Whole Dog Journal / Canine Dementia

Mercury, my Chihuahua-mix, turned 17 years old this year, making him (by far) the oldest dog amongst all of my friend’s dogs. When people see him, I’m always proud that they can hardly believe he’s as old as he is. Despite his age, Mercury is still in great physical shape and maintains an active life. 

Though Mercury is still very active I can tell he is slowing down and there are days when, just for a moment, he seems a bit confused. Our vets indicate that this is a normal part of aging, but it has me worried. 

It’s been estimated that more than 14% of pet dogs over the age of 8 show some symptoms of age-related cognitive dysfunction – and a whopping 68% of dogs aged 15 to 16 years have symptoms of cognitive impairment. 

Some pet owners might joke about “doggie Alzheimer’s,” but it’s a real thing. The degenerative brain disease that is very similar to Alzheimer’s in humans is properly called Canine Cognitive Dysfunction (CCD). 

Gaemia Tracy, DVM, is a neurologist at NorthStar Vets in Washington Township, New Jersey. He says that dogs with CCD generally exhibit behavioral changes ranging from a loss of housetraining to aggression, and often appear confused or disoriented. All dogs are at an equal risk; there are no known associations between breed or size and the risk of developing CCD. Dr. Tracy notes that he generally sees signs of CCD developing in affected dogs after the age of 8 to 10. 

SYMPTOMS

Dog owners are usually the first to notice that something is wrong or different with their dogs. Common symptoms to watch for include pacing, turning in circles, staring into space, or seeming lost and confused. In many cases, the dog’s temperament changes. Dogs who have been generally friendly may begin to show aggression – and typically aggressive dogs may become unusually friendly! 

Dogs experiencing an onset of CCD may also start to have difficulty navigating stairs or seem confused about how to get around furniture. CCD may also lead to dogs isolating and seeking out less attention, or generally become more fearful or anxious.

Veterinarians use the acronym DISHAA to describe typical symptoms of CCD. This stands for:  

• Disorientation – Examples include getting lost in familiar places, doing things like standing at the hinge side of the door waiting for it to open, or getting “stuck” behind furniture.
• Interactions – Changes in how or even whether the dog interacts with his people. He may withdraw from his family, and become more irritable, fearful, or aggressive with visitors. In contrast, the dog may become overdependant and “clingy,” in need of constant contact.
• Sleep – Changes in sleep patterns (such as being wakeful or restless in the middle of the night), vocalization at night.
• Housetraining – Increased house-soiling and/or a decrease in signaling to go out are common. Or a dog goes outside for a while and then eliminates in the house right after coming inside, or soils his crate or bed.
• Activity level – Decrease in exploration or play with toys or family members, and/or an increase in aimless pacing or wandering.
• Anxiety – Increased anxiety when separated from owners, more reactive or fearful to visual or auditory stimuli, increased fear or new places. 

Recently, the letter “L” was added to the end of the acronym:

• Learning/memory – Decreased ability to perform learned tasks, decreased responsiveness to familiar cues, inability/slow to learn new tasks. 

Dylan Fry, DVM, Diplomate American College of Veterinary Internal Medicine (DACVIM), a neurologist at NorthStar VETS, also notes that it’s important to watch for new compulsive behaviors (such as pacing) from your senior dog, as these, too, could be symptoms of CCD. If your dog is exhibiting any of the above symptoms or has developed a behavior or personality change, it’s a good idea for your dog to be seen by a veterinarian so you can discuss your concerns about CCD and rule out any other conditions like arthritis or other pain, vision, or hearing changes that may cause similar symptoms.

HOW IS CCD DIAGNOSED

Before your veterinarian can diagnose CCD, he or she will discuss the symptoms you are seeing at home and possible alternate causes. Your veterinarian is likely to do a thorough examination and blood work to rule out other causes. 

“CCD is a diagnosis of exclusion,” says Laurie Bergman, VMD, Diplomate American College of Veterinary Behaviorists (DACVB), a veterinary behaviorist with New Jersey’s NorthStar VETS. “First we have to rule out possible medical causes of these changes, including endocrinopathies (thyroid disorders), pain, and changes in sensory function.” 

Dr. Bergman notes that the time it takes to get a proper diagnosis can be frustrating for dog owners, but warns that even if your dog shows what seems like clear symptoms of CCD, the symptoms could be tied to a different condition. Tumors, inflammation, and infection in the brain can mimic the symptoms of CCD; if a dog is showing symptoms of CCD that can’t be connected to other conditions, veterinarians may recommend using a magnetic resonance imaging (MRI) scan to confirm the diagnosis. MRIs can show specific changes in a dog’s brain, such as atrophy or shrinking, which can aid in the diagnosis. 

PROGNOSIS 

Like Alzheimer’s in humans, CCD is a progressive illness. Dogs who have CCD don’t get better, but the condition can be managed. While the condition will worsen over time, says Dr. Fry, “the speed at which this occurs is variable.” Many dogs who have CCD can continue to lead comfortable and enriched lives. 

That said, dogs with CCD will require careful supervision and specific management to ensure that they are kept safe. Dr. Loenser notes that dogs with CCD are particularly prone to accidents such as falling down stairs, wandering off, or being hit by a car. “As long as the dogs are kept safe,” she says, “their prognosis is fair.” 

TREATMENT

There is one medication that is widely prescribed for dogs with CCD: Anipryl (selegiline hydrochloride). It been shown to slow the progression of CCD and may improve an affected dog’s brain function. 

Your vet may also discuss additional medications to improve your dog’s quality of life. For dogs who struggle to maintain a normal sleep cycle, Dr. Fry encourages owners to try giving their dogs melatonin, a hormone that can be purchased over the counter in most grocery or health food stores. This can sometimes help dogs adjust their internal clock and sleep more soundly. 

Additionally, anti-anxiety medications have also been shown to be helpful for some dogs with CCD. As with all supplements and medications, ask your vet whether any of these might be helpful for your dog.

WHAT TO DO AT HOME

There are a number of things that you can do at home to support your dog as her condition progresses. The most important task is managing your dog’s personal and household routines to keep her comfortable and safe. 

SIDEBAR: Nutritional Help for CCD

Dr. Loenser specifically advises that guardians should try to limit the amount of change in a CCD dog’s life. It’s really helpful to stick very closely to known routines and to be slow to make any kind of changes to those routines – including everything from who is in the home to furniture placement, mealtimes, etc. 

In particular, if your dog has CCD, you need to protect her from things in your environment that can be dangerous, especially stairs, decks without railings, and other dangers in your yard, as she may have lost good judgment regarding heights. You’ll also need to be especially attentive to your dog when on walks in order to keep her safe; she may wade too deeply into swift water, or step into the path of an oncoming bicyclist. Even if her past behavior and training has long been so good that she has been able to walk with you unleashed in the past, she may no longer have the cognitive capacity to do this safely any more.

A breakdown in housetraining is a common symptom of canine CCD. When dealing with this condition, “understanding goes a long way,” Dr. Bergman says. It’s important to remember that your dog isn’t lazy, spiteful, or trying to be bad, he just doesn’t know better anymore. Belly bands (for male dogs) and doggie diapers (for females) may be needed to prevent house-soiling by a dog who just doesn’t realize that she’s “going.”

SIDEBAR: She Wrote the Book on CCD

ENRICHMENT

It’s tempting to pamper older dogs, but this must include keeping them active. Making the comparison to how it is commonly accepted that “brain games” such as crossword puzzles can slow the onset of dementia in humans, Dr. Bergman advises that regular mental enrichment may slow the progression of CCD in dogs. Any kind of training, exercise, and social engagement can support the mental fitness of aging dogs. 

Of course, you should also be attentive to your older dogs’ physical condition; don’t push them to do anything too strenuous. Low-impact sports like scent work and trick training can be great ways to keep your senior dog’s mind active. 

Food-dispensing toys and puzzles are particularly good for senior dogs, who may not have as much interest in playing any more, but still enjoy their food! For older dogs at risk of CCD, Dr. Dylan suggests trying to keep them awake during the day, if possible, in order to establish and maintain a healthy sleep/wake cycle. 

That sounds challenging – and with multiple senior dogs in my home I’m abundantly aware of exactly how challenging it can be to keep them healthy and safe. CCD is concerning, but it’s comforting to know there are treatment options available to slow the progression of the disease.

Original post found here.