Love To The Max

"I've had Max since he was six weeks old," says Elizabeth Jones, a computer graphics specialist in Mesa, Arizona. She chose the white with gray Manx kitty because he was so playful and affectionate. Over the past 15 years, Max never met a stranger. "He'd always come right up to get in your lap, make himself comfortable, and just rub himself on your face," she says.

But in the last two years, Max's behavior and personality began to change. Max always loved food and hit the ground running at the sound of kibble hitting the bowl. So when treats lost their allure, Elizabeth knew something was wrong. Max slowly began to lose weight, and became reluctant to interact. He no longer demanded marathon lap-snuggling sessions, nor was he interested in head-bumping visitors. The gregarious cat she'd always known began to hide. Finally, last March when Elizabeth graduated from the university and found her dream job, things went downhill fast.

"He'd poop on my bed, or pee right in my spot where I sit on the couch," says Elizabeth. The glazed look in his eyes and his anxious behavior made Elizabeth fear that her beloved cat was losing his mind. Max either hid from her, or wailed for attention. Without warning, he'd climb into bed in the middle of the night, cry to wake her, and make a mess. "I was at the end of my rope," she says. "I had to deal with this ailing kitty that's always been so friendly and wonderful, and very loving." She knew not to take it personally, but dealing with middle-of-the-night messes made it hard. "It hurt so much to see him this way."

Elizabeth became more and more upset as Max's condition deteriorated. "He had this look in his eyes that said - 'who are you? where am I? I don't know what's going on! I'm upset, and I don't feel well,'" she says. "If you see an animal suffer like that, I feel it's your responsibility not to prolong that." She desperately loved her cat and was torn by the thought of losing him, but knew she'd ultimately have to put Max to sleep.

Although cat lovers of today are privileged to enjoy longer-lived cats-15 to 20 years isn't uncommon-we recognize aging cats may develop a health problem or disability. Most cats will not outlive us. Is it selfish to want to prolong his life? When is the right time to say goodbye? Cost of care, concerns over his comfort, and guilt about making these choices can make the last weeks or months together even more difficult.

There is no wrong answer. It doesn't matter what other folks think, or what they'd do-every situation is different, and what applies to others may have no bearing on your situation. Any choice you make that's based on love and concern for his welfare cannot be wrong.

The suffering for both Max and his loving owner had been going on for five months when Elizabeth received a questionnaire from Max's veterinarian. Dr. Kelly Moffat of the Mesa Veterinary Hospital requested information for a study about senior cat patients. Participation in the study included complete blood work, and physical and neurological exams. Elizabeth jumped at the chance that something would be found that could help return Max to normal or at least improve his quality of life.

The tests offered both good news and bad. For his age, Max was quite healthy. They couldn't find anything to treat. Dr. Moffat said there were no physical problems to account for his distress and behavior problems. Elizabeth's hopes fell when the doctor explained that at a certain stage of the game, some cats deteriorate on a cognitive level. The symptoms Max exhibited were typical of feline senility. This condition has more frequently been described in dogs and is pretty new to feline medicine.

"There's now a pretty well understood syndrome referred to as Canine Cognitive Dysfunction which basically represents a loss of memory and learning, or a reduction in learning memory," says Dr. Benjamin Hart, a veterinary behaviorist at University of California-Davis. He says that dogs, similarly to people suffering from Alzheimer's disease, develop a beta amyloid pathology in the brain. This is a starch-like protein that becomes waxy once deposited in the tissues.

Max's veterinarian was conducting one of the first scientific surveys of cats suffering from cognitive dysfunction. "I started the study two years ago, and have since looked at 155 cats aged 11 to 21 years old," says Dr. Moffat.

"You're more likely to see it in 15-year-old and older cats," says Gary Landsberg, DVM, a behaviorist in Thornhill, Ontario. He authored one of the first research papers on cats that concluded, in part, that as many as 80 percent of cats he sees that are over the age of 16 show signs of senility. "Some of the brain changes in [these cats] are similar to those seen in the early stages of human Alzheimer's," he says. Like the affected humans, cats with cognitive dysfunction also have deposits of amyloid material in the brain.