June is Alzheimer’s and Brain Awareness Month, and today we’re painfully aware of diseases like dementia and Alzheimer’s disease, especially the cognitive and memory problems they cause. Unfortunately, a similar problem can afflict cats and dogs. It’s called Cognitive Dysfunction Syndrome, or CDS.

Like other cognitive impairments in human patients, CDS often afflicts cats and dogs later in life: dogs at age 9 years or older, cats at 11 or 12.

You or your family veterinarian may notice the signs first in the exam room. Lots of these cats or dogs, when placed on the ground, will pace or aimlessly wander around a veterinary exam room, showing little interest in people. The opposite behavior may show up, too, with previously friendly pets cowering or fearful. 
What Cognitive Dysfunction Syndrome (CDS) looks like in cats and dogs

Veterinarians know Cognitive Dysfunction Syndrome through the signs we see in physical exams and though observing behavior. Doctors will use the acronym DISHAAL to catch many of the signs we see:
  • Disorientation: This difficulty with spatial awareness may show up as a pet getting stuck in corners, struggling to move around familiar objects and staring blankly at walls or into space. Other issues may include not recognizing people, not being able to follow familiar commands, and wandering.
  • Interaction changes: A pet who once was aloof and maintained distance may not mind petting, while a pet who once enjoyed social interactions with pets and other people may avoid or ignore them. Pets with CDS may act distant. This especially shows up in cats, who may have once been watchful of people, keeping their distance, and now don’t pay much attention to people petting or getting close.
  • Sleep changes: Pets who used to sleep through the night may wake often during the day, stay awake or vocalize. The opposite may be true of nocturnal animals, like cats.
  • House soiling: While cats may struggle with inappropriate elimination because of other health problems or behavior issues, dogs with CDS who were previously housetrained may start urinating and defecating indoors. 
  • Activity changes: Pets may show less interest in activities they used to enjoy, or normally sedentary pets may suddenly do more wandering, pacing around the home or walking aimlessly in a circle. 
  • Anxiety: Pets may get jumpy and develop fears and phobias of new things. They can experience new fear of familiar locations and situations or separation anxiety.
  • Learning and memory: Pets may lose all ability to retain old commands, and they may struggle to learn new behavior.

Other medical conditions or household issues can cause many of these same signs. While CDS is usually a result of problems in a pet’s brain, especially in older pets, underlying conditions like kidney failure and heart failure can predispose a pet to show signs of CDS.

Also, if a pet is experiencing significant pain or dysfunction in other parts of the body, that can cause many of the signs of CDS. Why? The brain is a highly metabolic organ, which means it’s sensitive to changes in blood pressure, hormone levels and nutritional deficiencies, and those can affect the brain. Your pet’s mental capacity has limits, and the more of your brain you need to use to deal with chronic pain and mobility problems, the worse your pet gets at paying attention, sticking to routines and dealing with everyday life.

A thorough exam and lab work by a veterinarian is necessary to rule out issues before settling on Cognitive Dysfunction Syndrome as the diagnosis. Lab work as well as more sophisticated diagnostics, like an MRI may help us see potential problems in the brain. 
 
How we can treat, but not cure, CDS 
It’s important to set realistic expectations as a pet owner. There are no surgeries that neurologists or other board-certified specialists can perform to cure CDS. It can be hard to get a lot of improvement, but we do see patients that improve their quality of life.

What could treatment look like? We may try a lot of things that could include:

  • Increase (modestly) physical activity: We don’t like to overwhelm pets with CDS, but increased physical fitness and some kind of interaction every day with the pet owner can help the brain. 
  • Calm down your household: Cats and dogs with CDS may struggle with lots of stimuli: too much noise, too many sounds, too much craziness. If it’s possible, try to cut down stimuli where your pets live and help out their hard-working brain. Try this especially at night (or during the day for cats), so your struggling pets can have the best chance to sleep.
  • Tackle the comorbidities (a fancy word for any other underlying conditions): If a cat or dog is struggling with other medical problems, your veterinarian may tackle those before trying to improve the CDS. A healthier pet has a better chance of a better quality of life. Pain control and anti-anxiety medication can help.
  • Consider medicine: Selegiline, if appropriate for your pet, is one of the drugs approved for use in animals to treat cognitive dysfunction.
  • Try nutraceuticals: Falling somewhere between better nutrition and pharmaceuticals is this category of health-helping products for pets. Supplements like Novifit, which contains S-adenosylmethionine (SAMe), or products with resveratrol may help brain functioning. Always check with your veterinarian before giving supplements to your cat or dog.
  • Change the diet: Packaged diets like Hill’s b/d and Purina’s Neurocare diets include fatty acids and other ingredients that may help brain health. 
  • Lower the anxiety: You may be able to do more than turn down the volume and keep the crazy parties to a minimum to help your pet deal with a diminished brain capacity. Products with natural calming agents like Adaptil, Composure, Feliway, Soloquin or Zylkene may help.


And remember: If your cat or dog is diagnosed with CDS, be kind to yourself so you can be kind to your pet. At the heart of this new diagnosis is a relationship that has changed between you and your pet. It can sometimes feel like you’ve lost a pet before they’re gone. 

While there is no surefire way to cure CDS in a cat or a dog, thorough examinations, proper diagnosis and supportive care like the options above can improve the quality of life for a cat or dog who’s struggling to get through everyday life.

You have options.

Dr. Johnny “Randy” Cross was born in North Carolina, was raised in Virginia, did his internship in New Jersey, his residency in Pennsylvania and now loves practicing as the first veterinary neurologist in Indianapolis. He gets excited about epilepsy, intervertebral disc disease, tumors of the nervous system, and infectious/inflammatory central nervous system diseases. After minoring in entomology, he was a bee keeper. He played team sports so long that now he carries with him the important lesson that everyone has an important role to play in a successful veterinary practice and in every successful patient, client and doctor relationship. His wife is a veterinarian as well, and they live in Carmel, IN, with their two daughters and various dogs, cat and horses. If you’re in his area, there's a good chance your veterinarian already has his personal mobile number. 

“While there is no surefire way to cure CDS in a cat or a dog, thorough examinations, proper diagnosis and supportive care like the options above can improve the quality of life for a cat or dog who’s struggling to get through everyday life.”