COGNITIVE DYSFUNCTION SYNDROME
Although a condition comparable to Alzheimer’s disease has not been documented in dogs and cats, our pets do experience varying degrees of decrease in cognitive function. As with humans, we do not totally understand the cause(s) of decreased mentation. Decreased cognitive function is also difficult to define in dogs and cats because they do not talk to us. We can’t assess their memory by asking questions such as address, birth date, age, name, etc. We have to rely upon observation to note that the patient is acting “differently”. Owners that have very little interaction with their pets or that have very little ‘concern’ for their pets often miss the subtle signs of early cognitive dysfunction.
Signs of cognitive dysfunction can be observed in 50% of dogs and cats over eleven years old. In dogs that are highly trained to do specific tasks (seeing eye dogs, assistance dogs, drug sniffers, etc.) decreases in cognitive function are occasionally observed as early as six years of age.
The clinical signs of cognitive dysfunction can be summed with an acronym “DISHA”.
* Disorientation: getting lost within a familiar environment such as the house or yard;
* Interactions with owners or other pets become altered in either extreme – apathy or aggression;
* Sleep-wake cycles altered often accompanied by excessive vocalization;
* House training and other learned behaviors may deteriorate;
* Activity may be altered to include reduced activity or incessant, aimless pacing or the onset of obsessive/compulsive behaviors such as licking and anxiety.
Each of these clinical signs of cognitive dysfunction can also be caused by physical problems such as infections, arthritis, genetic conditions, heart disease, etc. Toxicity, liver disease, and kidney disease can cause disorientation. Pain can cause changes in the patient’s attitude and activity. There are dozens of physical reasons why a pet may gradually or suddenly begin house soiling.
As we cannot talk to our patients we have to base our diagnosis of cognitive dysfunction upon careful observations and history provided by the owner and by the elimination of physical conditions and diseases. This usually requires some combination of laboratory tests, x-rays, ultrasound, and “trial and error” therapy. It is not at all uncommon to put an older, dull, lethargic patient on a pain reliever for ten to fourteen days and have the owner report a “new dog”. In situations like this, the dog has been in some degree of constant and chronic pain for a long time and has “given up on life”.
The ability of veterinary medicine to solve the problem of cognitive dysfunction is not much better than it is in human medicine. There are drugs that often provide some help to the senile patient; but, there are no cure-all drugs available. When clients bring pets to us complaining of senility we commonly find one of three situations: (1) there is actually no senility once the patient’s physical problems are diagnosed and treated; (2) the patient has been neglected so long and has so many secondary complications that there is basically no longer any help available; and (3) the truly senile patient brought to the hospital by an observant, concerned owner that can be helped sufficiently to return the pet to a reasonable quality of life.
Our goal is to assist in providing a quality life for the patient.