bowl of food and stethoscope icon


Useful information about the needs of cats and dogs with nutritionally sensitive health conditions.

Brain & Cognitive Disorders

Canine Cognitive Dysfunction Syndrome

Canine cognitive dysfunction syndrome is a degenerative, metabolic brain disorder, similar to Alzheimer’s disease in people, that is associated with advancing age. Multiple metabolic, functional, and structural changes occur in the brain with advancing age that, if severe, lead to cognitive dysfunction syndrome. Clinical signs can include problems with memory, attention, and trainability as well as disorientation, changes in sleep-wake cycle, and decreased social interaction. The prevalence of cognitive dysfunction syndrome has been estimated at 14% to 35% of dogs, and prevalence and severity increase with age. Although cognitive dysfunction syndrome is incurable, a multimodal management approach, including targeted nutrition, may help manage signs and slow further progression.  

canine brain icon

Key Messages

  • With age, metabolic, functional, and structural changes can occur in the brain that may lead to cognitive dysfunction syndrome.
    • Healthy brains rely on glucose as the primary energy source, but an aging dog’s brain becomes less efficient at metabolizing glucose, resulting in brain energy depletion. Regions of the brain critical to cognitive function have the greatest reduction in glucose metabolism.
    • Production of free radicals increases and levels of endogenous antioxidants decrease with aging, resulting in oxidative stress and damage to cells.
    • Increased levels of pro-inflammatory compounds contribute to a chronic, low-grade inflammatory state.
    • Blood vessels in the brain can become scarred and vessel walls thickened with aging. This decreases cerebral blood flow, which reduces delivery of energy and oxygen to brain cells.
    • B vitamins are involved in many metabolic reactions, including glucose metabolism and neurotransmitter production. In humans, studies have shown a link between vitamin B deficiency and cognitive dysfunction in the elderly.
  • Nutritional strategies targeted at these changes can help manage signs of cognitive dysfunction syndrome in dogs and slow further progression:
    • Medium chain triglycerides (MCTs) can provide an alternative energy source (both ketones and medium chain fatty acids) for the brain. Up to 60-70% of the brain’s energy needs can be met by ketones.
    • Antioxidants, e.g., vitamins C and E, may help reduce oxidative stress.
    • The omega-3 fatty acids DHA and EPA have anti-inflammatory activity.
    • The amino acid arginine, precursor to nitric oxide, may help improve cerebral blood flow.
    • B vitamins may support brain health. While B vitamin deficiency has been linked to cognitive dysfunction in people, additional research suggests that supplementation above levels needed to prevent deficiency may also provide cognitive benefits.
  • A Purina study showed that dogs with cognitive dysfunction syndrome fed a diet containing a proprietary blend of MCT oil, omega-3 fatty acids, antioxidants, arginine, and B vitamins significantly improved in 5 of 6 DISHAA categories within 30 days and in all 6 categories within 90 days.
conversation starter background image

"Your dog has cognitive dysfunction syndrome. Treatments are available including nutritional intervention, which may help manage the signs and slow progression. Completion of the DISHAA evaluation form every 6 months provides a way to track your pet's condition."

To Share With Pet Owner:

DISHAA Assessment Tool

A useful tool to monitor cognitive function in dogs.​

View Tool 1 min to 5 min

Additional Resources

Pan, Y., Landsberg, G., Mougeot, I., Kelly, S., Xu, H., Bhatnagar, S., Gardner, C. L., & Milgram, N. W. (2018). Efficacy of a therapeutic diet on dogs with signs of cognitive dysfunction syndrome (CDS): A prospective double blinded placebo controlled clinical study. Frontiers in Nutrition, 5. doi: 10.3389/fnut.2018.00127

Dewey, C. W., Davies, E. S., & Wakshlag, J. J. (2019). Canine cognitive dysfunction: Pathophysiology, diagnosis, and treatment. Veterinary Clinics of North America: Small Animal Practice, 49, 477–499. doi: 10.1016/j.cvsm.2019.01.013

Landsberg, G. M., Nichol, J., & Araujo, J. A. (2012). Cognitive dysfunction syndrome: A disease of canine and feline brain aging. Veterinary Clinics of North America: Small Animal Practice, 42, 749–768. doi: 10.1016/j.cvsm.2012.04.003

Kennedy, D. O. (2016). B vitamins and the brain: Mechanisms, dose and efficacy—A review. Nutrients, 8(2), 68. doi: 10.3390/nu8020068