Dementia in dogs and cats
As pets age, many owners worry about their failing health and conditions such as arthritis, kidney disease or cancer. But what about failing mental health? Sadly, just like in the human population, dementia is being recognised more and more within our pets and can cause great distress to both them and their owners.
We often see owners concerned about these ‘dementia-like’ signs their pet may have developed and wondering how they can care for them in their later years. Again, just as in human medicine, there is no cure but there are ways to combat the potential decreasing quality of life and make their later years more positive for all involved.
What is dementia?
According to the NHS, in human medicine dementia is defined as
“…..a syndrome (a group of related symptoms) associated with an ongoing decline of brain functioning.”¹
This can involve a loss of memory, changes in mood, problems with language and thinking, confusion and changes in behaviour. Dementia is not a disease in itself, but is an umbrella term for what results when a disease disturbs the normal functioning of the cognitive abilities of the brain.
In humans, Alzheimer’s disease is the most common cause of dementia and results from a build-up of proteins within the brain. These can clump together, leading to the development of plaques which interfere with the transmission of messages across the brain and can eventually cause parts of the brain to shrink. Alzheimer’s is a progressive disease for which there is no cure. Much about it is still not well understood, but parallels have been drawn between it and Canine Cognitive Dysfunction Syndrome in dogs².
Dementia in dogs and cats
Many owners of older animals will have experienced their pet showing ‘dementia-like’ signs. Often it is brought up at the annual vaccination appointments – “….they’re going a bit doo-lally…”; “….he forgets that he’s already got food in his bowl and asks for more!”; “…She’s messing in the house and she hasn’t done that since a puppy….”.
The prevalence of dementia in dogs and cats is very much likely to be underestimated. One study from 2001 suggested that 28% of dogs between 11 and 12 years old had at least one symptom of dementia and by the age of 15-16 this had risen to 68%³.
Cats are much less studied, but in 2003 a study showed that 36% of cats between 11 and 21 years of age had signs of cognitive dysfunction syndrome (CDS). When broken down, the numbers were similar to that in dogs – 28% of cats aged 11-14yrs and 50% of cats aged over 15yrs⁴.
Diagnosing dementia in pets
The diagnosis of dementia, or CDS, in our pets is one of exclusion, meaning that there isn’t one specific test that can be carried out to get a diagnosis – we need to rule out all the other potential causes first. A lot of the symptoms of dementia can also be seen in other diseases common in old age, so a thorough veterinary examination is always warranted.
Symptoms of dementia
The main symptoms of dementia, or CCDS, in dogs can be summarised by the acronym DISHAA, which stands for:
Disorientation:
They will generally become quite confused, so they may wander round aimlessly or get stuck behind furniture.
Interaction:
Their relationship with their owners can change – they often become more or less ‘needy’ towards them.
Sleep-wake cycle:
Dogs will often reverse their normal day and night routines, typically spending more of the night awake and most of the day in a light sleep pattern.
House soiling:
Although they’ll have been house trained for years, older dogs will often forget that training and forget to signal that they need to go out, leading to messing in the house.
Activity:
Although many dogs with CCDS can become very lethargic and be unwilling to exercise, often they can do the reverse and become more active, though these increased activity levels are often due to restlessness.
Anxiety:
Just like their human counterparts, dogs with dementia can very often be more anxious than they used to. This may link closely with their confusion and can be exacerbated by changes in routine.
Cats can also show all the above symptoms, but clinically we tend to see a lot of cats that show forgetfulness, especially around feeding, increased vocalisation, restlessness and changes in social interactions. As in dogs, these signs can also be commonly seen in other diseases, especially conditions such as hyperthyroidism, which we would want to rule out prior to making a presumptive diagnosis of CDS.
One of the best ways to work out if your dog may be suffering from dementia is to use the Canine Dementia Scale (CADES) which is a questionnaire that owners can complete to score the dog on various aspects of their lifestyle and behaviour.
Treatment for dementia
As we’ve already said, dementia cannot be cured; therapy is all about managing the condition and trying to maintain a good quality of life for the animal. There are three areas that can be looked at – environmental management, nutritional management and pharmacological management.
Environmental management means adapting the environment and potentially the pet’s daily activities to meet their changing needs. This may mean placing additional litter trays around the house for cats, or encouraging mental stimulation during the day to try to help with night-time wakefulness. In fact, just like in people, providing plenty of mental and physical enrichment can help with brain function.
Certain supplements are thought to be useful in managing dementia too, especially antioxidants and medium chain triglycerides (MCTs) and there are now formulated diets that contain these and more which aim to support brain health.
If the symptoms are becoming more severe and the animal’s quality of life is becoming compromised, as well as the owners’, then it may be worth considering using drug therapies to help. In the UK there is a drug – propentofylline – which is licensed for improving “dullness, lethargy and overall demeanour” in older dogs, and which may sometimes be prescribed to help with CDS. Unfortunately, there are currently no medications licensed for treating cognitive dysfunction in cats; one drug – selegiline – is licensed for CDS in the US but over here, it is only licensed for treating various anxiety-related disorders such as separation anxiety. Other anti-anxiety medications may also prove useful, but side effects and drug interactions need to be taken into consideration. Your vet will have to consider a wide range of factors when deciding what treatment is most suitable for your pet.
Living with a pet with dementia can be distressing for all involved, including the pet themselves, but recognising the signs early and asking for veterinary help can be of great benefit. Always speak to a member of our team if you have any worries or concerns about your pet – we’ll be happy to help.
References:
- 1. https://www.nhs.uk/conditions/dementia/about-dementia/what-is-dementia/
- Dewey CW, Rishniw M, Johnson PJ, Platt S, Robinson K, Sackman J, O’Donnell M. Canine cognitive dysfunction patients have reduced total hippocampal volume compared with aging control dogs: A comparative magnetic resonance imaging study. Open Vet J. 2021 Jan;10(4):438-442.
- Neilson, Jacqueline & Hart, Benjamin & Cliff, Kelly & Ruehl, William. (2001). Prevalence of behavioral changes associated with age-related cognitive impairment in dogs. Journal of the American Veterinary Medical Association. 218. 1787-91. 10.2460/javma.2001.218.1787.
- Moffat KS, Landsberg GM. An investigation of the prevalence of clinical signs of cognitive dysfunction syndrome (CDS) in cats. JAAHA 2003;39(5):512.
Management of Dogs and Cats With Cognitive Dysfunction | Today’s Veterinary Practice
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