hesitate to ask!

All the best,

Dr. B.


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Customer: replied 3 years ago.
Thank you for your advice Heather.
You are very welcome, Heather.

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All the best for Marge & yourself,
Dr. B.
Customer: replied 3 years ago.
Ps. Should I keep Marge on the fortekor ?or look at high blood pressure vet said I'd need to send her to an expert to get blood pressure results at some cost.
Hi again Heather,

I think the Fortekor is fine at this stage and I would say to keep her on it. Still, we'd have to consider potentially making a change (ie to Semintra) and/or adding blood pressure medication if her blood pressure is tested and still high. (Its not ideal to make changes or trying these kind of medication without actually testing the BP since making it too low isn't good for them either).

Now in regards to testing her blood pressure, I must say that I am surprised that your local vet cannot check this for you. (it is something that I have been able to do for my patients in a number of practices through the UK over the years. As well, it is quite non-invasive and non-expensive test that can be done in the consult room). Blood pressure testing itself does not really require a specialist to check and if your vet doesn't offer this service, you could potentially phone around to see if any other local practices could offer this service. That way, you to at least get this checked locally so that you can decide if she is managing on the Fortekor or if further treatment is needed.

All the best for wee Marge,
Dr. B.