Brain & Cognitive Disorders

Years in the Making: Preparing Clients for a CDS Diagnosis

Kelsey Bertamus
DVM
Mission Animal Hospital
Eden Prairie, Minnesota

Canine cognitive dysfunction syndrome (CDS) is a uniquely challenging condition. Its progressive nature, sometimes-dramatic effects on behavior and lack of a cure can make it a devastating diagnosis for pet owners. However, by taking a proactive approach to CDS education and grounding clients in a thorough understanding of the condition, veterinarians can set expectations for the first signs of disease and therapeutic intervention — helping to maintain the human-pet bond.

CDS screening: start early

The incidence of CDS in geriatric dogs is relatively high, believed to affect an estimated 14.2 percent of dogs aged 8 and older.¹ Knowing that, I begin screening dogs after they reach middle age at semi-annual or annual checkups. I consider dogs to be geriatric when they reach the last 25 percent of their breed’s suspected lifespan. For most large-breed dogs that happens around 6 or 7 years of age and small-breed dogs around 8 or 9 years of age. I consider middle age typically half the age that a pet becomes geriatric. It’s almost never too early to begin conversations with pet owners about CDS. Not only will they be familiar with the early warning signs, but they may be more amenable to therapeutic interventions, such as a diet formulated with a source of medium-chain triglycerides and antioxidants.

Clients should also understand that CDS is a diagnosis of exclusion. Catching it early depends on their ability to recognize its subtle signs, such as becoming less social or less interested in toys or family members. My goals are to present the signs of CDS in a way they can understand, then give them the tools to recognize the disease process.

I explain what the onset and development of CDS could look like to pet owners. The DISHAA acronym of recognizable clinical signs (Disorientation, Interaction, Sleep/wake cycles, House soiling, Activity and Anxiety) serves as a useful conversation guide when initially explaining the disease, and it is easily memorized for later reference.

After our initial discussion, we complete the Purina Senior Canine Cognitive Assessment and we revisit it every three to six months. This enables clients to reflect on how things may have changed over the course of the last year. I have found that talking about DISHAA at every checkup and having clients do evaluations at home can increase the likelihood of early diagnosis and, ultimately, earlier intervention.

Managing the message: client reaction to diagnosis

Owners’ response to diagnosis typically depends on how far the condition has progressed. While ongoing education and discussion with clients can help catch the condition in its early stages, this may not always be the case.

It may be challenging for clients to wrap their heads around a diagnosis of CDS, especially when what they might consider typical aging could actually be the first signs of disease. Like dogs, humans can also experience changes in memory, perception, learning and awareness as they age, so I often find it helpful to draw parallels between CDS and the experiences owners may have had when dealing with aging parents or grandparents.

While CDS is a challenging condition, in my experience clients typically are relieved when they are able to put a name on behavioral changes they previously may not have understood. And by working with their veterinarian to identify clinical signs early, they have the reward of knowing that an early diagnosis may have increased the likelihood that interventions such as diet, medications and behavior modification can improve their dog’s quality of life.

1. Salvin HE, McGreevy PD, Sachdev PS, Valenzuela MJ. Under diagnosis of canine cognitive dysfunction: a cross-sectional survey of older companion dogs. Vet J. 184: 277–81, 2010.