Achieve successful aging by navigating behavioral shifts in senior pets

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“Successful aging” is defined by a rate of cognitive deterioration that does not affect the day-to-day function, according to a published study led by Hannah E. Salvin, BAVBS (Hons) PhD, faculty of veterinary science at the University of Sydney, in Chippendale, NSW.¹ This would mean that normal signs of aging would not reflect any underlying pathology but would show signs of physical and cognitive changes. Wailani Sung, MS, PhD, DVM, DACVB, director of behavior and welfare programs of the San Francisco Society for the Prevention of Cruelty to Animals, discussed the behavioral signs and symptoms of aging in pets and when it could potentially be cognitive dysfunction in a Midwest Veterinary Conference session.²

What can trigger behavior changes?

Sung stated that behavioral changes in geriatric patients can be caused by a number of factors but some that she notices include a sudden change in schedule (inconsistent feeding time, different walk schedule), a death in the family or loss of companion, a scary experience (senior pets become less tolerant to stressors), chronic pain or discomfort, sensory deficits, and/or cognitive decline. These changes can cause a senior pet more anxiety and stress, as they are not as adaptable as they used to be at a younger age.

Signs of aging and diagnosing cognitive dysfunction

A study in people found that various physical signs could present in patients with cognitive dyfunction including the following:³

• Ocular biomarkers
• Retinal nerve fiber layer thinning
• Senile plaques
• Optic nerve cupping
• Changes in lens and blood vessels
• Changes in sense of smell (olfactory epithelium, amygdala, entorhinal cortex)
• Changes in nervous, muscular, and skeletal systems

“Because we see these changes in people, there are some corresponding changes in dogs. You might see that if you do the ophthalmologic exam and you see the lens is a little different, there’s changes in the blood vessels that you didn’t see before,” Sung said.

“People report that as they get older, their sense of smell also reduces, too. And that might affect their appetite. We know that with cats, our senior cats, if they have an upper respiratory [disease], they seem to not want to eat food. This might be playing a role in it…In the older animals, if we see a change in appetite that is unrelated to discomfort in their mouth or GI [gastrointestinal] related issues, we can start thinking: Should we warm up their food? Should we offer them food that has a rich aroma to entice them?” Sung added.

Sung also recommended encouraging clients to take a video of their dog or cat walking at a young age, middle age, and senior age to compare the gait and how it has changed. A video of movement up and down the stairs can also be helpful.

Canine cognitive dysfunction (CCD)

When a patient is aging but seems to be declining more rapidly or drastically than normal, it could be because of cognitive dysfunction. One study evaluated a random population of 97 spayed females and 83 neutered males between ages 11-16 years.⁴ The data showed that 28% (22/80) of dogs between 11 and 12 years of age had impairment in 1 or more categories of behavioral signs and 68% (23/34) of 15-16 year old dogs had impairment in 1 or more categories.⁴

Another study performed structured interviews with dog owners and found that the prevalence of cognitive decline ranged from 22.5% to 73.5% of dogs.⁵ However, in an owner survey, 75% of dogs had at least 1 behavioral symptom but only 12% reported it to their primary care veterinarian.⁵ In a different study led by Salvin, researchers estimated that the prevalence rate of CCD was 14.2% but only 1.9% were diagnosed by veterinarian.⁶ The rate of prevalence differs a bit between different studies, but what can be taken away from both of these examples is that the rate of prevalence and diagnosis is not equal, and Sung emphasized the importance of discussing cognitive decline with clients. The Salvin study also found the median age of CCD to be 11 years and 9 months,⁶ which could be helpful to keep in mind when seeing these senior pets for regular examinations.

Sung explained that research on cognitive dysfunction in cats is not as widely explored as dogs, but one study found that 28% of cats aged 11 to 14 years experienced cognitive dysfunction, while 50% of cats aged 15 years or older showed signs.⁷

Diagnosing

Diagnosing cognitive dysfunction is mostly a process of exclusion and ruling out other conditions. Evaluation scores can be helpful for both veterinary professionals and clients. Some examples Sung recommended using include:

• CADES (Canine Dementia Scale)
• CCDR (Canine Cognitive Dysfunction Rating)
• Feline grimace scale from Zoetis
• Osteoarthritis pain checklist for owners to evaluate
• Cognitive dysfunction syndrome evaluation tool from Purina

The signs and symptoms owners should look out for are clearly stated on these evaluation scales, but if they are not using a resource and just observing their pet, the following can be noted:

• Disorientation (in dogs)/Vocalization (in cats)
• Interaction changes
• Sleep-wake cycle changes
• House-soiling
• Activity level changes,
• Anxiety
• Learning and memory deficits

“In dogs, we know disorientation can be when they are lost and confused. They might ask to go outside but then go to the wrong door. Or you see them stuck in a corner,” Sung said. “Sometimes they stare blankly at the wall, not just for one second, but for a prolonged period of time. They also seem unable to localize sounds. They don’t respond to verbal cues. And they’re unable to recognize familiar people or places.”

“With cats, we particularly pay attention to the vocalization. It can occur at any time during the day and at night,” she continued. In her own practice, Sung stated that the disturbance in sleep-wake cycle was the No. 1 reason why clients would come to her with complaints.

Management

To treat cognitive dysfunction, Sung explained that it is more so focused on management of the condition. She recommended performing regular health checks every 6 months, ensuring that underlying medical problems are being treated and any necessary pain management treatments are being taken care of, controlling obesity, and educating clients with discussion on the signs to look for.

Sung also recommended having good traction on floors to prevent any slips or falls while the pets are walking around. Stairs or ramps to get up and down furniture can also be helpful to avoid jumping. Night lights can help pets walk around in the dark, especially if their eyesight is declining. More frequent bathroom breaks may be necessary to combat the house-soiling symptom.

Sung also underscored the importance of maintaining regular play and exercise, as well as mental enrichment. “You need to consistently recommend that clients play and exercise their pet. Just like us, if we’re sedentary, we’re going to age quicker, we’re going to suffer from more physical problems, and then we’re going to die sooner. If they want their pets to live a longer life, they need to continue exercising them, because the muscle will start wasting away,” she stated. “Mental enrichment is really important. If you improve mental and tactile stimulation, so make them do puzzle toys, it actually helps with synaptic development and buffers against cognitive decline.”

Allowing senior pets to have a lot of outdoor access can help with mental and physical enrichment so that they can walk around and get stimulation from sniffing. This can also help with reducing anxiety, according to Sung.

Psychoactive medications can be used but should target a symptom like anxiety or aggression. A discussion between the veterinarian and pet owner should help decide if this medication is needed short term or long term. Switching to a geriatric diet can be beneficial for needed nutrients as pets age.

In conclusion, the aging process in pets is a natural and inevitable part of their life cycle, accompanied by various physical and behavioral changes. As pets age, they require increased attention to their health and understanding for their needs to achieve better well-being and quality of life. Compassionate care, attention to signs of age-related conditions, and adapting to their changing requirements can contribute to a fulfilling and lasting companionship between pets and their owners during their golden years.

References

1. Salvin HE, McGreevy PD, Sachdev PS, and Valenzuela MJ. Growing old gracefully—Behavioral changes associated with “successful aging” in the dog, Canis familiaris. J Vet Behav. 2011;6(6), 313-320. https://doi.org/10.1016/j.jveb.2011.04.004

2. Sung W. Behavioral needs of senior pets. Presented at Midwest Veterinary Conference. February 20-22, 2024.

3. Ozawa M, Inoue M, Uchida K, Chambers JK, Takeuch Y, Nakayama H. Physical signs of canine cognitive dysfunction. J Vet Med Sci. 2019;81(12):1829-1834. doi:10.1292/jvms.19-0458

4. Neilson JC, Hart BL, Cliff KD, Ruehl WW. Prevalence of behavioral changes associated with age-related cognitive impairment in dogs. J Am Vet Med Assoc. 2001;218(11):1787-1791. doi:10.2460/javma.2001.218.1787

5. Landsberg G, Araujo JA. Behavior problems in geriatric pets. Vet Clin North Am Small Anim Pract. 2005;35(3):675-698. doi:10.1016/j.cvsm.2004.12.008

6. Salvin HE, McGreevy PD, Sachdev PS, Valenzuela MJ. Under diagnosis of canine cognitive dysfunction: a cross-sectional survey of older companion dogs. Vet J. 2010;184(3):277-281. doi:10.1016/j.tvjl.2009.11.007

7. Gunn-Moore D, Moffat K, Christie LA, Head E. Cognitive dysfunction and the neurobiology of ageing in cats. J Small Anim Pract. 2007;48(10):546-553. doi:10.1111/j.1748-5827.2007.00386.x