Hello, I'm Dr. Deb and will do my best to help you today.
I would agree that he probably does have Cognitive Dysfunction (CD) issues since one of the first signs is loss of housebreaking. This is always a very, very sad situation when our pets start to decline in this way.
And, when our pets start to decline in this way, it's a very difficult question to address as to when it's time to let go since there isn't always a clear cut answer to this question in every case, unfortunately.
For me, it comes down to quality of life issues; this is the priority although often this is very subjective between individuals.
When faced with this decision, I ask my owners to consider the following questions:
1. Does your pet have more good days than bad ones? Sometimes it helps to keep track of them on the calendar.
2. Do they still enjoy doing the things they used to enjoy doing (even if for shorter periods of time) or are they too painful, tired or weak to do so?
3. What is their attitude like? Are they lethargic or upbeat and enjoying interaction with the family?
I find that if you can answer these questions honestly and objectively, then it often helps make this difficult decision.
My personal opinion is that it's best to let our pets go before they deteriorate too far, while there's still some dignity to their lives but this is only my personal opinion. For me, quality of life trumps quantity.
If you're not quite ready to say good bye yet, I do have some suggestions which may help with his CD issues. If you try them and they aren't effective and his condition continues to decline, then at least you know you've done all that you can for him.
Since we often do not know which neurotransmitters or neuro-pathways are most affected by CD in each patient, abetter response may be seen in our pets ifa combination of several supplements and drugs are givenas opposedto only one or two. This sort ofcombinationcan help to improve thelevelof neurotransmitters in the Central Nervous System (CNS) and reduce oxidativedamage to brain tissue.
There are other modifications which can be made to lifestyle which may be beneficial which I’ve included below as well.
1.Cognitive supplements such as Neutricks, or Senilife
2.Combination of antioxidants such as Golden Years (Sogeval) , Antiox 5000 Ultra (Sovegal), Cell Advance 440for small and medium sized dogs (Vetriscience) and Cell Advance 880for large dogs.
3.Anti-inflammatory agents such as high dose fish oils (DHA> 300mg… not the total mg on the capsule but the DHA content). Fish oil may be effective for inflammation secondary to arthritis as well.
4.Over the counter, human Melatonin which can be especially helpful if sleep issues are present but it also has antioxidant properties.1-3 mg before bedtime.
5. CNS stimulants such as Selegiline 5-10mg/day which is a drug licensed for use in CD but would have to be prescribed by your vet.
6. Consider a prescription diet such as Hills' B/D dietor Purina senior diet with MCT oil.There’s some evidence that calorie restriction can help some dogs with CD so reduce calorie intake.
7. Evidence exists that daily and sustained exercise has positive effects in reducing progression of CD.Exercise daily: 1/2-1 hour walk twice daily
8. Sensory stimulation such as touching, brushing, and massage therapy may also reduce progression of CD.
There are always other supplements which can be added; however, patient compliance may become an issue at some point.But, others to consider would be:
- medium chain triglycerides i.e.,unprocessed coconut oil. 1-2 tsp/day
- SAMe manufactured by Virbacaka Novifit
Drugs to avoid, if possible, when CD is present:
1. Benzodiazepines such as Xanax orValium
3.Anticholinergics such as Benadryl
Factors which might increase CD progression:
1.High carbohydrate diets.
2.Excessive caloric intake
5. Highsaturated fat diets
I hope this helps although I know this is a very difficult situation for everyone. Deb