Cognitive Dysfunction in Dogs and Cats

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Proceeding of the LAVCLatin American Veterinary Conference

Oct. 25-27, 2010 Lima, Peru

Next LAVC Conference:

Oct. 24-26, 2011 Lima, Peru

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Cognitive Dysfunction in Dogs and Cats

Terry Marie CurtisDVM, MS, DACVB

College of Veterinary MedicineUniversity of Florida

(352) 294-4397

[email protected]

Age-related changes can manifest as alterations in a pets behavior. These changes can affect any of thebody systems alone or in combination. For example, behavior can change as a result of arthritis(reluctance to move, to go out to eliminate), changes in the digestive system and/or the urinary tract (lossof housetraining), changes in sight, hearing (less responsive to the owner, more easily startled, possibleaggressive response), and changes in taste and olfaction (change in appetite). In cats, hyperthyroidismcan result in variety of behavioral changes including inappropriate elimination and nighttime vocalization.Therefore, it is very important to ask your clients about any changes in their pets behavior during theannual physical examination. It is important to rule out any medical conditions that could be contributingto the behavior problem by conducting the appropriate tests (e.g. complete blood count, chemistry profile,thyroid panel, radiographs, ultrasound, and ophthalmic exam). Once any medical problems are ruled outand/or addressed, then behavioral issues can be considered. It is important to remember that any

medical conditions may be chronic and may contribute to contribute to behavioral abnormalities. Whenconsidering any age-related behavior problem it is good to get a thorough history, including the onset andduration of the problem, when and where the problem occurs, and any progression of the problem.

Any condition that causes the pet pain can result in irritability. This can lead to aggressive encounterswith family members. Pain can also alter normal house training and the pet can be less tolerant of walksand exercise. All of this can cause an increase in anxiety. There can be changes in the animals centralnervous system (brain and spinal cord), also. These changes can result in a decrease in white and graymatter, a decrease in oxygen levels, and a change in the neurotransmitters causing a decline incognitive function. For example, the pet can become less socially interactive, slower to obey commands,and less alert and aware of surroundings. The brains of older dogs have been found to have neuropathiclesions similar to those seen in people with dementia.

Common Behavioral Complaints of Geriatric Cats

House Soiling

Approximately 50% of cats presented for house soiling began to exhibit problems after 10 years of age.Medical causes include kidney disease, diabetes mellitus, hyperthyroidism, and loss of sight/olfaction.There may be status issues with other cats in the household. And it may be a sign of cognitivedysfunction.

Inter-Cat Aggression

This may be the result of a newer, younger cat in the household. The older cat may be afraid of this othercat. Pain could also be a component of the aggression, so it would be important to rule it out.Hyperactivity and Vocalization

This could be a manifestation of separation anxiety, sensory decline, cognitive dysfunction, pain ordiscomfort, or hyperthyroidism.

Nighttime Vocalization

This could be a manifestation of anxiety, sensory decline, cognitive dysfunction, or hyperthyroidism.

Common Behavioral Complaints of Geriatric Dogs

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Aggression

Human-directed aggression is most commonly defensive and motivated by anxiety and fear. It can alsobe secondary to pain and/or sensory decline. Signs would include increased vigilance, trembling, tailtucked, ears back, panting, and hiding.

Dog-dog aggression is commonly the result of a breakdown in communication especially if it occursbetween two dogs who previously got along together well. A loss of sensory ability hearing and seeing

can certainly change the way a dog can signal and/or receive signals from another dog. Cognitivedecline can also affect anxiety and reactivity, both of which can negatively impact inter-dog relationships.

House Soiling

As in cats, inappropriate elimination can be the result of kidney disease (decrease in function, urinaryincontinence), arthritis (inability to get out the door fast enough, inability to posture), neurologic (loss ofsphincter control), fear/anxiety (storm phobia, separation anxiety), cognitive decline (loss ofhousetraining).

Separation Anxiety and Noise Phobias

As dogs age, it is not uncommon to observe a new fear of being alone and/or of storms, or a progressionof existing anxiety associated with these stimuli. In some dogs, it may be the first sign of cognitivedecline.

Nighttime Restlessness

Sleep disturbances can be the result of medical problems that result in an increase in elimination needsand/or physical discomfort. They can also be the result of increased anxiety and can also be a sign ofcognitive decline.

Cognitive Dysfunction Syndrome (CDS)

Cognitive function is the mental process occurring within animals that cannot be directly observed suchas memory, learning, awareness, and perception. Cognitive tasks are the actual observable behaviorssuch as housetraining, spatial orientation, object discrimination, and response to family members. Thediagnosis of CDS relies on the owners recognition of signs, and is most likely under-reported. Ownerstend to assume that the signs that theyre seeing are the result of normal aging. What makes it alsodifficult to detect is that the syndrome has a gradual onset and progression, so many owners becomeused to the way the animal is. CDS is a diagnosis of exclusion, meaning that the dog or cat has had anextensive medical workup and there are no apparent medical or neurological causes. There is a SeniorPet Checklist for dogs (prepared by Pfizer Animal Health) that can help steer the veterinarian and theowner towards or away from the diagnosis of CDS. There are four major categories: disorientation,activity and sleep, housetraining, and interaction with family members. Under the category ofdisorientation are the following signs: wanders aimlessly, appears lost/confused, stares at walls/intospace, decreased response to verbal cues or name, unable to recognize familiar people/places, andforgets reason for going outside. Under the category of activity and sleep are the following signs: sleeps

more overall, sleeps less at night, decrease in purposeful activity overall, and increase in aimless activity(wanders, paces) overall. Under the category of housetraining are the following signs: urinates ordefecates indoors, eliminates in view of owners, eliminates indoors soon after being outside, and signalsless to go outside. Under the category of interactions with family members are the following signs:solicits less attention, less likely to stand for petting (walks away), less enthusiasm upon greeting, nolonger greets owners (even when aware that they are home), and may become more clingy. CDS is thelikely diagnosis when there is an absence of medical possibilities for the behavioral changes and one ormore hits on the checklist.

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Cognitive Dysfunction in Dogs and Cats