We all hope for as many happy, healthy years as possible with our pets. The normal process of aging comes with some signs of slowing down, but a cluster of behavioral changes may indicate a condition known as canine cognitive dysfunction.
Dr. Gene Pavlovsky, chief of staff of the Dr. John A. Coyne South Clinic at the University of Illinois College of Veterinary Medicine, explains the diagnosis and management of this condition and what you should watch for to promote your older dog’s welfare.
WHAT IS CANINE COGNITIVE DYSFUNCTION?
Canine cognitive dysfunction (CCD), also known as canine cognitive dysfunction syndrome, refers to a degenerative disease process occurring in the aging canine brain.
“CCD is a common, yet difficult-to-diagnose, neurodegenerative disorder. It involves progressive loss of structure and function of nerve cells in the brain,” Dr. Pavlovsky explains. “Studies have estimated that it occurs in 45% to 67% of dogs over 13 years of age.”
The changes in brain structure seen in dogs with CCD are similar to the changes seen in humans with Alzheimer’s disease. These changes in brain structure inevitably lead to changes in behavior.
“Common clinical signs displayed by dogs with CCD include sleep-wake cycle disturbances; changes in activity level and interactions with others; anxiety; house soiling; disorientation (staring, wandering, getting lost); reduced interest in eating, walking, or playing; decreased grooming; aggressive behavior; and frequent repetitive activities, such as pacing,” says Dr. Pavlovsky.
WHY IS CCD IMPORTANT?
“Dogs with CCD experience an increase in anxiety and stress, especially when routine is disrupted and novel stressors are introduced,” says Dr. Pavlovsky. “Anxiety and stress may in turn lead to reduced appetite and interactive behavior, further diminishing the dog’s wellbeing.”
Dogs cannot tell you how CCD makes them feel, so you need to watch for changes in behavior and signs of anxiety that indicate a need for intervention to manage the signs.
Dr. Pavlovsky also notes that canine cognitive dysfunction affects the quality of life not only for the dog but also for its family.
“Survey-based studies show that many caretakers of dogs with CCD describe strong feelings of attachment to their dogs, anticipatory grief in relation to making euthanasia decisions, worries about leaving their dogs alone, and general anxiety over their dogs’ wellbeing,” he says.
CCD DIAGNOSIS
Not every dog exhibiting the behavioral signs associated with CCD has this disease. Other conditions that can cause these signs include infection or inflammation of the central nervous system, conditions that alter blood flow to the brain, metabolic diseases (such as liver disease) that affect brain function, and brain tumors. These possibilities must be explored and addressed before diagnosing CCD.
“It is also important to investigate other disorders involving pain and anxiety, which may result in clinical signs similar to those of CCD,” Dr. Pavlovsky states.
So, how does your veterinarian diagnose your elderly pet with canine cognitive dysfunction? It largely relies on owner observation of clinical signs.
“While some diagnostic testing, such as imaging and biomarkers, could help confirm diagnosis, diagnosis is largely based on history from the owners and clinical signs,” says Dr. Pavlovsky.
Behavioral questionnaires, such as the Canine Dementia Scale and the CCD Rating Scale, help identify relevant behaviors. However, because these questionnaires are subjective and rely on the owner to report behaviors accurately, sometimes a diagnosis of CCD is missed or delayed until later in the progression of disease.
Dr. Pavlovsky stresses the importance of veterinarians conducting a thorough behavior assessment during wellness examinations and watching for signs associated with CCD.
CCD MANAGEMENT AND PROGNOSIS
Canine cognitive disorder is not a reversible or treatable disease. Management relies on dietary adjustments and supplementation, certain medications, and cognitive enrichment to enhance quality of life and slow down progression of the disease.
“Many dietary supplements have been evaluated for CCD, with most focusing on reducing oxidative stress as part of brain aging, a central concept in development of CCD,” Dr. Pavlovsky explains. “Examples of supplements include omega-3 fatty acids, medium-chain triglycerides, and s-adenosylmethionine (SAMe). Selegiline (Anipryl), which works by decreasing oxidative damage of neurons, is the only FDA-approved drug for CCD.”
Additionally, increasing physical activity has been shown to have a positive effect and slow symptom progression.
How quickly and how much these steps result in improvements varies among individual dogs.
Typically, owners notice positive effects very gradually. According to Dr. Pavlovsky, a study evaluating the effect of selegiline reported improvement in 77% of dogs 60 days after starting the medication.
Because CCD cannot be reversed, families often elect to euthanize severely affected dogs within 2 years of onset of clinical signs. Dogs that are only mildly to moderately affected may live a full lifespan.
Early diagnosis and management of canine cognitive disorder, along with owners and veterinarians working together, play a crucial role in preserving quality of life for aging dogs and their families.