Canine cognitive dysfunction
JULIE BUZBY DVM, CAVCA, CVA SEPTEMBER 27, 2021
toegrips.com/canine-cognitive-dysfunction-in-dogs-signs-solutions/
What is Canine Cognitive Dysfunction?
Canine cognitive dysfunction (also called canine cognitive disorder or CCD in dogs) is a relatively common disorder in older dogs that involves changes in your dog’s brain and decreased cognitive functions. It is estimated that CCD symptoms occur in 68% of dogs by the age of 16. In other words, nearly two-thirds of 15- to 16-year-old senior dogs have some manner of doggie dementia.
Equally important are the number of cases of cognitive dysfunction that go undiagnosed. According to research studies, in a group of dogs that are at least eight years of age, the incidence of CCD is expected to be around 14%. However, less than 2% have been diagnosed with this medical condition.
Often, dog parents chalk up behavior changes to “normal aging” when CCD may actually be the culprit.
The following table shows the percent of dogs at certain age intervals affected by at least one impairment associated with CCD.
What are the clinical signs of cognitive dysfunction in dogs?
Canine cognitive dysfunction syndrome is associated with degenerative changes in the brain similar to dementia and Alzheimer’s disease in people. These changes affect the function of the brain and can affect how your dog perceives the world, their mental state/awareness, and their ability to process sensory information.
If you are concerned that your aging dog may have this medical condition, watch for some common clinical signs including:
CLINICAL SIGNS:
HOW YOUR DOG MAY ACT:
Anxiety: Increased panting and pacing, unable to rest or relax, newly developed separation anxiety or noise phobias
Less engaged: Loss of interest in you or the family, sleeping more often, not wanting to play, decreased activity levels
Pacing: Repetitive walking around the house or walking in circles
Disoriented: Gets “stuck” in corners of the house, can’t remember how to go around furniture, forgetting where the water or food dish is located, unable to find door to outside
House soiling: Previously potty trained, but now has accidentsChange in sleep-wake cyclesWakeful and roaming at nighttime, unable to settle down and sleep at night
How will my vet diagnose canine cognitive dysfunction?
Unfortunately, the diagnosis of CCD is not always straightforward. There are a variety of other medical conditions that may cause signs similar to CCD. Plus, there is no easy, definitive test for CCD. Thus, the diagnosis is presumptively made through the process of elimination—a senior dog exhibiting the right combination of symptoms with no other explanation on lab tests.
Canine cognitive dysfunction rating scale
There are a variety of tools or rating scales that your vet may use to assess your dog’s behavior. One such canine cognitive dysfunction rating scale is the Cognitive Dysfunction Evaluation Tool by Purina:
www.purinainstitute.com/sites/default/files/2021-04/DISHAA-Assessment-Tool.pdf
Canine cognitive dysfunction supplementsThere are several dietary supplements that may benefit dogs with CCD. These include:
1. Establish a daily schedule and keep a routine. In general, many dogs thrive on routines, but even more so when they develop CCD. Getting up, going outside, eating, walking, and going to bed at a predictable time can help your dog feel more comfortable in his or her surroundings. Plus, he or she has a better idea of what to expect each day. Obviously, there are going to be times when circumstances require a change of routine, but whenever possible try to stick to your set schedule.
2. Help your dog enjoy appropriate physical exercise. Getting outside for some fresh air and exercise is great for a dog’s sense of wellbeing. What this looks like may vary a bit depending on your dog’s physical health. Some dogs may be up for exploring new neighborhoods, hiking, or going to new parks. Other dog’s with more physical limitations may enjoy a short jaunt around the yard or to the neighbor’s house. Watch your dog carefully for signs of pain or tiring, and let him or her take frequent breaks to sniff or rest for a few minutes.
Some dogs may also enjoy playing fetch, wading in a creek (be careful with swimming if your dog is easily disoriented), or running around the yard with a doggie friend. Again, pay close attention to how your dog is doing and give him or her rest breaks fairly often.
3. Give your dog appropriate mental stimulation.In addition to physical exercise, dogs with CCD also greatly benefit from mental exercise. This can take a variety of forms:
4. Safeguard your dog. Keep your dog safe by:
What is the prognosis for dogs with CCD?
Some dogs with more mild forms of CCD are able to live out their full lifespan with good management. However, this isn’t the case for all dogs. Unfortunately, CCD does tend to be progressive. This means that even with multiple interventions and the best possible care, the symptoms may continue to worsen.
Unfortunately, dogs with severe CCD often have symptoms that significantly impact their quality of life despite trying many treatment options. One study indicated that dogs with severe CCD are often euthanized within 18-24 months of diagnosis.
Making the decision for euthanasia:
CCD is a difficult and devastating diagnosis for dogs and their parents. Your dog may be physically healthy yet suffering from severe mental or behavioral challenges. Unfortunately, many parents of dogs with CCD will have to wrestle with the decision about when to euthanize their sweet pup. It isn’t a decision that I can make for you.
I want to assure you that severe CCD signs are a valid reason for deciding that euthanasia is the right choice for your dog. You aren’t giving up on your dog. And you aren’t being selfish because you are tired of being kept up all night or cleaning up accidents. CCD steals your dog’s dignity and sense of self.
I understand what a heart-wrenching decision it is even when you know it is the kindest thing you can do for your dog. And I think that chances are, you will know deep down in your heart when it is time to set your dear dog free from the confines of a mind ravaged by CCD.
How will you know if it’s time to euthanize your dog who is suffering from dementia?
Maintaining the human-animal bond should the most important goal at the end of any dog’s life. Dogs adore their human family more than anything else in their lives! So when they are unable to recognize their loved ones, or when the bond has been broken due to mutual stress, anxiety, and lack of sleep, the time has come to set them free from their struggles. Whenever the deep bond between human and dog is broken, there is no longer any quality of life. At that point, it may be the kindest decision to put down a dog.
It is incredibly difficult to consider euthanasia for your canine family member. But it is also incredibly difficult to watch him or her struggle through each day, confused, anxious, and exhausted. Caring for any dog at the end of his or her life is difficult. But perhaps caring for a dog with dementia is the most heart-wrenching.
You wish to be able to comfort your dog, but the old familiar comfort measures no longer work. And when your dog doesn’t even recognize you, your presence no longer brings the comfort it once did. You want to give your dog everything he or she needs, but your time and energy is spread thin.
This is very normal, and frustration is an expected response to a very stressful situation. But it often causes caregivers to feel isolated, lonely, and guilty. Giving up sleep, cleaning up after your dog many times every day, bathing him or her often, and having your beloved senior dog lash out at you in frustration and fear can leave you feeling overwhelmed and exhausted.
Your precious old dog needs an abundance of patience, love, and nursing care. That can be difficult to provide, even for the most loving and devoted person.
toegrips.com/canine-cognitive-dysfunction-in-dogs-signs-solutions/
What is Canine Cognitive Dysfunction?
Canine cognitive dysfunction (also called canine cognitive disorder or CCD in dogs) is a relatively common disorder in older dogs that involves changes in your dog’s brain and decreased cognitive functions. It is estimated that CCD symptoms occur in 68% of dogs by the age of 16. In other words, nearly two-thirds of 15- to 16-year-old senior dogs have some manner of doggie dementia.
Equally important are the number of cases of cognitive dysfunction that go undiagnosed. According to research studies, in a group of dogs that are at least eight years of age, the incidence of CCD is expected to be around 14%. However, less than 2% have been diagnosed with this medical condition.
Often, dog parents chalk up behavior changes to “normal aging” when CCD may actually be the culprit.
The following table shows the percent of dogs at certain age intervals affected by at least one impairment associated with CCD.
What are the clinical signs of cognitive dysfunction in dogs?
Canine cognitive dysfunction syndrome is associated with degenerative changes in the brain similar to dementia and Alzheimer’s disease in people. These changes affect the function of the brain and can affect how your dog perceives the world, their mental state/awareness, and their ability to process sensory information.
If you are concerned that your aging dog may have this medical condition, watch for some common clinical signs including:
CLINICAL SIGNS:
HOW YOUR DOG MAY ACT:
Anxiety: Increased panting and pacing, unable to rest or relax, newly developed separation anxiety or noise phobias
Less engaged: Loss of interest in you or the family, sleeping more often, not wanting to play, decreased activity levels
Pacing: Repetitive walking around the house or walking in circles
Disoriented: Gets “stuck” in corners of the house, can’t remember how to go around furniture, forgetting where the water or food dish is located, unable to find door to outside
House soiling: Previously potty trained, but now has accidentsChange in sleep-wake cyclesWakeful and roaming at nighttime, unable to settle down and sleep at night
How will my vet diagnose canine cognitive dysfunction?
Unfortunately, the diagnosis of CCD is not always straightforward. There are a variety of other medical conditions that may cause signs similar to CCD. Plus, there is no easy, definitive test for CCD. Thus, the diagnosis is presumptively made through the process of elimination—a senior dog exhibiting the right combination of symptoms with no other explanation on lab tests.
Canine cognitive dysfunction rating scale
There are a variety of tools or rating scales that your vet may use to assess your dog’s behavior. One such canine cognitive dysfunction rating scale is the Cognitive Dysfunction Evaluation Tool by Purina:
www.purinainstitute.com/sites/default/files/2021-04/DISHAA-Assessment-Tool.pdf
Canine cognitive dysfunction supplementsThere are several dietary supplements that may benefit dogs with CCD. These include:
- Melatonin—This “hormone of darkness” can help your dog sleep appropriately and may reduce anxiety. (More on the benefits of melatonin in our special section on dealing with sleep-wake disturbances below.)
- Fish oils—The omega-3 fatty acids for dogs found in fish oils can help promote brain health.
- Senilife®—This supplement is high in antioxidants which may help reduce brain aging behaviors (antioxidants help combat the free radicals in the brain of dogs with CCD).
- S-adenosylmethionine (SAM-e)— Dogs on a SAM-e supplement may show improved executive functions and may have lessened clinical signs.
- Medium-chain triglycerides (MCTs)—MCT oil for dogs can provide an easy-to-use energy source for the brain and may help improve brain function in dogs with CCD.
- Medications Your veterinarian may suggest several medication options for your dog with CCD:
- Selegiline (Anipryl®)—This medication inhibits the action of MAOB (which is unusually high in dogs with CCD). By doing so, selegiline for dogs increases the levels of dopamine in the brain. This reduces the clinical signs associated with CCD. In one study, 77% of dogs responded favorably to selegiline therapy after one month. As a word of caution, selegiline should not be given in combination with certain other medications, so always ensure that your vet knows all medications and supplements your dog is taking.
- Additional medications—Some dogs with CCD may benefit from anti-anxiety or anti-depressant medications, especially if anxiety is a big component of the dog’s symptoms.
1. Establish a daily schedule and keep a routine. In general, many dogs thrive on routines, but even more so when they develop CCD. Getting up, going outside, eating, walking, and going to bed at a predictable time can help your dog feel more comfortable in his or her surroundings. Plus, he or she has a better idea of what to expect each day. Obviously, there are going to be times when circumstances require a change of routine, but whenever possible try to stick to your set schedule.
2. Help your dog enjoy appropriate physical exercise. Getting outside for some fresh air and exercise is great for a dog’s sense of wellbeing. What this looks like may vary a bit depending on your dog’s physical health. Some dogs may be up for exploring new neighborhoods, hiking, or going to new parks. Other dog’s with more physical limitations may enjoy a short jaunt around the yard or to the neighbor’s house. Watch your dog carefully for signs of pain or tiring, and let him or her take frequent breaks to sniff or rest for a few minutes.
Some dogs may also enjoy playing fetch, wading in a creek (be careful with swimming if your dog is easily disoriented), or running around the yard with a doggie friend. Again, pay close attention to how your dog is doing and give him or her rest breaks fairly often.
3. Give your dog appropriate mental stimulation.In addition to physical exercise, dogs with CCD also greatly benefit from mental exercise. This can take a variety of forms:
- A “sniff-ari” (i.e. sniffing safari) where your dog gets to leisurely take in all the scents of his or her surroundings. The new smells provide mental stimulation and also serve as a natural break time on walks.
- Teaching your dog new tricks (because old dogs can learn new tricks!)
- Giving your dog puzzle toys where he or she has to lick, roll, chew, or otherwise manipulate the toy to get to the tasty food or treats inside. Have several of these puzzle toys and rotate them so your dog gets a “new” one each day.
- Playing brain games with your dog (a quick internet search will reveal dozens of possibilities).
- Providing new toys to play with (and playing with them with your dog).
4. Safeguard your dog. Keep your dog safe by:
- Closely supervising him or her in new or unfamiliar areas.
- Ensuring your dog is wearing a collar with an ID tag and is microchipped. This will help increase the chances you are quickly reunited if your dog does get lost.
- Blocking off dangerous areas of the house or yard such as a swimming pool, ravines, or steps if your dog is easily disoriented.
- Keeping your dog on a leash or in a fenced yard to prevent him or her from straying into the road or getting lost.
- Giving your dog a safe haven. This may be a room or area of a room where your dog can retreat for some peace and quiet when feeling overwhelmed.
- Establish a nighttime routine that includes one last late-night walk so that your dog can urinate before bed. This will help prevent accidents in the house. It will also reduce your dog crying to go out in the middle of night. Additionally, having a nighttime routine will signal to your dog that it is time to settle and get some rest. Senior dogs (and humans) seem to do best with a consistent schedule.
- Ensure your senior dog has soft, orthopedic bedding to avoid putting pressure on arthritic joints.
- If your dog does get up in the night, place night lights around your home so that he or she is able to traverse without bumping into furniture.
What is the prognosis for dogs with CCD?
Some dogs with more mild forms of CCD are able to live out their full lifespan with good management. However, this isn’t the case for all dogs. Unfortunately, CCD does tend to be progressive. This means that even with multiple interventions and the best possible care, the symptoms may continue to worsen.
Unfortunately, dogs with severe CCD often have symptoms that significantly impact their quality of life despite trying many treatment options. One study indicated that dogs with severe CCD are often euthanized within 18-24 months of diagnosis.
Making the decision for euthanasia:
CCD is a difficult and devastating diagnosis for dogs and their parents. Your dog may be physically healthy yet suffering from severe mental or behavioral challenges. Unfortunately, many parents of dogs with CCD will have to wrestle with the decision about when to euthanize their sweet pup. It isn’t a decision that I can make for you.
I want to assure you that severe CCD signs are a valid reason for deciding that euthanasia is the right choice for your dog. You aren’t giving up on your dog. And you aren’t being selfish because you are tired of being kept up all night or cleaning up accidents. CCD steals your dog’s dignity and sense of self.
I understand what a heart-wrenching decision it is even when you know it is the kindest thing you can do for your dog. And I think that chances are, you will know deep down in your heart when it is time to set your dear dog free from the confines of a mind ravaged by CCD.
How will you know if it’s time to euthanize your dog who is suffering from dementia?
Maintaining the human-animal bond should the most important goal at the end of any dog’s life. Dogs adore their human family more than anything else in their lives! So when they are unable to recognize their loved ones, or when the bond has been broken due to mutual stress, anxiety, and lack of sleep, the time has come to set them free from their struggles. Whenever the deep bond between human and dog is broken, there is no longer any quality of life. At that point, it may be the kindest decision to put down a dog.
It is incredibly difficult to consider euthanasia for your canine family member. But it is also incredibly difficult to watch him or her struggle through each day, confused, anxious, and exhausted. Caring for any dog at the end of his or her life is difficult. But perhaps caring for a dog with dementia is the most heart-wrenching.
You wish to be able to comfort your dog, but the old familiar comfort measures no longer work. And when your dog doesn’t even recognize you, your presence no longer brings the comfort it once did. You want to give your dog everything he or she needs, but your time and energy is spread thin.
This is very normal, and frustration is an expected response to a very stressful situation. But it often causes caregivers to feel isolated, lonely, and guilty. Giving up sleep, cleaning up after your dog many times every day, bathing him or her often, and having your beloved senior dog lash out at you in frustration and fear can leave you feeling overwhelmed and exhausted.
Your precious old dog needs an abundance of patience, love, and nursing care. That can be difficult to provide, even for the most loving and devoted person.