Dementia in Dogs

What are the signs of dementia? 
In dogs, dementia is usually referred to as cognitive dysfunction syndrome [1] or cognitive dementia [2]. Canine cognitive dysfunction is when aging dogs suffer from mental and behavioural decline associated with changes in their brains [1]. This condition is quite similar, but is not exactly the same, as that in Alzheimer’s disease in humans. In humans, the damage in Alzheimer’s disease is permanent and irreparable [2]. In dogs, however, the outlook is more positive because behavioral signs of dementia are temporarily reversible and the progress of the disease can be slowed down [2].
 
Cognitive dysfunction results from changes in the brain associated with aging such as decline in neurons, decrease in cerebrovascular blood flow, or increase of neurotoin deposits. This result in the dog’s decreased responsiveness to stimuli, and decreased ability to learn and remember. [8]
 
In the early stages of dementia, the signs are often non-specific and are hard to attribute to any specific cause, which includes: [2,7]
  • Decrease in energy and activity levels
  • Reduced social interaction
  • Loss of play
  • Mild disturbance of sleep pattern
  • Mild increases in fear and anxiety
  • Loss of appetite

​As the disease progresses, you can observe more severe signs such as:[2]
  • Changes in personality
  • Confusion and failure to interpret sensory information correctly (staring into space or at inanimate objects)
  • Loss of learned behaviours
    • House-training
    • Control commands
    • Food snatching and stealing in front of the owner
    • Elimination in front of the owner
    • Changes in emotionality
    • Worsening of existing fear and phobia problems
    • Increased anxiety
    • Depression
  • Impaired ability to new short-term memory
    • Repetition of behaviour (e.g., requests for attention, food or to go outside)
    • Difficulty acquiring new learning (e.g., being house-trained again)
  • Specific neurological impairements
      • Loss of the ability to sense one’s position and movement
      • Central blindness (blindness caused by damage to an area in the brain)
      • Central deafness (deafness caused by defects in the central nervous system)


How exercise helps? How play helps? Give examples of specific cognitive exercises to practice.
Exercise, along with play, training and work helps your senior dog by maintaining your dog’s cognitive function [5], and reducing or slowing down the progression of cognitive decline (early stage of cognitive dysfunction) [9].
 
This is because our dog’s brains, like human brains, follow the use-it-or-lose it. This means that if you leave your dog on his own, either because of ignorance or inaction, the dementia will worsen over time [1, 5, 9]. Providing aged dogs with a behavioral enrichment such as outdoor walks, social interaction, play toys, and cognitive training will help maintain your dog’s cognitive abilities and/or slow down cognitive decline.[4]
 
But owners should remember that excessive change can be stressful, especially to senior dogs, so that any change in the household routine should be done gradually.[5]
 
Simple exercises that you, the owner, can do to exercise your dog’s mental and physical abilities include:
  1. Activity feeding- done by simply scattering dried food or freshly cooked bone for the pet to find [2,7]. By doing nose-work exercises, your dog is having some olfactory stimulation, which may be one form of cognitive stimulation for your senior pet [7].
  2. Walking your dog- gives your dogs a chance to sniff around and meet other dogs and people. Social interaction and exposure to new stimuli is important for keeping your dog’s cognitive skills sharp. If your dog has arthritis and has difficulty walking, using pet strollers is an option. She may not be getting aerobic exercise by using a stroller but she is using muscles involved in balance and attentiveness.[7]
  3. Swimming- a good way to improve strength and stamina in older dogs that have become sedentary and unfit. Fitter animals can also enjoy more vigorous play and social contact with less risk of pain.[2]
  4. Basic obedience or clicker work or working to teach new or maintain old tricks for 5 minutes 3-4 times per day. Some of the training can be incorporated into daily life (e.g. if getting up the table, you can ask the dog to come with you and sit or wait and offer a paw).[7]
  5. Roll (instead of throwing) balls and Frisbees for your dog to chase and/or retrieve. You can also try rolling food toys, and puzzles. This will serve to enhance and maintain eye-paw coordination and because the toys/puzzles make noise, even dogs that are losing their sight and hearing acuity can benefit. [7]
 

Best practices aka Tips for around the house.
Aged Dogs with dementia have problems locating and getting to the resources they need. You, as the owner, have to make some simple changes in the house to suit the need of your sick and aging pet:[2]
  • Provide additional water bowls close to your dog’s resting areas [2]
  • Provide additional resting sites [2]
  • Provide steps or ramps for your dog to easily get on and off furniture [2]
  • Use mats or rugs that have traction to help the dogs get more exercise and have fewer elimination accidents [7]
  • If your pet has problems with his/her vision, it might be helpful to put some carpets and rugs that will help your dog identify central floor spaces and corridors without bumping into things, place a quiet radio in different rooms close to his/her resources to help the dog identify the location, put different scents to help the dog identify specific rooms [2]
  • Provide a properly designed bed area, with a well-padded wrap-around basket that is near the night light and place your recently worn clothing to help an anxious or confused pet [2]
  • Protect the pet from accidents (e.g. falling into the swimming pool, falling down stairs). [3]

How does food quality help in preventing or delaying dementia? 
It has been shown that specialized diets rich in antioxidants can slow down the progression of cognitive dysfunction, improve behavioural function and may have a protective effect [3, 4].
A study showed feeding aged dogs with an antioxidant fortified diet (daily dose: 21 mg/kg/day Vitamin E, 1.6 mg/kg/day Vitamin C, 5.2 mg/kg/day Carnitine, 2.6 mg/kg/day lipoic acid w/ fruits and vegetables equivalent to 5-6 servings/day) resulted in a slowing of the rate of decline in cognitive abilities. Furthermore, if the feeding of the antioxidant fortified food is started at a young age (2-4 years), this will result in significant improvement on a visual discrimination task compared to dogs of the same age that were fed with nonfortified food over the same time period. This finding means that feeding foods that are fortified with antioxidants at an early age will delay the onset of cognitive decline in dogs.[6]
 

Dietary treatment for dogs with dementia?
Dietary treatment for dogs with cognitive dysfunction is available.
 
 A commercially- available diet formulated for senior dogs (Hills Prescription Diet d/b) has been shown to improve memory, learning ability and clinical signs of cognitive dysfunction [9,3]. The diet is supplemented with antioxidants Vitamins E and C, selenium, beta carotene, and flavonoids and carotenoids, omega-3 fatty acids EPA and DHA. [9]
 
Another diet shown to improve cognitive ability available in the market (Purina One SmartBlend Vibrant Maturity 7+ Formula) contains MCTs (medium-chain triglycerides). When fed to the aged beagles for 8 months, the dogs fed with the said diet scored significantly better on several types of cognitive tasks than did the control group. [1]
 
The best time to implement dietary or supplement intervention is before the dog shows any signs of brain aging (4-5 yrs old for large dogs, 5-8 yrs old for medium dogs, no later than 8-10 years for small dogs). [7]


Any supplementation that helps?
Dietary supplements can help delay the onset and slow down the progress of cognitive decline in dogs. These include:
  • Poly unsaturated fatty acids (PUFAs), especially arachidonic acid (ARA), docosahexanoic acid (DHA) and eicosahexanoic acid (EHA).
PUFAs play a role in maintaining the integrity of neurons and enhancing energy use by neurons. [7]
  • MCT (medium-chain fatty acids)
MCTs increase fatty acid oxidation and so may increase omega-3 PUFAs in the brain. In old dogs, MCT-enriched diets have been shown to decrease levels of Alzheimer precursor protein and increase brain phospholipid and total lipid concentrations. [7]
  •  Phosphatidylserine
Dietary supplements containing phosphatidylserine, a membrane phospholipid, has been shown to improve performance accuracy in memory tests when given to dogs for 60 days (Senilife, CEVA Animal Health). The product also contains gingko biloba (has neuroprotective and antioxidant effects), Vitamin B6, Vitamin E, and resveratrol, which may protect against oxidative damage and reduce beta-amyloid secretion. [5]
 
Another product that contains phosphatidylserine (Activait) has also been shown to improve signs of disorientation, social interactions and housesoiling in dogs. It is in combination with omega-3 fatty acids, vitamins E and C, L-carnitine, alpha-lipoic acid, coenzyme Q and selenium. [5]
  • SAMe
Formed from methionine and adenosine triphosphate, SAMe may help maintain cell membrane fluidity and receptor function and regulate neurotransmitter levels as well as increase the production of glutathione. In dogs, SAMe has been shown to improve activity and awareness after 8 weeks of supplementation [5]
  • Apoaequorin
Apoaequorin is a protein naturally found in jellyfish. In laboratory trials, it can improve learning and attention, and can improve signs of brain aging. [5]
 

References
1.     Anderson, Eileen. Remember Me?: Loving And Caring For A Dog With Canine Cognitive Dysfunction. Dogwise Publishing, 2016.
  1. Bowen, Jon and Heath, Sarah. Behaviour Problems in Small Animals: Practical Advice for the Veterinary Team. Elsevier Health Sciences, 2005.
  2. Cote, Etienne. Clinical Veterinary Advisor: Dogs and Cats. Elsevier Health Sciences, 2014.
  3. Ettinger, Stephen J and Feldman, Edward C. Textbook of Internal Veterinary Medicine, 7th ed. Elsevier Health Sciences, 2009.
  4. Landsberg, Gary M.; Hunthausen, Wayne L.; Ackerman , Lowell J. Behavior Problems of the Dog and Cat3: Behavior Problems of the Dog and Cat. Elsevier Health Sciences, 2012.
  1. Maldeker, Lester and Peter Vajdovich. Studies in veterinary medicine. Springer Science & Business Media, 2011.
  2. Overall, Karen. Manual of Clinical Behavioral Medicine for Dogs and Cats. ElsevierHealth Sciences, 2013.
  3. Shaw, Julie and Martin, Debbie. Canine and Feline Behavior for Veterinary Technicians and Nurses. John Wiley & Sons, 2014.
  4. Tilley, Larry Patrick and Smith, Francis W.K. The 5-minute Veterinary Consult-Canine and Feline, 3rd edition. Lippincott Williams & Wilkins, 2004.

​Dietary Treatment for dogs with Dementia
  • Omega-3 fatty acids
Omega-3 fatty acids can be obtained from fish oil, particularly from cold-water fish such as herrings, sardines, and mackerel [5,9]. Fish oil is the best source of usable omega-3 fatty acids, EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid) [9]. Recommended dose for dogs is 100-150 mg EPA and DHA combined per 10 lbs of body weight [3].

  • Phosphatidylcholine (Choline)
Important for memory, intelligence and mood, posphatidylcholine is useful for cognitive disorders in dogs [2]. Choline is found in egg yolk, liver bran, wheat germ, soybeans, cauliflower, lettuce, and nutritional yeast [5]. In dogs, the recommended dose for cognitive disorders is 20-40 mg/animal given every 12-24 hours or at 10-15 mg/0.45 kg body weight every 24 hours [9].

  • Vitamin C
Vitamin C or Ascorbic acid is a powerful antioxidant and free radical scavenger. Natural sources if Vitamin C include fruits, vegetables, and organ meats. Vitamin C is sensitive to oxidative processes so the Vitamin C content of most foods decreases dramatically during storage and processing. Vitamin C can easily loss its activity if exposed to heat, light, alkalis, oxidative enzymes and minerals copper and iron [11]. Long-term dosages for Vitamin C are 50-125 mg twice daily for small dogs; 125-250 mg twice daily for medium-sized dogs; 250-500 mg twice daily for large dogs [5].

  • Vitamin E
Good sources for Vitamin E include cold pressed vegetable oils, nuts, seeds, green leafy vegetables, eggs, most fish and meats such as beef, duck, turkey leg, and chicken breast. Dose for dogs is 7 7.5 mg alpha tocopherol per 1,000 kcal/ME daily. [3]

  • Selenium
Fish, meat and eggs are good sources of selenium. Dose is at 87.5 µg (mcg) per 1,000 kcal.ME daily [3]. Selenium is a powerful antioxidant that works with Vitamin E to lengthen cell life, thus helping fight degenerative diseases. Dose for small dogs is 5-10 mcg daily; medium-sized dogs- 10-20 mcg daily; large dogs- 20-50 mcg daily. [5]

  • Flavonoids
Flavonoids (e.g. quercitin) functions like Vitamin C. Quercetin is a natural antioxidant bioflavonoid found in red wine, grapefruit, onions, apples, black tea, and in lesser amounts, in green leafy vegetables and beans. Suggested dosage (general use) of bioflavonoid complex in pets is 200 to 1,500 mg per day, divided into 2-3 doses. [8]

  • Carotenoids
Carotenoids (beta carotene, alpha-carotene, lutein, lycopene, betacryptoxanin, zeaxanthin, canxanthin, and astaxanthin) are found in orange and green vegetables, and highly pigmented fruits [11]. Sources of beta-carotene include sweet potatoes, carrots and pumpkins [3]. Lycopene is found in cooked tomatoes, watermelon, and other red foods [2]. Carotenoids act as an antioxidant and they protect cell membranes by stabilizing oxygen free radicals produced [11]. AAFCO-recommended nutritional daily dose of Vitamin A in dogs is 100 to 200 IU/kg/day [8].

  • Lipoic acid and L-carnitine
Lipoic acid and L-carnitine are mitochondrial factors that may enhance the function of aged mitochondrion by restoring the efficiency of the mitochondria and reducing oxidative damage to RNA [7].  Both have been found to benefit animals with behavioural changes caused by senility. [5]
 
Dietary sources of L-carnitine include meat and dairy products. Lipoic acid-rich animal tissues (in the form of lipoyllysine; bound to lysine) include kidney, heart, and liver. Plant sources for lipoic acid include spinach, broccoli, and tomatoes. It can also be found in lower amounts in peas, Brussel sprouts and rice bran.[1]
 
Recommended dose of L-carnitine for small dogs is 20-150 mg/kg, 3x daily; medium sized dogs-1 gram every 8-12 hours; and large dogs- 2 g every 8-12 hours [5]. Suggested dose for lipoic acid is 1-5 mg/kg body weight [5]. A study incorporating antioxidants and mitochondrial cofactors into the diet of adult dogs at a dose of 5.2 mg/kg/day of carnitine and 2.6 mg/kg/day lipoic acid has resulted in an improvement in learning ability of the aged dogs. [7]

  • Medium chain triglycerides
Natural sources of MCTs include milk fat and coconut and palm kernel oils. MCTs consist 7% of the total fatty acids in milk fat. MCTs are more abundant in coconut and palm kernel oils, with about half of each of these oils comprised of C12 fatty acid [6]. A study in beagles 9-11 years of age, supplementing MCT at a dosage of 2g/kg/day resulted in an improvement in brain energy metabolism and decrease amyloid precursor protein levels in old dogs [10].
 
References

  1. Augustin, Albert J. Nutrition and the Eye: Basic and Clinical Research. Karger Medical and Scientific Publishers, 2005.
  2. Brown, Steve. Unlocking the Canine Ancestral Diet: Healthier Dog Food the ABC Way. Dogwise Publishing, 2009.
  3. Dodds, Jean and Laverdure, Diana. Canine Nutrigenomics: The New Science of Feeding Your Dog For Optimum Health. Dogwise Publishing, 2014.
  4. Ensminger, Marion Eugene and Ensminger, Audrey H. Foods & Nutrition Encyclopedia, Two Volume Set. CRC Press, 1993.
  5. Fougère, Barbara. The Pet Lover's Guide to Natural Healing for Cats & Dogs. Elsevier Health Sciences, 2006.
  6. Kamel, B.S. Technological Advances in Improved and Alternative Sources of Lipids. Springer Science & Business Media, 2012.
  7. Mandelker, Lester and Vajdovich, Peter. Studies on Veterinary Medicine. Springer Science & Business Media, 2011.  
  8. Messonnier, Shawn. Natural Health Bible for Dogs & Cats: You’re A-Z guide to over 200 conditions, Herbs, Vitamins, and Supplements. Crown/Archetype, 2010.
  9. Messonnier, Shawn. Nutritional Supplements for the Veterinary Practice: A Pocket Guide. American Animal Hosp Assoc, 2014.
  10. Overall, Karen. Manual of Clinical Behavioral Medicine for Dogs and Cats. ElsevierHealth Sciences, 2013.