For many families, the first sign that something deeper is happening is not a limp or a lab value. It is a night that will not end. Your dog paces from room to room like they have forgotten why they stood up. Your cat yowls at 2 a.m. and then stares into space as if the house has become unfamiliar. You try a snack, a potty break, a fresh litter box, a cuddle—things that used to solve the problem—and nothing lands. In the morning, your pet may even eat breakfast, which can make you wonder if you imagined it. But you did not. Something has shifted, and it is exhausting for everyone.
When people talk about “pet dementia,” they are often describing canine cognitive dysfunction or feline cognitive dysfunction, an age-related neurodegenerative condition that can show up as disorientation, anxiety, sleep-wake changes, house soiling, and repetitive behaviors. The American Animal Hospital Association notes that cognitive dysfunction can significantly affect the human-animal bond, that early recognition matters because treatment tends to be more effective earlier, and that the condition may be underrecognized in its early stages.
What families most need in this phase is not a perfect label. They need a plan that reduces distress and protects dignity. That is where comfort care comes in. Comfort care does not mean “there is nothing left to do.” It means the goal of care becomes comfort and security first, with treatment choices evaluated by one core question: does this help my pet feel safe and well in their body today?
Why Appetite Can Stay “Normal” While Everything Else Is Falling Apart
One reason cognitive decline is so confusing is that the signs don’t always match what we expect from illness. Some pets keep eating while their sleep, confidence, and orientation unravel. Others eat less only at night, or only when the house is quiet. Some cats will vocalize or wander after dark but still jump onto the bed for breakfast as if nothing happened.
Eating is important, but it is not the whole story. Cognitive decline is often more about processing and regulation than about appetite alone: your pet’s ability to settle, remember routines, interpret sensations, and feel secure in familiar spaces. This is why your veterinarian may ask about sleep, pacing, night vocalizing, clinginess, confusion in doorways, or new fear responses even if you came in to talk about “anxiety.” The VCA Animal Hospitals overview emphasizes that cognitive dysfunction can occur alongside other medical disorders and that concurrent conditions should be ruled out before diagnosing cognitive decline.
The Pattern Vets Listen For: DISHAA
Many veterinary teams organize the signs of cognitive dysfunction using the acronym DISHAA, because it captures the most common buckets of change in a way families can recognize and report. The American Animal Hospital Association describes DISHAA as the historical framework for categories of clinical signs, and the VCA Animal Hospitals guide provides practical examples of what each category can look like at home.
- Disorientation: getting stuck, staring, seeming “lost” in familiar rooms, going to the wrong side of a door.
- Interaction changes: becoming clingier or more withdrawn, irritability when approached, altered social patterns with people or other pets.
- Sleep-wake changes: increased daytime sleep and nighttime restlessness, pacing, or vocalizing.
- House soiling: accidents, confusion about where to eliminate, loss of previously learned routines.
- Activity changes: less interest in play, repetitive behaviors, wandering, difficulty settling.
- Anxiety: new fears, phobias, separation distress, or generalized unease.
Two details in the veterinary literature tend to land hard with families. First, sleep disruption and nighttime restlessness are not “just old age.” AAHA notes that, in dogs, common signs include daytime sleeping and nighttime restlessness, decreased interaction, disorientation at home, and anxiety. Second, anxiety is not a side effect; it can be a central part of the disorder and deserves to be treated as seriously as pain.
How Common Is Cognitive Decline in Senior Pets?
Families often feel blindsided, as if they are the only ones dealing with a pet who suddenly seems “not themselves.” They are not. AAHA cites estimates that approximately 14–22.5% of dogs older than eight years may suffer from age-related cognitive impairment. The VCA guide also summarizes study findings suggesting that signs become more common with advanced age, reporting that 28% of owners of dogs aged 11–12 reported at least one DISHAA sign, increasing to 68% in dogs aged 15–16; it also reports cognitive-decline signs in cats, rising in frequency in very senior cats.
The practical takeaway is not the number. It is permission to treat this as a real medical and welfare issue, not a character flaw or a “behavior problem.” When your pet is pacing, panicking, or unable to rest, they are not being difficult. They are struggling.
The First Priority: Rule Out Problems That Look Like Dementia
Comfort care starts with clarity. Cognitive dysfunction can resemble other conditions, and many older pets have multiple issues at once. AAHA notes that cognitive dysfunction may be a diagnosis of exclusion and highlights the need for thorough history, physical and neurologic exams, and basic laboratory evaluation to rule out other causes. VCA similarly emphasizes that medical and behavioral assessments matter, because other conditions can drive each sign.
This matters because some of the most heartbreaking “dementia” nights are actually driven by pain, urinary tract disease, constipation, blood pressure problems, thyroid disease, sensory loss, or medication effects. If your pet is restless, ask your veterinarian about pain control and nausea control even if your pet is still eating. Ask about vision and hearing changes. Ask about urinary urgency, arthritis, and whether a new medication could be contributing to agitation. Often, comfort improves when the body’s basic distress signals are treated directly.
When Comfort Care Becomes the Priority
There is a point in many chronic illnesses where the question changes. Instead of “What else can we add?” it becomes “What helps most, and what burdens them?” Comfort care is not a single choice; it is a posture you take as a caregiver. You stop chasing perfection and start protecting sleep, calm, and dignity.
For cognitive dysfunction specifically, comfort care usually rests on three pillars: medical management, environmental management, and predictable routine. Medical management may include addressing pain and nausea and, when appropriate, treating the cognitive disorder itself. AAHA notes that while many therapies have been studied, selegiline is the only drug labeled for use for canine cognitive dysfunction, and it discusses client-completed questionnaires used at set intervals to monitor change and guide treatment. Environmental management can be as simple as night lights, blocked stair access, traction on slippery floors, and keeping furniture layout stable. Routine means fewer surprises: the same bedtime pattern, the same potty break timing, the same “safe zone” in the house.
Many families find the nighttime piece is the breaking point. If your pet cannot sleep and you cannot sleep, everyone’s coping capacity collapses. That is not a moral failure; it is biology. When sleep becomes fragile, comfort care becomes urgent.
How to Track “Struggle” Without Guessing: Quality-of-Life Tools
Cognitive decline can create a particular kind of doubt because the symptoms wax and wane. One night is terrible, the next is tolerable, and you start bargaining with the calendar. This is where quality-of-life tracking becomes a practical tool rather than an emotional minefield.
AAHA notes that multiple questionnaires exist as diagnostic and monitoring tools and that serial scores can help guide treatment and client education. The goal is not to turn love into math. It is to capture trends: sleep quality, anxiety frequency, ability to settle, accidents, disorientation episodes, and whether there are still more good days than bad.
If you want a structured way to discuss end-of-life decision-making with your veterinarian, many families also use broader quality-of-life scales, such as the HHHHHMM framework, to weigh pain, hydration, hygiene, happiness, mobility, and overall day quality. The Merck Veterinary Manual describes the HHHHHMM quality-of-life scale as a commonly used tool to guide discussions about euthanasia decisions for a particular pet at a particular time.
How You Know It’s Time to Talk About a Peaceful Goodbye
Families often wait for appetite to be the deciding factor, but cognitive dysfunction can make appetite a late or inconsistent sign. Instead, many veterinarians focus on unrelieved distress: persistent nighttime panic, inability to settle even with reasonable medical adjustments, fear of movement, recurrent accidents that are confusing or humiliating to the pet, or a life that has become mostly management and very little living.
What makes this decision uniquely difficult is that pets with cognitive decline often still have moments of recognition and affection. They may still seek you, still eat, still accept a favorite treat. That does not cancel their distress. It simply means the illness is uneven. When you start to feel that your pet is living in a body and mind that no longer feel safe, it is reasonable to ask your veterinarian about timing, what a crisis might look like, and whether planning a calm farewell could be kinder than waiting for an emergency.
Planning Ahead: Aftercare Choices You Can Make Gently
When a family is living with dementia-like symptoms in a senior pet, they are often carrying anticipatory grief for months. Planning aftercare in advance is one way to reduce pressure later. If cremation is likely, understanding the basics now can help you stay present when the day comes. Funeral.com’s guide on how much does cremation cost for pets explains what drives price differences and what to ask so you understand what is included.
Many families also want to browse memorial options without feeling like they are “jinxing” anything. If you expect ashes to be returned, Funeral.com’s collection of pet urns for ashes includes a wide range of pet cremation urns designed for dogs, cats, and other companions. If you are drawn to something that feels more like a portrait than a container, pet figurine cremation urns can be a particularly comforting style for families who want a memorial that looks at home on a shelf or table. If more than one person is grieving and you want to share a small portion, pet keepsake cremation urns are designed for sharing and personal tributes.
Some families prefer a wearable memorial, especially when grief is sharp and unpredictable. Cremation jewelry holds a tiny symbolic amount, and cremation necklaces are a common choice because they keep a loved one close without requiring a visible display. If you want a practical explanation of how these pieces work, Funeral.com’s guide Urn Pendants, Charms & Beads That Hold Ashes walks through the main types and what to consider for daily wear.
Keeping Ashes at Home, Water Burial, and What to Do With Ashes
In the weeks after a loss, many families are not ready to make a final decision about scattering or burial. That is why keeping ashes at home is so common. Funeral.com’s guide to keeping ashes at home offers practical, compassionate guidance on safe placement and household comfort, especially when different family members grieve differently.
Other families find that nature-based rituals feel more healing, particularly after a long season of caregiving. If your long-term plan includes water burial, Funeral.com’s guide water burial explains what happens during a ceremony and what families typically experience. If you are weighing what to do with ashes in an eco-conscious way, biodegradable options can be part of a gentle plan that aligns with your values.
How This Pet Journey Connects to Human Funeral Planning
Many families are surprised by how much pet loss reshapes their thoughts about end-of-life choices in general. It is common to start thinking about funeral planning for people in the family, or to begin researching options like cremation urns, cremation urns for ashes, small cremation urns, and keepsake urns because the questions are suddenly real: how to memorialize, how to share, what feels right at home.
Cremation is also increasingly common across the U.S., which is part of why more families are searching for guidance on ashes and memorial choices. According to the National Funeral Directors Association, the U.S. cremation rate is projected to reach 63.4% in 2025, with further growth projected in coming decades. CANA reports a U.S. cremation rate of 61.8% in 2024 and provides additional trend data. If you are learning and browsing, Funeral.com’s collections for cremation urns for ashes, small cremation urns, and keepsake urns can help you compare styles and capacities at your own pace.
A Compassionate Bottom Line
Dementia-like symptoms in senior pets can make families feel trapped in a cycle of vigilance: watching, worrying, trying to decode every night. If you are there, it is appropriate to treat comfort as the primary goal. It is appropriate to ask for help. It is appropriate to bring videos of nighttime pacing to your veterinarian, to ask about pain, nausea, sensory loss, and anxiety, and to talk openly about what “a good day” still looks like for your pet.
And if comfort care becomes the priority because the struggle is becoming the center of your pet’s life, that does not mean love ran out. It means love became more protective. Whether the next step is a new plan for sleep and anxiety, hospice-style support, or a peaceful goodbye, you are allowed to make decisions that defend your pet’s dignity and your family’s ability to be present. When you pair medical support with gentle planning—knowing your options for pet urns, pet urns for ashes, cremation jewelry, keeping ashes at home, or even a future water burial—you reduce the chance that a crisis will make the decision for you. You give your companion the gift of steadiness, which is often the kindest form of care at the end.
