We live in a world of amazing medical advances and technology. The combination of advances in veterinary medicine and the willingness of owners to invest in their pet’s health has allowed our companion animals to live longer and happier lives. With this longevity comes certain age related diseases, most notably, cognitive decline that resembles human dementia or Alzheimers in both pathology and progression. This change in mental function called Canine Cognitive Dysfunction (CCD), can begin to effect dogs as they approach senior age and is a progressive disease.
Cognitive Changes Can Vary
CCD can effect any breed with varying symptoms that can begin as early as 5 years old in giant breeds to the teen years in others. Early signs can be subtle changes in behavior or habits that can be easy to miss. Maybe they aren’t as interested in toys like they used be to or aren’t as quick to greet you at the door. As time goes by though, it will become clear that your dog’s mind is changing.
Some of the common symptoms of Canine Cognitive Dysfunction :
Change in sleep cycles– sleeping during the day and up at night, pacing at night, sleeping more over all
Increased Anxiety- common symptoms can be pacing, vocalizing, excessive panting, and trembling,
Decreased Activity- Not interested in things that used to interest them such as playing, less willing to go for walks or play with housemates
Inappropriate Vocalization- barking, whining, howling for not apparent reason
Incontinence- urinating and defecating in the house or inappropriate places (even after just having been outside), not indicating that they need to go out for potty breaks
Increased aggression- bite first mentality,some loose the ability to communicate with other dogs leading to fights or unwanted behavior
Less Social Interactions- becoming withdrawn or isolated even with family members, loss of interest in other housemates, generally less engaged in what is going on around them
Generalized disorientation- getting lost or seeming confused in their own house or yard, getting stuck in corners or under furniture, not able to figure out how to get out of a room or back home during a walk, forgetting to go to the food and water bowls when they are thirsty or hungry, staring at the wall
Make Sure That You Are Not Dealing With Another Health Related Issue
Just as with our human family members, it is hard to watch the decline in our pets. Over time, they begin to lose their independence and require more and more care to meet their daily needs. The good thing about canine cognitive dysfunction is that is a slowly progressing disease. Some pets will demonstrate only one or two symptoms in their lifetime while others could show more. The first thing that any pet owner needs to do if they are worried about CCD is to consider what signs that they are seeing and then consult their veterinarian. Several of the symptoms that we have discussed can also be from other health issues. Sometimes dogs can be crabby and change their behavior because they are in pain from arthritis. If a pet’s vision is declining they may be less willing to participate in the usual activities or navigate a once familiar area. Once we have determined that any other medical need of an aging dog is met, then we can evaluate the best way to manage the remaining symptoms of mental decline (if there are any)
Helpful Management Strategies
Diet Changes. What your pet eats can play a significant role in delaying cognitive changes as they age. Studies have shown the having a diet rich in antioxidants, medium chained triglycerides (MCT), antioxidants and omega 3 fatty acids can help to slow the progression of the disease. Companies such as Hills and Purina make specially formulated “brain” diets rich in these components. If you are interested in a more natural diet then look for one that centers around antioxidants, vitamin B, and omega 3 fatty acids. If you are cooking for your dog, make sure that the antioxidants are dog friendly like blueberries, dark green veggies, and sweet potatoes. For the MCT supplementation, coconut oil has been commonly used if the pet will tolerate it. (Any oil supplement can soften the poop and if you are already dealing with incontinence then that can be a disaster!)
Medication to Slow Progression and Reduce Anxiety.
Anipryl (selegiline) is one drug out there that is thought to reduce or slow down some of the destructive pathology in the brain. Medication that may reduce anxiety or aggression associated with the cognitive changes include fluoxitine, amitriptyline, benzodiazapines, and gabapentin. One daily supplement for anxiety that is promising is Solloquin. There are many stories out there about the use of CBD to manage anxiety in dogs but there are currently no scientific studies to support this claim. So the question is two parts: does CBD help reduce anxiety associated with canine cognitive dysfunction and if so, what would be the dosing ? The answer is that the two studies out there looking at the use of CBD products in dogs have focused on either epilepsy or pain control for arthritis so we don’t know. Also the CBD products are considered nutraceuticals and therefore are not regulated for purity and content. The biggest concern with CBD use, in my opinion, is the potential for serious issues with the quality of the product. My guess is that CBD products will eventually play a role in canine cognitive management in the future after we have worked out some of the existing issues.
Keep Them Active (both mentally and physically). Don’t treat your older dog as if they are old! Keep encouraging those walks and fun times. Make an effort to engage your senior pet with mental games like “find the toy” or offering behaviors like sit/stay/heel/giving paw for treats or rewards. Continue to make them “mind their manners” with commands and expectations if it is still within their comprehension. If your dog is showing some of the signs of CCD but still has the drive to participate in sporting events, keep going but maybe scaled back some or with more supervision in case they get confused. Give your dog a reason to get up and to get going every day. Most importantly, keeping an older dog active and awake during the day may help them hold on to their normal sleep cycle at night.
Stick to a routine. Try to have a routine feeding , walking , and bedtime schedule. Change is hard for these dogs and a source of anxiety so keeping eating, activity, and resting as routine as possible is important.
Modify the Environment. If your dog is getting stuck behind or under furniture and not able to figure how to get out, then limiting unsupervised access to parts of the house may be necessary. Baby gates and/or crating (if they were already used to a crate and accepted it as part of their routine) can keep an unsupervised disoriented pet out of trouble and safe from harm. You may need to block off stairs if your dog is unable to navigate them without the potential of falling. Harnesses and lift systems can be lifesavers if your dog needs a hand going up the stairs, in/out of the car, or even help keeping steady during potty breaks. Belly bands or doggy diapers can be very helpful in allowing a pet to remain with their family in the house and not isolated because of soiling concerns.
The Smoothing Out the Bumpy Road of Cognitive Decline
Aging is an unstoppable process that we are all going through. Some of the changes that come with the aging process are are good, some are not so good. A few of the management strategies that we have discussed are easy enough to implement earlier in life, before any signs of potential canine cognitive dysfunction even show up. Keep your dog active and stimulated while also feeding a nutrient rich diet with omega 3 fatty acids and good stuff like veggies. Easy, right? On a final note, if we can take a moment to assess the needs of our pets as they enter the later stages of their life and combine that with compassion, we certainly can smooth out the bumpy road of cognitive decline.
As a veterinary rehab therapist I have seen my fair share of hind end weakness in older dogs. This loss of function can be from a variety of causes. A thorough exam is a great place to start to rule out issues such as tick diseases, weakness from anemia or endocrine imbalance, and to localize any areas where pain may play a factor. Arthritic joints and orthopedic injury can lead to a pet that doesn’t want to move because of pain and discomfort.
Do We Really Know the Cause of the Weakness?
The hind end weakness that I am referring to is the generalized geriatric hind end weakness that we often see in senior aged dogs. Several of my patients go through a progressive decline in function that is not arthritic in nature but rather a neuromuscular degeneration. We can be quick to call this neurological decline Degenerative Myelopathy (which is a truly terrible disease similar to ALS in people) and set ourselves on a negative course of doom and gloom for the patient. In my rehab career I have seen many dogs with hind end weakness but only a few of them actually had true DM (diagnosed by DNA testing and/or MRI screening). The DM dog’s journey of decline to complete dependency was fairly quick (months) and very heartbreaking because their bodies gave out well before their spirit did. So let’s just agree that dogs can have many other neurological things happening to their body (age related muscle loss, spondylosis, lumbrosacral disease, degenerative disks to name a few) besides DM to bring them to their weakness issues. Why is this distinction important? In short, TIME. Many of these non-DM related causes have a much slower rate of decline and that makes all of the difference when keeping a dog on their feet. Can we manage this hind end weakness, whatever the cause, and give these dogs a good quality of life? Sure we can!
Needs and Goals: Let’s Be Realistic
The first place to start is with setting realistic goals. In the case of age related progressive hind end weakness, we will never restore full function in our pets. Rehabilitation therapy will slow the process of weakness and decline but won’t change its course. My rehab goal is to improve quality of life, teach families how to manage a changing pet, and keep my patients on their feet for as long a possible. In the older patient, I usually find that once we begin rehab therapy we are maintaining where they are now in function and may be able to get back some activities such as being able to climb stairs again or getting on the bed without help. If they are currently able to just walk around the block before tiring out, rehab therapy will not get them back to that three mile walk that they used to do a few years ago. Rehab therapy will realistically keep the weakening dog walking that block for as long as possible with the least amount of help and secondary issues. They can still play ball or tussle with their canine buddies, but with some modification to avoid over fatigue and injury.
I like to have my owners identify some things that their dog used to enjoy doing but are not able to do any more. These lost activities can be markers for improvement if they return or goals to achieve with therapy. It is also important to find out what actions an owner needs their pet to be able to do (like get in and out of the car, up and down entry stairs) in order for the owners to feel comfortable taking care of their pet at home. There is a delicate balance between the level of care that a person is able to give and the level of care that a disabled pet actually needs.
Managing Hind End Weakness: The Plan
- Manage any source of pain. While the neurological decline leading to weakness may not be a painful process, there is often secondary pain in some of the joints and muscles because of how a pet is moving or compensating. If they use their front legs to push themselves to their feet or to carry most of their weight, maybe the elbows and surrounding muscles are sore. Often times the muscles of the spine are affected by changes in posture, falling over because of instability, or slipping on some surfaces. Oral medication such as NSAIDs and supplements as well as laser therapy and/or acupuncture are great resources for pain control. Massage or a warm compress on aching muscles can bring relief and comfort as well. Let’s not forget home care devices such as the Assisi Loop for portable pain control.
- KEEP THEM LEAN!! These dogs are having a hard time lifting their body mass and staying on their feet. Carrying excess weight will make the loss of strength and mobility even worse and eventually shorten the amount of time that they have with you.
- Consistent home exercise. Shorter walks twice daily are a great way to keep a dog moving and grooving. Mix it up with changing terrain by walking on grass, pavement, sand, and other surfaces to increase the feedback your pet gets from their feet to their brain. Challenge stability by adding in wide circles or figure 8s to a walk. Encourage pets to step over things like tree branches to lift their feet. Walking on a low unstable surface such as an air mattress can help to strengthen core muscles and promote body awareness for stability. Avoid the long hikes or play activity that may cause over fatigue that takes days to recover from.
- Acupuncture. I like to think that this modality is great for helping what does work to work a little better. Acupuncture will help to strengthen the nerve-muscle connection and is our go-to therapy when there are incontinence issues along with the hind end weakness. With acupuncture there is an increased circulation to problematic areas, nerve and muscle stimulation, and usually a general sense of well being for the patient.
- Formal Rehabilitation Therapy. Adding in aqua therapy and targeted exercises can work to strengthen muscles and build endurance for home exercises and activities. About half of my rehab session with a patient and their people is spent talking. Each session is therapy for the pet and the owner because watching a pet change can be hard. Use your rehab therapist as a valuable resource to help with solutions for home care needs. We are reassessing needs and goals all of the time and having someone to guide the way can reduce anxiety for both the owner and their pet.
- Environmental Changes. Slick, slippery floors are a huge problem with the hind end weakness pets. They can lose their footing and then not be able to get themselves back up without assistance. Placing throw rugs over slippery surfaces will help your dog to navigate at home without falling. Block off stairs if the pet can not go up and down them without some issue such as slipping or falling. Ramps to get in the house or car have their place but you need to find the right size and fit that works for your situation.
- Mobility Aids. There are so many products out there when you look online or in stores that picking one for your needs can be a bit overwhelming. My advice is to look at the reviews, see what worked and did not work for that particular item, and think twice before purchasing anything. I have a box full of items that people bought on their own that ended up not working at all. For the larger dogs, I do have one product that I consistently recommend and that is the Help Em Up harness system. You can use it to help a dog get into the car, up the stairs, get onto their feet, and to stabilize them during other day to day activities. This harness system is not for everyone but seems to be helpful to the majority of my families that use it.
We Are Here For You!
It can be a very difficult thing to watch a beloved furry family member age and decline in mobility, among other things. It is important to remember that this journey of age related change is inevitable, but we can make it a whole lot more comfortable for everyone. There is help out there for you and your pets. You just need to take that first step with your veterinary professional to start your journey of management and support.
It’s A Dog’s Life
It seems that pets these days are living longer than ever thanks to advances in veterinary medicine and investment in care from animal owners. It is not unusual to see a dog that is in their teen years still active and relatively healthy. I say relatively because with age comes a few bumps in the road (so to speak). There are a variety of management techniques that can help families with older pets live an awesome quality of life through their golden years. Because that is what we all really want for our animal companions, isn’t it? We want them to have full and happy lives for the short time that they are with us.
1. Watch Their Weight!
Older dogs generally move less and have a slower metabolism than when they were younger. This means that they can pack on the pounds quickly. This can start a vicious cycle of gaining weight and then not moving well which leads to more weight gain and so on. Activity is important to weight management but the key to weight loss is controlling calories. Lean body condition is very important to general health, especially if there are mobility issues. With that thought in mind, make sure that the food that your geriatric companion is eating is of good quality, easy to digest, and not filled with empty calories from endless treats. Just like with humans, a healthy diet is important for basic wellness and a strong immune system.
2. Keep Them Moving.
Daily, regular exercise is important for mental stimulation as well as muscle strength. Muscle loss and hind end weakness are a common issue on our older pets. Give your animal companion a reason to get up and moving each day because once they go down (or don’t get up), things can progress quickly in a direction that we don’t want to go.
One option to consider is aqua therapy. Both the underwater treadmill and pool are great for holding on to muscle mass and for getting stiff joints moving again. Sessions every one to two weeks can set a healthy foundation for better walks at home. Remember the old saying, “A body in motion stays in motion”. Continue…