Amanda Steffen: You are listening to Senior Pet Talk, the show where we combine Western and Chinese medicine to give senior dog and cat parents the knowledge, the clarity, and the confidence to make sure that your pets' senior years are their best years yet. I'm Dr. Amanda Stefan. Let's get started. Hello, senior pet parent. I am Dr. Amanda Stefan, and thank you for coming to another episode of Senior Pet Talk, where we are going to cover everything integrative for senior dogs and cats. Today is a very special day because I want to talk to you about how to recognize early symptoms of dementia. So if you don't know, dogs and cats do suffer from cognitive decline or doggy or kiddie dementia. We don't have it as splayed out in veterinary medicine as they do in human medicine as far as like Alzheimer's versus dementia and all these different variations of things. We do know that there's probably multiple things going on that are causing it. However, unlike with people, we don't get to do an MRI or a CT on every patient that shows these symptoms, right? So a lot of this is extrapolation and going based on what we know and the changes that we see. And going through all those details. If you are watching on YouTube today, you get to see both of my senior dogs here with me. I have Emmett, my Frenchie, and Mabel, my Mastiffemix. So they are hanging out with me today. Hopefully they will be nice and quiet for you all. So I I think step one is always understanding that your dog or your cat can and likely will get dementia if they live to be old enough for that. I think that can be A little saddening to people, which I understand it can affect their quality of life pretty substantially. However, the positive of this is the earlier that we catch these symptoms and the more interventions that we opt into doing and are able to implement, the better chance we have of maintaining this and making it not something that affects their quality of life substantially. There have been situations where we have to talk about end-of-life decisions specifically for dementia. And I don't want your pet to be one of those cases. So today you are going to learn how to recognize those signs early. And you are going to be able to bring them up to your vet. And you are going to be able to do something about it. Okay. If you are already noticing multiple of these symptoms that we go through today, do not feel like you are too far behind or that there's no options for you, I promise you there's always an option. I have had very good success helping to treat and maintain dementia in senior dogs and cats and all the symptoms that go along with it with an integrative approach. So I promise there are things that we can do. Okay. So if you notice your dog is staring at walls or your cat is yowling at three o'clock in the morning and just wandering around the house, there's actually Often a reason for that. And it could be another medical reason where we could be talking about dementia. I think one of the hardest parts about dementia that I see is it is a rollout diagnosis, right? So Dr. Monica Tarantino and a lot of the other wonderful veterinarians through NC State have gotten together and put together a really good protocol for dementia. How to work up dementia for veterinarians. And that is something that we're progressing through and everyone's getting more information about. And I'm really excited about that. Thank you to all of the veterinarians involved with that work. I love that. But we also need to think about the things that we need to rule out before we talk about dementia. So unfortunately, it's one of these things where we don't have a Blood tests that we can do, or any sort of specific test we can do where we say, ⁓ well, yes, this dog or this cat has dementia. We really have to rule out all the other possibilities and go based on this acronym that I have. And then we can kind of break it down a little bit better that way. So we want to make sure that we're not dealing with pain because that is something that can worsen or mask dementia. And we want to make sure we're not dealing with things like dental disease. So dental disease can actually make dementia worse, which is very interesting. But it is one of those things I believe in my head, I relate it to chronic pain. And I talked about this in a previous episode. Chronic pain can worsen dementia. And I can definitely see that as someone who has rheumatoid arthritis and suffers from chronic pain myself. What we notice is that you kind of go a little crazy because you're so focused on your pain. And you do a lot more cycling in your brain than you would if you were pain-free. So making sure that we are treating things like pain and dental disease and high blood pressure can also cause some changes that look similar to dementia. So we need to have a really good work up on all of these patients first to make sure that we're not dealing with one of those things and get those things under control because a lot of times if we do, then the symptoms will improve. So I run my own in-home integrative senior dog and cat practice. And one of the things that I have done between that and all of my online work is I have modified this dishaw by Purina, cognitive decline calculator. And I've in my mind said dishaw V. So D-I-S-H-A-A-L-V. ⁓ We're gonna break down each of those different components of things in this conversation today. I think the dishaw doesn't always include cats. So I wanna make sure that our kitty cats are included in all of these conversations. That being said, let's talk about it. The D, disorientation. So this would be things like: are we noticing that our pet is now getting stuck in corners? We find them stuck. Between, you know, the corner of two walls and they seem like they don't know where to go, or they're just staring into that corner. Are they staring at walls? I, you know, we joke about this being like they're watching the ghosts or the poltergeists in the house because they're just staring at seemingly nothing. If they go to the wrong side of the door, like they're going to the hinge side of the door instead of where the door actually opens, and they fully know, you know, a year or two before. Which side of the door they were supposed to go to. They may not recognize people that they're familiar with. So if there's someone who doesn't come over often, but comes over often enough that they should recognize them, like grandma, and they don't notice them anymore, recognize them anymore, that could be one of the early symptoms of dementia as well. So that's the D component. The I stands for interaction changes. So this can often happen. I see this with cats and dogs. So we have a A cat now who used to be very spicy and did not want to be touched or held or anything like that. And now they're becoming very clingy and they want to be on your lap or around you all the time. Same thing with dogs, you know, can go both ways. But if we notice that our dog used to be very clingy, I noticed this with my dog Floyd. He used to want to be right next to me. He always wanted to be touching me. It was a joke that he always had to be touching me no matter what. He would lay right next to me. He th he couldn't get close enough. Like, and as he progressed in his dementia and with his brain tumor, I realized that he was starting to be more distant. And it really stressed him to be in those situations where I was kind of like trying to hold him in my lap or be very close to him. it would be more stressful for him. So I had to learn how to love him a different way and support him in a different way. And that can be really heartbreaking when we go through that. Also, if they seem more irritable when they're approached or they're more standoffish, things like that. Again, that's important to rule out eye changes, also with their decrease in their hearing and their sight and those types of things, it could make them startle a little easier. And that's not Specifically dementia, but those interaction changes can be related to cognitive decline or dementia. So we have disorientation, we have interaction changes. The next one is S. So our sleep wake cycles. This is one that causes ⁓ a lot of quality of life conversations. This is in humans considered sundowning, right? So we have a patient who Is especially with cats, I see this. They're up all night roaming around the house, yelling at nothing. Again, talking to the poltergeists. And it's hard for pet parents to get sleep. I had a patient that I saw for about six to eight months. His name was Cody. His parents had not slept in their bed all night for a year by the time they contacted me. And Cody would not be able to get comfortable in the bed and he would wake up about an hour or two after going to bed and he would want to wander downstairs. So the pet parents actually set up a bed downstairs, like a blowout mattress, and would sleep downstairs with him. And it wound up with one parent sleeping downstairs, one parent sleeping upstairs. It puts a little bit of strain on a relationship for those pet parents because they're, they haven't Slept in the same bed with one another for a year, right? So this can be one that substantially detriments a caregiver's quality of life and changes caregiver burden and caregiver fatigue pretty substantially. So this is one where I have had a lot of success with Chinese medicine options to help remedy herbs and acupuncture have been really paramount in these types of situations. I really enjoyed. Seeing the results with that. But these sleeping more during the day, staying up all night, they're got their cycles kind of off is a big Chinese medicine disease process that happens and is definitely something we can alter. So we have disorientation, we have interaction changes, we have sleep wake cycles, and the next one is house soiling. Okay. If we have a dog who has now started to pee in the house, and historically they were always very much housebroken, Floyd did this as well. He would never pee in the house. I would go to vet school and I would be gone for unfortunately 12, 13 hours some days. And he would hold his bathroom all the way until I got home. I tried really hard not to do that. I understand. life experiences. And at this stage of my life, I would never want my pets to be left alone for that period of time. But, you know, there we are. So if they're starting to have accidents in the house, whether that's pee or poop, can both can happen, then this could be a symptom that we're starting to have some cognitive decline. It is important also to take this to your veterinarian because this could also be a UTI, this could be bladder stones, this could be colon issues, this could be incontinent. This could be other things too. So it's important to notice house soiling versus incontinence. House soiling is going to be they are like squatting to go to the bathroom. Like they know they're going. Incontinence is often when they're sleeping all night and then they wake up and there's a puddle on their bed of urine or something like that, or they've pooped a little bit. And that can often be more of an incontinence conversation, right? For cats, this can be they're pooping in weird places. They may be pooping outside of the box or, you know, in your closet or peeing in different areas and they previously had been house trained. These things are important to keep an eye on because they can be one of our earlier signs of cognitive decline. All right, we're gonna keep going through this. Disorientation, interaction changes, sleep wake cycle, house soiling. The first A is activity changes. So this is going to be a pet who has less interest in play or has this repetitive pacing or licking that is abnormal for them if they have a reduced amount of engagement with things that they used to love doing. So they used to love playing ball and now they don't even seem like they understand what playing ball means. This can also again be pain related. So it's important to rule that out, but If they seem just very confused about those things at this stage and it has happened over a shorter period of time, this can be something that would be a red flag. I noticed with Floyd that pacing was one of the big things for him. And pacing tends to be a big thing for a lot of dogs. They often have sleepwake cycles mixed with pacing. So they wake up in the middle of the night and they pace around the house. I've had something as simple as a nightlight improve that. Because they wake up in the middle of the night, they're also a little disoriented, they are having some dementia, but also they're having some night blindness from their nucleosclerosis. If you remember from a previous episode, we talked about that. And they're having a difficult time seeing in the dark. So they start pacing around. Just placing a nightlight in that room can often make when they wake up, they go, ⁓ I'm in the bedroom and I know where I am and everything is good. And then they'll go back to bed. So there are very simple home modifications that we can do that can make very substantial improvements in quality of life for these guys. Have you ever left the vet with more questions than answers? And then you drive home and you go straight on to Google. Yeah, I hear that a lot. And honestly, it's exactly why I created my senior pet virtual consultations. Imagine we have 45 minutes where we go through everything. Your pet's full history, their specific challenges, their daily life, no rushing. We're gonna cover nutrition, integrative options, whole modifications, and quality of life. And I send you a personalized plan after so that nothing slips through the cracks here. But don't just take my word for it. Chelsea called it a senior pup therapy session and said she felt so much better afterwards. Adiba got recommendations her own vet had never thought to suggest, and Denise said that the consult was incredibly informative and helpful, giving her many options to help her dog Loki feel better. This is the conversation that your senior pet deserves. And honestly, The one you deserve too. The link is in the description. I'd love to help you. We have disorientation, interaction changes, sleepwake cycle changes, house soiling activity changes. The second A in this is anxiety. This is one that definitely creates some turmoil in pet parents and caregiver fatigue and those types of things. Maybe they are starting to not recognize new people. So they're starting to get a little bit more territorial over you or protective over you. That is an anxiety symptom. If they're starting to be afraid of storms and they were never afraid of storms before, if they start to have like a general nervousness around new situations, they used to love to go on a car ride and now they're not so sure about the car ride. Any of these things I've also seen with vet visits where Pet parents will say, I don't know, something terrible must have happened. And that's not really the case. A lot of times it's just that they are starting to get stressed more easily. One of the main things that we see that's a normal aging change is a decrease in serotonin and dopamine receptors in senior dogs and cats. Those are natural calming hormones. So that's their ability to calm themselves down. And if they are not able to produce those as well, then they're going to have more anxiety. So they're already. battling against not having as much serotonin and dopamine as when they were little or younger. And now, on top of that, we're having some dementia symptoms and changes to the brain that are causing them to be even more anxious. So I think it's really important to talk about this. And we are going to talk in another episode about different treatment protocols for anxiety specifically in dementia and senior pets, because I think that is one of the things that often creates a lot of caregiver fatigue. All right. Disorientation, interaction changes, sleepwake cycle, house soiling, activity, anxiety, the L is learning or memory changes. So we're gonna talk about my dog used to know how to sit and now they don't know that, seem to understand that cue anymore. If they forget how to do certain commands, They're slower to pick up on new things. So they used to be able to learn things really quickly and now they're having a slower, more difficult time with it or seeming a little bit more stressed with it. If they're having some trouble adjusting to new changes, maybe you just changed out the couch. But to them, that's their whole world, right? It's mostly that living room. So and maybe the couch is where they used to lay all the time and now they they won't lay on the couch or they're pacing in front of the couch. those simple things can be dramatic changes for senior dogs and cats. And we have to look at those things as, hey, this could be a sign of dementia or something more. Because again, the earlier that we pick up on these changes, the better we're going to be able to help treat them and give them a longer and better quality of life. Okay. So disorientation, interaction, sleep wake, House soiling activity changes, anxiety, learning and memory changes. And then the V. This is the one I added in to for cats. Vocalization. Okay. This is especially common in cats. Again, we go back to that night waking, the yowling that happens with cats. So they will start vocalizing around the house, especially at night, and they will. wake you up all night long. This can be another one that contributes to caregiver fatigue a lot. I've had good success with herbs in these situations. But there are a couple things that we can do to help it. My dog here, Mabel, she is on a couple things for cognitive decline. She's just a high anxiety dog anyways, but she also has started to become more vocal as she's gotten older. I think there's a Small side note I want to give you all in this conversation today is that senior dogs, especially, are going to dream louder as they become older. And that is a normal change of what we call the ponds part of the brain. And essentially it's not able to stop their like movements and barking and things like that in their sleep as much. So it is very common that you will notice my dog when he's 10 years old. made a lot more noises than when he was five years old and he was sleeping. Little barks and woofs and things like that. And they're really precious. And I recommend taking lots of videos of those moments because they're so beautiful and you're gonna want to look back on them. And I watch videos of Floyd doing his little boofing in his sleep and it is some of the happiest videos that I get to see of him. So okay. So if you are noticing two or more of these consistently And your pet is a senior, then I really recommend having a veterinary visit with your family vet or integrated vet or Chinese vet or whomever, because there are some things that we can do about this. I will say not all veterinarians know a lot of the options for this, but it is nice to know and for them to be able to talk through what options they do have for you. And potentially be able to navigate you somewhere else if they don't have a lot of options for you. I just want to push so much in this conversation that just because we see dementia signs doesn't mean it's something we cannot improve or give them a better quality of life for. Because I feel like that is a misconception in. veterinary medicine and in dementia is that it's only going to get worse and there's nothing we can do to help it and anything like that except for sedating them. And that is just absolutely not true. So I want to make sure you know that there's always options. And this is definitely something where catching it earlier is going to give us more of an opportunity to help. Okay. All right. You guys should know this by now. I repeated it so many times because I want to make sure that you can just rattle this off real fast. So disorientation, interaction changes, sleep wake cycle changes, house soiling, activity changes, anxiety, learning and memory changes, vocalization, dish, all V. Okay? If any of this sounded familiar to you and you are unsure about What options you have, please reach out to me. I would love to have more of a conversation about what the options that you have are and potentially what practitioners would be the best place for you to pursue additional conversations with or treatment from. And I hope that you all gain something from this and tune in for our next episodes that are going to be talking about different treatment options that we have for this and. Different things we can do nutritionally, supplementation wise, medication wise, alternative therapy wise. There's a lot of tools on our tool belt when it comes to dementia. So I want you to know this does happen. We know it happens, but there's a lot of things we can do to help. And there's always options for you. Okay. And if you can hear my dog snoring, I am sorry, but she is adorable. So all right. I hope you have a beautiful day. Please remember that you were always doing the best with the information that you have. And I am just here to give you more of it. Have a beautiful day and hug that senior baby for me. That's it for today. If this episode helped you, please leave a review or rate this podcast so we can get the word out to more pet parents who need to hear that they are doing a good job. And if you're interested in working more with me, you can find me on social media or at senior petconnection.com because we all need to stay connected. Remember that you are doing a great job with the information that you have in this moment. And I am just here to give you more of it. See you next week.