If you’re very lucky, you’ve had the pleasure of caring for a pet that has grown so very old that she had a little trouble remembering where she was at times.
She might also have had a little trouble discerning daytime hours from night, sleeping all day and then pacing around after the rest of the household had gone to bed.
Confusion, disorientation, dementia: call it what you will. But when it affects dogs, I lovingly refer to it as "dogzheimers," otherwise known [more clinically] as "canine cognitive dysfunction."
Although the disease process in dogs may be clinically different than human Alzheimer's, its effects appear quite similar to most pet owners: sleep/wake cycle disturbances, anxiety, inappropriate vocalization, repetitive behaviors (like pacing), elimination disorders (what you might call "incontinence"), and generalized disorientation.
While some very old cats experience a less pronounced version of this disorder, it is relatively common in geriatric dogs. Hearing and vision loss, also far more common in dogs than in cats, seems to accelerate the process by accentuating the disorientation these pets experience.
Most owners don’t appear alarmed at the onset of these symptoms. They seem to take it for granted that old animals will suffer the same changes so many humans undergo in later years. But if humans with dementia are any guide, dog lovers would do well to keep their ear to the ground on these symptoms and take early action upon their manifestation.
Why? Because disorientation often yields to anxiety, and ultimately to generalized deterioration of every major organ system (as well as a predisposition to a multitude of other diseases). Moreover, dogs with dementia, in spite of their physiological limitations, can live a whole lot longer than most pet owners assume. And that would be fine, but for their perpetual state of anxiety and/or discomfort.
What’s my tack on these cases? For starters, during physical exams of older pets, I ask about alertness — especially when people start talking hearing loss and vision loss. Is the dog bumping into things at night? Is he less likely to look up when you enter a room? For pets with cataracts, even at an early stage, I suggest a trip to the ophthalmologist for an evaluation and cataract surgery, if possible.
If dogs are just starting to show signs of disorientation, I try to talk people into adhering to a stricter schedule when it comes to feeding, walking, time at home, etc. Why? Because your schedule is their schedule. And a strict routine is excellent therapy for confused pets — it’s orienting.
For more severe cases, I discuss the benefits of Anipryl (selegiline), a drug that seems to reverse some of these symptoms … to a minor extent, I must admit. Anti-anxiety drugs may also be indicated for some dogs. Amazingly, some dogs with advanced dementia are quite relaxed, but most display some degree of stress — especially when lost in a corner of a room or when they find themselves alone and awake in the middle of the night.
The most comprehensive approach to canine cognitive dysfunction includes the services of a veterinary behaviorist. Some of these specialists are miracle workers when it comes to helping owners re-orient their confused geriatric pups. I’m often surprised by how just one visit can make a tremendous difference. It’s might be expensive, but it's still far cheaper than drugs or new carpeting, for example.
So many of these dogs are euthanized before their time, simply because the incontinence or vocalization became far too much for the family to handle — and because no one took the time to explain that a dog can have a comfortable, productive life even after the loss of normal brain function. Some cases are exceptional and can’t be satisfactorily helped, every situation is different, but you’ll never know until you try.
For my part, I find that I euthanize way too many old dogs whose happiest days could still be ahead of them. It’s my firm belief that if owners could be brought around to accepting that an old dog requires only as much attention and special care as a puppy, then perhaps they wouldn’t throw up their hands in disgust over a little stool on the floor. After all, we’re going to be there ourselves someday, if we're lucky.
Dr. Patty Khuly