March 30, 2024 / General Health / By Dodds
Canine Cognitive Dysfunction Syndrome (CCD) is a gradual and common degenerative disease in dogs due to changes in the brain.
Four decades ago, we would have thought that CCD is a part of “the normal aging process” in a companion dog. It can be. However, research has revealed that CCD is analogous to dementia or Alzheimer’s Disease in humans.
Similar to other degenerative diseases like osteoarthritis, CCD is the interplay of genetics, environment, nutrition, and lifestyle that continues to be unraveled. Fortunately, research has given us diagnostic tools, signs, and treatment options to delay or lessen disease progression.
Signs of CCD
Signs of CCD can be so gradual that companion pet parents may not even notice them because they adapt to them or excuse them.
- Disorientation
- Behavioral changes – ex. irritability
- Interaction – ex. nonrecognition of familiar people or pets
- Sleep pattern changes
- House-soiling
- Activity level changes
- Anxiety
- Learning changes
Of course, the signs could be due entirely to something else. For instance, house-soiling. Did the companion dog’s environment change due to a move, urinary tract infection (UTI), weather, addition or loss of a companion, new baby or child in the home, CCD, or a combination of two or more? Fortunately, tests are available to gauge the level of CCD.
Testing
Hemopet’s CellBIO test does not directly diagnose cognitive decline. CellBIO measures cellular oxidative damage, which has been proven to be associated with cognitive decline.
Veterinarians will also need to rule in or out other potential causes of the signs such as UTIs or hypothyroidism, and have a few other tests available to diagnose CCD such as the Canine Cognitive Dysfunction Rating Scale (CCDR) or Canine Dementia Scale (CADES).
Both of these tests rely on observations, which can be subjective. So, the best method is to complete one of the tests every six months or so on any dog of any age (particularly seven years or older). You can do this at home. Doing it on a scheduled basis instead of daily or weekly gives the room needed to account for seasonal changes, or “good days” and “bad days.”
The researchers that developed CADES performed comparisons every six months to validate their test. Sadly, they found that the rate of conversion at the 6-months follow-up of normal aging to mild cognitive impairment was 42%, while conversion rate of mild to moderate cognitive impairment was 24%. At twelve months, the conversion rates almost doubled to 71.45% and 50%, respectively.
Canine Cognitive Dysfunction Rating Scale (CCDR)
Instructions: Circle the number that corresponds to your dog’s behavior based on frequency, transfer number to score, multiply where needed, add to calculate total.
| Questions | Never | Once/Month | Once/Week | Once/Day | >Once/Day | Score |
|---|---|---|---|---|---|---|
| How often does your dog pace up and down, walk in circles and/or wander with no direction or purpose? | 1 | 2 | 3 | 4 | 5 | |
| How often does your dog stare blankly at the walls or floor? | 1 | 2 | 3 | 4 | 5 | |
| How often does your dog get stuck behind objects and is unable to get around? | 1 | 2 | 3 | 4 | 5 | |
| How often does your dog fail to recognize familiar people or pets? | 1 | 2 | 3 | 4 | 5 | |
| How often does your dog walk away while, or avoid being petted? | 1 | 2 | 3 | 4 | 5 | |
| Questions | Never | 1-30% times | 31-60% times | 61-99% times | Always | Score |
| How often does your dog have difficulty finding food dropped on the floor? | 1 | 2 | 3 | 4 | 5 | |
| Questions | Much Less | Slightly Less | The Same | Slightly More | Much More | Score |
| Compared with 6 months ago, does your dog now pace up and down, walk in circles and/or wander with no direction or purpose? | 1 | 2 | 3 | 4 | 5 | |
| Compared with 6 months ago, does your dog now stare blankly at the walls or floor? | 1 | 2 | 3 | 4 | 5 | |
| Compared with 6 months ago, does your dog have difficulty finding food dropped on the floor? | 1 | 2 | 3 | 4 | 5 | (Multiply by 2) |
| Compared with 6 months ago, does your dog fail to recognize familiar people or pets? | 1 | 2 | 3 | 4 | 5 | (Multiply by 3) |
| Compared with 6 months ago, is the amount of time your dog spends active? | 1 | 2 | 3 | 4 | 5 | |
| 0-39 = Normal; 40-49 = At Risk; 50+ = CCD | Total | Score |
Canine Dementia Scale (CADES)
Circle the number that corresponds to your companion dog’s behavior or signs, calculate the category score, and add all the category scores.
| A. Spatial Orientation | Abnormal behavior of the dog was never observed | Abnormal behavior of the dog was detected at least once in the last 6 months | Abnormal behavior appeared at least once per month | Abnormal behavior was seen 2–4 times per month | Abnormal behavior was observed several times a week | Score |
|---|---|---|---|---|---|---|
| Disorientation in a familiar environment (inside/outside) | 0 | 2 | 3 | 4 | 5 | |
| Failure to recognize familiar people and animals inside or outside the house/apartment | 0 | 2 | 3 | 4 | 5 | |
| Abnormally responds to familiar objects (a chair, a wastebasket) | 0 | 2 | 3 | 4 | 5 | |
| Aimlessly wandering (motorically restless during day) | 1 | 2 | 3 | 4 | 5 | |
| A reduced ability to do previously learned task | 1 | 2 | 3 | 4 | 5 | |
| Total | 0-25: | |||||
| B. Social Interaction | Abnormal behavior of the dog was never observed | Abnormal behavior of the dog was detected at least once in the last 6 months | Abnormal behavior appeared at least once per month | Abnormal behavior was seen 2–4 times per month | Abnormal behavior was observed several times a week | Score |
| Changes in interaction with a man/dog, dog/other dog (playing, petting, welcoming) | 0 | 2 | 3 | 4 | 5 | |
| Changes in individual behavior of dog (exploration behavior, play, performance) | 0 | 2 | 3 | 4 | 5 | |
| Response to commands and ability to learn new task | 0 | 2 | 3 | 4 | 5 | |
| Irritable | 0 | 2 | 3 | 4 | 5 | |
| Expression of Aggression | 0 | 2 | 3 | 4 | 5 | |
| Total | 0-25: | |||||
| C. Sleep-Wake Cycles | Abnormal behavior of the dog was never observed | Abnormal behavior of the dog was detected at least once in the last 6 months | Abnormal behavior appeared at least once per month | Abnormal behavior was seen 2–4 times per month | Abnormal behavior was observed several times a week | Score |
| Abnormally responds in the night (wandering, vocalization, motorically restless) | 0 | 2 | 3 | 4 | 5 | |
| Switches over from insomnia to hypersomnia | 0 | 2 | 3 | 4 | 5 | |
| Total | Score X 2 (0-20): | |||||
| D. House Soiling | Abnormal behavior of the dog was never observed | Abnormal behavior of the dog was detected at least once in the last 6 months | Abnormal behavior appeared at least once per month | Abnormal behavior was seen 2–4 times per month | Abnormal behavior was observed several times a week | Score |
| Eliminates at home in random locations | 0 | 2 | 3 | 4 | 5 | |
| Eliminates in its kennel or sleeping area | 0 | 2 | 3 | 4 | 5 | |
| Changes in signalization for elimination activity | 0 | 2 | 3 | 4 | 5 | |
| Eliminates indoors after a recent walk outside | 1 | 2 | 3 | 4 | 5 | |
| Eliminates at uncommon locations (grass, concrete) | 1 | 2 | 3 | 4 | 5 | |
| Total | 0-25: | |||||
| Total score (A + B + C + D) | 0–95: | |||||
| Clinical stage: • Normal aging (Score 0–7) • Mild cognitive impairment (8–23) • Moderate cognitive impairment (24–44) • Severe cognitive impairment (45–95) |
Treatment of CCD
No cure exists for CCD, but there are many tools available to slow its progression.
Prescription Medications – There are prescription medications available. Instead of resorting to those immediately, talk to your veterinarian about trying the other methods mentioned below.
Activity, Activity, Activity! – We cannot stress enough the need for physical activity such as a walk and interactive toys.
Diet –
- Leafy greens (supply folate, vitamin B- 9) – kale, spinach, collard and mustard greens
- Cruciferous vegetables (supply folate, carotenoids) – broccoli, cauliflower, bok choy, Brussels sprouts
- Beans/legumes (supply choline)
- Whole grains (gluten-free = quinoa, millet, rice, soy, corn, flax, TEFF, tapioca)
- Berries/cherries (supply anthocyanins, antioxidants, vitamins C and E). In fact, you can use them as treats.
- Omega 3 fatty acids (are anti-oxidant, anti-inflammatory) – Fish oil is an example. We prefer smaller fish such as sardines and anchovies. These fish do not have a build-up of mercury in their systems. The high DHA contains higher concentrations of vitamin E, taurine, choline, and l-carnitine, which can also play a positive role in healthy cognitive function. Whatever fish oil you choose, please ensure your companion dog does not have a food sensitivity or intolerance to it as revealed by NutriScan.
- Yellow squash, asparagus, tomatoes, carrots, beets (supply folate, vitamin A, iron)
- Nuts (supply omega fatty acids, vitamins E and B-6, folate, magnesium); but not macadamia, walnuts, hickory nuts or black walnuts, pecans and Brazil nuts for dogs
- Seeds (supply zinc, choline, vitamin E)
- Spices (are anti-oxidant, anti-inflammatory; eg. turmeric)
- Herbs such as Ashwagandha, an anxiolytic to help reduce chronic stress
Supplements –
- Alpha Lipoic Acid – Hemopet’s proprietary blend, BioBlend Super 6, contains alpha lipoic acid.
- Medium-Chain Triglycerides – An excellent example of this is unrefined, expeller pressed coconut oil. The agreed-upon amount to start is 1/4 teaspoon for dogs less than 15 pounds and 1 tablespoon for larger dogs. You will need to balance coconut oil for weight management. If your companion dog is doing well and not exhibiting any side effects such as diarrhea and weight gain, the standard threshold is 1 teaspoon per 10 pounds of body weight per day. Coconut oil is high in fat and can cause diarrhea if too much is given.
- Melatonin
- S-Adenosylmethionine (SAM-e)
- Phosphatidylserine – Is found in many cognitive support blends. Two well-known examples are Senilife and Aktivait.
References
Bray, Emily E et al. “Associations between physical activity and cognitive dysfunction in older companion dogs: results from the Dog Aging Project.” GeroScience vol. 45,2 (2023): 645-661. doi:10.1007/s11357-022-00655-8, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9886770/.
Dodds, Jean. Exercising Your Companion Dog and Mental Health, Hemopet, 20 Jan. 2020, https://hemopet.org/exercising-dog-mental-health/.
Madari, Aladar, et al. “Assessment of severity and progression of canine cognitive dysfunction syndrome using the canine dementia scale (cades).” Applied Animal Behaviour Science, vol. 171, Oct. 2015, pp. 138–145, doi.org/10.1016/j.applanim.2015.08.034, https://www.sciencedirect.com/science/article/abs/pii/S0168159115002373?via%3Dihub.
Salvin, Hannah E et al. “The canine cognitive dysfunction rating scale (CCDR): a data-driven and ecologically relevant assessment tool.” Veterinary journal (London, England : 1997) vol. 188,3 (2011): 331-6. doi:10.1016/j.tvjl.2010.05.014, https://www.sciencedirect.com/science/article/abs/pii/S1090023310001644?via%3Dihub.
Skoumalova, A et al. “The role of free radicals in canine counterpart of senile dementia of the Alzheimer type.” Experimental gerontology vol. 38,6 (2003): 711-9. doi:10.1016/s0531-5565(03)00071-8, https://pubmed.ncbi.nlm.nih.gov/12814808/.
Yarborough, Sarah et al. “Evaluation of cognitive function in the Dog Aging Project: associations with baseline canine characteristics.” Scientific reports vol. 12,1 13316. 25 Aug. 2022, doi:10.1038/s41598-022-15837-9, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9411588/.Post navigation
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