Researchers develop guidelines for diagnosing, monitoring canine cognitive decline
North Carolina State University
An international working group of canine cognition experts has released a set of guidelines for veterinarians to use in diagnosing and monitoring canine cognitive dysfunction syndrome (CCDS), or canine dementia. The guidelines offer a standard definition of the condition as well as practical diagnostic criteria and are meant to aid both clinicians and researchers in helping senior dogs with cognitive issues.
“We are seeing CCDS diagnoses with increasing frequency, but there isn’t a standardized method for the diagnosis,” says Natasha Olby, Dr. Kady M. Gjessing and Rahna M. Davidson Distinguished Chair in Gerontology at North Carolina State University. “We wanted to propose that standardized method as a starting point that can be built upon over time.” Olby is the leader of the working group and corresponding author of the work.
Similar to Alzheimer’s disease in humans, CCDS is defined as a chronic, progressive, age-associated neurodegenerative syndrome, characterized by cognitive and behavioral changes. These changes can include things like altered activity levels, sleep disruption, anxiety, house soiling, and learning and memory impairment.
“The good news here is that there is increased interest in finding treatments for CCDS,” Olby adds. “But in order to develop those treatments we must first be sure there’s an agreed upon definition of the condition.”
The group created a diagnostic flowchart to help veterinarians establish a diagnosis with two different levels of certainty, and they proposed three definitions of severity, ranging from mild to debilitating impairment.
The group recommends that veterinarians start monitoring dogs for cognitive changes via routine senior dog surveys when dogs are about 7 years old.
If behavioral abnormalities are reported by the caregiver, follow-up with a CCDS scale – a more detailed questionnaire – is recommended with ongoing monitoring every six months. Beginning at age 10 years, use of a CCDS scale every 6 months is recommended for all dogs.
The next steps are to rule out other ailments through physical and neurological exams, including brain imaging if possible.
The researchers hope providing a workable definition of CCDS and its diagnostic criteria will pave the way toward improved diagnostics and therapeutics.
“I selected the participants in this working group from experts in field who are either actively working on CCDS or who historically have set the standards – from those who first defined it to those who translated it into clinical practice,” Olby says. “We recognize that this document is just the start of the process, but it was developed as a working live document that can be added to over time as our understanding improves.”
The work appears in the Journal of the American Veterinary Medical Association and was supported in part by the American Kennel Club’s Canine Health Foundation (grant #03440).
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Note to editors: An abstract follows.
“The CCDS Working Group Guidelines for Diagnosis and Monitoring of Canine Cognitive Dysfunction Syndrome”
Authors: Natasha Olby, Margaret Gruen, North Carolina State University; Joseph A. Araujo, Transpharmation Canada, LTD; Phillipa Johnson, Cornell University; Eniko Kubinyi, ELTE Eötvös Loránd University, Budapest Hungary; Gary Landsberg, Veterinary Behaviour Consultant, Richmond Hill, ON, Canada; Caitlin S. Latimer, University of Washington, Seattle; Stephanie McGrath, Julie A. Moreno, Colorado State University; Brennen McKenzie, Loyal Animal Health, Inc.; Monica Tarantino, Senior Dog Veterinary Society, Alexandria, VA; Holger Volk, University of Veterinary Medicine, Hannover, Germany
Published: Dec. 24, 2025 in Journal of the American Veterinary Medical Association
Abstract:
Canine cognitive dysfunction syndrome (CCDS) is diagnosed with increasing frequency, yet standardized diagnostic guidelines are lacking. The CCDS Working Group, an international group combining experts in the field and primary care veterinarians, proposes a definition of the syndrome and practical diagnostic criteria designed to aid clinicians and researchers alike. CCDS is defined as a chronic, progressive, age-associated neurodegenerative syndrome, characterized by cognitive and behavioral changes that affect daily life to varying degrees. These changes affect the behavioral domains of disorientation, social interaction, sleep disruption, house soiling, learning and memory, activity changes, and anxiety (DISHAA). We propose three severity stages. In mild CCDS, signs are subtle, of low frequency or severity with preserved function. With progression, behavioral changes become more apparent and impactful, requiring management adjustments. In severe CCDS, debilitating deficits are overt, significantly impairing basic functions and necessitating comprehensive support. Two diagnostic levels are proposed. Level 1 is based on consistent history of progressive DISHAA signs, identification of alternate causes through physical, orthopedic and neurological examination and laboratory work, either normal neurological examination or evidence of symmetrical, diffuse forebrain dysfunction, and persistence of signs following management of relevant comorbidities. Level 2 includes a brain MRI showing cortical atrophy with cerebrospinal fluid (CSF) cell counts within normal limits. Definitive post-mortem histopathological confirmation rests on cortical atrophy, amyloid deposition, myelin loss, neuroinflammation, and amyloid angiopathy. Future priorities include the development of blood biomarkers and cognitive testing batteries for routine clinical settings, both of which will refine diagnostic accuracy and therapeutic monitoring.
Journal
Journal of the American Veterinary Medical Association
Method of Research
Literature review
Subject of Research
Animals
Article Title
The Canine Cognitive Dysfunction Syndrome Working Group guidelines for diagnosis and monitoring of canine cognitive dysfunction syndrome
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