Síndrome de disfunción cognitiva (demencia en perros y gatos)
CDS, Canine cognitive dysfunction (CCD / CCDS), Feline cognitive dysfunction (FCD), Dog dementia, Cat dementia, Senility / "just old age", Sundowning (night-time restlessness)
El síndrome de disfunción cognitiva es la demencia en las mascotas. Al envejecer, el cerebro de algunos perros y gatos cambia de una forma muy parecida a la enfermedad de Alzheimer en las personas, así que la mascota puede parecer pérdida en un cuarto conocido, caminar sin rumbo o maullar y llorar de noche, olvidar dónde hace sus necesidades, o dejar de saludarte como siempre lo hacía. No es que tu mascota se porte mal ni que sea terca, y es mucho más frecuente de lo que se diagnostica. Muchas de esas mismas señales también vienen de cosas que sí se pueden tratar, como el dolor de las articulaciones, la enfermedad del riñón, la tiroides acelerada en los gatos, la presión alta, o la vista y el oído que se van apagando. Por eso el primer paso es una revisión completa con el veterinario o la veterinaria, y no suponer que solo es la edad. Antes que nada, tres reglas de seguridad. Primera: nunca le dé a su mascota medicina para el dolor de personas: ibuprofeno (Advil, Motrin), naproxeno (Aleve), aspirina ni acetaminofén/paracetamol (Tylenol, y el paracetamol que viene escondido en los antigripales). El acetaminofén puede matar a un gato con una sola tableta común, y los antiinflamatorios humanos provocan úlceras en el estómago y falla del riñón en perros y en gatos. Segunda: nunca le dé a un animal la medicina de otro animal. Una pastilla de artritis para perro (carprofeno, meloxicam, deracoxib, firocoxib o grapiprant) puede ser mortal en un gato, y una dosis calculada para un perro grande no es la dosis de un gato ni de un perro chico. Tercera: no empiece, no suspenda, no cambie ni duplique ninguna medicina, suplemento o alimento por su cuenta: llame primero a la clínica. Eso incluye los medicamentos humanos para la demencia y los suplementos humanos "para el cerebro", que nunca se han demostrado seguros ni eficaces en perros ni en gatos. Y por más segura que esté de que es demencia, lea la lista de emergencias de esta página antes de decidir esperar hasta la mañana: varias emergencias de verdad se ven exactamente igual que una mala noche de demencia.
Qué podría notar
- Se pierde o se queda trabado en lugares conocidos: se para en una esquina, mira la pared, o va al lado equivocado de la puerta. Ojo con una diferencia importante: si presiona la cabeza contra la pared o contra un mueble y se queda así, eso no es lo mismo y es una emergencia (vea la lista de señales de alarma)
- Camina sin rumbo, está inquieto o llora de noche, y duerme mucho más de día. Ese cambio de día y noche es uno de los primeros cambios que muchas familias notan
- Vocaliza en momentos o lugares poco habituales, a menudo de noche. La vocalización inapropiada en general (no específicamente de noche) fue la señal más reportada en una encuesta de gatos con disfunción cognitiva: 40.0% de los gatos afectados, 32 de 80 (PMID 35536055)
- Hace sus necesidades dentro de la casa, o el gato lo hace fuera de la caja de arena, cuando antes era muy limpio
- Muestra menos interés en saludarte, en las caricias o en jugar. O al contrario, se vuelve mucho más pegajoso y se angustia al quedarse solo
- Olvida rutinas, su nombre u órdenes que ya sabía, o parece no oírte ni verte
- Se choca con las cosas, duda en los escalones, o tropieza con muebles que siempre han estado ahí
- Come menos, o se queda parado frente al plato como si no supiera qué hacer
Estándar de atención
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Estudie y trate las condiciones que la imitan antes de tratar el cerebro — en ambas especies
Aprobado / respaldado por guíasEvery sign on the DISHAA list is also produced by something else in a senior pet. In cats the mandatory short list is osteoarthritic pain, chronic kidney disease, hyperthyroidism and systemic hypertension; hypertension in cats is usually secondary to CKD or hyperthyroidism, causes ocular, cardiac, renal and brain target-organ damage, and amlodipine besylate is the treatment of choice. In dogs the short list is pain, hypothyroidism, hyperadrenocorticism, hepatic disease, intracranial disease and sensory loss. This step is not a formality: it is the step most likely to change the pet's life, and skipping it is how a treatable disease gets labelled dementia. Order of operations for a pet with house-soiling: rule out pain, rule out urinary and GI disease, then consider cognitive decline, then treat as behaviour.
Productos nombrados: Amlodipine besylate is named by ISFM as the treatment of choice for feline hypertension. Telmisartan (Semintra, NADA 141-501) is FDA-approved with the verbatim indication "SEMINTRA is indicated for the control of systemic hypertension in cats." Methimazole-class antithyroid therapy, radioiodine and thyroidectomy are the feline hyperthyroidism options. No canine dose or product from this step transfers to cats, and no product on this list may be started, stopped or dose-adjusted at home without speaking to the prescribing veterinarian.
2023 AAHA Senior Care Guidelines describe a systematic, evidence-guided assessment of healthy and unhealthy senior dogs and cats and explicitly address the client misconception that decline is unavoidable old age (dog and cat). 2021 AAFP Feline Senior Care Guidelines make blood pressure a minimum diagnostic in senior cats and treat pain as its own syndrome to be considered in every senior cat (cat). ISFM hypertension guidelines are a formal practice guideline (cat).
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SOLO PERROS: clorhidrato de selegilina (Anipryl) — la única indicación aprobada por la FDA para esta enfermedad localizada en cualquier especie, y un medicamento con contraindicaciones firmes
Aprobado / respaldado por guíasLabel indication, verbatim from the FDA Freedom of Information Summary: "Anipryl tablets are indicated for the control of clinical signs associated with canine Cognitive Dysfunction Syndrome (CDS)." Recommended dosage, verbatim: "0.5 -1.0 mg/kg once daily, preferably administered in the morning. Initially, dogs should be dosed to the nearest whole tablet. Adjustments should then be made based on response and tolerance to the drug." This is a veterinary prescription decision, not an owner decision, and it cannot be made until the concurrent-medication review in the safety section has been done: selegiline is a monoamine oxidase B inhibitor and must not be combined with SSRIs, tricyclic or tetracyclic antidepressants, tramadol, bupropion, meperidine or other opioids, or sympathomimetics such as ephedrine, pseudoephedrine and phenylpropanolamine, and amitraz-containing tick collars and dips are themselves MAO inhibitors. Report the pivotal numbers honestly, because they are modest and the placebo response was large. In 199 client-owned dogs (181 evaluable at 4 weeks) randomised to placebo, 0.2 mg/kg or 1.0 mg/kg for the first 4 weeks, improvement at 1.0 mg/kg versus placebo was: sleep pattern 52.7% vs 16.7% (p = 0.001), activity 54.7% vs 28.6% (p = 0.012), house training 34.8% vs 26.3% (p = 0.030, and non-monotonic - the 0.2 mg/kg group scored 38.9%). Three of six domains did NOT reach significance: orientation 55.2% vs 35.5% (p = 0.098), responsiveness 52.1% vs 41.8% (p = 0.499), greeting 32.6% vs 25.0% (p = 0.584). FDA's own verbatim conclusion: "Anipryl administered at 1.0 mg/kg once daily was shown to provide safe and effective control of clinical signs associated with CDS in pet dogs. The onset, duration and magnitude of response varied with individual dogs." And the durability caveat, verbatim: "The duration of effect may be as short as 8 weeks in about 50% of the cases." A widely quoted 77.2% improvement figure at day 60 comes from an OPEN-LABEL, uncontrolled study of 641 dogs and is not a controlled efficacy result. Anipryl is prescription-only because, in FDA's words, "professional expertise is required for the diagnosis of clinical signs associated with cognitive dysfunction syndrome and for the monitoring of adverse events and response to therapy." Selegiline is NOT approved for cats by FDA or any regulator located; it has been used extra-label in cats, and canine dosing must not be carried across.
Productos nombrados: Selegiline hydrochloride (Anipryl), NADA 141-080, sponsor Pfizer Inc., CDS indication approved 10 December 1998 as a supplement to the original 30 May 1997 approval; 2, 5, 10, 15 and 30 mg tablets; Rx. Selegiline is the levorotatory form of deprenyl HCl and acts as a monoamine oxidase B inhibitor, so a drug-interaction review is mandatory before co-prescribing - the pivotal trial specifically excluded dogs on "medications known to interact with Anipryl," and one trial dog on concurrent metronidazole, prednisone and trimethoprim-sulfa developed weakness, confusion, incoordination and "seizure-like" activity after about a week that resolved when all drugs were stopped. The trials also excluded dogs with other behavioural problems such as aggression, so efficacy and safety in aggressive dogs are unstudied.
FDA-approved indication supported by a placebo-controlled, multi-site, dose-ranging clinical field trial plus an open-label dose-confirmation trial (dog). The supporting open-label 641-dog study is uncontrolled and is Tier 3 evidence at best (dog).
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PERROS: cambie la dieta, no solo agregue un suplemento — nutrición terapéutica enriquecida con TCM (una intervención solo canina)
Ensayo controlado en esta especieTwo lines of canine evidence support medium-chain triglyceride (MCT) enrichment, and both are in dogs. In client-owned dogs with CDS signs, 87 dogs were randomised into three arms of 29 (control, 6.5% MCT oil plus a brain protection blend, 9% MCT oil plus the blend) and fed for 90 days: all 6 categories of CDS signs improved significantly (p < 0.05) on the 6.5% MCT diet, and the honest comparator is that the control diet improved in 4 of 6 categories too. The 9% arm only improved in dogs that accepted the diet, which is a palatability warning as much as a dose finding. In colony aged Beagles, 8 months of a 5.5% MCT-supplemented diet produced significantly better performance on most of a cognitive test battery with elevated circulating beta-hydroxybutyrate, supporting the ketone-as-alternative-brain-fuel mechanism. The systematic review across 30 trials found that studies of enriched diets were of higher methodological quality than studies of supplements, that omega-3 fatty acids showed cognitive benefit especially at higher doses, that antioxidants from plant extracts and vitamins E and C alone were less effective but remain necessary to stabilise the omega-3s, and that SAMe, MCTs, homotaurine and apoaequorin "also showed promise" - which is the correct strength of claim, not established efficacy. The same review counted 27 canine trials against 2 feline ones, which is why this step is labelled DOGS: no MCT-enriched cognitive therapeutic diet for cats was located, and this recommendation does not transfer to a cat. Owner behaviour runs the other way: in 394 owners of dogs with age-related behavioural change, 54% used dietary supplements (most commonly fish oil, 48%) but only 8% changed the base diet - a direct mismatch with where the evidence is stronger. Transition any new diet gradually and under veterinary direction; see the safety section for why abrupt diet change is more dangerous in a cat than in a dog.
Productos nombrados: Not a drug. Therapeutic diets and supplements are not FDA-approved drugs and no diet may be marketed as treating or preventing dementia. This protocol describes nutrient composition (MCT percentage, omega-3 dose, B vitamins, antioxidants, arginine) rather than a disease claim.
One 90-day prospective double-blinded placebo-controlled clinical study in 87 client-owned dogs with CDS signs, industry-authored (Nestle Purina and CanCog); one 8-month controlled colony-Beagle cognitive-testing study, industry-authored; one systematic review of 30 trials (27 canine, 2 feline) appraised with a modified CAMARADES checklist (all dog).
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GATOS: existe apoyo nutricional, pero la evidencia felina son dos ensayos, en gatos mayores sanos, no en gatos con demencia diagnosticada
Evidencia preliminarThe one identifiable feline intervention trial fed middle-aged and old cats (5.5 to 8.7 years) a base diet with or without a blend of antioxidants, arginine, B vitamins and fish oil, after assignment to cognitively equivalent groups on baseline testing. The supplemented cats performed significantly better on 3 of 4 cognitive test protocols (egocentric learning, discrimination and reversal learning, and acquisition of a spatial memory task). Two things belong on the same page every time. First, these were middle-aged and old cats undergoing laboratory cognitive testing - not client-owned cats with a clinical diagnosis of FCD - so this is evidence for supporting brain ageing, not evidence for treating feline dementia. Second, the systematic review of 30 cognition trials in ageing pets found only 2 feline trials against 27 canine ones (PMID 39827310), so every feline cognitive-support statement on this page stands on canine data and says so in the same sentence. There is no approved dietary or pharmaceutical intervention for cognitive dysfunction in cats located in any jurisdiction. In a cat with CKD - prevalence 50% to 68.8% in the senior feline cohorts cited in this protocol - a renal therapeutic diet may be the higher priority and may conflict with a cognitive-support diet; that trade-off is a veterinary decision, and any diet change in a cat must be made gradually because a senior cat that stops eating is at risk of hepatic lipidosis.
Productos nombrados: None approved. A 2010 review states plainly "the absence of any approved dietary or pharmaceutical interventions for cognitive dysfunction" in cats. Any pharmacological attempt in a cat is extra-label, is the prescribing veterinarian's decision for an individual patient, and is not presented here as established care.
One controlled colony/laboratory cognitive-testing trial in cats, industry-authored (Nestle Purina), in cats without a clinical FCD diagnosis; plus a systematic review documenting that only 2 of 30 trials in the field were feline (cat).
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Manejo del entorno, enriquecimiento y una rutina predecible — la intervención con la mejor relación costo-beneficio
Ensayo controlado en esta especiePractical, specific, and free: keep furniture and litter-box positions unchanged; add night lighting along the route to water and the litter box or garden; swap to low-sided, larger litter boxes and add one on every floor for cats; add ramps or non-slip runners; feed, walk and settle at the same times each day; keep short, low-stress training or food-puzzle sessions going during the day to load the sleep-wake cycle in the right direction; block access to stairs, pools and gaps behind furniture where a disoriented pet gets stuck; and put human medicines, supplements and xylitol-containing foods behind a closed door, because a disoriented senior pet gets into things it never used to. Never restrict water at night to control nocturia or indoor accidents: it is a common owner workaround and it is dangerous in chronic kidney disease, diabetes mellitus and hyperthyroidism - the three mimics this protocol is built to find. Manage the accidents with more litter boxes, night lighting, waterproof bedding and a late toilet trip instead. In aged dogs, the combination of behavioural enrichment and an antioxidant-fortified diet raised temporal-cortex BDNF mRNA toward young-animal levels, while either intervention alone gave intermediate levels, and BDNF correlated positively with cognitive performance and inversely with cortical amyloid-beta - a mechanistic reason to pair enrichment with nutrition rather than choosing one. Be honest about ceiling effects and precise about what moved: in 42 dogs aged 8 years and older with mild-to-moderate CCD, five weekly structured group-training sessions (scent-based or physical) left CADES scores unchanged - "CCD scores remained stable across all phases, suggesting no measurable cognitive changes" - while caregiver burden fell significantly in both arms and the physical-training arm showed improved accelerometer sleep scores. So enrichment should be offered for function, safety, sleep, quality of life and the family's own load, not as reversal of dementia.
Productos nombrados: Not a drug intervention.
Controlled colony study with molecular endpoints in aged dogs (dog); guideline-level recommendation for environmental management of the senior pet (dog and cat); one 5-week prospective study of 42 dogs with mild-to-moderate CCD reporting no change in the cognitive score but significant reduction in caregiver burden and, in the physical-training arm, improved sleep scores (dog, honest mixed result).
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Trate el dolor concurrente — con medicamentos correctos para la especie, nunca trasladados entre especies, y nunca con un analgésico humano
Aprobado / respaldado por guíasPain is the most common confounder and the most common untreated cause of the behaviours owners report as dementia. Start with the absolute rule: no human analgesic goes to a dog or a cat. Acetaminophen/paracetamol is lethal in cats and is dangerous in dogs; ibuprofen, naproxen and aspirin cause gastrointestinal ulceration, perforation and acute kidney injury in both species; and a canine NSAID given to a cat can kill. In cats, the anti-nerve-growth-factor monoclonal antibody frunevetmab (Solensia) is FDA-approved to control OA pain, with honestly modest effect sizes in the pivotal RCT of 275 cats (number needed to treat 9 and standardised effect size 0.3 on the Client Specific Outcome Measures at day 56) and a disclosable adverse-event signal of skin disorders (32/182 treated vs 8/93 placebo) plus a published case series of five cats with moderate-to-severe pruritus and self-trauma after injection. Feline NSAID use must follow the 2024 ISFM/AAFP consensus: feline-specific drug, feline-specific dose, feline-specific duration, pre-prescription screening and attention to CKD, which is common in this age group. In dogs, the corresponding biologic is bedinvetmab (Librela, FDA-approved 5 May 2023) and the approved canine NSAIDs are carprofen, meloxicam, deracoxib and firocoxib plus grapiprant. No canine product or dose on this list may be used in a cat, and in a dog receiving selegiline the analgesic choice is constrained: tramadol and other opioids, including meperidine, must not be combined with a monoamine oxidase inhibitor - see the safety section before adding anything for pain.
Productos nombrados: Cats: frunevetmab (Solensia), NADA 141-546, approved 13 January 2022, the first monoclonal antibody FDA-approved for any animal species; meloxicam and robenacoxib (Onsior) per label and geography - the US robenacoxib label is for postoperative pain and inflammation for a maximum of 3 days, not chronic OA. Dogs: bedinvetmab (Librela); carprofen, meloxicam, deracoxib, firocoxib, grapiprant. Never acetaminophen/paracetamol in a cat, at any dose, in any formulation; never ibuprofen, naproxen or aspirin in either species without veterinary direction; never a canine NSAID in a cat.
FDA-approved indications in the respective species, with RCT support of modest effect size in cats; consensus guideline for long-term feline NSAID use (cat); FDA approval plus consensus pain guidelines in dogs (dog).
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PERROS: S-adenosilmetionina (SAMe) como complemento, con sus límites declarados
Ensayo controlado en esta especieIn a double-blinded, placebo-controlled trial, 36 dogs older than 8 years with at least one month of cognitive dysfunction signs received SAMe tosylate 18 mg/kg (n = 17) or identical placebo (n = 19) for 2 months, with concurrent behavioural treatment forbidden. SAMe-treated dogs improved more than placebo in activity (57.1% vs 9.0% at 8 weeks, P < 0.003) and awareness (59.5% vs 21.4% at 8 weeks, P < 0.01), and the aggregate mental impairment score fell by more than 50% in 41.2% of SAMe dogs versus 15.8% of placebo dogs. The limits: n = 36, a 14-item owner questionnaire as the only outcome, 8 weeks of follow-up, and authorship from the manufacturer's medical department. The systematic review lists SAMe among supplements that "showed promise," which is the correct strength of claim. There is no feline SAMe cognition trial. Do not add SAMe, or any other supplement, without telling the clinic first: supplements interact with prescribed drugs, some human formulations contain xylitol, and a dog on selegiline needs its whole medication and supplement list reviewed.
Productos nombrados: S-adenosylmethionine (SAMe) tosylate, marketed as a veterinary nutraceutical, not an FDA-approved drug, and not presented here as approved therapy.
One randomised, double-blinded, placebo-controlled trial, n = 36, owner-questionnaire outcome, industry-authored (dog). No feline data located.
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Apoyo al cuidador, seguimiento de la calidad de vida y un plan explícito para el final de la vida
Aprobado / respaldado por guíasNight waking, vocalisation and house-soiling are the signs that break households, and caregiver burden is a legitimate clinical endpoint in this disease - the canine group-training study measured it alongside sleep and activity, and it was the outcome that actually moved. Set expectations at the first consultation: CDS is progressive, the goal is function and comfort rather than reversal, and treatments are judged over months, not days. The 2023 AAHA Senior Care Guidelines include palliative and hospice care and client education as part of senior care, and the 2021 AAFP feline guidelines address quality of life, budgets of care and euthanasia decision-making directly. Agreeing in advance on what a bad week looks like is kinder than deciding in a crisis at 3 a.m. Give the family a same-day contact route and tell them plainly which changes mean call us now rather than wait for the next appointment.
Productos nombrados: Not a drug intervention.
Guideline-level recommendation in both species; caregiver-burden instruments used as endpoints in a canine CCD study, where burden fell significantly across the intervention (dog and cat).
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Emergente y aún no estándar de atención — senolítico más precursor de NAD+, donepezilo de depósito, trasplante de microbiota fecal
Evidencia preliminarThree canine signals exist and none of them changes practice yet. (1) Senolytic plus NAD+ precursor combination (LY-D6/2): 70 dogs with mild-to-moderate cognitive impairment randomised to placebo, low or full dose; a significant between-group difference in owner-reported CCDR score at the 3-month primary endpoint (p = 0.02), largest in the full-dose group. But there was NO difference on in-house cognitive testing and NO difference in accelerometer-measured activity, the authors state "All groups showed improvement in cognition, frailty, and activity suggesting placebo effect and benefits of trial participation," and the intervention was a combination so nothing can be attributed to NAD+ alone. The trial used an ORAL product; injectable or nasal NAD+ at 500-1000 mg has no canine or feline data at any dose. (2) Long-acting intramuscular donepezil depot: 32 dogs randomised to high dose, low dose or control, with significant improvement in CCDR, CADES and DISHAA in the high-dose group at days 14 and 28 and lower serum neurofilament light chain in both treated groups at day 28; 28 days of follow-up, n = 32, pharmaceutical-company co-authorship, and no regulatory approval anywhere. This is an investigational veterinary depot formulation and it is not the human donepezil tablet: human donepezil and memantine have no approved veterinary indication, no established dog or cat dose, and must never be given to a pet from a human prescription. (3) Faecal microbiota transplantation: 11 dogs, open-label, no control; only 6 dogs had complete 90-day DISHAA data, of whom 4 improved and 2 worsened. That is hypothesis-generating and nothing more. None of the three has any feline data, and none is offered as treatment.
Productos nombrados: LY-D6/2 (senolytic plus NAD+ precursor, investigational, oral); donepezil depot injection (investigational, not approved for animals in any jurisdiction); faecal microbiota transplant capsules (not an approved drug). Human-label donepezil and memantine are not veterinary products and are not dosed for dogs or cats. None of these is presented as treatment.
One randomised controlled trial with a positive owner-reported endpoint and negative objective endpoints (dog); one small randomised 28-day industry-affiliated trial (dog); one uncontrolled 11-dog pilot (dog). No feline data for any of them.
2023 AAHA Senior Care Guidelines for Dogs and Cats — American Animal Hospital Association (AAHA). It covers both species, which is why it is the governing document for this protocol. No ACVIM, AAHA or ISFM/AAFP consensus guideline specific to cognitive dysfunction syndrome in dogs or cats was located in this search, and none is cited here as though it existed. The closest species-specific companions are the 2021 AAFP Feline Senior Care Guidelines (PMID 34167339, DOI 10.1177/1098612X211021538), which name cognitive dysfunction syndrome, frailty and pain as senior-cat considerations and make blood pressure a minimum diagnostic; and, for the canine clinical algorithm, a 2026 peer-reviewed review rather than a guideline (Dondi M, et al. Evidence-Based Clinical Management of Canine Cognitive Dysfunction Syndrome: Diagnostic Algorithms, Practical Guidelines, Critical Appraisal of Biomarkers and Translational Limitations. Animals (Basel). 2026;16(7):1114. PMID 41976093. DOI 10.3390/ani16071114). Drug-specific safety language on this page is taken from the FDA Freedom of Information Summary for NADA 141-080 and from the selegiline hydrochloride prescribing information, not from a guideline.
Cómo se diagnostica
- Take a structured behavioural history first, ideally on a scored owner questionnaire - CADES or CCDR in dogs, and the DISHAA framework (disorientation, interaction changes, sleep-wake changes, house soiling, activity change, anxiety) to make sure all six domains are asked about. CDS is a clinical diagnosis of exclusion built on documented change over time, not a test result (Dondi M et al. Animals (Basel). 2026;16(7):1114. PMID 41976093. DOI 10.3390/ani16071114).
- Full physical and neurological examination including deliberate assessment of vision and hearing. Sensory decline reproduces disorientation, unresponsiveness and startle-aggression, and it is common in exactly the age group in question.
- Minimum database: CBC, serum biochemistry, urinalysis and indirect blood pressure. The 2021 AAFP Feline Senior Care Guidelines include blood pressure assessment as a minimum diagnostic procedure in both apparently healthy and ill senior cats (PMID 34167339, DOI 10.1177/1098612X211021538). Check blood glucose in any insulin-treated patient presenting with new nocturnal disorientation before attributing it to CDS.
- Cats specifically: total T4, because apparent hyperthyroidism prevalence is 8.7% in cats 10 years and older and drives restlessness, vocalisation and night activity (PMID 25028466); and renal staging, because CKD prevalence was 50% in a randomly age-stratified feline cohort and 68.8% in cats recruited for degenerative joint disease studies (PMID 24217707, DOI 10.1177/1098612X13511446).
- Deliberate pain and orthopaedic assessment in both species, and especially in cats. In 100 cats aged 6 years and older, increased inappropriate elimination was significantly associated with osteoarthritis (P = 0.046), and cats with OA usually do not limp - an arthritic cat may simply be unable to climb into a high-sided litter box (PMID 20083417, DOI 10.1016/j.tvjl.2009.12.014).
- Dogs specifically: consider endocrine testing for hypothyroidism and hyperadrenocorticism, and hepatic evaluation, where the history or bloodwork points that way. The Anipryl field trial excluded dogs with concurrent debilitating disease or drugs that could affect behaviour precisely because these confound the assessment (FDA FOI Summary, NADA 141-080).
- Take a complete medication and exposure history before any prescribing decision, and ask specifically about antidepressants (fluoxetine, clomipramine, amitriptyline), tramadol and other opioids, decongestants containing ephedrine, pseudoephedrine or phenylpropanolamine, and amitraz-containing tick collars and dips. Each of these bears on whether selegiline can be used at all - see the safety section.
- Advanced imaging (MRI) where onset was rapid, progression is fast, signs are asymmetric or lateralising, or seizures are present - to exclude intracranial neoplasia and cerebrovascular disease. Note that MRI in dogs and cats requires heavy sedation or general anaesthesia, which carries its own risk in a geriatric patient with the comorbidities this work-up is designed to find; stabilise renal, cardiac, thyroid and blood-pressure status first, and see the safety section on sedative choice in a dog receiving selegiline. Fluid biomarkers are promising but not clinical tests: plasma neurofilament light chain correlated with CADES score (r = 0.41, p = 0.025) in 39 aging pet dogs and with inhibitory control performance (r = -0.7, p <= 0.001), and remains a research measure (PMID 35431246, DOI 10.3233/JAD-215562).
Dónde encaja un biológico
Nuestro propio producto, calificado con la misma regla
Respuesta corta: no. Buscamos, y no hay buena evidencia de que un biológico ayude aquí.
No existe evidencia controlada de que las células madre, los exosomas o los péptidos mejoren la disfunción cognitiva en perros o gatos. El único estudio que les dio estos productos a perros para un cambio cognitivo no tuvo grupo de comparación, duró dos semanas, midió solo con encuestas a las familias y lo escribieron en su mayoría empleados del propio fabricante (siete de nueve autores). En gatos no se localizó ningún estudio publicado. En una enfermedad donde hasta el 41.8% de los perros que recibieron placebo fueron calificados como mejorados en el estudio del medicamento aprobado, un estudio así no puede separar el beneficio real de la esperanza. Tampoco hay datos de que estos productos lleguen al cerebro en ninguna de las dos especies. Por eso PetSmartMeds no ofrece estos productos para la demencia y pone su esfuerzo en lo que sí tiene respaldo: la revisión médica que encuentra causas tratables, la selegilina aprobada por la FDA en perros, la alimentación enriquecida con triglicéridos de cadena media en perros (no existe una dieta así con evidencia en gatos), tratar el dolor que acompaña con medicamentos correctos para cada especie, y los cambios en casa que mantienen segura a una mascota mayor.
Qué existe
Esta sección aún no está disponible en español.Exactly one published study has given a cell or exosome product to dogs for cognitive change, and it cannot support an efficacy claim. Kim et al. 2025 gave human embryonic-stem-cell-derived MSCs to 21 geriatric small dogs and human ES-MSC-derived extracellular vesicles to another 21, assessed the Canine Cognitive Dysfunction Rating (CCDR) and Liverpool Osteoarthritis in Dogs (LOAD) owner questionnaires before and 2 weeks after treatment, and reported no notable side effects and improvement in both scores in both groups (Front Vet Sci 2025;12:1549870, PMID 40206251, DOI 10.3389/fvets.2025.1549870). The design defeats the conclusion: there was NO placebo arm, follow-up was 2 weeks, the outcomes were owner questionnaires - the single most placebo-susceptible endpoint class in veterinary medicine - seven of the nine authors were employed by the manufacturer (five at Daewoong Co., Ltd. Bio R&D Center and two at Daewoong Pet Corp.), with only two independent authors, both at Kangwon National University, and the source cells were human embryonic stem cells, a xenogeneic and regulatorily loaded material. The placebo problem is not theoretical here: in the Anipryl registrational trial, 16.7% to 41.8% of placebo-group dogs were rated improved across the six behavioural domains at four weeks (sleep 9/54, 16.7%; activity 16/56, 28.6%; greeting 12/48, 25.0%; housetraining 15/57, 26.3%; orientation 22/62, 35.5%; responsiveness 23/55, 41.8%; FDA FOI Summary, NADA 141-080, Table 1), so a single-arm 2-week questionnaire study in this disease would look positive whether or not anything was in the syringe. The other canine neurological stem-cell data sit largely in spinal cord injury and intervertebral disc disease: the 2024 review of 45 companion-animal stem-cell studies from 2015-2023 lists the canine neurologic models evaluated as "canine cognitive dysfunction, intervertebral disc disease, spinal cord injury," and in the same breath records that 22 of the 45 studies were open-label baseline-controlled and only 12 were randomised and controlled, "making overall study interpretation difficult" (PMID 38795363, DOI 10.1093/stmcls/sxae034). Beyond that review, which excluded experimentally induced models, there is one experimentally induced canine demyelination study - a disease dogs do not get naturally - where both intrathecal stem cells and exosomes beat control on clinical, MRI and histological endpoints, and the cells outperformed the exosomes (PMID 38459498, DOI 10.1186/s12917-024-03920-4). For peptides the answer is shorter: no peptide in the catalogue has controlled efficacy evidence in dogs, cats or horses for any indication, let alone this one; BPC-157 and TB-500 have essentially nothing clinical in companion animals and TB-500 is FEI-banned; and Semax, Selank and Epitalon are human or Russian-registered nootropics with no located canine or feline pharmacokinetic, safety or efficacy data. The closest thing to a positive cognitive signal from an anti-ageing molecule in dogs is the oral senolytic plus NAD+ precursor combination (PMID 38811634), which improved an owner questionnaire at 3 months but moved neither in-clinic cognitive testing nor accelerometer activity, and which was a combination product - so it cannot be attributed to NAD+ and it does not license an injectable or nasal NAD+ product in either species.
Qué no se ha demostrado
Esta sección aún no está disponible en español.There is no placebo-controlled trial of any mesenchymal stromal cell product, any exosome or extracellular-vesicle product, or any peptide, for cognitive dysfunction syndrome in dogs or in cats. No published study in cats was located in this search - not a controlled trial, not an uncontrolled series, not a case report. No product has efficacy data for cognitive dysfunction in dogs or cats, and no brain-penetration data in either species. The only canine pharmacokinetic data located for any of these molecules is for BPC-157 in laboratory beagles: after intravenous and intramuscular dosing the parent peptide showed linear kinetics with an elimination half-life under 30 minutes and mean absolute intramuscular bioavailability of approximately 45-51%, with urinary and biliary excretion and rapid metabolism to small peptide fragments and free amino acids (He L, et al. Front Pharmacol 2022;13:1026182, PMID 36588717, DOI 10.3389/fphar.2022.1026182). That is a sub-30-minute half-life in healthy laboratory dogs, which argues against clinical use for a chronic neurodegenerative disease rather than for it, and it is pharmacokinetics, not efficacy. No cognitive, imaging, biomarker or neuropathological endpoint has ever been shown to change in a controlled fashion in either species with any of these modalities. Two further claims are not defensible and are not made on this page. First, these products are not immune-invisible: Punzon et al. 2023 found that BOTH equine and canine MSCs raised antibody titres in dogs, so "immune-privileged" and "zero-flare" are not supportable, although safety in that study was nonetheless acceptable (Front Vet Sci 2023;10:1098029, PMID 37266387). Second, the existence of an authorised cell product is not transferable evidence: DogStem (EMA EMEA/V/C/005829, marketing authorisation holder EquiCord S.L.) is authorised by the European Medicines Agency - not by FDA - uses EQUINE umbilical-cord MSCs in DOGS, and is indicated for reduction of pain and lameness associated with osteoarthritis of the elbow or hip. Its SmPC section 5.1 states that in the pivotal field trial 51% of DogStem-treated dogs and 5% of placebo-treated dogs demonstrated treatment success on the primary endpoint (improvement on force-plate gait analysis 8 weeks after administration), falling to 39% versus 11% at 12 weeks; the underlying randomised placebo-controlled trial is Punzon et al., J Am Vet Med Assoc 2022;260(15):1947-1955, n = 80, PMID 36198051. That is OSTEOARTHRITIS, in the limbs, in a single joint, in dogs at least 1 year old and over 15 kg, and the same SmPC states that persistence of the cells after intra-articular administration is not known because no biodistribution studies were conducted - so it says nothing whatsoever about the brain. In the United States no animal cell or exosome product is FDA-approved; FDA states on its cell- and tissue-based products page that no animal cell- and tissue-based products (ACTPs) are FDA-approved, they are regulated as new animal drugs requiring approval under CVM Guidance for Industry #218, and FDA CVM has issued a warning letter treating "conditioned media" - the upstream material from which exosome preparations are made - as an unapproved new animal drug (Safari Stem Cell, LLC, MARCS-CMS 661023, 5 April 2024).
Fuentes
- Kim 2025 - the only dog-dosed MSC/EV study for cognitive change; uncontrolled, 2 weeks, 7 of 9 authors manufacturer-employed — Kim TY, Kim NH, Chae JA, Oh HK, Yang S, Moon JB, Wi SM, An JH, Yu JM. Evaluation of cognitive and mobility function in geriatric dogs following treatment with stem cell and stem cell extracellular vesicles derived from embryonic stem cells: a pilot study. Front Vet Sci. 2025;12:1549870. PMID 40206251. DOI 10.3389/fvets.2025.1549870 https://doi.org/10.3389/fvets.2025.1549870
- Punzon 2023 - both equine and canine MSCs raised antibody titres in dogs; "immune-privileged" is not defensible — Punzon E, et al. Front Vet Sci. 2023;10:1098029. PMID 37266387. DOI 10.3389/fvets.2023.1098029 https://doi.org/10.3389/fvets.2023.1098029
- Punzon 2022 - the n=80 canine randomised placebo-controlled trial behind DogStem; osteoarthritis of elbow or hip, not the brain — Punzon E, Salguero R, Totusaus X, Mesa-Sanchez C, Badiella L, Garcia-Castillo M, Pradera A. Equine umbilical cord mesenchymal stem cells demonstrate safety and efficacy in the treatment of canine osteoarthritis: a randomized placebo-controlled trial. J Am Vet Med Assoc. 2022;260(15):1947-1955. PMID 36198051. DOI 10.2460/javma.22.06.0237 https://doi.org/10.2460/javma.22.06.0237
- DogStem - EMA-authorised (not FDA-approved) equine UC-MSC product for canine osteoarthritis; the 51% vs 5% force-plate figure is SmPC section 5.1 — DogStem suspension for injection for dogs, Summary of Product Characteristics section 5.1 and 5.2, EU Union Register / EU Veterinary Medicines Information, EMA product number EMEA/V/C/005829, marketing authorisation holder EquiCord S.L.; CVMP summary of positive opinion EMA/CVMP/576246/2022, 17 June 2022 https://www.ema.europa.eu/en/medicines/veterinary/EPAR/dogstem
- Williams 2024 - review of 45 companion-animal stem-cell studies; canine neurologic models were CDS, IVDD and spinal cord injury; 22 open-label, only 12 randomised controlled — Williams ZJ, Pezzanite LM, Chow L, Rockow M, Dow SW. Evaluation of stem-cell therapies in companion animal disease models: a concise review (2015-2023). Stem Cells. 2024;42(8):677-705. PMID 38795363. DOI 10.1093/stmcls/sxae034 https://doi.org/10.1093/stmcls/sxae034
- Induced canine demyelination model - cells outperformed exosomes, and dogs do not get this disease naturally — Controlled intrathecal stem cell versus exosome comparison in an experimentally induced canine demyelination model. BMC Vet Res. 2024. PMID 38459498. DOI 10.1186/s12917-024-03920-4 https://doi.org/10.1186/s12917-024-03920-4
- BPC-157 canine pharmacokinetics - the only canine PK data located for any of these molecules; elimination half-life under 30 minutes in beagles, and PK is not efficacy — He L, Feng D, Guo H, et al. Pharmacokinetics, distribution, metabolism, and excretion of body-protective compound 157, a potential drug for treating various wounds, in rats and dogs. Front Pharmacol. 2022;13:1026182. PMID 36588717. DOI 10.3389/fphar.2022.1026182 https://doi.org/10.3389/fphar.2022.1026182
- Senolytic plus NAD+ precursor - positive owner questionnaire, negative objective endpoints, combination product, oral route — Simon KE, Russell K, Mondino A, et al. Sci Rep. 2024;14(1):12399. PMID 38811634. DOI 10.1038/s41598-024-63031-w https://doi.org/10.1038/s41598-024-63031-w
- Anipryl FOI Table 1 - the placebo-group improvement rates (16.7-41.8% of dogs, per domain) that make uncontrolled CDS studies uninterpretable — FDA Freedom of Information Summary, ANIPRYL (selegiline hydrochloride) Tablets, NADA 141-080, 10 December 1998, Table 1: Proportion of Improved Dogs at Week 4 by Dose Group https://animaldrugsatfda.fda.gov/adafda/app/search/public/docume
- FDA CVM - animal cell- and tissue-based products are new animal drugs requiring approval, and none is FDA-approved — FDA Center for Veterinary Medicine, Guidance for Industry #218, Cell-Based Products for Animal Use (Final, June 2015); FDA, Cell and Tissue Products for Animals / FDA's Role in Veterinary Regenerative Medicine https://www.fda.gov/regulatory-information/search-fda-guidance-d
- FDA CVM enforcement - conditioned media named among cell- and tissue-based products treated as unapproved new animal drugs — FDA Warning Letter to Safari Stem Cell, LLC, MARCS-CMS 661023, 5 April 2024, Division of Biological Products Operations II https://www.fda.gov/inspections-compliance-enforcement-and-crimi
Seguimiento de la respuesta
Cómo saber si está funcionando
Dogs: the owner-performed sustained-gaze video test is the measure this protocol ships with, paired in clinic with a veterinarian-administered structured scale. The sustained-gaze test is the best owner-performed task in this literature: 20 dogs, owners recorded it at home in triplicate weekly for 3 weeks, 162 of 183 videos were acceptable, within-dog test-retest ICC 0.96, intra- and inter-observer ICC 0.99 and 0.96 for gaze duration, and gaze duration was significantly associated with CADES score (p = 0.0026); note that it requires owner training materials and trained-observer video assessment, so it is a human-review pipeline rather than a questionnaire. The CAnine DEmentia Scale (CADES) is the in-clinic instrument a veterinarian may use, and it outperformed the Canine Cognitive Dysfunction Rating scale (CCDR) head-to-head on convergent validity: in 39 dogs aged 9.3-15.3 years, CADES correlated with sustained attention duration (r = -0.47, p = 0.002), inhibitory control (r = -0.51, p = 0.002), a detour task (r = -0.43, p = 0.001) and plasma neurofilament light chain (r = 0.41, p = 0.025), while CCDR correlated only with inhibitory control (r = -0.46, p = 0.005). CADES items, per-item scoring, domain structure and severity cut-offs are not reproduced on this page; they belong to the source publication and are for the attending veterinarian to apply. Cats: no validated feline cognitive instrument was located. This protocol provides a structured sign-frequency log built on the open-access sign list in MacQuiddy 2022 (inappropriate vocalisation, disorientation, altered interaction, sleep-wake change, house-soiling) plus a night-vocalisation and litter-box diary. It is a plain-language care tool for tracking one patient over time, not a validated instrument, and it is presented to owners in those words.
Hoel JA, Templeton GB, Fefer G, et al. Sustained Gaze Is a Reliable In-home Test of Attention for Aging Pet Dogs. Front Vet Sci. 2021;8:819135. PMID 35004935. DOI 10.3389/fvets.2021.819135; Madari A, Farbakova J, Katina S, Smolek T, Novak P, Weissova T, Novak M, Zilka N. Assessment of severity and progression of canine cognitive dysfunction syndrome using the CAnine DEmentia Scale (CADES). Appl Anim Behav Sci. 2015;171:138-145. DOI 10.1016/j.applanim.2015.08.034 (verified via Crossref; not indexed in PubMed under that search); Fefer G, Panek WK, Khan MZ, et al. Use of Cognitive Testing, Questionnaires, and Plasma Biomarkers to Quantify Cognitive Impairment in an Aging Pet Dog Population. J Alzheimers Dis. 2022;87(3):1367-1378. PMID 35431246. DOI 10.3233/JAD-215562; Salvin HE, McGreevy PD, Sachdev PS, Valenzuela MJ. The canine cognitive dysfunction rating scale (CCDR). Vet J. 2011;188(3):331-336. DOI 10.1016/j.tvjl.2010.05.014; MacQuiddy B, Moreno J, Frank J, McGrath S. J Feline Med Surg. 2022;24(6):e131-e137. PMID 35536055. DOI 10.1177/1098612X221095680
Frecuencia sugerida: Re-score the cognitive instrument quarterly, and justify that interval on disease tempo and on the way the approved drug was actually studied rather than on any claim about survey fatigue. The Anipryl registrational programme assessed owner-rated change at 4 weeks and again at 12 weeks, found that some dogs who had not improved by week 4 had improved by week 12, and reported that the duration of effect "may be as short as 8 weeks in about 50% of the cases" (FDA FOI Summary, NADA 141-080). A roughly 3-month re-score therefore matches the interval over which this disease and its only approved treatment were shown to change, and it is long enough that a single bad week does not read as progression. Short intervals are not noise for every endpoint, and one canine study makes that concrete: over five weeks in 42 dogs with mild-to-moderate CCD, CADES did not move at all, while caregiver burden fell significantly and accelerometer sleep scores improved in the physical-training arm (Taylor TL, et al. Geroscience. 2026. PMID 42126808. DOI 10.1007/s11357-026-02309-5). So layer faster, cheaper items on top of the quarterly cognitive score: a weekly sustained-gaze video in dogs, and a weekly tally of night-waking episodes and out-of-box eliminations in either species, since those are the items that drive caregiver burden and change soonest. Re-screen the medical mimics on the senior-care guideline schedule - blood pressure and renal values in both species, plus total T4 in cats - reassess pain at every visit rather than only when the owner reports limping, and re-take the full medication, supplement and flea-and-tick product list at every visit in any dog on selegiline. One rule is non-negotiable: an uncontrolled owner-reported time series drifts toward improvement whether or not a product works, so these check-ins are never aggregated or presented as evidence of product efficacy. The monitoring loop is a care tool for the patient in front of the veterinarian, not an evidence-generation engine.
Preguntas que puede responder en casa
- In the last week, how many nights did your pet wake you by pacing, crying or wandering? (write the number)
- In the last week, how many times did your pet have an accident indoors, or a cat go outside the litter box?
- Does your pet still come to greet you, and does it still respond to its name or to being petted - more, the same, or less than a month ago?
- Has your pet got stuck or seemed lost in the house, stood in a corner, or gone to the wrong side of a door?
- Has your pet pushed its head against a wall or a piece of furniture and held it there? (this one is different from staring at a wall - tell us straight away)
- Is your pet eating and drinking normally, and finishing meals without standing at the bowl as if unsure?
- Has anything changed in the medicine list since we last spoke - any new prescription, over-the-counter product, supplement, or flea or tick collar? Please list everything, including anything you gave without telling us.
- On a scale of 1 to 10, how hard has the last week been for you and your household? (this matters to us and we ask it on purpose)
- Dogs only: record the 30-second sustained-gaze video this week and upload it with your answers.
Última revisión: 2026-09-20 · Cada afirmación de esta página lleva una fuente que usted puede verificar. Si alguna no se sostiene, díganoslo y la corregiremos. science@petsmartmeds.com
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