Dementia In Older Dogs
As dogs age, some develop behavior problems. I hear lots of stories about dogs who whine and pace at night. Owner's also complain about their dog 'losing' their house breaking. These may be signs of a geriatric disease called Cognitive Dysfunction Syndrome (CDS). I think of it as senility in dogs.
Common signs of CDS are:
1) Anxiety- including separation anxiety. It is not uncommon for separation anxiety to recur in dogs who suffered from it earlier in life.
2) Disorientation- Initially the periods of disorientation are short in duration. As the dog ages, the periods increase in length and frequency.
3) Changes in sleep patterns.
4) Compulsive behaviors. In my experience, pacing and licking are the two most common. These behaviors increase in frequency and duration as the dog ages.
5) Increased vocalization.
6) House soiling- either urine and/or feces. Many older females suffer from urinary incontinence caused by a lack of estrogen. We can treat this with estrogen supplementation. It is important to perform a thorough work-up to differentiate between CDS, urinary tract problems, estrogen related incontinence or other causes.
7) Phobias.
8) Aggressive behaviors- Older dogs may become aggressive for many reasons. Some Dogs with arthritis snap at the grandkids because of pain. The same thing happens in dogs with Lyme Disease.
Unfortunately, there is no definitive test for CDS. The diagnosis is made by excluding other medical problems and a thorough medical history. I have people video their pet's abnormal behavior at home and keep a diary as well. I usually recommend blood work including a CBC, Complete Chemistries, Tick Disease Profile, urinalysis, x-rays and a Valley Fever test if the pet has been to Arizona or Saudi Arabia. If the client wishes to pursue further diagnostics, I refer them to a neurologist for a CT scan or MRI.
CDS is an incurable disease at this point in time. It will progress despite therapy. The goal of treatment is to make the dog and their family as comfortable as possible by minimizing the signs. I recommend the following:
1) Establish a predictable routine. If the dog knows what to expect, it helps decrease anxiety.
2) Make the environment as safe as possible. Some dogs are worse at night. Night lights and exercise before bed seem to lessen the signs.
3) DAP diffusers or collars- Dog Appeasing Pheromes help some dogs relax. I prefer the collar because it travels with the pet wherever they roam.
4) Increase antioxidants in the diet. I have had some patients improve on Hill's b/d.
5) Try to enrich the dog's environment. Dogs who suffer with this disease tend to progress more slowly if they live with another dog. I have also seen improvement in dogs that have regular play times. My own dog was much better after a game of fetch in the pool. She loved to swim after her toy.
6) I reserve drug therapy for moderate to severe cases. Selegiline (Anipryl by Pfizer Animal Health) is the most common drug used for this disease. In my experience, the drug works best for the treatment of anxiety and phobias.
Common signs of CDS are:
1) Anxiety- including separation anxiety. It is not uncommon for separation anxiety to recur in dogs who suffered from it earlier in life.
2) Disorientation- Initially the periods of disorientation are short in duration. As the dog ages, the periods increase in length and frequency.
3) Changes in sleep patterns.
4) Compulsive behaviors. In my experience, pacing and licking are the two most common. These behaviors increase in frequency and duration as the dog ages.
5) Increased vocalization.
6) House soiling- either urine and/or feces. Many older females suffer from urinary incontinence caused by a lack of estrogen. We can treat this with estrogen supplementation. It is important to perform a thorough work-up to differentiate between CDS, urinary tract problems, estrogen related incontinence or other causes.
7) Phobias.
8) Aggressive behaviors- Older dogs may become aggressive for many reasons. Some Dogs with arthritis snap at the grandkids because of pain. The same thing happens in dogs with Lyme Disease.
Unfortunately, there is no definitive test for CDS. The diagnosis is made by excluding other medical problems and a thorough medical history. I have people video their pet's abnormal behavior at home and keep a diary as well. I usually recommend blood work including a CBC, Complete Chemistries, Tick Disease Profile, urinalysis, x-rays and a Valley Fever test if the pet has been to Arizona or Saudi Arabia. If the client wishes to pursue further diagnostics, I refer them to a neurologist for a CT scan or MRI.
CDS is an incurable disease at this point in time. It will progress despite therapy. The goal of treatment is to make the dog and their family as comfortable as possible by minimizing the signs. I recommend the following:
1) Establish a predictable routine. If the dog knows what to expect, it helps decrease anxiety.
2) Make the environment as safe as possible. Some dogs are worse at night. Night lights and exercise before bed seem to lessen the signs.
3) DAP diffusers or collars- Dog Appeasing Pheromes help some dogs relax. I prefer the collar because it travels with the pet wherever they roam.
4) Increase antioxidants in the diet. I have had some patients improve on Hill's b/d.
5) Try to enrich the dog's environment. Dogs who suffer with this disease tend to progress more slowly if they live with another dog. I have also seen improvement in dogs that have regular play times. My own dog was much better after a game of fetch in the pool. She loved to swim after her toy.
6) I reserve drug therapy for moderate to severe cases. Selegiline (Anipryl by Pfizer Animal Health) is the most common drug used for this disease. In my experience, the drug works best for the treatment of anxiety and phobias.
I have a 16 yr old dog with this disorder. He was put on Tramadol for pain, Myristol to see if it would help with his arthritis and Xanax for his anxiety attacks. His anxiety attacks are so bad now, nothing works. He was put on Anipryl last year with no response to the drug. It did nothing for him. Is there anything else we can give him for his anxiety. I have been to two different vets and am not getting any new ideas for his anxiety attacks.
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My own dog Susie suffered with anxiety so I can sympathize with what you are going through. I would ask one of your veterinarians to post your dog's story on the Veterinary Information Network in the behavior folder. VIN is an on-line veterinary community that allows general practitioners to consult with specialists. Hopefully, one of the veterinary behaviorists will have some new ideas.
Susie's anxiety attacks worsened if her osteoarthritis was bothering her. I found the combination of carprofen (a non-steroidal anti-inflammatory) and gabapentin ( a drug used for pain of neurologic origin) for the arthritis and amitriptyline (an antidepressant) for the anxiety worked the best for her. Be sure to discuss the side affects of all medications and treatments with your veterinarian before trying them on your dog. At his age, he might have other health factors that will limit what therapies you may try.
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My 17 years old bichon has this disorder and was keeping us awake all night with his barking. The most recent one I am now using is working great and it is a natural product called Bio-Calm (a liquid) which is given into the mouth in a syringe and not bad tasting. I can even increase the dosage if necessary. It is made in Guelph, Ont. Canada for Centaur VA animal health and can be purchased through your vet. Its a life saver for us. The product which also worked before this was called Calms Forte from the healthfood store but it was pill form and more difficult to give. Our dog also is starting with kidney disease so the vet felt the all natural would be the best way to go. I hope this helps.
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Our 12.5 year old corgi just attack our 12.5 year old dachshund for the very first time. Our doxy usually gets snippy with our corgi. I have never seen him do this before. We left them with our daughter to watch for 2 weeks, she grew up with them. Not sure what to do next. We notice that is is slipping with his back end (right & left)and his front right or left. Any ideas?
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I am worried that your dog has a cervical disc problem that is causing the problems with his front and back legs. Disc problems are very painful. Some dogs will snap and bite to prevent anyone from touching them and causing more pain. Bring him to your veterinarian right away before his condition deteriorates any further. Also, keep him off slippery floors, do not let him jump and use a harness instead of a collar to prevent further injury.
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Thank you, I missed giving some information, the corgi has been with us since he was a 7 weeks. He was sitting on a different couch, my daughter and the were sitting the other couch, the doxy jumped down and then the corgi pounced on him and started attacking. If he was just sitting why attack?
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That does make a difference. With the new history I would think about dominance. Which dog is normally more dominant? Ask your daughter what happened before the attack. Did she push the corgi off the couch to make room for the doxie? Did she give the doxie a special toy or treat? Find out if she did anything that would show favoritism to the doxie.
We humans do not think like dogs. Sometimes we pet, feed or acknowledge the submissive dog in the family before the dominant one. The dominant dog blames the submissive dog for the infraction, not the people. They attack to re-establish their superiority. Couches and beds are considered valuable possessions to a dominant dog. The height makes them feel even more superior. If your corgy had no other health problems, I would hypothesize that the corgy was putting the doxie in his place. But with the signs you describe I am worried that it might be more than that. I think it is best to have the corgy examined by your veterinarian. They will be able to perform a neurologic examination to make sure your dog's brain, cranial nerves and long tracts are functioning properly.
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Our 17 year old sheltie/pomeranian cross Chester is showing signs of dementia. He is deaf and his eye sight is not wonderful,he is pacing and crying at night, getting into corners and behaving strangely almost always at night.He is urinating inside,sleeping almost all day. He is still very affectionate and loves attention.What can we do? He is a much loved family pet.
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From your description, I am worried that your dog is developing dementia associated with aging. Talk to your veterinarian right away. There are several drugs that might help him feel better. Also, get some night lights for him. Animals like people, find it more difficult to see at night when they age. Place one in his sleeping area and one by his water bowl. Always turn on the yard lights on when your take him outside. Some of my older patients refuse to go outside unless the lights are on. Lastly, try to keep him awake more during the day so he will sleep through the night. Stimulate him mentally with short walks (it is okay if you have to carry him), new toys or anything else he enjoys. Exercise his brain as well as his body to keep him young at heart.
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Dear Dr Kris, we do leave the lights on for him. I will take him for more walks. I have not been taking him so often as he gets spooked by other dogs and pedestrians.He usually sleeps on our son's bed, but, has taken to coming to me at about 3.00am every morning and jumping onto our bed. If I get up and pat him back to sleep like a baby he is quite content !! This would be ok if I did not have to work full time. I will take him back to the vet. He is not in any pain, is eating and drinking and generally calm.
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Good job on the lights and nurturing him back to sleep. From the additional details, it sounds like an anxiety based problem which is common in early dementia. My own dog suffered from that when she got older. The good news is that there are drugs to help them feel better. Your veterinarian will help you decide which one is best for your dog. Just remember, it takes awhile to get the proper drug and dose for your dog. Hope for, but don't expect miracles over night.
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My 14 year old cocker paces around and around the house for hours in the evening. She'll plop down to rest for maybe a 30 seconds or a minute, then she's up and pacing again. She often (not always) just sits and pants. She is deaf (has been for several years), and seems to be losing her vision and possibly smell (sometimes can't find a treat that's on the floor right in front of her - she knows it's there and searches for it but has trouble finding it.)
She also is pooping in the house - easily once or twice a day. She doesn't like to do it outside, especially if it's dark or rainy. We'll keep her out for quite awhile, but she just keeps sitting at the door to come in. Then a few minutes after she's back inside, she poops in the house.
She does still greet people, follows her favorite person around the house, and likes to chase her ball a little bit (but can't always find it). She also is still trainable to some extent - when rewarded with a few treats she learns quickly to repeat the behavior. (But we don't know how to UNtrain the pacing, panting, and pooping.)
She's been checked by the vet - Cushing's Disease has been mentioned, but at her age of 14 we really don't want to pursue testing or treatment.
What possible treatments, medications, or training could we give her to help with the three Ps - pacing, panting, and pooping?
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Your poor dog! It sounds like she suffers from anxiety. Fortunately, we have drugs and other techniques to help dogs with this condition. Besides implementing the suggestions from my blog post, I would probably start her on drug therapy. Since I do not know her complete medical history, I cannot recommend a specific drug. Please contact your veterinarian right away. They will be able to help you establish a treatment plan for her.
I know living with the three P's is no fun but hang in there. I have seen drug therapy work wonders in these patients.
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Thank you. I will call the veterinarian.
Last time we were there a month or so ago we got Composure. Giving her several of them in the evening does help with the panting/pacing, but doesn't help at all with the pooping. Outside she sniffs around and looks like she might go, but then she comes back to the door. We keep telling her to go back to the lawn, and she will, but finally we give up and she comes back in and poops a few minutes later.
How could a drug help with this? It seems like a behavioral issue. ?????
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From your description, it sounds like the Composure is controlling the anxiety portion of your dog's problem since the pacing and panting have stopped. I am concerned that she has developed a substrate preference. When she defecates inside, does she always go on the same surface, i.e rug, tile, wood floor? If so, place a piece of her preferred substrate outside in the area where you want her to defecate. A piece with her scent on it works the best. When she uses it regularly, gradually make the piece smaller and smaller until she goes on the grass.
I know how frustrating this problem can be. Hang in there! Please keep me informed of her progress.
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Yes, the pacing and panting are reduced - still there, but not like before.
And no, she doesn't go on the same area. Sometimes rug, sometimes hardwood floor, sometimes right in front of us, sometimes not. (If we see her hunching over we pick her up and carry her outside immediately.)
However, I think we're showing that you CAN teach an old dog new tricks
We take her out at the right times, and stand there to watch until she goes. If she heads back for the door we point back outside emphatically; she gives us a rueful look, walks back out, and poops! No accidents inside for about 5-6 days, since we started rewarding outside pottying.
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You are absolutely right. Old dogs can learn new tricks! Be sure to give the Milk Bone to her outside. I have patients who go through the motions outdoors then run indoors for their treat without really taking care of business. A few minutes later, their owner finds a mess in the house. Rewarding them outside teaches them the treat is for urinating or defecating in the yard, not running back into the house.
I am glad the panting and pacing are reduced. Some of these anti-anxiety drugs take weeks to establish blood levels. Keep in touch with your veterinarian so they can help you adjust her dosage to keep her comfortable. Happy holidays!
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I have an eleven year old irish setter/golden mix. We adopted him when he was around 6 years old. He has always been a little 'different'. He is one funny dog. In the past few months he has been barking a lot at night, we turn on the light, he goes out and barks to come right back in. He has no idea why he wants to go out. He paces around the house. will lay down for a few moments, gets back up and around the house he goes. He pants and I know he is upset because he will exhaust himself and come smack the side of my bed by my face while he does this so I will pet him. I can pet him, but it doesn't stop his panting or wandering. He in the last week has started chewing on furniture and dog beds. He doesn't eat any of it. he just chews. He has been licking himself and no amount of redirecting him changes that. I have two other dogs that he has no problems with. He certainly tries to sleep more during the day. My daughters who are 8 and 5 keep asking me why Red is so sad. It is breaking my heart. I don't really know what to do to help him. I have always had dogs, and I have never had this happen. Please help us.
Thank you
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Poor Red! Sounds like he is suffering from severe anxiety although he needs a physical exam and diagnostics to be sure. Thankfully, there are treatments available to help him. Contact your veterinarian right away to discuss. I have had good luck combining behavior modification techniques with drug therapy in these cases. Since most of these drugs are metabolized by the liver, I recommend blood work prior to therapy.
Most importantly, I want to encourage you to hang in there with Red. My own dog suffered from anxiety the last four years of her life. She paced all night long until she collapsed. After eight weeks of therapy, the sadness lifted and she enjoyed life again.
Good luck with Red! Please feel free to contact me if you have any other questions.
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We have a rescued dachshund/poodle mix who is the light of my life. He is estimated to be anywhere between 13 and 20. When we got him, he was amazingly house trained, as in never ever made a mess in the house.
He's always been an obsessive licker- of himself and of us, but as of two weeks ago, he is restless for the first two hours we go to bed (paces, asked to get on the bed and then immediately jumps off, paces, more- wash rinse repeat- you get the picture. He eventually settles down, though he no longer wants to sleep with us. Then, the restless pacing cycle starts all over again at about 4:30 am, 2 hours before we normally get up. The big kicker was today, when we got up to take him out, we stopped two minutes to make coffee and I turned around and he was peeing in the dining room. He's never behaved like this before- but it sounds like dementia. I love my baby boy and want to do everything I can. I'm not sure if it is too late to help him?
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I agree with you. It sounds like this could be dementia. The good news is that it is not too late to help him. Talk to your veterinarian right away. There are several medications you may try. Please let me know how it goes and thanks for taking in an older stray!
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Our Dalmation, Bisbee, is 15 1/2 years old, is on tramadol and aspirin 2x/day for pain in back and rear legs. Legs occasionally splay out on her and back paws sometimes drag during a step. She is also on 1/4 Proin (?) 1x/day, for urination dripping (works like a charm). Of late, however, she has been waking up around 1 AM and will pace to go outside then back inside, over and over again for about 2 hours (it is currently 3AM as I write this)! She also often poops during this time, but it doesn't appear to lessen the pacing. Pooping also occasionally occurs in the house on her way to the door (doesn't have the same control). Heavy panting seems to increase during these middle of the night hours. I am so tired and frustrated but fear it is even harder on her.
The last blood work showed elevated BUN, which would be expected for her age. She is happy, wags and smiles, even takes off for a limited trot, but this night time routine of pacing and panting is killing all of us. From other entries, there appears the possibility of reducing this with meds, yes? Are these signs of dementia, heart failure or something else perhaps?
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First of all, congratulations on 15 1/2 years for Bisbee. That's wonderful! The symptoms you describe could indicate the early stages of dementia. The dose of Proin being utilized is on the low end of dosing. I suggest you inquire of your veterinarian regarding both of those items. In people, I know urinary tract infections are sometimes implicated in cases of dementia. My friend's mom actually suffered from this. I have starting checking for this in animals. I wish you great luck with Bisbee. Old friends with whom we share many wonderful memories are precious indeed!
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I have a 13/15 year old male dog, Chance, that I adopted 8 years ago from the pound. His breed is believed to be lapso apso/maltase. Recently, he has started pacing the floor at night, only resting for a couple of minutes at a time, he cries constantly especially at night, and he seems to forget that he is housebroken several times a week. He is losing his vision, his hearing , and smell. His crying is not consolable. We have spoken with the vet and he seems to think that we should treat for a UTI. He has been treated for a UTI 3 -4 times in the past 6-8 months. The vet has given him previcox for arthritis as well.
Any suggestions on how to help him? His nighttime behavior has become so extreme that my husband and I take turns sitting up with him at night.
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Poor Chance! From your description, the clinical signs seem consistent with age related dementia. In humans, a UTI may cause signs of dementia which is likely why your veterinarian wants to treat him for it. Since he has been treated several times, I would recommend a urinalysis and culture to make sure he has an infection and then, identify the correct antibiotic to use.
If he does not have an infection, there are several different anti-anxiety drugs to try. As you know from this post, my own dog suffered from anxiety as she aged. I was able to control it reasonably well with medication. Your veterinarian will be able to prescribe the best one for Chance based on his laboratory work and physical exam. Just remember, not all dogs respond to each medicine. If the first drug doesn't work, try another.
I want to sincerely thank you and your husband for sitting up with Chance during this difficult time. Your presence does comfort him! When he is anxious, try holding him close to your body. Most owners tell me, this helps their dog calm down. If you have read the book Animals in Translation by Temple Gradin, she talks about building a squeeze cage for herself to use when she became anxious. The pressure on her body brought her a feeling of security and helped her calm down.
I hope that helps. Good luck with Mr. Chance.
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Dear Dr Kris Nelson: Our beloved dog Tate is fourteen. Last year he had a huge lump removed from his side, a soft tissue sarcoma.He did so well. Four months later it started to grow back. I think he was as disappointed and upset as we were. We were told it might grow back again and considering his age, I couldn't bear putting him through the operation again. In the last few months he has begun dragging the leg on the side the tumor is growing on and his back legs are weakening. He too has begun pooping in the house. He is eating well, his vision is great, eyes bright, his coat healthy, his sense of humor and wonderful personality present however he seems a lot like an old senile person of late. He is a husky cross, our little Wolf. We cherish him beyond belief and want the best for him. My real concerns are should I let him be or attain the drugs to help from what I've read sounds like a type of dog dementia, and also acquire something that will help his hips and back legs. What do you think about putting him through another operation for the growth on his shoulder? Thank you!
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My heart goes out to you and Tate during this difficult time. Dealing with cancer is never easy in animals or humans. We don't want our pets to suffer yet at the same time, we don't want to make an end-of-life decision too quickly and rob them of the time they have remaining. I just went through this with my dove, Job, so I know how difficult it is.
Unfortunately, I cannot offer you specific counsel because I do not personally know Tate and the details of his condition. You, your family and your veterinarian must decide what is best for Tate based on his clinical signs and attitude. I would recommend you sit down together and discuss all the options available. If you decide to skip surgery, then ask your veterinarian about the different things (medications for inflammation as well as anxiety and pain, acupuncture, etc.,) that can be tried.
How do you know when it is time? With most animals they will tell you. I know that seems vague, but one day they look into your eyes and you just know. Unfortunately, this is not the case with animals who suffer from dementia. In my experience, these patients lose the ability to communicate, making the decision more difficult. Since we know that heart rates increase with pain, I have people monitor their pet's heart rate at rest.
Again, I want to extend my sympathies to you and Tate. He sounds like a wonderful dog and you sound like a very caring person.
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Dear Dr. Nelson:
I can't tell you how much I appreciate your compassionate and knowledgeable response to my email! It means the world to Tate and I and his dad. We did visit the vet yesterday and like you, she was wonderful. She did not recommend putting him through another operation, we are trying anti-inflammatories with tummy pills to protect his stomach and his kidneys, and we are monitoring his personality and behavior. Keeping in mind and preparing ourselves for the next step. And I will look into acupuncture! Tate is our life, and he has fulfilled my life to no end, so to be lucky enough to have your thoughtful response and talking to the wonderful vet we saw yesterday is invaluable to us and helps us to cope with this difficult time in all our lives - thank you so much!!
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It was my pleasure to help. I wish you and Tate the best.
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Hi there:
Thank you for this. Unfortunately our beautiful dog Tate passed away yesterday. He was ready to go, his body broke down and he was coming to his natural end. Our wonderful vet Barb came to our home to assist him out of this life onto the leg of his next journey. And Tate was so calm and ready. He closed his eyes and went to sleep even before his tranquilizer was administered. He died as peacefully and beautifully as he lived - our saint.
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I am sorry to hear about Tate's passing but grateful that it was peaceful. Losing a pet is never easy, especially a charmer like Tate. Please know that my thoughts are with you as you navigate this difficult time.
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Dear Dr. Nelson:
Thank you so much for this and for your earlier advice. It certainly is heartbreaking but Tate is in me and all around. I can feel him. I need now to adjust to having his spirit's presence around opposed to his physical one and to the fact that my life has completely changed. A great dog is life's most precious gift and I feel so grateful for having Tate in mine.
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Hi.articles give me hope.I have 20 yr old Tibetian terrier Winston,who is being treated for dementia.He walks around in circles all the time ,then falls down and we have to help him up.He can't see but has great appetite.It is 24 hr care for him.vet has put him on phenobarbitone and Valium but can't see any results yet.I really don't want to have to put him to sleep.If these pills don't work can yu recommend something else.Thanking you
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Wow, 20 years old! Winston must be an incredible dog. I am sorry to hear about his circling. If he does not respond to the pheno and valium, there are other drugs your veterinarian may prescribe to help Winston with his anxiety including Selegiline (Anipryl by Pifzer Animal Health) and amitriptyline. I wish you and Winston all the best in the time he has remaining.
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I was so sorry to read about Tate, my thoughts are with you. Our animals are most certainly an integral part of our lives and their deaths must be mourned.our own beautiful dog Chester is almost 18.5 years and each day ia a blessing, I cannot imagine our lives without him.Thank you Dr Kris for your advice re dogs with dementia,as we live in Australia I find your site invaluable.
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Hi Pauline:
Thank you for your thoughts for Tate. I hope Chester is doing well! I feel like I want to keep talking about Tate everyday and to help me mourn his loss I wrote a tribute to him on my blog that I feel all loving dog owners will relate to - it can be read at the website above.
I agree that Dr Nelson's advice is wonderful and so helpful for all of us -
a very special vet! Dr Nelson and our vet here in Toronto,Dr Houghton, are admirable - Tate, my husband and I were so lucky to have happened upon them when we did.
Take care.
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Dear Alexandra,
I read your blog about your beautiful Tate, and judging from his photo, he was very intelligent.I am sure that his spirit will be with you and his Dad always.Chester is presently lying on my feet and having a chin rub, he is just gorgeous, the prince of our family.
All the very best .
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