Health

WHAT IS CCD?

Sally Hummel is a friend whose dog, Rugby, was diagnosed with CCD. She tells us about his struggles and what she tried to help him through his days.

CCD is also commonly called Cognitive Dysfunction Syndrome (CDS). Both terms are used interchangeably to describe the same disease. To simplify things, CCD is the canine version of Alzheimer’s Disease. It’s a progressive neurodegenerative disorder that affects senior dogs who are typically 9 years and older. It creates changes in the brain that slow the mental functioning of dogs, resulting in loss of memory, motor function, and learned behaviors from training early in life. Like Alzheimer’s Disease, currently there is no cure for CCD, and research continues. CCD affects every dog differently, and the average life span post diagnosis is roughly 2 years. From my own personal experience, early diagnosis can make the biggest difference in how long your dog will live with the disease. I caught things early with Rugby, and he lived three years with it, being euthanized at age 15.

The changes I was seeing in my 12-year-old Rugby were subtle and gradual. It was hard to know if what I was seeing was just old age related, or something more sinister, but I knew that I wanted to run things past his vet at Rugby’s upcoming annual checkup. I was not prepared for the news that I would hear from his vet. His diagnosis of Canine Cognitive Dysfunction (CCD) was something I had never heard of, and it sent me on a journey of reading and research to learn ways to help my senior dog.

To make Rugby’s initial diagnosis, his vet looked several categories of criteria. These were the early things that I saw in Rugby that his vet used to diagnose him. All dogs are different, so someone else’s experience could be completely different.

Disorientation: Initially, Rugby would often stare off into space and stare at walls or corners for extended periods almost like he wasn’t even there. He didn’t seem to care about birds and squirrels outside much, and he had always loved chasing them and noticing any movement in the trees. His interest in all things outdoors slowed considerably.

Abnormal Interactions: Initially, Rugby lost all interest in toys, and this was a sharp departure for him. He had always loved playing with his toys and even chose them to sleep with him. He had loved to play fetch and grunt his beloved polka dot piggies. He showed no interest in toys to the point that he wouldn’t even take one when it was offered. This behavior was HUGE to me and signaled something really off was happening in him.

Sleep/Wake Cycle Disturbances: Rugby began sleeping a lot more during the day, which I simply attributed to his age.

Housebreaking Issues: Rugby had started to have the occasional pee accident, and in 11.5 years of living with him, he had never, ever had any accidents past the first night in his new home. I attributed this to old age as well, thinking that he might be experiencing some incontinence.

Activity Changes: Rugby had always been a super high energy dog. As a Sheltie mix, he could run for hours and never seem to tire! He was definitely slowing down, and again, I thought it was simply because he was 12 and he was finally feeling his age.

Anxiety: This was always present in Rugby anyway, so it was hard to tell if he had new anxiety or not! Initially, I saw him become more worried about food. He wanted to eat earlier and earlier, and always seemed to feel a little hungry throughout the day, which was new behavior.

Learning/Memory Changes: This one was a huge red flag for me, as Rugby and I trained almost every single day, even though he was 12 years old! I can clearly remember the day that I asked Rugby to “Crate Up” as I had done many times before on a daily basis. He stood in front of his crate with the door wide open and looked inside like he just had absolutely no idea what to do. Even when I tossed a cookie into his crate, he looked at the cookie and then back up at me with a completely lost look on his face. He also seemed to have difficulty remembering what to do when he heard known cues. He forgot how to back up or get out of the way to avoid being stepped on, and often looked at me with a blank look on his face. Simple cues like “Sit” were accompanied with a short pause before compliance, and that was also a change from his normally prompt responses to any known cues.

These were the criteria that my vet used to diagnose him, but as you can see, many of those things can also be attributed to simple old age or arthritis, hearing or eyesight changes, or even another disease. Fortunately, I have a wonderful relationship with my vet, and we had done blood work on a regular basis since Rugby was ten, so she was able to rule out other diseases pretty quickly and attribute his puzzling behavior to cognition issues even though he also had a significant hearing loss going on as well.

She recommended switching his food to a neuro support dog food and added an oil supplement to provide energy to Rugby’s brain. We saw immediate good results from that. While Rugby didn’t gain back any of the things he had lost, he did seem far more alert and less living in a foggy state. He went back to enjoying his yard and learning some new tricks again. I had already been offering various enrichment activities like puzzle toys and puzzle feeders to Rugby for his entire life, so for us, it was nothing new. But I did see him able to enjoy those things again, and they helped to reduce his anxiety.

Early diagnosis is absolutely the key to managing the disease well. There are foods, supplements and prescriptions that can help our seniors dramatically! While those things don’t help dog regain what they’ve lost, studies seem to show that they do help prolong the progression of the disease, and that’s a game changer for your dog. Many dog owners don’t recognize changes until their dogs are well involved in the disease and more serious symptoms are noticed. For us, those symptoms would have presented in year two to year three. The entire first year of Rugby’s diagnosis, we didn’t see huge behavioral changes, and the neuro support care that we added made huge positive impacts for his life. If we had waited a year or more to start the food and supplement changes, I doubt if Rugby would have done as well as he did.

Here are symptoms to look for in your own senior dog. Believe it or not, dogs are considered seniors by age 7, so I think I would personally recommend watching for anything amiss from age 7 forward. CCD can start as early as age 8, and catching things early is critical. This is not an all-inclusive list. Several things on this list weren’t present in Rugby until year two or three, and often started very subtly and grew as the disease progressed. Sundowning started with Rugby “fluffing” his bed every day for an hour or two in the late afternoon, but within six months or so had morphed into pacing for those same hours. Eventually, he also started circling with the pacing, and what had started with an hour or two grew to regular, consistent behavior for nearly the entire time that Rugby was awake every day.

  • Daily “sundowning” which involves relentless pacing and circling for hours at a time.
  • Loss of housebreaking, including any understanding of where an appropriate place is to go.
  • Increased overall fear and anxiety
  • Forgetting known behaviors
  • Having motor skill difficulties
  • Performing repetitive behaviors
  • Withdrawing from family or wanting any sort of attention
  • Being frightened of people your dog once knew
  • Inability to learn new things
  • Barking for no reason
  • Restless or sleeping less at night
  • Getting into tight places and being unable to get themselves out
  • Startling easily
  • Difficulty with eating and drinking (finding the bowls, aiming the mouth, keeping food in the mouth)

Practical Helps

Living with a dog who has CCD is not without lots of challenges! Because this disease is progressive, as your dog loses skills, it means that those skills are gone. They aren’t coming back. It’s a lot of grieving a dog who is gone, and yet still with you. So, while Rugby was physically still present with me, everything that made Rugby who he was, was eventually gone. I lived with a strange dog who simply looked like my Rugby but acted nothing like the dog I knew as Rugby. It is truly a very sad and long goodbye.

Because the disease is always evolving and changing, I had to figure out new ways of doing things all the time. One change might work for a few months, but when the disease evolved, that “fix” might not work for the new stage, and I needed to find another new solution to the problem. It’s a bit like trying to nail Jell-O to a tree!

Some of the things that make CCD tricky to manage and live with are the loss of basic skills that your dog once knew. Housebreaking, for example, can be very difficult to manage. Rugby had never had accidents prior to CCD. He started out with a pee accident every 2-3 months. By the middle of year two, he rarely pottied outside, and never signaled that he needed to go. To help with managing that end of things, I resorted to limiting where Rugby was allowed in the house, and those rooms had wall to wall potty pads so that cleanup was easier.

I established a very strong routine for Rugby, including a strict bedtime. He seemed to function much better if I stayed with a predictable routine, but that’s not easy to do when your dog has unpredictable behavior! Rugby was far less anxious and slept much better at night if I put him to bed early! A 30-minute delay in his bedtime could result in 4 extra hours of pacing and circling, often until 2:00 am or so.

When he was anxious about food, I split his daily calories into several small meals, and spaced them out about every thirty minutes or so during his sundowning hours. That really seemed to help his food anxieties. I switched from a food bowl to a pie plate. Rugby lost the ability to drink, so I added his daily quota of water or low sodium chicken broth to his kibble, and he was able to get his liquid as it soaked into his food. I also offered daily snacks in things like snuffle mats, lick mats, and simple puzzle feeders that he could manage. It’s really important to exercise your dog’s mind even as his brain power lessens over time.

His sundowning hours were full of generalized fear and anxiety, so I found that an OTC calming chew seemed to help him in that department. Other dog owners may find that CBD oil is helpful for their dogs. You may have to try several things in order to find something that is effective for the stage that your dog is in.

Create a safe environment for your dog. This can involve rearranging furniture, blocking tight spaces to prevent him from being able to get stuck, and having a safe confinement area when you can’t be home with him. This can look like a crate or exercise pen, for example. Dogs can get stuck behind toilets, so sometimes bathroom confinements can be dangerous. Remember that CCD drives your dog to seek out tight places, and so you need to carefully consider those sorts of things when you live with your dog long term.

Rugby lost his ability to tolerate touch, and often seemed to be very uncomfortable when he was petted. He avoided being touched, and that made grooming him tricky! He startled very easily, so I tried to do his brushing and nail trims when he was really soundly asleep, because he could generally sleep through it. I focused on small bits at a time, to keep things manageable for him.

In all, Rugby fought CCD for three years, and was euthanized at age 15. By the time he was euthanized, he experienced virtually every symptom that the disease offers. What I attribute his long life to was, his early diagnosis. Because I recognized his behavior changes very soon after they started, we were able to get the cognitive support that helped him to have a much better quality of life and more importantly, to slow the progress of the disease!