Doggie Dementia: What Every Human Should Know
The risk of developing Canine Cognitive Dysfunction (CCD) increases with the age of the dog, as shown by several research studies. photo: AdobeStock
Have you noticed changes in your older dog’s behavior lately? More accidents inside, loss of interest in favorite activities, changes in sleeping patterns? It could be the start of Canine Cognitive Dysfunction (CCD), also known as Cognitive Dysfunction Syndrome (CDS) or, more colloquially, as doggie dementia.
CCD is a complex condition that affects many older pets and may cause a variety of changes in a dog's behavior, awareness, learning, memory, sleep patterns, or social interactions. Symptoms of CCD may range in severity from mild to debilitating and may also overlap with those of other medical conditions common in older dogs. CCD is a progressive condition and, as symptoms worsen, it may affect not only the quality of life of the pet but also the human-animal bond.
As our pets are living longer due to a variety of factors - including good nutrition, elimination of infectious diseases, better management of chronic medical conditions, and overall improvement in home and veterinary care - this condition is being recognized with increased frequency. Still, it’s a common misconception that mild cognitive impairment is part of normal aging. Unfortunately, this assumption can lead to a delay in diagnosis and therapy. That’s why early recognition of CCD by both pet owners and veterinarians is crucial.
Risk Increases With Age
The risk of developing CCD increases with the age of the dog, as shown by several research studies. A 2001 study revealed the presence of CCD in 28% of dogs 11-12 years of age and in 68% of dogs 15-16 years of age. Similarly, a 2009 study showed that 22.5% of dogs over the age of 9 showed cognitive impairment.
While the risk factors for the development of CCD are still being evaluated, research shows that the biological basis for CCD in dogs is similar to that found in the aging human brain and also bears similarities to Alzheimer’s disease. Biological changes include loss of brain tissue, increase in volume of the fluid in the ventricles of the brain, deposition of toxic proteins around the neurons, oxidative damage leading to neuronal death, mitochondrial dysfunction leading to decreased cellular energy production and decreased ability of the brain to utilize glucose, and changes in the blood supply to the neurons. Understanding the biological basis of CCD is key to developing a therapeutic approach.
What To Watch For
Symptoms of CCD may include:
Disorientation: staring off into space, walking into walls, not recognizing owners and familiar pets.
Changes in social interaction: decreased interest in affection, increased aggression.
Changes in sleep-wake cycle: pacing/restlessness/vocalization at night, sleeping more during the day.
Loss of house training.
Increased anxiety.
Lack of interest in normal activity like walking/playing.
Compulsive behaviors.
Diagnosis and Treatment
CCD tends to be a diagnosis of exclusion. This means that, while CCD should be on the radar for both pet owners of older dogs and their veterinarians, it’s important to first rule out medical conditions such as changes in vision and hearing, neurological conditions including brain tumors, neuromuscular disorders and seizures, pain from osteoarthritis, endocrine diseases including diabetes/thyroid/adrenal gland disorders, and metabolic conditions including liver and kidney disease.
That’s why a comprehensive evaluation - including a thorough physical exam, baseline blood/urine testing, and imaging - is a crucial starting point before arriving at a diagnosis of CCD in older pets. The DISHAA questionnaire, available here, is a useful tool for owners and vets to help diagnose and monitor cognitive impairment in dogs.
While there is no cure for CCD, a multimodal treatment approach, as outlined below, may keep it from worsening and help address symptoms.
Diet. Diets rich in omega-3 fatty acids, Vit. B, Vit. C, Vit. E, carotenoids and flavonoids are beneficial for dogs with CCD. A few prescription diets are available that are made specifically for CCD.
Cognitive Enrichment. Regular exercise, mentally stimulating toys, and social interactions have all been shown to improve the cognitive function in dogs with CCD and may be done in a home environment, as well as at physical rehabilitation facilities. Physical rehab has the additional benefit of supporting the mobility of pets and managing their pain as they age.
Supplements. A variety of supplements are sometimes used for CCD, including Gingko, Melatonin, L-Theanine, SAMe, Apoaequorin, and Senilife among others.
Pharmaceuticals. Selegiline is the only FDA-approved drug for the treatment of CCD, but there is considerable variability in the response to this medication. Anti-anxiety medications such as Trazodone, Fluoxetine, and various benzodiazepines may be used for certain behaviors that are part of the CCD complex.
Alternative Therapies. Integrative therapies such as acupuncture and traditional Chinese medicine are showing promise in rodent and human models and may be beneficial in dogs as well.
There is no single approach to managing CCD in our older dogs and, sadly, no magic key to turn back time. But recognizing CCD early, ruling out medical conditions, and using a tailored approach for each patient are crucial tools for helping our older pets live their longest and best lives - and to maintaining the bonds of love we share with them.