Confused, Restless or Stuck: What is Cognitive Dysfunction in Cats and Dogs?
If you are a cat or dog parent who has a pet with cognitive dysfunction (CD), you know how confusing it can be for them and you. The changes in your pet can be characterized as similar to those of a person with Alzheimer’s disease. It can be difficult to understand what the pet you have loved for so long is going through and how you can help. It’s important to try and understand what is happening with your pet.
What causes CD?
Cognitive dysfunction results from gradual and age-related degeneration of the brain. This can happen from a build-up of a substance called amyloid, which creates a toxic environment for brain cells—and a general loss and deterioration of brain cells—which results in an inability to process information. This difficulty in processing information results in behavioral and physical changes and is more commonly known as dementia.
CD is diagnosed based on clinical signs. Some of the observable changes are changes to sleep cycles, interactions with people and other animals, disorientation or confusion, eating habits, and elimination habits. Common symptoms include:
Pacing and/or restlessness
Getting stuck in corners or under/behind furniture
Dazing off or seeming lost
Confusion
Sundowning, or worsening symptoms at night
Treatment Options are Few
Although there are some supportive options, CD is a progressive and degenerative disease with no cure. Diets that target brain health are available and include antioxidants, fatty acids and other ingredients that target the health of brain cells. Similarly, supplements exist with the same goal.
Selegiline is a monoamine oxidase inhibitor (MAOI), a class of drugs to treat depression and other nervous system disorders, that is sometimes used in the treatment of Parkinson’s disease in people and is often discussed in the treatment of CD in dogs and cats. Selegiline reduces the breakdown of dopamine in the brain, which is a neurotransmitter that plays a role in pleasure, motivation, and learning. Selegiline can also influence the levels of the stress hormone known as cortisol, and naturally-occurring stimulants including amphetamine and methamphetamine. Like all MAOIs, it may take 2 to 6 weeks to reach full efficacy and to notice any symptom relief.
Unfortunately, selegiline has more than a few drug interactions, meaning it cannot be combined with certain drugs. Because selegiline’s efficiency is anecdotal and not guaranteed to work in every patient, it is difficult to justify prescribing it for pets that are already taking a large number of medications that are proven to treat other symptoms or illnesses affecting them, since prescribing selegiline may require those to be discontinued.
One way you may be able to keep cognitive dysfunction at bay is enrichment. This includes play, toys and exercise, which promote brain health. In people, daily exercise is linked to a reduced risk of dementia. Spending time with your pet doing something they enjoy will benefit both of you and maintain the special bond that you already share as you work through CD with them.
Goals of Care for Cognitive Dysfunction
Because there is no cure for CD, our goal for treatment is to maximize comfort and quality of life. This often includes:
addressing any underlying concurrent diseases or illnesses, especially sources of pain
eliminating areas they may get stuck in or under, and furniture they get stuck behind
reducing confusion by maintaining a set schedule and routine
using tools such as a night light in common areas
reducing risks of slips and falls by using non-slip surfaces and blocking off staircases and elevated furniture
using pharmaceuticals and supplements to achieve sedation at night and promote good sleep hygiene
adjunctive therapies such as acupuncture to address the Eastern diagnosis for cognitive dysfunction, loss of Shen (Spirit or the Mind) and reduce any existing pain or discomfort
encouragement to maintain appetite by offering a variety, home cooking, or introducing an appetite stimulant
Key Facts about Cognitive Dysfunction
Cognitive dysfunction is a progressive and degenerative disease that has symptoms mirroring those of dementia in people. There is no effective treatment or cure. Instead, our goals for palliative care include maintaining comfort, appetite, and sleep while monitoring quality of life.
It can be difficult living with a pet with cognitive dysfunction. Finding the support you need is essential for the health of your pet and you. If you are concerned your pet may have cognitive dysfunction or are interested in talking about palliative care for CD, including changes to your home environment, diet, supplements, medication and/or acupuncture, we can help. You can schedule a virtual consultation where we will review your pet’s medical records, discuss their current health status, and come up with the best set of options for you and your pet.
