Dietary interventions for the treatment of canine cognitive disfunction syndrome

Cognitive disfunction syndrome (CDS) is an age-related disorder similar to Alzheimer Disease (AD) in human which is becoming more widely recognized companion animals, especially in dogs [1]. The condition has been extensively studied in dogs which seem to be the best spontaneously occurring animal model for human AD [1,2]. CDS usually occurs in elderly dogs entering in the senior phase of life and affects between 14% and 35% of the senior pet dog population, with a dramatic increase of the CDS prevalence with age, affecting up to 68% of dogs aged 15 years of age [3]. When facing a patient with presumptive CDS, a complete physical examination and full laboratory screening should be performed to rule out any medical conditions mimicking or contributing to a behavioural diagnosis [4]. Both risk and preventive dietary factors have been identified for AD in people, and the same are suspected to play a role in CDS [3]. After the medical and diagnostic workup, a definitive behavioural diagnosis of CDS through CAnine DEmentia Scale (CADES) is needed [5]. As veterinarians begin improve their knowledges on CDS and starts to diagnose this condition more frequently, effective therapeutic interventions are needed. There are many medications successfully used for the treatment of canine and feline behavioural conditions but only few could be used with some success in CDS, considering that the use of most drugs is off-label. Currently, there are only few proprietary products approved by both EFSA and FDA for treatment of behavioural conditions, such as selegiline, clomipramine, and dexmedetomidine, which might be used for the treatment of canine CDS, separation anxiety and noise aversion with good success rate [5]. In both human AD and canine CDS nutraceuticals and therapeutic diet as well as the inclusion of behaviour modification and environmental management have a considerable impact on both the development and progression of cognitive decline [3,5]. The most commonly used functional ingredients in CDS behavioural nutraceuticals and therapeutic diets included alpha-casozepine and alpha-lactalbumin, apoaequorin, L-theanine, Magnolia officinalis and Phellodendron amurense, medium chain triglycerides, omega 3 fatty acids, s-adenosylmethionine, tryptophan, vitamin E, Ginkgo biloba, phosphatidylserine, resveratrol, pyridoxine blend, alpha-lipoic acid and L-carnitine [5]. Many non-prescription nutraceuticals and therapeutic diets aimed to aid the management of behavioural conditions, mainly for cognitive dysfunction syndrome and anxiety, have entered the market in recent years and significative research effort is nowadays directed in that route. Veterinarians are exposed to an overflow of promotional materials from manufacturers, but critical steps must be taken to ensure the selection of an appropriate product for their patient. This choice should be based on a critical review and understanding of available scientific literature regarding efficacy and safety, the product’s functional ingredients and their mechanisms of action and safety, as well as patient characteristics and client needs. It is important for veterinarians to discuss therapeutic options available with owners before prescribing treatments, to determine which approach will be the most likely to comply. After initiating a treatment and management strategy, regular checks and follow-up with both the patient and the client is of paramount importance, aiming to gage over time response to treatment and determine whether refinements need to be made.