Supplements Can Ease CDS
By Narda G. Robinson, DO, DVM, MS, FAAMA
Aging is hard. It impacts vision, audition and mobility, creating ever steeper uphill battles for many senior dogs and cats in their later days.
As age advances, cognitive and behavioral status may likewise decline.1 These dogs exhibiting disorientation, diminished activity, reduced social interactions, sleeping changes, growing anxiety or aggression, and new onset house soiling may be facing cognitive dysfunction syndrome (CDS).2
CDS remains a diagnosis of exclusion because many causes of organ and systemic dysfunction can mimic it. Most notably, the common geriatric afflictions of spinal pain and compressive myelopathy often go unrecognized or misinterpreted.3 Taking the time to gently palpate the myofascia and skeletal components associated with the back and neck can give vital differential diagnostic information about the nature and location of back or neck pain without having to force the neck or back into uncomfortable and unnatural ranges of motion.
Simply evaluating reflexes aids in the determination of the level of neurological embarrassment, i.e., whether the cause is an upper or lower motor neuron lesion, based on the presence, degree or absence of crossed extensor reflexes, anal tone, conscious proprioception and muscle tone.
Furthermore, many common geriatric afflictions, such as neoplasia, infections, immune-mediated illness, organ dysfunction and endocrinopathy, can change the way a dog or cat behaves, as can pain.4 Therefore, ruling out non-CDS etiologies of fear, tension, aggression and altered responsiveness to stimuli becomes paramount to successful and early intervention.
Behavioral screening questionnaires serve as important aids in diagnosing. A marketing research summary indicated that 75 percent of caregivers of dogs over 7 years old noticed one or more behavioral signs of CDS, but only 12 percent voluntarily reported these changes to their veterinarians. Thus, veterinarians should engage their clients in conversations about behavioral changes related to aging.5-6
The aging canine brain exhibits strong similarities to its human counterpart, Alzheimer’s disease. Brain deterioration takes place in both species in the cerebral cortex as well as the hippocampus, the seat of learning and memory. Alterations include cortical atrophy, ventricular widening and beta-amyloid plaque formation.7 Oxidative stress potentially promotes the formation of beta-amyloid plaques by inciting microglia or macrophages to emit neuropathogenic cytokines.
Nutraceuticals can improve neurotransmitter levels and function, modulate inflammation and lessen free-radical burden through antioxidant activity.8 In so doing, these products may slow the inevitable neuropathological march toward dementia by maintaining membrane fluidity, restoring neurotransmitter levels and limiting mitochondrial exposure to the damaging influence of free radicals.
Oral SAMe Helps
Oral s-Adenosylmethionine, or SAMe, alleviates signs of age-related cognitive decline in dogs as well as humans. According to one double-blind, placebo-controlled trial, SAMe-treated dogs showed significant improvements in activity and awareness of their surroundings without serious adverse effects.9 How it accomplishes this remains unknown, but the clinical effects might stem from SAMe’s ability to improve monoamine neurotransmitters levels and metabolism, membrane fluidity, and receptor function. By fostering neuronal membrane fluidity, receptor proteins can more readily move through within the lipid bilayer and couple with neurotransmitters, facilitating neurotransmission.
Phosphatidylserine (PS), a phospholipid, resides within the neural membrane and likewise improves its fluidity. The neuroprotection afforded by PS may further improve learning and memory by stimulating acetylcholine release and modulating acetylcholinesterase activity. PS increases the synthesis and release of dopamine and inhibits the age-related loss of both NMDA and hippocampal nerve growth factor receptors.10 The omega-3 fatty acids docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) generate neuroprotective metabolites and work synergistically with PS to improve cognition.11-12
Although a recent study found no benefit for human Alzheimer’s patients ingesting Ginkgo biloba,13 an uncontrolled clinical trial spanning 10 veterinary practices in Europe found statistically significant positive benefits in dogs with geriatric behavioral disturbances.14
Over a third of dogs were considered by the investigators to be completely free of clinical signs after four weeks. A 2008 report on a crossover clinical trial indicated improvement in short-term memory performance in aged beagles who received Ginkgo in conjunction with other brain-benefiting compounds.15
Nutritional antioxidants counter the oxidative damage to proteins manifested by aging brains, and dietary manipulation can improve cognitive performance.16 The mitochondrial cofactors alpha-lipoic acid (ALA) and l-carnitine counterbalance reactive oxygen species released by aging mitochondria. Diets or supplements containing ALA and l-carnitine elevate cellular concentrations of these required cofactors and restore mitochondrial efficacy and limit oxidative damage to RNA.
Adding foods to the diet such as nuts and oils (for vitamin E) and fruits (to supply additional vitamin C) can supply the components required to formulate the complex antioxidant network that achieves maximal in vivo effectiveness.17 Antioxidant-rich flavonoid- and carotenoid-containing foodstuffs are appearing more frequently in dog food, as evidenced by the inclusion of spinach flakes, tomato pomace, carrot granules and citrus pulp.18
If geriatric dogs with cognitive conditions respond favorably to diet and supplements, the question arises about when antioxidant supplementation should start, and if supplementation can be prophylactic.19
On the other hand, one might ask, “Why wait?” Combining antioxidant-fortified diets along with behavioral enrichment encompassing social, physical and mentally challenging activities throughout life may be the perfect prescription not only for healthy aging but for healthy living as well.20 <HOME>
Narda Robinson, DVM, DO, Dipl. ABMA, FAAMA, offers an evidential and scientific perspective on the latest trends in complementary and alternative veterinary medicine.
1. Head E. and Zicker S.C. “Nutraceuticals, aging, and cognitive dysfunction.” Vet Clin Small Anim. 2004; 34:217-228.
2. Dodd C.E., et al. “Can a fortified food affect the behavioral manifestations of age-related cognitive decline in dogs?” Veterinary Medicine. 2003; 98(5):396-408.
3. Robinson N.G. Based on the author’s and pain medicine colleagues’ experience in the Colorado State University Center for Comparative and Integrative Pain Medicine, 2006-present.
4. Landsberg G. “Therapeutic options for cognitive decline in senior pets.” J Am Anim Hosp Assn. 2006; 42:407-413.
5. U.S. Marketing Research Summary, “Omnibus Study on Aging Pets, November 2000”; Hill’s Pet Nutrition, Topeka, Kan.
6. Hill’s Pet Nutrition website. Article obtained on Nov. 24, 2008. Click here to access article.
7. Head E. and Zicker S.C. “Nutraceuticals, aging, and cognitive dysfunction.” Vet Clin Small Anim. 2004; 34:217-228.
8. Ruehl W.W., et al. “L-Deprenyl therapy for canine cognitive dysfunction. Kirk’s current veterinary therapy XIII: small animal practice.” Philadelphia: W.B. Saunders, 2000, p.53-57.
9. Rème C.A., et al. “Effect of S-adenosylmethionine tablets on the reduction of age-related mental decline in dogs: a double-blinded, placebo-controlled trial.” Veterinary Therapeutics. 2008; 9(2):69-82.
10. Osella M.C., et al. “Canine cognitive dysfunction syndrome: prevalence, clinical signs and treatment with a neuroprotective nutraceutical.” Applied Animal Behaviour Science. 2007; 105:297-310.
11. Kidd P.M. “Omega-3 DHA and DPA for cognition, behavior, and mood: clinical findings and structural-functional synergies with cell membrane phospholipids.” Altern Med Rev. 2007; 123):207-227.
12. Heath S.E., et al. “Nutritional supplementation in cases of canine cognitive dysfunction – a clinical trial.” Applied Animal Behaviour Science. 2007; 105:284-296.
13. DeKosky S.T., et al. “Ginkgo biloba for prevention of dementia.” JAMA. 2008; 300(19):2253-2262.
14. Reichling J., et al. “Reduction of behavioural disturbances in elderly dogs supplemented with a standardized Ginkgo leaf extract.” Schweizer Archiv fur Tierheilkunde. 2006;148(5):257-263.
15. Araujo J.A., et al. “Improvement of short-term memory performance in aged beagles by a nutraceutical supplement containing phsophatidylserine, Ginkgo biloba, vitamin E and pyridoxine.” Canadian Veterinary Journal. 2008; 49:379-385.
16. Head E., Rofina J., and Zicker S. “Oxidative stress, aging and central nervous system disease in the canine model of human brain aging.” Vet Clin Small Anim. 2008; 38(1):167-178.
17. Head E. and Zicker S.C. “Nutraceuticals, aging, and cognitive dysfunction.” Vet Clin Small Anim. 2004; 34:217-228.
18. Swanson, K.S. “Using genomic biology to study brain aging and cognitive function. Nutritional biotechnology in the feed and food industries.” Proceedings of Alltech’s 22nd Annual Symposium, April 2006.
19. Head E. and Zicker S.C. “Nutraceuticals, aging, and cognitive dysfunction.” Vet Clin Small Anim. 2004; 34:217-228.
20. Head E. “Combining an antioxidant-fortified diet with behavioral enrichment leads to cognitive improvement and reduced brain pathology in aging canines. Strategies for healthy aging.” Ann NY Acad Sci. 2007; 1114:398-406.
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Supplements Can Ease CDS
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