Yet another product has entered the market aimed at treating Canine Cognitive Dysfunction Syndrome (CDS). This age-related brain disorder is analogous to dementia in elderly humans, and it involves a number of significant behavioral changes. Affected dogs may get lost in the house, they may have disrupted sleep and restlessness at night, they may show changes in social interactions with people and other animals, and they may experience a breakdown in housetraining. All of these are important symptoms that can adversely affect the quality of life for both pets and owners.
There are no dramatically effective treatments for this disorder, but there are plenty of remedies for sale. The prescription mechanism selegiline has been approved by the FDA for use in this condition, and there is some limited clinical trial evidence to support a benefit, however it is not by any stretch of the imagination a cure. As is typical for incompletely understood diseases with no clearly effective conventional treatment, CDS presents an attractive target for marketers of alternative therapies. And while it is laudable to seek to discover and promote a remedy for an otherwise untreatable disease, unfortunately most of the products targeted at CDS are brought to market well before adequate legitimate research confirms they are safe or effective. Rather than seeking an FDA label approval, which requires significant efforts to prove safety and efficacy, many companies prefer to market their remedies as supplements or nutraceuticals, taking advantage of the lack of effective regulation of such products.
I have previously written about nutraceuticals and CDS (updated here), but the newest product takes a novel approach. Rather than vitamins, antioxidants, or herbs, this product contains as its “active” ingredient apoaequorin, a protein found in certain jellyfish that has long been used in molecular biology research as a tool for monitoring the level of calcium inside of cells. The cleverly named Neutricks (as in “teach an old dog new tricks,” though I can’t help hearing an echo of the unrelated product Neuticals), supposedly reduces the symptoms of CDS by protecting nerve cells in the brain from damage associated with excessive calcium levels.
The company web site references a number of studies showing that injecting apoaequorin into rat brains can protect nerve cells from death when they are later removed from the rat and deprived of oxygen in test tubes (1, 2, 3). This is an interesting finding, but obviously a long way from showing that the product has any clinical benefits in dogs with CDS. Such preliminary animal model research is a necessary first step on the road to proving such a real-world benefit, but by itself it is totally inadequate to justify putting the product into your dog.
One very important step that the maker of Neutricks seems to have skipped (though, as always, I may simply not be able to find all the relevant information, so I am certainly open to being shown additional evidence) is demonstrating that the protein can be absorbed and get to meaningful levels in the brain of dogs when given orally. Proteins are usually destroyed in the stomach (that’s primarily what this organ is for), so many compounds that have significant effects when injected are useless taken orally. A classic example is rattlesnake venom, which can easily kill you when injected by the snake’s fangs into your body, but which is perfectly safe to drink.
The same company also markets apoaequorin as a supplement to treat symptoms of Alzheimer’s and dementia in humans, under the name Prevagen. The company is apparently enrolling and planning a large number of clinical trials studying apoequorin as a treatment for Alzheimer’s disease, other cognitive and memory disorders, autism, multiple sclerosis, Parkinson’s, and apparently any disorder whatsoever involving nerves and calcium. There is apparently only one clinical trial actually completed, and as another blogger has also already pointed out, this pilot trial of 56 participants was uncontrolled, unblinded, and methodologically quite weak. Again, such preliminary studies are appropriate to identify possible side effects or benefits that influence the decision to continue with further research, but they prove nothing and certainly do not justify marketing a product for actual use in patients.
(The company has also issued several press releases discussing “promising interim results” from a human trial involving apoaequorin and memory, but the details of the trial are not yet available, and no peer-reviewed publications of any results have appeared, so it is impossible to evaluate the quality or significance of the results)
As for veterinary research, the company apparently contracted an outside research firm to run a trial of Neutricks in dogs. The study involved 24 laboratory Beagles 9-17 years of age. The subjects were randomly assigned to a placebo group, a low-dose treatment group, and a high-dose treatment group. The subjects were selected from a larger group on the basis of preliminary testing to find animals that reliably performed certain cognitive testing tasks but which “tended to perform at below maximal levels to allow for the possibility of seeing memory enhancement.” The treatments were given and testing done in a properly blinded manner.
The results of pre-treatment testing showed no difference in performance between the three groups. There were three cognitive tests administered: a delayed non-matching to position task (DNMP), a discrimination task, and an attention task. The results were as follows:
1. DNMP Task- No significant difference was seen in performance of the three groups. The report lists some post-hoc manipulation of the data which also show no statistically significant differences but the notorious “trend” often used to imply an effect where the data doesn’t actually show one.
2. Discrimination Task- The low-dose group showed a score and error rate statistically greater than the control and the high-dose group, which did not differ. This is, of course, the opposite of what you would expect if the agent worked since a dose-response relationship, in which the effect increases as the dose increases, is by far the most common result seen with effective medications. It seems most likely that this was simply the inevitable apparently positive result one sometimes sees when testing multiple effect measures in a clinical study. If it is repeatable in multiple studies and by different investigators, then it could turn out to be a real finding.
3. Attention Task- No significant differences between groups were seen in overall performance. The report keeps mentioning results that were “marginally significant” or “approaching significance,” but these are meaningless spin terms. The purpose of significance testing is only to decide, with a pre-determined level of assurance, whether the result could be due to random chance or not. If the usual cutoff of 5% (P=0.05) is used, then a significant result only means that the finding would appear by chance alone only 5 out of 100 trials. It doesn’t mean that the result is due to the effect of treatment or any other specific hypothesis. And when test results don’t reach this 5% level of probability, they are by definition not significant, period.
Some additional post-hoc manipulation of the data yielded a significant difference between the high-dose and the control groups in 1 out of 3 different conditions, with no difference at the other conditions or for the low-dose group.
No adverse events were reported.
Overall, the results of this trial clearly do not justify the clinical use of apoaequorin in treating CDS. The company has not apparently demonstrated even the most basic element in building a case for such use, that the product is absorbed when taken orally and reaches meaningful concentrations in the brain. They have not reported in vitro or laboratory model results that have any direct relevance to the pathology or clinical features of canine cognitive dysfunction. The clinical trial they are using as a marketing tool was conducted on healthy laboratory research Beagles, not owned pets with CDS, and even in this trial there were almost no significant effects seen in subjects getting the product.
Could it work? Sure.
Is there clear evidence it doesn’t work? No.
Is there any significant evidence of risk? No.
And finally, is there any meaningful evidence of beneficial effects? Nope.
So while I certainly would love to see additional, and more relevant testing of apoaequorin and the underlying hypothesis behind its use, at this time it is just another example of selling wishful thinking to people without a lot of better options. I understand why desperate pet owners are willing to grasp at such straws, but I consider it ethically questionable, and certainly scientifically insupportable, to sell them.
L-amphetamine and L-metamphetamine are metabolites of fda approved selegiline which may contribute to the pharmacological effects of the drug. A study out of the UK showed no CDS benefit for this FDA approved drug. When I gave clients both the fda and UK studies they no longer wanted to buy the FDA approved drug. If anyone has a good study that can show an effect in dogs beyond what would be expected of a amphetamine I would like to see it. Maybe these FDA CDS approved drugs would be helpful when dogs stay up at night to study for final exams.
art malernee dvm
fla lic 1820
Just on a lark (“can’t hurt, might help”), I have been giving Neutricks to our 14 yr.old hunting dog for 2 1/2 weeks. She eats B/D (Hill’s) and has also been taking Senelife since mid-January, 2011. Within days (3?) of starting on Neutricks, our dog no longer paces throughout the night, is far more active and alert, and is much more relaxed. Is it that the B/D or Senelife have finally taken effect? Is it the combination of all 3 products? Frankly, I do not know nor do I care…our dog is much more herself and for that we are grateful.
My Vet prescribed Neutricks for my dog who is 14 years old.
I gave it to her for a week and noticed a very bad change to her.
She seemed to be in pain especially when I tried to pet her on the head or tried to
pick her up. I stopped giving it to her and within a few days she was herself again.
I don’t know what the side effects are but I didn’t help my dog it just seemed to make
her worse.
Thanks for sharing your story. Most of the time, only people who feel a product is helpful talk about their experience, which gives the impression of only positive responses. Realistically, anecdotes alone can’t tell us whether a product is generally safe or effective, but since people find them so compelling it’s important to have at least some balance.
I have been giving my 15 yr old schnauzer Neutricks for 3 weeks now. I have seen no improvement. She has been on selegeline for 2 years also. No improvement with that either. She is diabetic and has cushings. Physically her diseases are under control. It’s the CCD that is taking a toll on all of us. I am going to try some herbs from a holistic vet. It can’t hurt.
I wish that were true, but there is plenty of evidence that inadequately tested herbal therapies can do harm.
Best of luck.
I have been giving Neutricks to my 15 year old retriever mix for about 3 weeks and he is much less confused and the nightly pacing has stopped. As far as I’m concerned, this pill has performed amazingly well.
Hello- did you review the results associated associated with this press release, released a year after this post?
http://www.globenewswire.com/newsroom/news.html?d=239044
I can’t find any results other than the Beagle trial reviewed in the original post. The Neutricks web site doesn’t have any other clinical trial data from dogs, and nothing shows up on PubMed, which covers most of the peer-reviewed literature.
If you have access to a copy of a study I haven’t seen, or a link I could follow to the study report, I’d be happy to review it.
I have been giving our 11 year old Golden Retriever Neutricks for approximately 2 weeks now. The pacing has stopped, the SEVERE anxiety attacks and destructive behavior have stopped and he is generally back to his old self. We tried this as a last resort as nothing else had worked and we had got to a stage where we were having to medicate/sedate him just to leave him alone. We were sadly considering euthanasia for our old chap. As a health professional, I am as dubious about uncontrolled/poorly researched trials as the next person – however Neutricks has worked for us. I am so pleased!
I’m glad things are working out for you, but unfortunately no matter how many anecdotes like this we collect, they don’t add up to a reliable guide to what works or doesn’t work. Did you know 3% of renal carcionmas, once thought to be inevitably fatal, regress spontaneously?
I have been giving my 12 year old Welsh Terrier Neutricks for about 6 weeks. I noticed a difference in his behavior within a couple of days. He is much more active, acts like a puppy, shows no signs of side-effects, there is a noticable difference. I have been looking for reports from other dog owners and this blog has been very helpful. I will continue to give it to my dog and if any side effects show up, I will report it here.
When I ordered this product in November, it was .26 per pill.
Now, the best I can do is .54 per pill.
Has it helped my 14+ year old shelter dog?
I’d like to believe so, but it could be the glucosamine sulfate or the COQ-10, too.
I can’t afford this medicine anymore.
I bitterly believe its popularity has caused the price increase, it has more than doubled in less than 6 months.
Im just starting to give my dog neutricks. Ill post weekly if I notice any changes. Its only been two days and I havent seen any changes yet. Does anyone know how long they were giving this medicine before they noticed any changes? Thanks Greg
So its been 9 days now, and I cant believe how much “ollie ” has changed for the better. No more pacing around, or nervous, he acts like he did a couple of years ago. He is almost 16 years old. He is now relaxing and sleeping the whole night. WOW, Im sold for sure, it really works, at least it has for ollie. He seems happy and relaxed.
My 16 year dog has been diagnosed with Canine Cognitive Dysfunction. Anipryl is not available in the country I live in, although Selegiline for humans is freely available off the counter. My dog is on various other medications and supplements which my vet felt may interact adversely with Selegiline. So we decided to try Neutricks. As you rightly say, desperate pet owners will clutch at straws.
I’ve had a bottle of Neutricks flown in from the US, and my dog has been having it for 3 days now. I’ve been hoping to see some signs of improvement, I know it’s only been 3 days, but I’m still hoping and praying.
By the way, he’s only 5.7 kilograms (1 kilo = 2.2 lbs, I think). We are giving him only half a tablet to start with. Does anyone know if I should increase it to 1 tab, or stick to half?
I’d appreciate hearing from someone re the dosage.
AB
i bought neutricks from my vet, who i love and trust. i’ve just gone through the first bottle. i don’t think it’s made much of a difference; my dog seems a little better but that could be due to other factors. i think i will buy a second bottle and see how it goes, but so far the difference has not been dramatic. but, i don’t think she is as impaired as some of the dogs described above.
I understand your objections and agree that “real” trials need to be done but…
I have a 15 year old female pug. about 2 years ago she started staring into space, and acting link she didn’t know me. My vet told me to try Neutricks. It helped within the first week. The fact that it worked so quickly made me suspicious and I kept second guessing myself, asking if she was really improving or was I just trying to convince myself of it. She really was. After a year or so she declined a bit again and my vet said to increase the dose. Right now she is on 2 tablets a day and is still with me cognitively. I wish some one would develop something for her deafness and failing vision! (I am a natural skeptic, and a health care professional as well but seeing is believing.)
Seeing may be believing, but it isn’t a guide to what’s actually true. People saw and believed in bloodletting for thousands of years, but they were wrong. And here is an entire web site devoted to reports of people who are certain they have seen space aliens. The fact is that if we could simply just that appearances always reflected reality, we wouldn’t need science.
Cognitive dysfunction is a poorly understood syndrome with variable and inconsistent symptoms all of which rely on us to assess subjectively. This is exactly the sort of problem that is difficult to assess objectively and appears to respond to every nostrum on the market. I’m glad your dog is doing well, but testimonials simply aren’t a reliable form of evidence, and they have led us in the wrong direction so many times in medical history that we really need to demand more than this as evidence for the therapies we give our pets.
Anipryl is not available in the country I live in, >>>
Do you live in the UK? It’s been ten or twenty years ago but when I bought my first bottle of FDA approved Anipryl I did a search for studies about it and found one out of the UK that looked the same as far as the abstracts as the study the FDA used to approve the drug. The drug salesman told me that some older doctors were taking it themselves but their urine will test positive for amphetamine. I gave the client that information and had enough clients decline to buy Anipryl that I had to throw the rest of the bottle out when it went expired.
One thing that I have wondered about is whether an owner who chooses to give their beloved older dog such a supplement then naturally pays much closer attention to the dog, trying to determine if there is a beneficial effect, and actually creates or amplifies the beneficial effect by dint of the additional attention. Has anyone noticed this type of effect?
Cheri, yes.
http://en.wikipedia.org/wiki/List_of_biases_in_judgment_and_decision_making
I give my 18 year old mini mini schnauzer Neutricks and it helps.
What I also found extremely helpful was to expose him to my seasonal affective disorder device – sky effects – it is a bright light – mine comes with an ionizer. The light makes him calm and he likes the smell of the ionizer. Provide all the anti-rational you like, all I know is my dog is now calm and relaxed!!
And I carry a magic charm in my pocket to repel polar bears. Never seen one here in California, so be as skeptical as you like, I know it works!
I have my dog on a mix of nuetricks, vivitonin, cholodin with a little fish oil and vitimin e. This mix has made a world of difference. My german shepard mix about 14 years old was diagnosed with CCD and was an anapril which was not helping at all. The house now sleeps most nights, the indoor accidents have stopped as had the lost look. The panting comes and goes, but I will take that over continuous barking all night long.
I’ve been giving my westie Neutricks for about a month with at best mixed results. The one thing I’m certain it has improved is his ability to sit on bare floors without losing his footing. Perhaps a little less wandering around at night.
HOWEVER, he’s been doing some flinching of his head both when my hand approaches (he’s close to blind so maybe I’m startling him) but also separately from that. It often seems more like a twitch or like a small electrical storm (very momentary) is going on in his head. Sometimes his personality seems a little better but other times he seems to be in pain and very short-tempered and quick to bite.
Today when I picked him up from the groomer’s they said he seemed to be in a lot of pain and was limping and evidently he did resist a new employee(!) who was washing him but he absolutely cannot walk on that leg now and is in a great deal of pain even with a full dose of metacam (.9 cc?) for 15 lbs. His head is now shaking quite a bit (off & on) along with his body sometimes. Who knows what’s caused any of this but I’m very suspicious of the Neutricks regarding what seems to be neurological symptoms to me. (I’ve had him to the vet and he’s trying to rest right now).
For what it’s worth, I won’t be giving him that drug again.
Skeptvet, why are you so hell-bent on disproving Neutricks? I have a 20 year old Pomeranian who has exhibited a rapid mental decline in the past few months. She no longer recognized me, looked dazed much of the time, got the “shakes” upon being startled, paced around, and got stuck in corners. I was a day away from taking my lovely Coco to the vet and wondering if it would end in euthanasia. I found out about Neutricks from a coworker, and within a week I have my Coco back. She is alert during the day and makes eye contact. She had stopped barking, but she now barks again. I have my coco back. This product is a godsend.
You clearly have misunderstood everything I’ve said. I am not “disproving” anything. It is not possible to make a judgment about whether or not the product works without appropriate scientific evidence, and the whole point of this article is that that evidence doesn’t exist. Neutricks may work, or it may not. What I am saying is that anecdotes like yours don’t help us decide, and that it is inappropriate for the company to make many of the claims they do without making the effort to test them scientifically. Anecdotes support every treatment ever invented, so either everything works or anecdotes don’t. If your anecdote proves Neutricks works, then bloodletting works, astrology works, Lourdes water works, and so does every other remedy ever. Surely you can see why this approach is a problem?
Just started my 15 yr old Jack Russell on Neutricks. She was having accidents in the house and some staring. After 3 days she had almost no accidents. However now she is not eating, and she never missed a meal, drinking lots of water and just laying in her bed. Hard to,keep her on her feet.
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Has anyone on here tried Cell Advance 880? This and Neutricks were recommended for my 13.5 year old labrador, however I only chose to try the Cell Advance 880 first.
Just started my 15 year old pit-cross on Neutricks. I do animal rescue and am pretty objective about their health. Jack has been exhibiting behaviors like pacing, having accidents in the house, unresponsiveness to commands, etc. I will assess him over the next month and let you know what happens. This dog, who I rescued when he was 9 months old and in terrible shape from mistreatment and abandonment, is my soul. I want him with me a little longer but I will not prolong any discomfort he may be in. I will let you know how things work out. (FYI, my other dog, Kelsey, a rescued Field Lab, is my heart.)
Kudos to the pet owners who have sought treatment for their beloved pets rather than automatically give up. Kudos to these people who have shared their stories.
Having my own mysterious health issue — that no western MD, or scientific test could explain, I suffered for many years before finding an alternative medical doctor who took the time and gave me a proper diagnosis to get well, mostly through the treatment of alternative therapies. I learned the very hard way, that scientific studies are not an end all. What is the end all for me, is “How do I feel?” Likewise, I pray my 11.5 year old border collie will experience relief from this new and frightening behavior change of staring, confusion, wandering, being despondent. I appreciate the skeptvet having a website but I will not accept scientific studies as the only proof of the efficacy of this. Too often a simple herbal remedy (that is much less costly than a pharmaceutical) can provide the same or better benefit, and without toxic side effects. The medical community needs to be more open minded. We are individuals. One size does not fit or cure all. This is true in everything, and I believe also for our beloved pets.
Scientific studies are not about “one-size-fits-all” or ignoring how patients feel. they are about recognizing that there are innumerable ways in which our personal observations and judgments can go wrong, and these have proven remarkably unreliable for thousands of years in helping us improve health compared with the unprecedented success of scientific medicine in the last couple of centuries. Science is, of course, deeply imperfect as are all human endeavors. It is just a whole lot better than the alternative.
I encourage you to read these articles that discuss in much more detail why anecdote simply don’t help us evaluate medical treatments.
Why We’re Often Wrong
Testimonials Lie
The Role of Anecdotes in Science-Based Medicine
Why We Need Science: “I saw it with my own eyes” Is Not Enough
Don’t Believe your Eyes (or Your Brain)
My vet has just suggested this as a possible remedy to my dog’s behavior changes. It appears this article is over 5 years old, but some comments are only two months old. Were there no additional tests in the last five years? (That is my assumption, but I do try not to make those often.)
My 14 YO schnauzer has been taking Senilife for about six weeks. I really can’t say if he’s doing better or if I just want him to be doing better. But, there are still some problems. I will probably add this and see if there is any additional (real or imagined) improvement. I’m pretty skeptical, but he’s my whole world. I realize that this makes me pretty susceptible to the claims of every “snake oil” salesman out there, but I can’t stop trying to help him.
I wish there were more studies on this and other CCD “treatments” so that I could help him faster rather than play as much “trial and error” with what may be limited time.
I’m an extremely skeptical person, especially with magical cure-alls for my furbabies. Currently, I have a 12 year-old lab/chow mix and. 17 year old dachshund.
When my mix was 9, all his hair started falling out , and about 75 percent of his body was covered in blisters. I spent almost 9 months trying all the “holistic” approaches found on the internet.
He was diagnosed with pemphigus. I read blogs everywhere and followed any message board i could find. Sadly the dogs on those boards never got any better, with most passing or having to be euthanized within a year after developing pemphigus.
I was determined to not let that happen to my baby and finally gave up on the quackery and took my dog to a dermatologist.
It wasnt cheap, and they actually found a cancerous tumoe in his anal glands AND he started developing pneumonia due to not seeking proper medical care.
Thanks to my awesome vets, its now been 3 years, hes cancer-free and his pemphigus is pretty much under control. 90 percent of his hair is back, blisters are gone and has lived well beyond a year.
All this is due to science and research, so i can see why skepvet is advocating further research before fully endorsing these products.
With that being said, sadly my 17 year old dachshund now has CCD. I have just ordered some neutricks, cholodin, senelife and anipryl (which ironically from the countless hours ive spent research this disease, seems to be least promising).
I just started the regimen today, and will be keeping as much records as i can in his progress ( or lack thereof). Ill be taking pics videos and documenting everything i can to try to avoid the above mentioned phantom effects.
Currently, his symptoms are:
Glazed over looks
Doesnt recognize me half the time
Cranky (snaps occasionally)
Walks on circles for long periods of time
Gets “stuck” in places where he could easily back out of
Takes forever to fall asleep at night, and extremely hard to wake up afterwards
Sticks nose in food and water bowl and just sits there 3 out of 4 times without eating/drinking
Goes to the wrong side of sliding door half the time when coming back in
Recently started having small accidents in the house about once every other day.
Im going to document any changes ( good or bad) in the above symptoms over at least the next 2 months and post here if anyone is interested.
Thanks for your time
I went through this with my 16 year old dog “dementia” it gets worse. All you can do is have the vet prescribe comfort meds, mine was on an antipsychotic that was similar to thorazine. It was the only thing that would calm him down. Be careful with all the gobbledygook, not only is it useless but it can give them diarrhea.
In the end he was almost total care and my other dog attacked him when he cried, which is normal for pack behavior. So, you may want to separate them when you are not there.
I found this site helpful http://dogdementia.com/blog/
Best of luck.
I am skeptical of all such products, but at the moment am so sleep-deprived from the old guy’s nightly pacing that I am willing to try Neutricks, if it is reasonably safe. But I have found no information if it is safe for dogs with renal disease (and of course, many senior dogs do have impaired kidney function). Have you any knowledge or opinion about that?
As I often point out, lack of evidence includes both effectiveness and safety. So while there are not specific reports I am aware of of harmful effects, the lack of testing means no one really knows how likely these are. Using such products is always a gamble.
I will point out, though, that there has been a lawsuit against this company and several FDA actions concerning both uninvestigated side effects in people and unsupported claims of efficacy.
I found this Yahoo article regarding a dog with insomnia:
“My Dog Had Insomnia, And Now I Feel Guilty for Not Seeing It as a Symptom of Something Much More Serious
“After an ultrasound, the vet at Angell reported that Harvey had a tumor on his spleen, and it was causing internal bleeding. It’s possible the tumor is benign,” the vet told us, “But we can’t know until we get it out.”
https://www.yahoo.com/news/dog-had-insomnia-now-feel-180000358.html
Vivitonin is excellent for dogs with age related dementia and very old dogs in general
( prescription only ).
Evidence?
Lol. Anything I say will be anecdotal. Most of my teenagers are pretty good however their activity level increases in that from not wanting to come on exercise, they want to come out with the pack and they are active on the walks. If there is appetite loss for no reason, certainly the drug wakes that up which helps maintain weight. I have only had two go mentally vague and again that improved hugely …….my observation, they stopped the wall staring and were able to find the dog door again ! Do you prescribe this drug in your practice ?
I should add that my vet used to get me to try another med. first and it had no effect from my observations. Now if I need it, they get Vivtonin straight away.
Neutricks absolutely rejuvenated my Parents’ Springer. They were considering euthanasia last Spring, and now she is alert, happy, and vital. Still stiff from arthritis, but at 14 years, she’s doing pretty well.
Why Anecdotes & Testimonials Can’t Be Trusted
So then, reading through many of your articles, posts and blogs, what would you recommend to treat an elderly dog with CCD?
So far, I’ve been using Hills prescription diet b/d for about 2 months, and have had my 18 year old Jack Russel on selegiline for about 3 weeks now.
She was howling when I came home at lunch to walk her, that’s stopped thankfully.
She had never exhibited that behavior before. She was disinterested on our daily walks and didn’t sniff anything, which usually the walk takes forever because she sniffs everything. She’s now back to barking for the harness to be put on when I get home and having her nose to the ground and sniffing happily along the way. She still does spin though. I use Dramamine to help keep her from getting too dizzy. Again, anecdotally, there are what appear to be improvements. My ex wife and I share her every two weeks. So I don’t see her for a two weeks, which helps when trying to determine if her behavior has changed. We walk twice everyday, I engage her as best I can, try to play games to help her to be more aware. Keep her on a high antioxidant and omega 3 diet, etc.
But, as you say there is no real evidence to support these observations regardless of how unbiased I am trying to be.
Which is why I ask, if this was you, what would your course of action be? What have you seen to be the most viable treatment plan?
I think your approach is totally reasonable. In the absence of clearly proven effective treatments, we experiment with treatments that have low-quality evidence to support them. Every individual is different, so I don’t have a single general approach for dogs with CCD.
I have used selegilene, and I always discuss it. But apart from the poor research evidence, my own experience, and that of the other vets I work with, is that it rarely seems to help. SOmetimes I will use anti-anxiety meds if pets seem anxious (trazadone, benzodiazepines, SSRIs), and sometimes this helps them sleep at night. I always make sure any pain or other medical issue is controlled if possible.
I have discussed the Hills and the new Purina diets, but I haven’t yet had an owner who wanted to try them. They are unlikely to do harm unless a pet has a specific dietary need.
Many of my older patients are on fish oils for arthritis anyway by the time CCD becomes an issue, so it’s hard to know if this is helping that too.
And I generally avoid the supplements because they are mostly implausible, have no specific evidence regarding safety or efficacy, and there is no regulation or quality control so I think they present some risk. Cannabinoids are currently popular, and I’ve had a few owners report positive experiences with them, but again I always make it clear that in the absence of real research, we could make life worse for their pet rather than better, so these kinds of things are when people feel quality of life is really poor and are willing to roll the dice. I don’t object to that so long as they understand the risks.
Jim, have you noted any improvement in using Hills prescription diet b/d.?
I have seen a few reviews that people seemed to think it has helped their dogs.
Ron,
As I mentioned above, her behavior has changed, she is no longer howling and she does not appear to be as anxious or afraid as she was before. She is once again enjoying her walks.
But, is that really because of the food? I can not be certain because as the “skepvet” says many times here throughout this website, there is not nearly enough proven statistical data to say for certain if it has really helped. No real controls, I can’t find any data that uses tried and true scientific methods.
All I can say is that if, like me, you feel it necessary to do something, try the food and see if it appears to work for you and possibly the Selegiline.
Sorry if I am being kind of vague here, but as I said I can not say for all certainly if my dog Zoe would have recovered on her own or not.
For now, since it seems to be working even if coincidentally, I’ll keep using both the Selegiline and the Hill’s food.
Good luck.