By Dr. Karen Becker DVM

Veterinar­ians sometimes use the acronym DISHA to evaluate evidence of dementia in a senior dog:

• Disorientation — Is your dog walking aimlessly about the house, staring at the walls, or even losing her balance and falling? The key here is that even when she’s in her normal, familiar environment, she gets disoriented, for example, she goes out her doggy door to the backyard, and then seems to forget how to get back in. There can also be a loss of spatial awareness.

• Interactions — Is your dog interacting differently with family members or other pets in the home? This can involve sudden or increasing irritability or even aggression in a dog who’s been friendly and social all her life. It can also take the form of withdrawal from family members and the features of daily life she was once very interested in, such as a knock at the door or the appearance of her leash, meaning she’s about to get a walk.

• Sleep — Is your dog no longer sleeping through the night, or is restless or wakes frequently? Like many older people, senior dogs can experience changes in sleep patterns or even a disruption in circadian rhythms. Your dog may begin pacing at night instead of falling into a deep slumber as he once did. Some dogs even reverse their schedules entirely, doing during the daytime what they used to do at night and vice versa.

• House soiling — Is your dog no longer alerting you when he needs to go out? Is he urinating or leaking urine indoors? When a dog seemingly “loses” his housetraining, there’s no clearer evidence that something’s amiss with either his health or his cognition.

• Activity level changes — Does your dog seem restless, agitated, or anxious? Does she have a decreased appetite? You may notice she’s no longer coming to the door to greet you or loses focus and no longer responds as she once did to familiar stimuli.

Some dogs seem to forget how to get the food or water out of their bowls or forget where the bowls are located. There can also be periods of restlessness, or repetitive behaviors such as pacing in circles, head bobbing or leg shaking.

Suggestions to Help Your Older Dog Stay Mentally Sharp

1. Offer lots of opportunities for exercise, socialization, and mental stimulation — Senior and even geriatric dogs still need daily exercise to maintain good health and physical conditioning.

While older dogs can’t exercise or compete with the same intensity as their younger counterparts, they still derive tremendous benefit from regular walks — especially gentle, unhurried sniffaris — and other age-appropriate physical activity on a daily basis. There are also a variety of strengthening exercises that can be of tremendous help to aging canine bodies.

No matter how old your dog is he still needs regular social interaction with other pets and/or people. Short periods of socialization and playtime in controlled situations are ideal. Food puzzle and treat release toys provide fun and a good mental workout, as does nose work and brief training sessions to refresh his memory or teach him a new skill.

2. Schedule regular senior wellness check-ups — I recommend twice-yearly wellness visits for pets no matter the age, but this becomes even more important for dogs getting up in years. Ask your functional medicine veterinarian to perform a blood test, including an A1c test to check your pet’s internal organ and metabolic health to make sure you’re identifying possible issues early on.

Alzheimer’s is also called Type 3 Diabetes because so many patients have insulin resistance and persistent hyperglycemia. Keeping your dog’s A1c low and steady means you’re controlling for this variable. If you notice A1c rising in your senior dog, it’s time to take action. Keeping abreast of your animal companion’s internal metabolic changes as she ages is the best way to catch any disease process early.

Over-vaccinating is something older animals do not need, so advocate for your older dog by refusing additional vaccines and insisting on titer tests instead. A titer is a blood test that measures protective immunity against disease. Chances are your dog is very well-protected.

3. Feed a nutritionally optimal, species-specific fresh food diet — A species-specific, nutritionally balanced diet that is rich in healthy fats, including omega-3 fatty acids such as krill oil and others such as MCT oil, is very important for cognitive health.

The best fuel for an aging dog is a variety of living, antioxidant-rich whole foods suitable for a carnivore. Eliminate all refined carbohydrates (which are just unnecessary sugar), as well as grains, potatoes and legumes.

Calculate how much starch your dog is eating and keep it under 20%. Replace those unnecessary carbs with extra high-quality protein and healthy fats. Eliminate extruded diets (kibble) to avoid the toxic byproducts of the manufacturing process that have been linked to neurodegenerative disease.

Processed dog foods are manufactured in a way that creates byproducts that can affect cognitive health, including heterocyclic amines, acrylamides and advanced glycation end products (AGEs).

Fresh, biologically appropriate foods provide the whole food nutrients your pet’s aging brain requires. The right diet will also support the microbiome, which has been linked to improved cognitive health in humans, and I’ve seen an improvement in dogs as well.

4. Provide beneficial supplements — In dogs with CCD and older pets in general, nutraceuticals can significantly improve memory, and the effects are long-lasting. Studies of medium-chain triglycerides (MCTs) such as coconut oil show they can significantly improve cognitive function in older dogs.

Supplementing with MCTs is a great way to offer an instant fuel source for your dog’s brain. I recommend 1/4 teaspoon of coconut oil for every 10 pounds of body weight, added daily to food. If you use MCT oil instead of coconut oil start slowly and use less, as loose stools aren’t uncommon when beginning this supplement.

I also recommend providing a source of methyl donors, such as SAMe (S-adenosylmethionine), which can assist in detoxification and reduce inflammation. Other supplements to consider are jellyfish extracts, glutathione and resveratrol, which is Japanese knotweed. Japanese knotweed has been proven to help reduce free radical damage and beta-amyloid deposits.

Lion’s mane mushroom has some impressive research tied to improved cognition and vinpocetine has been trialed on dogs with positive results. Phosphatidylserine and ubiquinol, which is the reduced form of CoQ10, feed your dog’s mitochondria and improve cellular energy.

When it comes to general senior health supplements, I typically recommend digestive enzymes and probiotics for all older pets. I also recommend an omega-3 fatty acid supplement such as sustainably sourced krill oil (my favorite, because it’s the cleanest) or algal DHA for pets who can’t tolerate seafood. Curcumin is another supplement that benefits the brain and body.

5. Minimize stress in all aspects of your dog’s life — Fortunately, there are many things you can do to minimize anxiety and stress in your older dog.

Senior and geriatric dogs, especially those with dementia, are often disoriented, so sticking to a consistent daily routine your pet can count on can help him stay oriented, which will in turn reduce his anxiety. Try to get up and go to bed at the same time each day, feed him at the same times, and go for walks on a set schedule.

Keeping him at a healthy weight and physically active will help control arthritis and degenerative joint disease as he ages. Acupuncture and chiropractic care, stretching, and hydrotherapy (exercising in water) can also provide enormous benefits in keeping dogs mobile in their later years.

Regular massage can help keep your senior dog’s muscles toned and reduce the slackening that comes with aging. Massaged muscles are looser, which makes it easier for him to move around comfortably. Massage also improves circulation and encourages lymphatic drainage.

It can ease the stiffness of arthritis, which helps him maintain his normal gait and active lifestyle. Massage also loosens the muscles around joints, which helps promote ease of movement.

If your dog is having some urine dribbling or incontinence as a result of his age (and not caused by an underlying condition that should be addressed), provide him with more frequent potty trips outside. You can also reintroduce him to a crate if he was crate trained initially. Acupuncture can also be very beneficial for age-related incontinence.

If your dog has problems hearing or seeing, use odor cues like pet-friendly essential oils or pheromone products to help him find his way around. Also consider purchasing or building ramps if he’s having trouble getting into the car or up on the bed or a favorite chair, and if he’s slipping or unsure on bare floors, add some runners, yoga mats or area rugs.

For sleep problems, try increasing his daytime activity level. Let him sleep in your bedroom. Sleeping near you should help ease any anxiety that may be contributing to his nighttime restlessness. Melatonin supplementation can also be beneficial.

Guide him with clear cues and easy-to-follow instructions, and when you talk to him, keep your voice quiet, calm and loving.