Charting CDS Science And Looking To The Future

The charting of CDS science is helping veterinarians accurately portray the health of pets.

There are scores for evaluating patients with dental problems, for overall body condition and for distinguishing levels of pain. Why not a means for scoring the cognitive condition of aging pets?

The idea is just one of the potential steps forward addressing cognitive decline in animals. And as Ken Lambrecht, DVM, considers the growing possibilities, he gets more and more excited.

“We are just in the infancy of diagnosis and treatment,” he says, “but it’s encouraging that we’re seeing new options that reflect an evidence-based approach.”

Each step in the treatment of cognitive dysfunction syndrome, or CDS, can mean a substantial advance in quality of life, says Dr. Lambrecht, founding owner and clinical medical director at Westside Family Pet Clinic in Madison, Wis.

The AAHA-accredited small-animal practice sees a healthy number of senior patients. That’s why Lambrecht champions early detection and has added questions about cognitive function to every six-month senior wellness exam he and his clinic colleagues perform.

At Westside, the list of options for addressing cognitive issues has included Anipryl tablets and Hill’s Prescription Diet Canine b/d. To that list, the doctors have added a new chewable dietary supplement, Neutricks by Madison-based Quincy Animal Health.The product was released in November and uses the same patented jellyfish protein as Prevagen, developed by Quincy Bioscience for use by people with Alzheimer’s disease. Neutricks seeks to provide replacement calcium-binding proteins for senior pets experiencing a decline in brain function. During the summer, Westside enjoyed success with Neutricks as a test practice for the supplement, which was provided free to clients with senior dogs and cats exhibiting symptoms of cognitive decline. In return, the pet owners provided feedback on the product’s effectiveness.Quincy is making Neutricks available only through licensed veterinarians because it wants to involve pet owners and clinicians in a growing dialogue about geriatric symptoms of cognitive dysfunction, says Dave Merrick, general manager of Quincy Animal Health.

Participating in the test period spotlighted the need for increasing awareness and tools in the diagnosis and treatment of cognitive decline, Lambrecht says.

“The hard part is the areas of overlap,” he notes. “We see symptoms that could be related to arthritis, visual or hearing impairment, bad teeth, pain or something else. So we don’t always know where we are [regarding cognitive decline] because multiple things can be going on.”

About 20 dogs and six cats have been put on Neutricks by veterinarians at Westside, with about half seeing improvement ranging from “It seems like he’s a little better” to “Oh, my gosh, he’s behaving like he did years ago,” Lambrecht says.

Client Linda Bartlett saw her 12-year-old Japanese Chin, Meka, shed her lethargy and listlessness while on Neutricks.

“She had gotten to where she was wandering without seeming to know where she was,” Bartlett says. “Now she’s participating in our lives again. It has really opened our eyes. There were a couple of days I wanted to take it myself.”

Filling out a behavior chart helped Bartlett—and the clinic—become more aware of connecting symptoms with cognitive function and, in successful cases, with improvement. Clients with pets on Neutricks during the test period assigned scores from 1 to 7, depending on severity, in six categories: disorientation, housetraining, pain, sleep and activity, disposition, and interaction with family members.

In each category, clients addressed specific signs. For instance, under disorientation, one client answered with a 7 (meaning “always”) to “Has difficulty finding door; stands at wrong door to go outside.” Another responded with a 1 (“never”) for “Urinates indoors” and a 4 (“sometimes”) for “Does not recognize specific people.”

The tool could be a good starting place in tracking improvement or decline over time, Lambrecht says.

He adds that as a component of his clinic’s wellness exams, an assistant will ask a series of questions about behavior, then alert the veterinarian to any irregularities. It takes follow-up to “drill down to the subtleties” to diagnose CDS, he says. Lab work and other testing can help identify or eliminate conditions with overlapping symptoms, Lambrecht notes. Describing his practice as “fairly traditional,” Lambrecht says he and his colleagues regularly incorporate supplements into treatment plans.

The clinic has a considerable number of clients who work in the medical field, “and they want to know what the basis is for any product we prescribe,” he adds. “They also expect us to take preventive steps if we can, and they’re receptive when I bring up that (Neutricks) has science to support it.”

The science of cognitive function is at the heart of Quincy Bioscience and Quincy Animal Health, says Mark Underwood, a neuroscience researcher who is also co-founder and president of the parent and its subsidiary.

Underwood says research points to an imbalance of calcium ions as an indicator of neurodegenerative human diseases such as Parkinson’s and Alzheimer’s.

Calcium-binding proteins play a role in keeping brain cells from harm, he says. But over time, both people and animals don’t make enough of the proteins to keep the brain balanced, and cells become more vulnerable to destruction.

“The more the calcium-binding proteins are depleted, the more accelerated the neurodegenerative process becomes,” he says.

Performing undergraduate research at the University of Wisconsin, Milwaukee, in the mid-1990s, Underwood first investigated the jellyfish protein apoaequorin as a possible replacement for calcium-binding proteins lost through cognitive decline.

Now the technology has been used for years by people taking Prevagen, and a study commissioned by Quincy has found statistical improvement in cognitive function by senior dogs in a control group.

A key measure of success with pets is reducing the number of candidates for behavioral euthanasia, Underwood says.

Both the company president and Lambrecht look forward to more research that will give veterinarians both the understanding and the tools to better address cognitive dysfunction.
For now, it’s good to have treatment options that help foster new levels of awareness and new opportunities to possibly curb decline, the doctor says.

“Any time we can talk about prevention,” he notes, “it’s very exciting.”

This Education Series story was unwritten by Quincy Animal Health of Madison, Wis.

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