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Veterinary Talk by Dr. Jim Humphries

Cognitive Dysfunction Syndrome

Cognitive Dysfunction Syndrome (CDS) is a condition related to the aging of a dog’s brain, which leads to changes in awareness, deficits in learning and memory, and decreased responsiveness to stimuli. Cats may also show these changes, but less is known about this disease in cats. Although the initial symptoms of the disorder are mild, they gradually worsen over time, also known as ìcognitive decline,î just as it is in humans. In fact, clinical signs of CDS are found in half of all dogs over the age of 11, and by the age of 15, 68% of dogs display at least one sign.Symptoms and typesThe symptoms you will see are some degree of these: ï Disorientation/confusion ï Anxiety/restlessness ï Extreme irritability ï Decreased desire to play ï Excessive licking ï Seeming disregard for previously learned training or house rules. ï Slow to learn new tasks ï Inability to follow familiar routes ï Lack of self-grooming ï Fecal and urinary incontinence ï Loss of appetite (anorexia) ï Changes in sleep cycle (i.e., night waking, sleeping during the day)What causes this disease? It is thought that just as with human cognitive decline, the exact cause is debated among experts, but the formation of amyloid plaques in the brain is a rather consistent finding and genetic factors may predispose an animal to develop this issue.How do we diagnose the problem? It is typically diagnosed when the dogís family notices the onset and nature of the symptoms and possible incidents that might have caused the unusual behaviors or complications. We can then perform a complete physical examination to evaluate the overall health status and cognitive functions of the dog. Because we must rule out other causes of neurological disease (brain tumors or injury), routine blood tests, ultrasounds and X-rays are typically recommended.How do we treat this common disease? Dogs with CDS require therapy and support for the rest of their life. However, your help can make a world of difference when it comes to improving your dog’s cognitive functions. The best thing you can do is to maintain a healthy and stimulating environment, this will slow the progression of ìcognitive decline.î This typically involves staying consistent with your daily routine of exercise, play, and training. In addition to medication and behavioral therapy, your veterinarian may suggest employing a special, balanced diet to improve the dog’s cognitive function like memory and learning ability. This diet is also typically supplemented with antioxidants, vitamin E and C, selenium, flavonoids, beta carotene, carotenoids, Omega-3, and carnitine ó all considered excellent for improving the dog’s cognitive functions.Here are the ways we treat this disease:ï Avoid exposure stimuli known to distress the animal.ï Early rewarding of any normal, preferred, or good interactive or elimination behaviors and encouraging normal movementï There should be absolutely no punishment. This includes any physical, verbal, deprivational or mental punishment for issues that occur as a result of this condition. Such actions will render the patient more anxious.ï Try to prevent the dog from simply wandering or other odd behaviors while keeping it comfortable. You may have to confine the dog in an area with an absorbent surface if incontinence is an issue. ï Use mental stimulation in the early stages. This is important and may delay progression. Treat balls, food toys, games involving puzzle solving, safe exercise, interactive tasks (get the mouse, bring the ball, etc.), and olfactory stimulation are useful.More long-term treatments:ï Physical and mental stimulating exercises, such as swimming, massage, range of motion exercises are excellent. Make it fun for them.ï Also, encourage relaxation.ï If ìloss of house-trainingî occurs, ensure that the animal is taken out frequently to minimize the cost of house soiling. Reward frequently as you would for a young pup; and, if needed, a doggy diaper will decrease both client and dog distress.ï Encourage reestablishment of daily cycles by feeding at regular hours and at least a few hours before bedtime, and you may need to administer a tranquilizer at times.ï Protect the pet from accidents (e.g., falling into the swimming pool, falling down stairs).ï Specialized diets rich in antioxidants decrease the rate of cognitive dysfunction progression, improve behavioral function and may have a protective effect. There are special prescription diets your veterinarian can recommend that help.ï Some commercial supplements are also recommended as preventative agents (e.g., SenilifeÆ, CEVA; NovifitÆ [SAM-e; Virbac]; Omega-PetÆ is an excellent omega-3 fatty acids made by Nordic Naturals).ï The monoamine oxidase inhibitor, selegiline (AniprylÆ), once a day is currently the drug of choice.Living and managementYou should check in with your dogís doctor to evaluate a response to therapy and the progression of symptoms. However, if you notice any behavioral changes in the dog, notify them immediately. For stable dogs, twice yearly checkups are sufficient, unless new problems arise. CDS can become so severe as to be life threatening, so I highly recommend these steps to try to slow the progression of this disease and the slow loss of your best friend.

Dr. Jim Humphries has been a veterinarian for 45 years. He has served in the U.S. Army Veterinary Corps and as the veterinarian at the CBS News Morning Show in New York and CNN. He has written for Family Circle Magazine and the Wall Street Journal. He now serves as an adjunct professor at the College of Veterinary Medicine at Texas A&M University. He lives in Falcon with his wife, horses and Great Danes (and chickens).

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