5 Common Neurological Conditions in Elderly Dogs

Aging dogs can develop neurological conditions that affect their brain and its ability to function. Because the brain controls all body functions, including voluntary and involuntary muscle movement, symptoms can be tough to interpret. Diagnosis and treatment may require a veterinary neurologist or neurosurgeon. 

Let’s take a look at some common neurological conditions that can affect older dogs.

A stroke is the result of ischemia (lack of blood) in the brain caused by an obstruction or bleeding from a ruptured blood vessel. Each has its own set of precursors, but their symptoms are similar. Treatment will depend on discovering and treating the causes.

Symptoms

Acute symptoms of stroke depend on the part of the brain affected and the severity of the obstruction or bleed. Symptoms can range from dizziness and muscle weakness to seizures and collapse.

• Abnormal behavior 
• Loss of balance
• Head tilt, usually to only one side
• Falling over in the direction of the head tilt
• Frequent shaking of the head
• Circling
• Muscle weakness 
• Signs of vision loss
• Reeling gait
• Inability to recognize familiar people and objects in the environment
• Seizures
• Sudden collapse

Causes

Interruption of blood flow may be caused by an obstruction like a blood clot. Clots can form in many parts of the body and can break off and travel to the brain. A clot that travels within the body is called an embolus. Clots can arise from:

• Cardiac arrhythmias that allow blood to pool in the heart and form a clot
• Damage to the lining of a blood vessel such as a tear or erosion
• Foreign substances in a blood vessel such as a fatty clot
• Surgery – a common cause of the formation of emboli
• Abnormally rapid blood clotting
• Indwelling catheters, especially those that have been in place for several days
• Endocarditis, or heart inflammation 
• High cholesterol
• Infectious clots

When a blood vessel ruptures, the normal blood flow may be interrupted. Brain bleeds can also cause pressure from blood caught between the brain and the rigid skull, which can damage delicate brain tissue. Causes of bleeding in the brain may include:

• Trauma 
• Abnormally slow blood clotting due to e.g. a coagulopathy
• Hypertension
• Ingestion of rodent poison
• Kidney or liver disease
• Thyroid disease

Diagnosis

Since symptoms of a stroke can have a variety of causes, a complete workup will be aimed at narrowing down the possibilities, including a thorough medical history and physical exam. Blood work will consist of a complete blood count, blood chemistry panel, blood coagulation panel, and a thyroid panel. 

Vital signs and an EKG can help determine cardiac causes. If an infection is suspected, blood, urine, and fecal cultures may be done. Imaging includes X-rays, CAT scan and/or MRI. A vet may also do a lumbar puncture (spinal tap) to obtain cerebrospinal fluid for examination.

Treatment

Treatment aims to restore blood flow to the brain if possible, treat underlying conditions, and control symptoms. To decrease damage to the brain, treatment is ideally started within four hours of the stroke’s onset. Intravenous fluids to support the circulatory system and prevent dehydration will be administered, and if an infectious clot is found, antibiotics or antivirals may be administered. Fluids will aid in flushing the system of any poison.

Surgery may relieve pressure on the brain from bleeding, or allow extraction of an obstruction. Administering clotting factor helps decrease bleeding, and blood thinners can help prevent clots. The dog may need to stay at the veterinary clinic until they’re stable, and a veterinary neurologist may be involved in diagnosis and treatment plans.

Physical therapy addresses functional deficits of balance and any muscle weakness. Instructions will be given to pet caregivers on how to manage the dog’s mobility and nutritional needs at home.

Average cost of treatment: $800-$6,000

Canine cognitive dysfunction (CDD) may arise as a dog approaches middle-to-old age. In some circles, it’s referred to as “doggy dementia.” Cornell University’s College of Veterinary Medicine estimates that 35% of dogs over the age of 8 suffer from some degree of CCD. 

Symptoms

• Disorientation 
• Sleep pattern changes
• Regression in previous skills, such as housetraining
• Inactivity 
• Pacing
• Excessive barking
• Lethargy
• Withdrawal from physical contact
• Weakness
• Inability to navigate in a familiar environment
• Depression 

Causes

During the aging process, canine cognitive dysfunction may develop from brain damage over time. Minerals and chemicals can interfere with normal neural communication. Other factors that may trigger CCD in the senior dog include:  

• Accumulation of damaging molecules called free radicals 
• Sudden, radical changes in routine or environment
• Presence of plaques in the brain caused by amyloid β protein (Aβ), cerebral amyloid angiopathy (CAA), or ubiquitin-positive granules (UBQ) 
• Accumulation of metals such as aluminum and mercury

Diagnosis

Symptoms of canine cognitive dysfunction are similar to symptoms of other central nervous system conditions, and diagnosis focuses on ruling out other conditions like stroke, metabolic disease, or vestibular syndrome. A complete history and physical exam, along with behavioral testing can lead to a preliminary diagnosis of CCD. 

Imaging may reveal plaques or other abnormalities. Because some medications can mimic the symptoms of CCD, the veterinarian will want to review the dog’s med list. The Canine Dementia Scale or CADES is a standardized test that measures deficits in social interaction, house soiling, sleep-wake cycles, and spatial orientation. The presence of one or more factors may assist in determining cognitive dysfunction levels and inform treatment plans.

Treatment

Cognitive deficits can be prevented or improved to some degree with mental and physical activities throughout the dog’s life. Exercise, doggy puzzles, training sessions, and games have a positive impact on brain function. Prevention and treatment of CCD can begin in younger dogs and continue into their senior years. 

Management may also include a diet that includes antioxidants to counter the effects of free radicals and other toxic chemicals. Most high-quality foods are rich in antioxidants from the addition of fruits and vegetables. Antioxidants can also be supplied in supplements or produce.

Medications to relieve symptoms and improve cognitive quality may be prescribed, including N-acetyl-D-mannosamine (ManNAc) and Phosphatidylserine, a fatty acid. Depression is treated with antidepressants. Natural supplements have also been helpful in dogs with CCD, including Ginkgo biloba, resveratrol, coconut oil, and SAMe. 

Average cost of treatment: $1,000 - $2,000

Canine idiopathic vestibular syndrome is an inner ear condition that is also known as “old dog syndrome.” While this condition can occur in a dog of any age, elderly dogs are especially vulnerable. “Idiopathic'' refers to an unknown cause.

Symptoms

Since the inner ear sends information to the brain about body position and balance, this condition can cause symptoms affecting orientation and mobility. These dysfunctions are often the ones noticed first by the pet parent.

• Wide stance
• Circling
• Head tilt
• Falling or rolling 
• Abnormal eye movement
• Abnormal eye position
• Squinting
• Inability to walk correctly
• Frequent shaking of the head
• Vomiting
• Motion sickness
• Behavior changes like lying down to eat or drink

Causes

Sometimes the cause of a dog’s canine vestibular syndrome is unidentifiable (idiopathic)

. When the cause can be determined, it may be:

• Head trauma
• Middle ear infection
• Toxic effects of certain antibiotics (streptomycin, gentamicin)
• Genetic disposition, particularly in Doberman Pinschers
• Hypothyroidism

Diagnosis

The aim of diagnosis is to rule out other causes of the symptoms, such as a tumor, hypothyroidism, or stroke. The veterinarian will, in addition to a medical history and physical exam, complete blood tests such as a thyroid panel, complete blood count, and a chemistry panel. 

Imaging will help to rule out tumors or other physical abnormalities, as well as the presence of ischemic or hemorrhagic stroke. Diagnosis is often made by moving the dog into specific positions while observing for nystagmus or strabismus.

 An ear examination will confirm or rule out an infection or heavy mite population and inflammation. 

Treatment

Treatment of canine idiopathic vestibular syndrome depends on the specific cause, as well as reduction of symptoms such as nausea and vomiting. Veterinarians often adopt a “wait and see” approach for these dogs. Spontaneous improvement may take as little as three days to two weeks. The dog often recovers completely, although a head tilt may remain. This is not a life-threatening condition and giving the dog time to recover on their own is usually recommended. 

The vet will coach pet parents on how to care for their dog during recovery, including providing a quiet place away from activity, and good lighting to help them focus. Rugs and padding on the edges of tables can prevent injury and discomfort. Support to improve the dog’s orientation can be made by rolling a thick blanket in a “c” shape and arranging it around the pooch. 

Veterinarians discourage pet parents from carrying their dogs around. These dogs need to move within their environment to recover their balance and reduce symptoms.

Average cost of treatment: $300 - $2,000

Brain tumors are relatively uncommon in dogs, but when they occur in older dogs, seizures are usually the first sign. A study of 97 dogs diagnosed with brain tumors revealed that, of the 33 breeds represented, Golden Retrievers were most often affected. Other vulnerable breeds are Doberman Pinschers, Old English Sheepdogs and Boxers. Almost all cases were in dogs older than five years, and the most common tumor was a meningioma, which forms in the tissue that covers the brain. Seizure activity in a dog older than four years should raise suspicion of a brain tumor. Tumor activity before this age is more likely to be epilepsy or something else. The risk for a brain tumor rises with age.

Tumors can be primary (arising in the brain itself), or secondary. Secondary tumors result from the spread of cancerous tissue from other areas of the body, such as the mammary tissue. Tumors may be benign, only growing locally, or metastatic, meaning they come from or spread elsewhere in the body. Metastatic tumors represent half of all tumors found in canines. Benign tumors in the brain can cause pressure on brain tissue in the closed space of the skull.

Symptoms

Signs of a brain tumor mimic other neurological conditions like stroke, brain inflammation or Cushing’s Disease, which often features a pituitary tumor.

• Seizures
• Tremors
• Lethargy
• Muscle weakness
• Abnormal hair growth
• Abnormal behavior 
• Decreased or loss of vision
• Appetite loss
• Neck sensitivity
• Circling
• Wobbling walk

Causes

Exposure to substances found in the environment can cause brain tumors. Genetics also plays a role.

• Genetic predisposition
• Environmental carcinogens (in air, water, food, household toxins)
• Trauma
• Immune system abnormalities

Diagnosis

Brain tumors may be detectable in skull X-rays. Detailed and definitive results can be achieved with an MRI and CT scan with contrast dye. Examination of blood samples and central nervous system fluid help narrow down the exact type of tumor. In some cases, a biopsy of the tumor may be done, although a tumor’s position in the brain may make this diagnostic procedure hazardous, especially for older dogs.

Treatment

Depending on the type of tumor, its location, and size, treatment may include surgery, followed by radiation and chemotherapy. A craniotomy involves removing bone tissue from the skull to access the tumor. This is most effective when there is a single, small tumor lying close to the surface. If the tumor isn’t accessible, is too large, or is made up of multiple segments, surgery may be impossible. In these cases, treatment consists of radiation, chemotherapy, administration of steroids, and anticonvulsants.

Radiation and chemotherapy alone may shrink a tumor and extend a dog’s life, but they don’t cure it. Palliative care focused on inflammation and fluid reduction, neurological symptoms, and pain is typically required. Veterinarians may recommend euthanasia for advanced tumors.

Average cost of treatment: $5,000 - $25,000

Encephalitis in elderly dogs is usually caused by chronic inflammation of the brain, often from latent canine distemper infection or other viral diseases. This may be known as “old dog encephalitis.” 

Acute encephalitis typically occurs in young adult or adult dogs. Certain small breeds are known to be predisposed to the condition, including Yorkshire Terriers, Chihuahuas, Maltese, and Pugs. In old dog encephalitis, the condition is chronic and results from long-term infection and inflammation. 

Symptoms

Encephalitis symptoms are associated with inflammatory neurological deficits, and can include:

• Fever
• Pain
• Behavior changes
• Depression
• Loss of balance
• Seizures
• Decreased and unequal pupil size
• Partial or complete blindness
• Decreased responsiveness
• Head tilt
• Facial paralysis
• Stumbling
• Circling

Causes

Unresolved brain infections in young dogs can cause encephalitis in senior dogs, slowly developing over time. The resulting gray matter deterioration is responsible for many of the signs and symptoms. Encephalitis causes may also be unknown.

• Bacterial or viral infection, especially canine distemper
• Vaccination complications
• Parasites
• Autoimmune disorders
• Genetic predisposition

Diagnosis

To diagnose encephalitis in older dogs, veterinarians rely on a complete medical history, including a history of infection as a younger dog. This is followed by a complete physical exam that demonstrates neurological deficits and other symptoms. Lab tests include a complete blood count and chemistry panel, along with urinalysis. These tests help rule out other conditions as well.

Imaging including MRI and CT scan may diagnose asymmetry in the brain, and white inflammatory areas. A cerebrospinal fluid analysis may also be performed. A biopsy can provide information but it can be dangerous, especially for an elderly dog so is not commonly performed.

Treatment

Treatment focuses on supportive care, symptom relief, and reduction of inflammation. Steroids, antibiotics or antivirals may be given to treat infection and inflammation, along with immunosuppressants such as prednisone (a steroid), cytosine, and arabinoside.

Long-term treatment includes follow up veterinary neurologist care and physical therapy.

Average cost of treatment: $300 - $5,000

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