FRYour older cat yowls at night, gets lost in a room he knows, forgets his litter box? It is never "just old age" until an exam has ruled out a treatable cause; after that, it may be cognitive decline, a kind of pet "Alzheimer's."
The signs
It creeps in over weeks or months, and it is easily mistaken for age.
His voice. Louder and more often, sometimes alone in another room, often at night.
Lost at home. Stuck in a corner, staring at a wall or into space, forgetting a meal he just ate.
With you. Clingier and more demanding, or more distant; quicker to get irritated.
His nights. Sleeping by day; pacing and calling out at night.
The litter box. Going beside it or elsewhere, as if he had forgotten where it is.
His days. Less play, less grooming, aimless wandering, a worried look.
Each can also come from pain, the bladder, the thyroid, blood pressure, the kidneys, hearing or eyesight: no single sign makes the diagnosis.
What cannot wait
Cognitive decline is not, in itself, an emergency. What changes over a few hours is something else.
Go now if any one of these signs appears
- He has a seizure or collapses, even for a moment. In an older cat, a first seizure counts, even a short one.
- He suddenly cannot see: he bumps into things, or both pupils stay wide in a lit room.
- He cannot get up, keeps rolling and cannot stop, or his back legs will not carry him; on insulin, staggering is enough.
- His awareness has changed all at once (he is less awake than usual), or he pushes the top of his head into a wall and stays there.
- He keeps going in and out of the litter box, straining, crying, and nothing comes out or only a few drops, even if he seems constipated. Do not decide based on your cat's sex.
- He breathes open-mouthed, fast at rest, or with his belly heaving on every breath.
- He may have swallowed, or been given, a human medication. Do not make him vomit, and bring the packaging.
- He is suddenly in severe pain and cannot get comfortable.
Where to go. Go to a 24/7 emergency centre near you; call them on the way. During our opening hours (shown live on our emergency page), call us on the way instead: we will tell you where to go. Outside our hours, including evenings, nights, weekends and holidays, we have no emergency service. At the wheel, no phone in your hand: let a passenger call, or use hands-free.
Call us the same day
No red sign, but something new: his head has started to tilt or he is staggering; the change came on or got worse over a few days; he seems to be in pain; he refuses a real meal, or eats much less. The same day, not tomorrow morning. Outside our hours, a 24/7 emergency centre answers.
None of these? Book an appointment (opens in a new tab) for his workup.
Give no home medications
After sleepless nights, you want to help him sleep. But cats are a species apart: several ordinary products kill them.
Acetaminophen (Tylenol)
Fatal to cats, even a single tablet. There is no safe dose. If your cat swallowed any, it is an immediate emergency.
Ibuprofen (Advil), naproxen (Aleve), aspirin
Toxic: digestive ulcers, kidney damage. Never a human anti-inflammatory, for any reason.
Human sleep aids and calming pills (Gravol, Benadryl, melatonin), leftover prescriptions
Never without direction. A cat "settled" blindly is a cause still advancing while everyone relaxes.
Essential oils, "natural" products, CBD
A cat clears several oil compounds poorly: never on him, in his food, or in a diffuser where he lives. "Natural" does not mean safe: avoid them all.
Another animal's prescription
What relieves a dog can kill a cat, and a dose calculated for another patient is not a dose.
Has he swallowed or been given one? Go to a 24/7 emergency centre; during our hours, call us on the way instead.
Treatable causes first
These conditions can cause the same signs, several can be treated, and they often come together; finding one does not rule out cognitive decline. Treating a cause can ease the crying.
An overactive thyroid. Restlessness, hunger, weight loss, yowling at night. A blood test looks for it, and it is treatable.
High blood pressure. Often silent, it can leave him confused, yowling at night, or show up as sudden blindness. It often comes with kidney or thyroid disease, and it is treatable.
The kidneys. He drinks and pees more, goes outside the box, loses weight.
Pain: arthritis, teeth. He stops jumping, hides, grooms less, misses the box, is restless at night. It can be eased.
Urine, diabetes, constipation. Small amounts, blood, accidents outside the box, thirst, hunger.
Fading hearing or sight. He startles, hesitates at dusk, sounds different.
The brain. Circling, seizures; sometimes only behaviour changes.
At the clinic: ruling out the rest
Cognitive decline is diagnosed when signs persist after the rest is ruled out or treated: no blood test or questionnaire confirms it in cats.
Here, a senior cat's workup brings together a full physical exam, a blood test that includes the thyroid, a urinalysis and a blood pressure reading; depending on the case, radiographs are added. Sometimes a trial of pain relief shows whether pain is playing a part.
We check blood pressure here, in dogs as well as cats, on an awake animal, with no needle and no anesthesia: a cuff, a quiet room, several readings averaged together. It is not automatic at every visit; we do it when the picture calls for it.
We have neither CT nor MRI: when needed, brain imaging is done at a specialty centre, and your veterinarian will point you there.
Your night log
At the clinic, he will not replay his night: note it in the log below, and film an episode without disturbing him.
At home
These steps do not cure him, but they help him find his way. Change one thing at a time.
Same times, same places. Meals, play and bedtime at set hours; bowls, litter boxes and bed that stay put.
A night light between his sleeping spot and his litter box.
A litter box he can find. Add a low-sided box near where he sleeps, and one on every floor. An accident is never his fault: never punish him.
Everything within reach. Water, food and a warm bed on the same floor, a ramp or step up to his favourite spots, non-slip rugs.
At night, calm. Scolding him or shutting him away from you can make the crying worse; reassure him calmly, without feeding him at every cry.
Outdoors, never alone: confused, he may not find his way back.
Follow-up and quality of life
Cognitive decline cannot be cured, but its signs can ease, and the sooner we talk about it, the better. Approaches also exist for cognition itself: talk to your veterinarian before starting anything.
Your nights matter too: bring them up at the appointment, and we look first at easing them. Our quality-of-life assessment helps you put words to what you are seeing, and our end-of-life guide answers the harder questions.
Night log
What I see, night after night, for the appointment. Fill it in by hand; nothing is stored in your browser.
- Name
- Appointment on
- My 24/7 emergency centre and its number (list: montreal.vet, 24/7 centres page)
- Since when, and all at once or little by little?
- What has changed at home in recent months
- His medications and products, as written on the label
| Date and time(night, evening or day) | What he did, in words(meowing, wandering, staring at a wall, stuck somewhere, looking for his litter box, asking for a meal he just had) | How long, by the clock | Where he was, and what he was looking at | Just before(asleep, just ate, a noise, the light turned off) | What calmed him, or nothing(We write it down; we never scold.) | The litter box(urine or stool outside it? where? small amounts, blood? trouble getting in?) | A video?(time of the file) |
|---|---|---|---|---|---|---|---|
sleeping more? still jumping up? grooming? playing? eating and drinking as usual? clingier or more distant? jerks at a sharp sound (foil, keys)?
Go without finishing this log
he has a seizure or collapses (a first seizure counts); suddenly cannot see; cannot get up, keeps rolling or his back legs will not carry him; his awareness changes all at once, or he pushes his head into a wall; he strains in the litter box with no result; breathes open-mouthed, fast at rest or with his belly heaving; may have swallowed, or been given, a human medication; staggers while on insulin; is suddenly in severe pain and cannot get comfortable. To my 24/7 emergency centre; during the clinic's hours, I call the clinic instead, on the way, never phone in hand.
I call the clinic the same day
otherwise, his head starts to tilt; he staggers; he seems to be in pain; he refuses a real meal or eats much less; things change over a few days. Outside its hours: my 24/7 centre.
Bring it to the appointment, even unfinished, with your videos on your phone. It is not a test: no points, no total. Give him nothing for the night without the team. Hôpital Vétérinaire Métro Iberville · 514 223-1197 · montreal.vet
Frequently asked questions
Why is my old cat yowling at night?
Is it just old age?
How do I know if my cat has dementia?
Is my cat suffering?
How can I settle him at night? Can I give him something?
Should a cat with dementia be euthanized?
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Updated October 16, 2026 · Hôpital Vétérinaire Métro Iberville
This guide is provided for informational and educational purposes only. It does not constitute veterinary medical advice and is not a substitute for a consultation with a qualified veterinarian. Every animal is unique and their health must be evaluated individually. If you have concerns about your pet's health, contact our clinic or consult a veterinarian promptly. Outside our hours, a 24/7 emergency centre answers.
Is your older cat changing?
During our opening hours, call us or book an appointment for his workup. Outside our hours, a 24/7 emergency centre answers.