Dogs showing early signs of dementia can still enjoy quality of life

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15 September 2020
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A dog showing the early signs of canine dementia can still enjoy quality of life, as Isabel George has discovered with her own dog, Scrummy.

There has always been an element of the eccentric about our rescue dog. In her 12 years of life with us, Scrummy has never totally abandoned the resourceful tactics of a wily street dog: she drinks from puddles, and never misses the chance to finish an abandoned cup of tea, or hoover up a reachable morsel of food. Scrummy’s survival instincts would give Bear Grylls an inferiority complex!

Scrummy has always been on top of life: monarch of the garden, commander of the sofa, guardian of our family. She runs like the wind, snores like a piglet, and gets vocally jealous when we ‘dance’ with the goldfish (but that’s another story). Scrummy is the lovable, characterful opportunist who makes our house a home. Scrummy was just Scrummy… until the summer of 2019.

One night she just didn’t want to go for her walk. She was fine walking in the daytime, but not in the dark. We wondered if she was losing her sight. And then when she did walk, she decided how far — sometimes it was just to the end of the drive. Even a slow-paced, evening beach walk on holiday in North Wales no longer seemed to give her pleasure. She voted with all four feet, and simply sat down like an immovable lump, and then ran, old-style, back towards the house where sleep became a much more attractive pastime.

Then, almost at the same time, came the very uncharacteristic eating less and drinking more. That was it… we booked her in for a check-up.

One full MOT pass later and we were all breathing a sigh of relief. Scrummy was officially fine physically and, apparently, rather remarkable for her age (13 years). But, like it or not, our four-legged family member was not just greying at the muzzle, she was getting on a bit.

In human years, Scrummy was an octogenarian. I told the children that expecting her to still enjoy long country walks or beach run-arounds was a bit like expecting their grandmother to run the London Marathon. It just was not going to happen.

We worked on a new plan based on accepting the new facts of our dog’s life: Scrummy enjoyed the shorter, daytime walks and her ‘senior’ wet diet — fed in smaller portions spread through the day — and a new big, fluff y cushion worked a treat.

But then came the strange stuff. It began with the thousand-yard stares. I admit we all found it a bit funny at first. Scrummy would plod along, then suddenly stand stock still, or just stare at the walls, for what seemed like ages. Suddenly, it stopped being funny.

Then came the ‘midnight wanderings’ around the house and sometimes the garden. A trip out for a wee would turn into a full patrol of the garden and a bit of a bark too if it took her fancy. On one occasion, she decided to bed down by the bird bath at 3am.

We were watching our dog become an unpredictable new version of herself: the once fool-proof guard dog now sleeps so heavily that determined intruders could probably burgle the bed from under her. The dog who stole the sofa for entire evenings now spends that time wandering in and out of the room for no apparent reason.

She sometimes sits in her favourite chair, looking out into the garden, ‘talking’ to herself and grumbling at the birds, perfectly happy in her world, but there is a new distance in her eyes.

As a rescue dog, Scrummy has always been a gradually unfolding story, but she settled immediately into her role of family comforter and protector.

When she came to us, life was just settling into a new rhythm for me and the children and she gave herself to all four of us in different ways. Gifted with a kind of canine sixth sense, Scrummy always seemed to know who needed her most and when. Now it is Scrummy who needs our help.

I started to diary the changes in Scrummy and it became clear that we were entering a period of progressive change.

We knew that we could not stop it happening, but we were reassured, on veterinary advice, that what was happening could be managed — and not to worry.

Understanding canine dementia

From an owner’s perspective, understanding canine cognitive dysfunction (CCD), also referred to as cognitive dysfunction syndrome, as it’s not exclusive to dogs, begins with accepting two realities: it is a progressive condition and there is, as yet, no cure.

In this and many other ways it is similar to Alzheimer’s disease in humans and so, in older dogs where there is a change in ‘normal’ behaviour, it could be a sign of changes occurring in the brain and the decline in cognitive abilities.

Vets often use the acronym DISHA — Disorientation, Interaction, Sleep cycle, House soiling, Activity — to describe the classic signs of CCD. These five points are based on the most common changes reported by the owners of older dogs:

DISORIENTATION: Wandering around as if lost in their own home. Sometimes the confusion leaves dogs staring blankly at familiar people and surroundings, and they can become visibly agitated and upset.

INTERACTION: Seeking extra attention is associated with asking for more information to deal with anxiety. Sometimes there is a change to reluctance to interact and play. A show of uncharacteristic hostility towards other pets is an indication that the dog is feeling different about social interaction.

SLEEP/WAKE CYCLE: Changes in sleep patterns for CCD sufferers can mean longer daytime snoozes and a new phase of overnight wanderings and ‘wee’ trips.

HOUSE SOILING: Dogs may lose some of their associated learned behaviours such as the usual practice of going outdoors to relieve themselves. Incidents of soiling while sleeping are unusual so need to be checked by a vet.

ACTIVITY: A noticeable slowing down and a reluctance to exercise is common. Repeat pacing, circling, and inappropriate whining and barking can enter the mix too.

As yet, no specific diagnostic testing exists for canine dementia and so many of the signs highlighted by the DISHA guideline could indicate a physical problem, such as chronic pain, organ failure, or a variety of conditions affecting the glands and hormones of the endocrine system, all of which need early veterinary attention.

Professor of veterinary behavioural medicine at the University of Lincoln Daniel Mills acknowledges that it’s not possible for owners to know what their dog is feeling and experiencing. “It’s totally understandable for owners to assume that changes in their elderly pet’s behaviour can simply be attributed to the normal ageing process, but I would urge owners never to assume.

“Instead, keep a record of any behaviour changes and then discuss the findings with your vet as soon as possible. The notes provide vital clues to assist a diagnosis and we all know that early intervention in any condition can be crucial in terms of treatment of any underlying medical conditions, and, if appropriate, management of cognitive dysfunction syndrome.”

An initial visit to the vet surgery is likely to start with a full clinical examination to include routine blood and urine tests and a full discussion of the dog’s past and recent history. Professor Mills added: “Vets often rely on the client questionnaires to identify potential sufferers. The canine cognitive dysfunction rating scale is a series of 13 questions, which have shown 98.9 per cent overall diagnostic accuracy. This all points to the value of an owner’s care and helpful observations. Many of the signs of CCD are also signs of chronic pain, which can often be very effectively managed, so it’s important to have them ruled out.”

Statistics suggest that around one in three dogs over the age of 11 suffers from signs of CCD with the inevitability of more long-living pets presenting with symptoms in the future. That’s why it is reassuring to know that a mass of ongoing veterinary research into the effects of brain ageing in canine patients is currently being carried out worldwide.

What the scientists already know is that the process of ageing creates physiological changes, which affect a dog’s emotional make-up as well as his behaviour. A healthy nerve function — where information is transmitted quickly and smoothly across the nerve pathways to the mind and body — is vital for good cognitive function. Canine cognitive dysfunction, as a neurodegenerative condition, messes with the process.

How does a dog get dementia?

One of the characteristics of this condition, unlike normal ageing, is the build-up of a chemical known as beta amyloid. This is a protein that accumulates in the brain and replaces some of the nerves sending messages to receptors in the body.

In people with Alzheimer’s, or cats and dogs with CCD, large ‘plaques’ of amyloid build up in the brain. No one is sure why, but one theory is that it’s the body’s failure to deal with the normal day-to-day damage that cells experience — what is known as oxidative stress.

Managing and monitoring the progression of CCD symptoms is best achieved under the guidance of a vet, simply because this is a disease that needs diagnosis and veterinary treatment. A vet will also be able to translate the observed changes and apply the latest clinical knowledge on the condition.

Sarah Heath, veterinary specialist in behavioural medicine, is keen to point out that every dog’s case is individual and special.

She explained: “Any management plan created to support a dog with CCD needs to be tailored to the individual, looking at their environment, diet and supplements, and selected pharmaceuticals.

“But the main helping strategies can begin at home, where the emphasis rests on the security of the familiar, so keeping to routines, avoiding change, and maintaining a stable and secure home are the key.”

Diets designed to support older dogs showing signs of dementia often contain antioxidants, which combat oxidative stress and have been clinically proven to help dogs in cognitive tests. There are also a number of dietary supplements (nutraceuticals) such as essential fatty acids (Omega 3), which act to improve the quality of neurone impulse and a dog’s brain function in the ageing process.

A body of research specifically looking into diet and brain ageing has already seen the arrival of clinically proven nutraceutical products such as Aktivait Dog, containing a combination of ingredients that, working together, significantly improve nerve function and certain behavioural changes in dogs with CCD.

“A combination of diet with environmental enrichment appears to have the greatest overall positive effect in dogs,” said Professor Mills. “There’s no halting the ageing process but there is evidence that an appropriate senior diet, supporting supplements, and appropriate exercise can, potentially, slow down cognitive decline.”

Many veterinary practices offer senior clinics where owners can talk through concerns and receive advice on monitoring and managing, and even preparing for the stages of dementia that lie ahead. “Cognitive decline can be a challenging condition to diagnose and manage,” continued Professor Mills. “But there is some reassurance for dog owners in that with the range of management options available, and with early intervention, it is more than possible to maintain a quality of life for canine dementia patients.”

Sarah advises:

Leave beds, bowls, toys, and favourite snooze spots where your dog expects to find them. Relocating items can prove disorientating and cause anxiety.

Stick to familiar walks and ‘smell’ trails, but keep outings short and, if willing, more frequent.

Use a minimum vocabulary to reduce the chance of confusion or instruction overload.

Consider using a canine appeasing pheromone such as Adaptil Calm to help signal security and safety in the home.

Make play interesting, with hiding and foraging games, rewarding with food or calm praise.

Isabel concludes:

Sometimes I feel that I am grieving for the younger version of Scrummy and find myself testing her interest in her once favourite games: she still loves chasing bubbles in the garden, but it’s all so tiring now and that’s the sad bit.

But then, she surprises us and joins in for sessions of lockdown yoga — well, she lies on her back, waving her legs in the air! I can see now that this is just another stage in our dog’s life. I feel positively reassured that Scrummy is still in there; she knows who we are, she seems happy, eats, sleeps, and exercises when she wants, and still has her sense of humour.

We have this covered and that’s because we owe her more than words can ever express.