Canine Dementia

What it is, what you can do about it.
By Susan and Michael Cain, October 2017

Our boy Mic’s symptoms were so subtle and their onset so gradual that we didn’t initially see them. In fact, our other dogs noticed them first. Mic, a Pembroke Welsh Corgi then 12, had always embodied good dog manners. He’d never met a dog who didn’t like him. Suddenly, he was enraging his pack-mates. We sympathized: his nighttime barking was fraying our nerves.

Though a number of vet visits and lab tests revealed nothing, Mic continued to decline. When his spatial perception deteriorated, we realized that he was acting like some elderly people we had known, and concluded, almost tongue-in-cheek, that he had “doggy dementia.”

Turns out we were right. Though many veterinarians and dog owners are unaware of it, canine cognitive dysfunction, or CCD (also known as cognitive dysfunction syndrome), affects a significant portion of the senior dog population. The advances in veterinary medicine and improved owner care that have helped dogs live longer have also increased the incidence of CCD, but as many as 85 percent of cases may go undiagnosed.

“It’s a big issue, and there’s not much awareness of it, even among vets,” says Leticia Fanucchi, DVM, PhD, a veterinary behaviorist and director of Veterinary Medicine Behavioral Services at Washington State University’s Veterinary Teaching Hospital. “I get that question—‘Dogs get dementia?’— even from colleagues.” But CCD is nothing new.

“I first started recognizing symptoms of what we now refer to as ‘cognitive dysfunction’ in dogs over 30 years ago,” says Dennis Thomas, DVM, a holistic practitioner in Spokane, Wash., and author of Whole-Pet Healing. “We didn’t have a catchy term for the disease so I called it ‘pre-senility syndrome.’”

Defined

CCD, an umbrella term for four separate cognitive forms, is an age-related neurobehavioral syndrome leading to a decline in cognitive function that can be devastating to the human/canine relationship. The forms are as follows:

Involutive depression (or depression occurring in the dog’s later years), similar to chronic depression in humans. Several factors may be involved, but untreated anxieties seem to play a key role. Because some of the symptoms— circling, wandering and house soiling—often result in the dog’s confinement, anxiety can increase, which, in turn, worsens the symptoms. Other symptoms of this form of CCD include lethargy, sleep disorders, decreased learning and vocalizing.

Dysthymia.

This often involves loss of awareness of body length and size. “Dogs with dysthymia often get stuck,” explains Fanucchi. “Behind furniture, in a corner. All they have to do is walk backwards, but they don’t know that.” Other symptoms include disrupted sleep-wake cycles; constant growling, whining or moaning; and aggressive behavior. “If you interrupt a dog while he’s in a dysthymic state, he can get mad and bite,” cautions Fanucchi. Causes of this form are thought to include hyperadrenocorticism (such as Cushing’s disease) and long-term steroid therapy.

Hyper-aggression.

In old dogs, hyper-aggression is associated with the dysfunction of structures related to the neurotransmitter serotonin. Cortical tumors may also be involved. “Dogs with this form of CCD lose their ability to communicate with other animals,” explains Fanucchi. “They neither give appeasing signals to other pets in the house nor understand when others send them. They bite first and warn second.”

Confusional syndrome.

This involves a profound decline in cognitive ability. According to Fanucchi, it is the closest thing to Alzheimer’s in humans. “They just don’t seem to learn well in any form anymore. They forget familiar features of their lives, including other pets and people. When it’s more advanced, they forget who their owners are.”

As with human dementia, the causes of CCD are not well known, but accumulations of sticky proteins called beta-amyloid plaques around neurons and the breakdown of neurons resulting in so-called neurofibrillary tangles are considered to be the leading culprits. As in humans, both phenomena affect the brain by interrupting nerve impulse transmission.

Diagnosis

When we recognized the possibility of dementia in Mic, we began researching and quickly discovered Eileen Anderson, whose book, Remember Me?, and website, dogdementia.com, are invaluable CCD resources.

Among Anderson’s many helpful tools is a CCD symptom checklist, which comes with a warning. “The most important thing to understand is that any apparent CCD symptom could also point to a serious, and perhaps treatable, medical condition,” Anderson stresses. The first stop, she says, is the vet.

When standard tests reveal no medical cause for dementia symptoms, it’s time to consider CCD. While dog owners may find that— given the veterinary community’s limited awareness of the condition —they’re initially on their own, some practitioners are better versed in its treatment. Veterinary behaviorists and holistic veterinarians are particularly good options.

Though ongoing research offers hope for a cure, CCD is not currently considered reversible. However, certain forms of CCD may be preventable, and for others, the symptoms can be minimized. As with humans, lifelong holistic care is key. At some point in every dog’s life, routine preventive care must be fine-tuned with the specific aim of offsetting a dog’s potential for developing CCD. This involves the addition of anti-aging factors through diet and supplements. Fanucchi says that timing varies depending upon size, as larger dogs tend to live shorter lives. “Begin giant breeds at age five, small breeds at 10, others in between.”

Treatment

According to Fanucchi, CCD treatment involves management of behavior and environment, enhanced diet, and medication. Its dual goals are slowing the disease’s progress and improving quality of life for dogs and their people.

“Behavior can be effectively managed by providing daytime activities and opportunities for play, and structured social interaction for physical and mental stimulation,” says Fanucchi. “Exposure to sunlight will help regulate the sleep-wake cycle. If they can’t walk anymore, use a wagon or a stroller. Managing the environment is also very important. Make it more predictable. Pet-proof the house just as you’d toddler-proof it.” Providing adequate toileting opportunities is essential as well, as old dogs can’t “hold it” as they did when they were younger; diapers, pads, and waterproof bed and furniture covers may be helpful.

Nutrition options fall into two categories, commercial and natural, or home-prepared whole foods. Commercial foods focus on the addition of antioxidants for cellular-level health and to reduce oxidative stress on the brain, and medium-chain triglycerides for cognitive improvement. Only a few commercial pet food manufacturers offer prescription senior dog food.

Holistic veterinarian Thomas acknowledges commercial foods’ benefits but advises a different course. “I don’t recommend heatprocessed food for dogs. I recommend feeding a balanced, wholesome, natural diet with the same beneficial supplements added.”

The pharmacological approach to CCD treatment also focuses on control of oxidation and enhancement of brain function. The antioxidant supplement SAMe has proven effective in both staving off CCD and moderating its symptoms. Antioxidant nutritional supplements such as Denamarin, silybin, vitamin E, Cholodin and omega-3 fatty acids can be added to any diet, as can Solliquin, which contains an amino acid that can reduce CCD-related anxiety. Consult with a veterinarian before adding supplements to your dog’s diet.

The drug primarily used to treat CCD by improving brain function is selegiline (Anipryl). A monoamine oxidase inhibitor (MAOI), it is thought to improve brain chemistry by reducing the breakdown of dopamine and other neurotransmitters.

Alternative therapies offer a complement to conventional CCD treatments. For example, Traditional Chinese Medicine is thought to operate consistent with quantum physics, on the molecular and atomic levels, by addressing energy imbalances. “I encourage looking for alternative forms of treatment as well as the conventional,” says Thomas. “I prefer to treat this disease with acupuncture and Chinese herbs, supplements, diet modification and energy medicine.”

Endpoint

If nothing else gets a CCD-affected dog first, the dementia will eventually force a very tough decision. “When dogs’ bodily functions become so impaired that they lose quality of life, that’s when the hard call is made,” says Fanucchi.

“It’s just a matter of time until they deteriorate to the point that other systems fail. You don’t want to see your pet in this state—it’s very hard.”

Thomas agrees. “That is the toughest thing a dog caretaker has to address. It usually comes down to what the caretaker defines as ‘quality of life.’ Veterinarians can often help because they are not emotionally involved and can explain how the situation is affecting everyone.”

Making this decision can be especially hard when the animal is otherwise healthy. “It can be extremely difficult to consider euthanasia for a dog that is at a healthy weight, not necessarily in pain and occasionally coherent,” says Eileen Anderson. She points to a tool that can help: the Villalobos Quality of Life Scale. Designed by veterinarian Alice Villalobos, it offers an objective means of inventorying quality-of-life details. “Even those hesitant to do the numbers will benefit from the Villalobos scale, considering its unbiased presentation of the facts.”

Research Offers Hope

Alzheimer’s has never been reversed in human beings, but it may have been in two Australian dogs. Recently, a team of veterinary and human medical researchers at the University of Sydney Brain and Mind Centre appear to have restored cognition in these CCD-suffering dogs using the animals’ own stem cells.

The procedure involved growing neural cells from skin cells and inserting them into the dogs’ brains. The dogs have been rated as CCD-free based on independent application of the University of Sydney–developed CCD Rating Scale, and their owners report a significant return of the animals’ original personalities.

While at a very early stage and with a minuscule sample, the process appears to offer hope for humans as well as dogs. Although human and canine brains are different, their similarities are striking, with dementia symptoms and their practical impact and response to treatment being almost identical in both.

“The procedure is not to be undertaken lightly since it involves anesthetizing the dog twice and, well, brain surgery,” Anderson points out. “The good news is that two dogs with dementia have successfully undergone the procedure. This fascinating research offers some hope.”

Judging by Mic, the approaches described here can work. A natural diet augmented with SAMe and other supplements improved his cognition. Thanks largely to acupuncture and Chinese herbs, his formerly debilitating physical deficits were controlled. Treatment eliminated his nighttime barking and, under supervision, his packmates tolerated him. He lived nearly two mostly happy and relaxed years after the onset of CCD. Had Mic’s symptoms not improved, we would simply have followed Eileen Anderson’s golden rule.

“All that matters,” she says to anyone who will listen, “is to love the dog in front of you.”

Sue Cain is a nurse practitioner who spends her free time with her Pembroke pack, practicing and competing in agility. Mike is a freelance writer.

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