Written by Shannon Fujimoto Nakaya, DVM
Mental confusion, senior moments, doggie dementia, alzheimer's, cognitive dysfunction syndrome . . . these conditions were not ones that I considered real problems. After all, how much mental capacity does an older pampered pet really need? Then I got to see doggie dementia in action through my dog Nalu (that's him on my logo). At 16 years of age, Nalu's blood tests were textbook perfect, there was nothing abnormal on xray, his cardiac evaluation was stellar, he was independently mobile and going for regular walks on the beach. In short, he was a darned healthy 16 year old dog . . except for his brain which had started to rot.
This is the dog who had gone everywhere with me since he was 9 weeks old. When I worked in an office, he waited under my desk while I was seeing patients (we spent time together between patients). When my husband took a job in New York and I worked in Massachusetts, Nalu and I drove back and fourth spending 5 nights in one state and 2 nights another. Over the years, he traveled to California, New Hampshire, Maine, North Carolina, Washington DC, Arizona, Colorado, and even Milan, Italy. After we moved to Hawaii and I started a house call practice, he rode around with me for 7 years. And then we had a couple of experiences where he capsized off the passenger seat and couldn't fix his position.
There were other signs as well. The dog who never missed a meal, who ate without asking what it was or whether it was digestible, was becoming a picky eater. He developed periods of anxiety during which times he would be mentally unreachable and inconsolable: his eyes would not focus, he would not respond to sound or touch or smell -- there was just no connecting with him. Initially, it was intermittent and subtle -- we kind of joked that he was having a "senior moment." But as it progressed, it became more devastating, and ultimately, despite all my efforts, his quality of life declined such that I chose to fulfill my promise that I would support him and care for him as long as it could be good. When it was no longer good, when the anxiety became overwhelming unless he was heavily medicated and in a drug-induced stupor, it gave me the strength to facilitate a graceful exit for a dog whose body was otherwise good.
So supporting pets experiencing confusion and anxiety are very real to me and here are some of my tips:
- Establish a routine. It reportedly helps humans with alzheimer's and it did help with my dog in early stages. Even when they might not be completely connected, their autopilot can get them through the day.
- Keeping the lights on an night helps decrease anxiety in some animals.
- Some animals respond to thunder shirts (www.thundershirt.com) or body wraps.
- Soothing scents such as a few drops of lavender essential oil applied to a cloth around the pet's neck or a pillow.
- Music therapy has been shown to relax animals.
- Some pets respond well to herbal relaxants such as rescue remedy, valerian, chamomoile. Check with your veterinarian whether any of these are appropriate for your pet.
- I maintained my dog on Chinese herbals for "stasis of the mind." This level of more potent herbal medicine does require consultation with and prescribing from a veterinarian trained in traditional Chinese veterinary medicine or TCVM.
- Antioxidants? Coenzyme Q10 is theorized to slow down progression of Alzheimer's in humans. Absolute benefit has not yet been proven in humans or animals. It is generally regarded as a safe over-the-counter supplement. Check with your veterinarian about whether this is appropriate for your pet.
- There is one drug called l-deprynyl which is labeled for treating dogs with cognitive dysfunction syndrome. It works for some dogs, but not for all. As in humans, I suspect that there are different types of dementia in dogs and some will respond better to this therapy than others. There are many, many drugs and herbs that interact badly with L-deprynyl so if your pet is taking this drug, please check with your veterinarian before combining it with ANY other prescriptions or herbal supplements.
- Other drugs are simply for alleviating symptoms that can accompany dementia. Examples are appetite stimulants and drugs for alleviating anxiety. As conservative as I am about prescribing mood-altering substances, I will admit that Nalu experienced better living through modern chemistry for several months with low doses of alprazolam, a anti-anxiety drug that works on the receptors in the brain.
- A comment based on my experiences as a veterinarian: Whether it is a sedative, anti-depressant, or anti-anxiety drug, different patients respond differently to mood-altering substances and sometimes you need to try a couple different substances to achieve the most desirable effect.
- Another comment based on my experiences as a veterinarian: Geriatric patients with dementia can be exquisitely sensitive to the effects of drugs that penetrate the blood-brain barrier, as are mood-altering substances and sedatives and narcotic pain medications. I usually start with lower than recommended doses and if needed, work my way towards the recommended dose based on the patient's response.