What is Canine Cognitive Dysfunction (CDS)? Symptoms, Assessment, and Treatment Guide

Cognitive dysfunction syndrome (CDS) is a chronic, progressive neurodegenerative disease that leads to a gradual decline in cognitive abilities, with clinical symptoms primarily manifested as behavioral changes.

Common behavioral changes in cognitive dysfunction

CDS can cause six major categories of behavioral impacts, namely disorientation, interaction changes, sleep-wake cycle alterations, house soiling, activity changes, and anxiety, collectively referred to as DISHAA:

• Disorientation: For example, getting lost at home, getting stuck in corners or behind doors, wandering aimlessly.
• Interaction changes: Becoming indifferent or overly dependent on the owner or other animals, no longer responding to calls or caresses, showing no reaction when the owner comes home.
• Sleep-wake cycle alterations: Sleeping more during the day and less at night, barking at night, unable to settle down to sleep.
• House soiling: Forgetting the usual place to defecate and urinate, and doing so indiscriminately.
• Activity changes: Reduced play or exercise, engaging in repetitive, meaningless activities (such as pacing back and forth), decreased exploration of new things.
• Anxiety: Fear or hostility towards new things, panic or aggression towards things that were once considered safe, restlessness without apparent reason.

How to diagnose and assess CDS?

Since any disease affecting cognitive functions of the brain can cause similar symptoms, the diagnosis of CDS is mainly exclusionary. When a pet exhibits the aforementioned symptoms of dementia, first rule out other possible causes of behavioral changes, such as age-related degeneration of other organs, chronic pain, loss of vision or hearing, endocrine disorders, tumors, and other diseases. If no abnormalities causing the symptoms are detected and the disease progresses relatively slowly, CDS can be highly suspected. Subsequently, the DISHAA scoring sheet can be used for preliminary assessment to quantify the severity of symptoms and as a basis for future follow-up.

Dog Dementia DISHAA Scale

The following is the DISHAA assessment scale created by Dr. Gary Landsberg. Each item below has a score from 0 to 3 based on the severity, with 0 indicating none, 1 indicating mild, 2 indicating moderate, and 3 indicating severe. You can compare and score based on your pet’s condition:

• Easily stimulated / fearful by visitors, family members, or other animals, or showing aggression towards them.
• Sleep-wake cycle alterations.
• House soiling, learning and memory decline.
• Less capable of learning new things, or a decline in response to previously learned commands, names, or tasks.
• Reduced time exploring and playing with toys / reduced time playing with family members or other pets.
• Appearance of repetitive compulsive behaviors, such as circling, air biting, licking lips, staring at a spot.
• Increased fear of space / place (e.g., new environments or outdoors).

Dog’s DISHAA Dementia Scale Scoring

• If the score is between 4-15, the symptoms of dementia are mild.
• If the score is between 15-33, the symptoms of dementia are moderate.
• If the score is greater than 33, the symptoms of dementia are severe.

How to prevent and treat CDS?

Currently, there is no cure for CDS, but its progression and impact can be delayed or mitigated through various means:

• Provide a consistent and comfortable environment: Avoid moving furniture or changing home decor, which may confuse and stress elderly pets. Ensure all necessities are easily accessible. Reduce noise at night to help them sleep.
• Stimulate your pet’s brain and senses: Regular companionship and play, training, and social activities. Use toys that stimulate cognitive functions, such as puzzle toys, treat-dispensing toys, or interactive games. Avoid overstimulation or causing frustration; each session can be short but must have positive feedback, and absolutely no scolding.
• Maintain physical health: Moderate physical activity can promote blood circulation and oxygen supply, as well as burn off excess energy and stress. Elderly pets may have chronic joint problems, and excessive exercise should not cause additional harm.
• Nutritional supplements:
  • Omega-3 fatty acid supplements (EPA, DHA)
  • Medium-chain fatty acids
  • Antioxidant supplements (Vitamin C, Vitamin E, SAMe, etc.)
  • Phosphatidylserine
  • Apoaequorin
• Pharmacological treatment: When necessary, medications targeting specific symptoms can be used to improve behavioral symptoms, such as anti-anxiety drugs, sedatives.

Conclusion

Cognitive dysfunction is a serious behavioral issue that can severely affect the quality of life of pets and their owners, and is one of the main reasons for pets being euthanized. Currently, there is no cure, but by optimizing the environment, supplementing nutrition, and assisting with medication, the deterioration of symptoms and the severity of symptoms can be slowed down and alleviated as much as possible.