{"id":127547,"date":"2025-03-11T18:35:40","date_gmt":"2025-03-11T18:35:40","guid":{"rendered":"https:\/\/todaysveterinarynurse.com\/?p=127547"},"modified":"2025-03-11T19:08:03","modified_gmt":"2025-03-11T19:08:03","slug":"aging-gracefully-with-cognitive-dysfunction-syndrome","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/behavior\/aging-gracefully-with-cognitive-dysfunction-syndrome\/","title":{"rendered":"Aging Gracefully With Cognitive Dysfunction Syndrome"},"content":{"rendered":"<div class=\"su-spacer\" style=\"height:20px\"><\/div><div class=\"su-note\"  style=\"border-color:#d8d8d8;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><div class=\"su-note-inner su-u-clearfix su-u-trim\" style=\"background-color:#f2f2f2;border-color:#ffffff;color:#333333;border-radius:3px;-moz-border-radius:3px;-webkit-border-radius:3px;\"><b>Abstract<\/b><\/p>\n<p class=\"p1\">Cognitive dysfunction syndrome (CDS) is an age-related disease in dogs and cats similar to Alzheimer disease in humans. CDS is an incurable, progressive disease that causes brain dysfunction and behavior changes. Clients may be unaware that their senior pet is at risk and may miss early signs. Veterinary nurses knowledgeable about signs associated with cognitive decline can educate clients about treatment and management techniques. This invaluable support during a pet\u2019s senior years can dramatically improve quality of life.<\/p>\n<p><b>Take-Home Points <\/b><\/p>\n<ul>\n<li class=\"p1\">CDS is a progressive disease that affects a pet\u2019s brain and behavior.<\/li>\n<li class=\"p1\">CDS is diagnosed by reviewing clinical signs and excluding other potential causes.<\/li>\n<li class=\"p1\">There is no cure for CDS, but comprehensive treatment and management plans can help slow progression and lessen signs.<\/li>\n<li class=\"p1\">Consultation with a board-certified veterinary behaviorist should be considered when navigating combined physical and behavioral health concerns.<\/li>\n<\/ul>\n<\/div><\/div>\n<p class=\"p1\"><span class=\"s1\">D<\/span><span class=\"s1\">ogs and cats are more than pets\u2014they are family members. They share homes, secrets, and countless life experiences with their family, creating strong human\u2013animal bonds. With modern veterinary care, pet lifespans have increased.<sup>1<\/sup> These additional years bring joy, but health challenges are common. Along with the body, the brain ages, and its optimal functioning declines with time. This can negatively impact a pet\u2019s behavior, daily activities, social interactions, and quality of life.<sup>2<\/sup> Veterinary nurses can help educate clients about their pet\u2019s aging brain and guide prevention and management strategies and prescribed treatment plans. <\/span><\/p>\n<h2 class=\"p3\">Cognitive Dysfunction Syndrome Overview<\/h2>\n<p class=\"p2\"><span class=\"s1\">Sensory information processing, behavioral responses, learning, and memory formation are all part of cognition.<sup>3<\/sup> Cognitive dysfunction syndrome (CDS) describes the degenerative anatomic and physiologic brain changes and cognitive and behavioral signs that occur during aging. CDS is a progressive disease that affects dogs and cats and is often compared to Alzheimer disease in humans.<sup>3<\/sup> For decades, dogs have been used to study causes of and treatments for Alzheimer disease, as they display similar brain and behavior changes. Cats have recently been added as effective models. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">In dogs and cats with CDS, brain imaging reveals signs such as decreased brain volume, loss of neurons and synapses, accumulation of amyloid <\/span><span class=\"s2\">\u03b2<\/span><span class=\"s1\"> plaque, changes in blood flow such as microhemorrhage, and oxidative DNA damage. These structural changes reduce the effective transmission of neurochemicals necessary for nervous system communication.<sup>4<\/sup><\/span><\/p>\n<h3 class=\"p4\">Clinical Signs<\/h3>\n<p class=\"p2\"><span class=\"s1\">Categories of clinical signs of CDS in dogs and cats are listed in <\/span><span class=\"s3\"><b>TABLE 1<\/b><\/span><span class=\"s1\">. The mnemonic acronym DISHAA is used to represent these categories in dogs, and VISHDAAL has recently been introduced for cats. Not all pets with CDS display signs in every category.<\/span><\/p>\n<p><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Table1.jpg\"><img fetchpriority=\"high\" decoding=\"async\" class=\"aligncenter size-full wp-image-127551\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Table1.jpg\" alt=\"\" width=\"2041\" height=\"1003\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Table1.jpg 2041w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Table1-300x147.jpg 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Table1-1024x503.jpg 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Table1-768x377.jpg 768w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Table1-1536x755.jpg 1536w\" sizes=\"(max-width: 2041px) 100vw, 2041px\" \/><\/a><\/p>\n<p class=\"p2\"><span class=\"s1\">Other medical or behavioral problems can present with similar signs (see <\/span><span class=\"s3\"><b>Signs of Aging in Senior Pets<\/b><\/span><span class=\"s1\"> sidebar). For example, house soiling can occur with urinary tract infections, diabetes mellitus, and pain-related conditions such as osteoarthritis as well as with CDS. Changes in activity level or anxiety could be due to behavioral problems such as thunderstorm or noise phobias or generalized anxiety. CDS can also escalate or alter existing behavior problems, and treatment may need to address both issues.\u00a0<\/span><\/p>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">Signs of Aging in Senior Pets<\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">Canine and feline lifespans can be broken into phases based on physical development and behavior. Dogs can enter their senior life stage at 10 years of age (depending on their size) and cats at 12 years (<strong>TABLE A<\/strong>).<sup>1,2<\/sup> Cognitive changes are likely in senior pets, with age of onset, severity, and signs varying among individuals. Educating clients about potential signs helps them recognize subtle changes and alert the veterinary team for guidance.<\/p>\n<p><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_TableA.jpg\"><img decoding=\"async\" class=\"aligncenter size-full wp-image-127552\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_TableA.jpg\" alt=\"\" width=\"1717\" height=\"430\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_TableA.jpg 1717w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_TableA-300x75.jpg 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_TableA-1024x256.jpg 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_TableA-768x192.jpg 768w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_TableA-1536x385.jpg 1536w\" sizes=\"(max-width: 1717px) 100vw, 1717px\" \/><\/a><\/p>\n<p>Sensory organs for scent, vision, hearing, taste, and touch can decline as a pet ages.<sup>3<\/sup> Alterations in stimulus detection change how the pet receives and interprets sensory information. If the pet\u2019s cognition is impaired, the pet becomes less effective at processing sensory stimuli and their behavior may change. For example, a pet may not greet their family member arriving home from work because they do not hear the door opening. The lack of greeting could also be due to cognitive decline if the pet forgets that the door opening signals the family member\u2019s arrival.<\/p>\n<p>Internal organs, joints, and muscles decline as the pet ages, also affecting behavior. Such behavior changes could be signs of an aging and sick brain, body, or both. For example, arthritis may cause a pet to house soil if pain limits its ability to access the toileting area. Endocrine disorders such as Cushing\u2019s disease can cause irritability and increased thirst and urination.<\/p>\n<p>Medications used to treat chronic conditions may have side effects mimicking cognitive decline.<sup>4<\/sup> For example, a pet with increased appetite from steroid treatment may start aggressively guarding food, and gastrointestinal upset from antibiotics or NSAIDs could decrease interest in food and engagement during play.<\/p>\n<p>Many clients accept aging changes as inevitable and discount their importance. This can lead to missed opportunities for enjoyment and decreased pet welfare. During senior wellness visits, behavior inquiries can help identify signs of physical and cognitive decline to enable treatment.<\/p>\n<p><strong>References<\/strong><\/p>\n<ol>\n<li>Vogt AH, Rodan I, Brown M, et al. AAFP-AAHA feline life stage guidelines. <em>J Feline Med Surg<\/em>. 2010;12(1):43-54. doi:10.1016\/j.jfms.2009.12.006<\/li>\n<li>Salt C, Saito EK, O\u2019Flynn C, Allaway D. Stratification of companion animal life stages from electronic medical record diagnosis data. <em>J Gerontol A Biol Sci Med Sci<\/em>. 2023;78(4):579-586. doi:10.1093\/gerona\/glac220<\/li>\n<li>Denenberg S, Liebel F, Rose J. Behavioural and medical differentials of cognitive decline and dementia in dogs and cats. In: Landsberg G, Mad\u2019ari A, \u017dilka N, eds. <em>Canine and Feline Dementia: Molecular Basis, Diagnostics and Therapy<\/em>. Springer Cham; 2017:13-58.<\/li>\n<li>Landsberg G, Nichol J, Araujo JA. Cognitive dysfunction syndrome: a disease of canine and feline brain aging. <em>Vet Clin North Am Small Anim Pract<\/em>. 2012;42:749-768. doi:10.1016\/j.cvsm.2012.04.003<\/div><\/div><\/li>\n<\/ol>\n<h3 class=\"p4\">Causes<\/h3>\n<p class=\"p2\"><span class=\"s1\">The cause of CDS is unknown, but advancing age is the biggest predictor of occurrence.<sup>6<\/sup> Aging, also called senescence, decreases the body\u2019s ability to adapt to physiologic, immunologic, and environmental stressors, resulting in low-grade inflammation.<sup>7<\/sup> These age-related inflammatory changes are known as inflammaging.<sup>8<\/sup> Immune dysfunction occurring with age is also known as immunosenescence.<sup>9<\/sup> When the immune system is dysfunctional and inflammation is chronic, the brain undergoes chemical and anatomic changes that result in cognitive decline and CDS.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">The formation of amyloid <\/span><span class=\"s2\">\u03b2<\/span><span class=\"s1\"> (senile plaques) and tau protein plaques in the brain has long been associated with Alzheimer disease and has also been found in dogs with CDS.<sup>10,11<\/sup> These plaques impair neuronal functions and further neurodegeneration. When neurons cannot communicate effectively, cognitive changes occur.<sup>10<\/sup> <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Research into the potential role of the gut microbiome has been advancing rapidly. The gut and brain communicate bidirectionally through the gut\u2013brain axis (central nervous, endocrine, and immune systems).<sup>12<\/sup> The microorganisms in the gut play a significant role in neuron development, neurotransmitter production, and thereby cognition.<sup>13<\/sup> Microbiome imbalance or dysbiosis has been found in patients with Alzheimer disease, and it is postulated the disease may begin in the gut.<sup>14<\/sup> Aging, stress, chronic inflammation, invading pathogens, antibiotics, diet, and environmental toxins can affect the microbiome.\u00a0<\/span><\/p>\n<h3 class=\"p4\">Diagnosis<\/h3>\n<p class=\"p2\"><span class=\"s1\">Evaluating behavior is key to diagnosing CDS, and several surveys have been designed as measurement tools. For dogs, the CADES (Canine Dementia Scale), the CCDR (Canine Cognitive Dysfunction Rating) scale, and the CCAS (Canine Cognitive Assessment Scale) are available.<sup>15-17<\/sup> A scale specific for cats was developed by MacQuiddy et al.<sup>18<\/sup> These questionnaires rely on the client\u2019s observation of their pet at home; therefore, their accuracy may be skewed by the client\u2019s under- or over-reporting behavior occurrence and severity. Research centers have used task-based learning and memory tests for dogs and cats to study cognition and CDS. A validated at-home version of these tests to enhance diagnostic methods is not yet available. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Magnetic resonance imaging can reveal CDS-related anatomic changes in the brain, including amyloid <\/span><span class=\"s2\">\u03b2<\/span><span class=\"s1\"> plaques, but absence or severity of such changes does not always correlate with cognitive signs. Recent research has revealed certain blood biochemistry markers associated with CDS, specifically alanine aminotransferase, aspartate aminotransferase, sodium, chloride, and the central nervous system injury biomarker NfL (neurofilament light).<sup>19<\/sup> However, in-clinic testing protocols and parameters specific to CDS diagnosis are not yet established.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Without a definitive cause and because signs overlap with various age-related diseases, a diagnosis of CDS is based on exclusion.<sup>20<\/sup> A comprehensive assessment should include a thorough medical examination that evaluates all body systems. For example, the musculoskeletal system should be evaluated for pain or movement limitations that could impact the pet\u2019s activity level or elimination choices, and a neurologic examination could help rule out altered mentation, proprioception, or other deficits that could alter behavior. Sensory organs can be checked to determine if decline that could impair perception and social interaction is occurring. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Blood analysis can be used to determine overall organ health and reveal endocrine pathologies such as hypothyroidism or hyperthyroidism, which can affect behavior. When elimination behavior changes are observed, a urinalysis can help assess kidney and bladder health and a fecal analysis can rule out parasitic involvement. Hypertension can also influence behavior; therefore, a blood pressure check can be helpful. Additional diagnostics or referral to a specialty service might be indicated based on general examination and laboratory test and behavior history findings. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">A behavior history and CDS-specific owner questionnaire should inquire about the pet\u2019s daily routine, family members, and lifestyle. The frequency and intensity of any behavior concerns, their initial occurrence, and how they may have changed over time with correlation to household events should be determined. <\/span><\/p>\n<h3 class=\"p4\">Prognosis<\/h3>\n<p class=\"p2\"><span class=\"s1\">CDS is a progressive disease without a known cure. As the pet ages, more signs of cognitive decline are likely. Increased awareness of observable signs, prevention of contributing factors when possible, early treatment, and client support can combine to enhance the pet\u2019s quality of life.\u00a0<\/span><\/p>\n<h2 class=\"p3\">Management and Treatment of Cognitive Dysfunction Syndrome<\/h2>\n<p class=\"p2\"><span class=\"s1\">Although CDS cannot be cured, only managed, it is best treated with a comprehensive care plan that addresses the brain, body, and behavior. Dietary adjustments, supplements, medications, and physical and mental exercise should all be considered. <\/span><\/p>\n<h3 class=\"p4\">Diet<\/h3>\n<p class=\"p2\"><span class=\"s1\">Senior pets have different nutritional needs than younger animals, such as fewer calories to match their activity level, higher protein to retain muscle mass, and increased digestibility to ensure effective nutrient absorption. Pets with CDS can benefit from dietary ingredients that focus on aging and brain changes. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Omega-3 fatty acids (docosahexaenoic acid and eicosapentaenoic acid) have been shown to decrease inflammation, antioxidants (vitamins C, E, and B) fight free radical damage in the brain, and medium-chain triglycerides provide an effective brain energy source.<sup>21<\/sup> Many pet food manufacturers have added these nutrients to senior diets. Two therapeutic canine veterinary diets specially formulated for brain health are Hill\u2019s Prescription Diet b\/d Brain Aging Care (<\/span><a href=\"http:\/\/hillspet.com\" target=\"_blank\" rel=\"noopener\"><span class=\"s3\">hillspet.com<\/span><\/a><span class=\"s1\">) and Purina Pro Plan Veterinary Diets NC NeuroCare (<\/span><a href=\"http:\/\/proplanvetdirect.com\" target=\"_blank\" rel=\"noopener\"><span class=\"s3\">proplanvetdirect.com<\/span><\/a><span class=\"s1\">).<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Microbiome modulation is being explored for humans with Alzheimer disease, but definitive treatment recommendations for humans, dogs, or cats are premature.<sup>22<\/sup> Therapies in consideration are antibiotics to decrease pathologic bacteria; prebiotics, probiotics, and postbiotics to boost beneficial organisms; fecal microbiota transplantation to reboot the microbiome; and other emerging biotechnologies.<sup>23<\/sup> <\/span><\/p>\n<h3 class=\"p4\">Supplements<\/h3>\n<p class=\"p2\"><span class=\"s1\">Several dietary supplements are available for pets with CDS and are intended to benefit general health or help relieve signs of CDS (<\/span><span class=\"s3\"><b>BOX 1<\/b><\/span><span class=\"s1\">). These supplements are given daily and may take several weeks for full benefits to be observed. Some labeled for dogs have been used off-label in cats.<\/span><\/p>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 1 Veterinary Supplements for Cognitive Dysfunction Syndrome and Anxiety<\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\"><strong>Cognitive Dysfunction Syndrome<\/strong><\/p>\n<ul>\n<li><strong>Senilife<\/strong> (Ceva, <a href=\"http:\/\/senilife.com\" target=\"_blank\" rel=\"noopener\">senilife.com<\/a>)\u2014blend of antioxidants (phosphatidylserine, pyridoxine, Ginkgo biloba extract, resveratrol, and \u03b1-tocopherol)<\/li>\n<li><strong>Aktivait<\/strong> (VetPlus, <a href=\"http:\/\/vetplus.co.uk\" target=\"_blank\" rel=\"noopener\">vetplus.co.uk<\/a>)\u2014blend of antioxidants, carnitine, phosphatidylserine, and fatty acids<\/li>\n<li><strong>S-Adenosyl-L-methionine<\/strong> (various manufacturers)\u2014naturally occurring metabolite. Supplementation can enhance neurotransmitter levels.<\/li>\n<\/ul>\n<p><strong>Anxiety <\/strong><\/p>\n<ul>\n<li><strong>Anxitane<\/strong> (Virbac, <a href=\"http:\/\/us.virbac.com\" target=\"_blank\" rel=\"noopener\">us.virbac.com<\/a>)\u2014contains l-theanine, an amino acid in green tea extract<\/li>\n<li><strong>Zylkene<\/strong> (Vetoquinol, <a href=\"http:\/\/vetoquinolusa.com\" target=\"_blank\" rel=\"noopener\">vetoquinolusa.com<\/a>)\u2014contains \u03b1-casozepine from hydrolyzed cow\u2019s milk protein<\/li>\n<li><strong>Composure Pro<\/strong> (Vetriscience, <a href=\"http:\/\/vetriscience.com\" target=\"_blank\" rel=\"noopener\">vetriscience.com<\/a>)\u2014contains proprietary Colostrum Calming Complex, L-theanine, vitamin B1, and L-tryptophan<\/li>\n<li><strong>Solliquin<\/strong> (Nutramax, <a href=\"http:\/\/solliquin.com\" target=\"_blank\" rel=\"noopener\">solliquin.com<\/a>)\u2014contains whey protein concentrate, magnolia and phellodendron extracts, and L-theanine<\/li>\n<li><strong>Calming Care<\/strong> (Purina, <a href=\"http:\/\/purina.com\" target=\"_blank\" rel=\"noopener\">purina.com<\/a>)\u2014contains the proprietary probiotic strain <em>Bifidobacterium longum<\/em> BL999<\/div><\/div><\/li>\n<\/ul>\n<h3 class=\"p4\">Medications<\/h3>\n<p class=\"p2\"><span class=\"s1\">Despite decades of research and multiple drug developments, effective prevention or removal of amyloid <\/span><span class=\"s2\">\u03b2<\/span><span class=\"s1\"> and tau protein plaques in animals and humans has remained elusive. <\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Selegiline (Anipryl; Zoetis,<\/span><a href=\"http:\/\/zoetisus.com\" target=\"_blank\" rel=\"noopener\"><span class=\"s3\"> zoetisus.com<\/span><\/a><span class=\"s1\">), a monoamine oxidase inhibitor, is the only drug labeled for CDS in dogs. It inhibits the destruction of the neurotransmitter dopamine, decreases free radical damage, and increases nerve growth factor. When started early, it can improve clinical signs.<sup>24<\/sup> Selegiline has been used off-label in cats with anecdotal success.<\/span><\/p>\n<p class=\"p2\"><span class=\"s1\">Common behavior medications such as fluoxetine, clomipramine, and amitriptyline all increase the neurotransmitter serotonin, as do amitraz (a tick and mite killer) and mirtazapine (an antinausea drug\/appetite stimulant). Excessive serotonin levels can cause serotonin syndrome with signs that can include elevated heart rate, difficulty breathing, dilated pupils, tremors, increased temperature, and high blood pressure. Phenylpropanolamine, a medication often used for urinary incontinence, can also cause high blood pressure if combined with selegiline. <\/span><\/p>\n<p class=\"p5\"><span class=\"s1\">Because effective medications to prevent or cure CDS do not yet exist, the following medications are often used off-label to manage clinical signs in dogs and cats:<\/span><\/p>\n<ul>\n<li class=\"p6\"><span class=\"s1\">Human antidepressants\/antianxiety medications (e.g., fluoxetine, sertraline, buspirone, bupropion) given daily can help reduce signs of irritability, restlessness, repetitive behavior, and anxiety in dogs and cats. Reconcile (fluoxetine hydrochloride; PRN Pharmacal, <\/span><a href=\"http:\/\/prnpharmacal.com\" target=\"_blank\" rel=\"noopener\"><span class=\"s3\">prnpharmacal.com<\/span><\/a><span class=\"s1\">) and Clomicalm (clomipramine hydrochloride; Virbac, <\/span><a href=\"http:\/\/us.virbac.com\" target=\"_blank\" rel=\"noopener\"><span class=\"s3\">us.virbac.com<\/span><\/a><span class=\"s1\">) are veterinary drugs labeled for separation anxiety in dogs and may be used for signs of CDS. <\/span><\/li>\n<li class=\"p6\"><span class=\"s1\">Sedatives and other anxiety-reducing medications (e.g., gabapentin, trazodone, benzodiazepines) can be used as needed to help with restlessness, sleep disturbance, pacing, and anxiety. <\/span><\/li>\n<li class=\"p6\"><span class=\"s1\">Propentofylline (Vivitonin, MSD Animal Health; currently unavailable in the United States) can decrease free radicals and inflammation in the brain and improve the synthesis of nerve growth factors. <\/span><\/li>\n<li class=\"p7\"><span class=\"s1\">Nicergoline (Fitergol, Merial; currently unavailable in the United States) can improve blood circulation within the brain.<\/span><\/li>\n<\/ul>\n<p class=\"p2\"><span class=\"s1\">Many board-certified veterinary behaviorists (<\/span><span class=\"s3\">dacvb.org<\/span><span class=\"s1\">) offer professional consultations with general practitioners to discuss cases and medication options.<\/span><\/p>\n<h3 class=\"p3\">Enrichment and Exercise<\/h3>\n<p class=\"p2\"><span class=\"s1\">Stimulating a pet\u2019s sensory systems and physical exercise can benefit brain health.<sup>25<\/sup> Clients should be encouraged to offer enrichment for each sense organ and provide variety (<\/span><span class=\"s3\"><b>BOX 2<\/b><\/span><span class=\"s1\">).\u00a0<\/span><\/p>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 2 Sense-Specific Enrichment Ideas<\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">\n<ul>\n<li><strong>Smell:<\/strong> Herbs\/spices, worn shoes and clothing, searching for hidden kibble<\/li>\n<li><strong>Vision:<\/strong> Riding in the car, bird feeder outside the window, apps and streaming videos designed for pets, toys to stalk during play, cardboard boxes for hiding<\/li>\n<li><strong>Hearing:<\/strong> Different genres of music and pet-specific recordings, nature sounds, toys that make different sounds, sound apps<\/li>\n<li><strong>Taste:<\/strong> Different flavors, textures, and temperatures of food; chew toys; food puzzles<\/li>\n<li><strong>Touch:<\/strong> Warming\/cooling mats, different toy textures, massage, gentle brushing<\/div><\/div><\/li>\n<\/ul>\n<p><span class=\"s1\">Food-based enrichment may create the most dramatic interaction, but other sensory experiences, even if the engagement is brief, are still valuable (<\/span><span class=\"s3\"><b>FIGURE 1<\/b><\/span><span class=\"s1\">).<\/span><\/p>\n<div id=\"attachment_127548\" style=\"width: 359px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Fig1.png\"><img decoding=\"async\" aria-describedby=\"caption-attachment-127548\" class=\" wp-image-127548\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Fig1.png\" alt=\"\" width=\"349\" height=\"262\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Fig1.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Fig1-300x225.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Fig1-768x576.png 768w\" sizes=\"(max-width: 349px) 100vw, 349px\" \/><\/a><p id=\"caption-attachment-127548\" class=\"wp-caption-text\">Figure 1. Food-based enrichment in the form of a food puzzle. Courtesy Paisley Lunchick<\/p><\/div>\n<p class=\"p2\"><span class=\"s1\">For dogs, going for a walk stimulates all senses and can be very enriching. If the dog\u2019s mobility is limited, the client can capture \u201cscent pictures\u201d and bring the enrichment to them. Collecting a scent picture requires only a rag and a plastic bag; the client can rub the rag on an object or area to transfer the scent, then seal it in the bag to take home, where they can take it out and present it to the pet for sniffing (<\/span><span class=\"s3\"><b>FIGURE 2<\/b><\/span><span class=\"s1\">). If the client has an able-bodied dog, that dog can help determine the best scents to collect during walks.<\/span><\/p>\n<div id=\"attachment_127549\" style=\"width: 360px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Fig2.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-127549\" class=\" wp-image-127549\" src=\"https:\/\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Fig2.png\" alt=\"\" width=\"350\" height=\"197\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Fig2.png 1080w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Fig2-300x169.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Fig2-1024x576.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarynurse.com\/wp-content\/uploads\/sites\/3\/2025\/03\/Yuschak_CDS_TVNSpring25_Fig2-768x432.png 768w\" sizes=\"(max-width: 350px) 100vw, 350px\" \/><\/a><p id=\"caption-attachment-127549\" class=\"wp-caption-text\">Figure 2. \u201cScent picture.\u201d Senior dog with limited mobility sniffing interesting scents collected during their caregiver\u2019s daily walk.<\/p><\/div>\n<p class=\"p2\"><span class=\"s1\">Another form of practical enrichment is playing training games with the pet. Clients can either practice the pet\u2019s favorite tricks or teach them new ones using positive reinforcement training. Pets with mild cognitive decline can still learn. Training is cognitively enriching, provides social bonding, and can teach functional life skills such as how to walk up a ramp.<\/span><\/p>\n<h3 class=\"p4\">Complementary Therapies<\/h3>\n<p class=\"p2\"><span class=\"s1\">Products that can have a general calming effect may help pets with CDS. Species-specific pheromones for dogs (Adaptil, Ceva [<\/span><a href=\"http:\/\/ceva.com\" target=\"_blank\" rel=\"noopener\"><span class=\"s3\">ceva.com<\/span><\/a><span class=\"s1\">]; Thunderease, ThunderWorks [<\/span><a href=\"http:\/\/thundershirt.com\" target=\"_blank\" rel=\"noopener\"><span class=\"s3\">thundershirt.com<\/span><\/a><span class=\"s1\">]) and cats (Feliway; Ceva, <\/span><a href=\"http:\/\/us.feliway.com\" target=\"_blank\" rel=\"noopener\"><span class=\"s3\">us.feliway.com<\/span><\/a><span class=\"s1\">), body wraps that apply gentle swaddling-like pressure (Thundershirt; ThunderWorks, <\/span><a href=\"http:\/\/thundershirt.com\" target=\"_blank\" rel=\"noopener\"><span class=\"s3\">thundershirt.com<\/span><\/a><span class=\"s1\">), and essential oils such as lavender and chamomile can be tried. Alternative veterinary modalities such as acupuncture and massage may also be indicated.<\/span><\/p>\n<h3 class=\"p4\">Environmental Adaptations<\/h3>\n<p class=\"p5\"><span class=\"s1\">Modifying the home environment to meet the aging pet\u2019s comfort and functionality is often necessary. Pets with CDS are more easily stressed, which can negatively affect overall health and hasten cognitive decline. Enabling the pet to remain active and engage in their favorite activities boosts wellbeing. Clients should focus on the pet\u2019s daily core needs and adjust to match their preferences and the household\u2019s unique environment. Veterinary nurses can recommend options that allow choice, making changes gradually, being patient if the pet\u2019s adjustment is slow, and maintaining consistent and predictable schedules. The following are some common, useful adaptations:<\/span><\/p>\n<ul>\n<li class=\"p6\"><span class=\"s1\"><b>Eating: <\/b>Use raised bowls that do not easily slide or tip, warm food to enhance smell and taste, and a preferred food texture and size that can be easily chewed. <\/span><\/li>\n<li class=\"p6\"><span class=\"s1\"><b>Drinking: <\/b>Use raised bowls that do not easily slide or tip and provide the pet\u2019s preferred water temperature and bowl type. Some pets prefer a water glass with ice cubes, shallow dishes, a dripping faucet, or pet water fountains with filtered water. <\/span><\/li>\n<li class=\"p6\"><span class=\"s1\"><b>Resting\/sleeping: <\/b>Provide pet stairs or ramps to allow the pet to get onto the bed or couch; warming devices; bed padding and covers that do not tangle, trip, or limit balance; easily washable pet beds; quiet, undisturbed space that is safe from being stepped on or bumped; and natural daylight and darkness for proper circadian rhythm.<\/span><\/li>\n<li class=\"p6\"><span class=\"s1\"><b>Mobility: <\/b>Provide nonslip rugs to ensure traction and prevent falls, extra space to navigate furniture and obstacles to minimize tight turns and backing up, harnesses and support slings for balance and lifting, ramps as an alternative for stairs, and ramps or steps to get pets in and out of vehicles.<\/span><\/li>\n<li class=\"p6\"><span class=\"s1\"><b>Social interaction: <\/b>Give plenty of attention, petting, play, and preferred activities for bonding. Provide abundant and accessible basic resources to prevent competition between household pets. <\/span><\/li>\n<li class=\"p6\"><span class=\"s1\"><b>Hygiene: <\/b>Perform gentle bathing and grooming using techniques the pet prefers.<\/span><\/li>\n<li class=\"p7\"><span class=\"s1\"><b>Elimination: <\/b>Provide extra litter boxes with low sides, easy access to toileting areas\/litter boxes, extra walks or toileting trips with rewards for going, waterproof beds, and furniture covers.<\/span><\/li>\n<\/ul>\n<h2 class=\"p3\">Summary<\/h2>\n<p class=\"p2\"><span class=\"s1\">Pet dogs and cats are living well into their senior years, and preparing for and supporting their changing medical and behavioral needs are key. CDS can be a challenging condition to navigate and can greatly affect quality of life. Veterinary nurses educated in cognitive care can advocate for patients\u2019 needs and support clients to maximize a long, healthy relationship. <\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Pet dogs and cats are living well into their senior years, and preparing for and supporting their changing medical and behavioral needs are key.<\/p>\n","protected":false},"author":236,"featured_media":127550,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":0,"footnotes":""},"categories":[811],"tags":[192,145],"class_list":["post-127547","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-spring-2025","tag-continuing-education","tag-peer-reviewed","column-continuing-education","column-features","clinical_topics-behavior"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast 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