The Long Goodbye: Recognizing and Supporting Pets Through Cognitive Decline

Confusion, disrupted sleep, and sudden accidents in the house are easy to write off as “just old age.” Veterinary behavior experts say pet owners and clinicians alike need to start recognizing these as potential signs of dementia — and to know there's a lot that can be done once it's caught.

A dog who suddenly forgets the way to the back door. A cat who paces the hallway at 3 a.m., yowling into the dark. For years, these moments have been chalked up to “getting old.” But a growing body of veterinary research says something else may be happening: dementia, medically known as cognitive dysfunction, and it's far more common in aging pets than most owners realize.

Dr. Joel White, a clinical assistant professor at the Texas A&M University College of Veterinary Medicine and Biomedical Sciences, has spent time helping owners connect the dots between behavior changes and brain health. Cognitive dysfunction develops as changes in the brain interfere with how a pet thinks, learns, and remembers — and it can start showing up earlier than most people expect.

A Disease That Hides in Plain Sight

Signs of cognitive dysfunction in dogs can appear as early as age 8, affecting roughly one in ten dogs at that age. By 18, the odds climb dramatically — an estimated 80% of dogs that age show signs of the condition. In cats, symptoms tend to surface around age 10, and more than half of cats over 15 display behaviors consistent with dementia.

White points to two forces driving the numbers upward: pets are simply living longer thanks to advances in veterinary medicine, and the profession is getting sharper at spotting a disease that used to slip under the radar.

The early warning signs read like a checklist any pet owner might recognize without thinking twice: wandering without a clear purpose, house-training accidents, trouble navigating stairs or doorways, shifts in hearing or responsiveness, and vocalizing more than usual. Cats add one more tell — excessive grooming that leaves behind bald patches.

That overlap is exactly what makes dementia so easy to miss. Trouble with the stairs can look like arthritis. Accidents in the house can look like a urinary tract infection or kidney disease. Feline patients complicate the picture further — cats are notoriously skilled at masking illness from both owners and veterinarians, and older cats frequently develop hyperthyroidism, a thyroid condition whose behavioral symptoms can mimic cognitive decline almost exactly.

Getting to a Diagnosis

There's no single blood test that confirms dementia in a pet. Instead, veterinarians typically lean on owner-reported behavior questionnaires, building a picture from the accumulation of symptoms over time — the more boxes checked, the stronger the suspicion. Blood work, physical exams, and neurologic evaluations help rule out competing diagnoses along the way. For a definitive look at the brain itself, an MRI is the gold standard, though the need for anesthesia and the associated cost keep it out of reach for many cases.

Managing Life With a Cognitively Declining Pet

There's no cure for cognitive dysfunction, but there's meaningful ground between doing nothing and doing everything. Keeping a pet's mind and body engaged — leash walks and fetch for dogs, food puzzles and interactive toys for cats — can help slow the sense of decline, even when arthritis or other conditions complicate exercise. Owners have gotten creative: swimming for larger dogs, gentle tub time or stroller and backpack outings for smaller pets who can no longer manage a full walk.

Environment matters just as much as activity. For pets significantly affected, predictability becomes protective: blocking off hazardous areas, padding sharp furniture corners, and resisting the urge to rearrange rooms or relocate. A brain already struggling to make sense of the world doesn't need the added task of relearning it.

Nutrition has a role too. Diets rich in medium-chain triglycerides and antioxidants like vitamin E and omega-3s have shown promise in easing clinical signs — though while several formulated options exist for dogs, the same targeted diets haven't yet made it to market for cats. When lifestyle and diet changes aren't enough, medication becomes a conversation to have with a veterinarian, since individual pets can respond quite differently to the same drug.

Patience, Not Perfection

For most owners, the hardest part isn't the diet changes or the vet visits — it's the emotional toll of watching a once-sharp companion slip further away, one confused night at a time. Frustration is a normal response to being woken up repeatedly or cleaning up yet another accident on the rug. White's advice for those moments is simple: pause, take a breath, and remember “the pet is ill, not intentionally misbehaving.”

Dementia changes what life with an aging pet looks like. It doesn't have to change how much that pet is loved. With early recognition, a clear-eyed diagnosis, and small daily adjustments, owners can help their dogs and cats hold onto comfort, connection, and quality of life for however many years remain.

Source: Dr. Joel White, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, via Texas A&M Stories (Sept. 3, 2026).