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Cognitive Dysfunction: Management
Cognitive dysfunction is a degenerative neurologic disorder of senior pets. Signs start subtly and progress gradually. A recent veterinary article described six different types of signs:
Spatial disorientation and confusion: wandering, staring, going to unusual places.
Treatment There is no known cure for cognitive dysfunction. Management of the signs is best achieved by multimodal therapy - combining several different treatments.
Some treatments have been proven to be effective in clinical trials:
Environmental enrichment can improve cognitive function. Regular exercise, introduction of new toys, daily massage sessions, and regular training sessions are examples.
Dietary therapy can also help. Diets fortified with antioxidants, mitochondrial cofactors, and essential fatty acids have been shown to improve cognitive function and delay cognitive decline in dogs. Hill's Prescription Diet B/D contains a mixture of fruits and vegetables and incorporates antioxidants (mixed tocopherols, vitamin C, beta-carotene, carotenoids, flavenoids) in addition to vitamins C and E and mitochondrial cofactors (L-carnitine, DL-alpha-lipoic acid). In studies the diet improved cognitive performance in 2 to 8 weeks.
Selegeline is a medication sometimes used to treat human patients with Parkinson's Disease. It has been shown to have some efficacy in the treatment of cognitive dysfunction in dogs. A response is usually noted within two weeks, and, in one study, the positive response rate at one month was 25%.
A nutraceutical, S-adenosylmethionine (SAMe) was found to be effective in a clinical trial.
Some treatments have not been studied in clinical trials but have been anecdotally reported to be effective:
Anti-inflammatory drugs may be of benefit since inflammatory changes have been identified in the brains of dogs with cognitive dysfunction.
Certain phytochemicals (biologically active substances found in plants) may have therapeutic potential by antioxidant activity and decreasing brain amyloid burden: curcumin, green tea catechins, reservatrol.
Complimentary therapies may calm the patient, reduce anxiety, and normalize the sleep/wake cycle. Valerian root, dog-appeasing pheromone (Adaptil Collar and Diffuser), melatonin, phosphatidalserine, ginkgo biloba, DHA (an omega-3 fatty acid) and various mitochondrial co-factors and antioxidants.
Tranquilizers may be of benefit, especially when used as a small evening dose for dogs and cats whose signs occur particularly at night.
Some drugs increase blood flow to the brain. Propentofylline and nicergoline are not available in the US. Adrafanil and modafinil might increase alertness, memory and learning, but more research needs to be done.
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