Is Your Senior Dog Showing Signs of Canine Cognitive Dysfunction?

If your older dog has been staring at walls, pacing the house at 2am, or having accidents indoors despite being reliably house-trained for years, you’re not imagining things. These can be signs of canine cognitive dysfunction (CDS), sometimes called dog dementia, and it’s more common in senior dogs than most people realize.

The good news: this isn’t a dead end. Understanding what’s happening in your dog’s brain, and what you can do about it, makes a real difference.

What is canine cognitive dysfunction?

Canine cognitive dysfunction syndrome (CDS) is a brain condition that affects older dogs much the way Alzheimer’s affects people. As a dog ages, toxic proteins called beta-amyloid plaques build up in the brain, slowly damaging the neurons (the cells that carry signals and keep the brain working). Over time, that damage adds up, and your dog’s thinking, memory, and awareness start to slip.

CDS typically shows up in dogs over 9, and the risk goes up significantly with age. It’s not a normal part of aging, but it is a common one. If your dog seems confused in spaces they’ve known their whole life, that’s worth taking seriously.

Signs of canine cognitive dysfunction: the DISHAA framework

Vets use a tool called the DISHAA framework to organize the most common canine cognitive dysfunction symptoms. It stands for Disorientation, Interaction changes, Sleep-wake cycle changes, House soiling, Activity level shifts, and Anxiety. Here’s what each one actually looks like from your side of the leash.

Category	What you might notice at home
Disorientation	Getting stuck in corners or behind furniture. Staring blankly at walls or into space. Standing at the hinge side of a door instead of the handle side. Seeming lost in familiar rooms or the backyard.
Interaction changes	Less interest in greeting you at the door. Withdrawing from people or other pets they used to seek out. Occasionally seeming not to recognize a familiar face.
Sleep-wake cycle changes	Restless pacing or whining at night. Sleeping heavily during the day but awake and confused after dark. A general flip in their usual sleep schedule.
House soiling	Having accidents indoors despite being reliably trained for years. Forgetting to signal that they need to go out. Going to the bathroom right after coming in from outside.
Activity level shifts	Less interest in play, walks, or toys they used to love. Repetitive, purposeless movements like circling or pacing.
Anxiety	Increased clinginess, whining, or general restlessness. Heightened anxiety, especially at night or in new situations.

At-home symptom tracker: a staged canine cognitive dysfunction checklist

At-home symptom tracker: a staged canine cognitive dysfunction checklist

Use this staged guide to track what you’re seeing and bring it to your next vet appointment. It gives your vet a clearer picture than a brief exam alone, and it helps identify whether symptoms are progressing over weeks or months.

Early stage: mild and easy to miss

Your dog occasionally hesitates or seems confused in familiar spaces, but bounces back quickly. They’re slightly less enthusiastic about greetings or play than they used to be. Nighttime wake-ups are happening once or twice a week, and indoor accidents are rare, maybe once or twice a month. There may be mild, occasional anxiety without an obvious trigger.

Moderate stage: noticeable and consistent

Your dog regularly gets stuck or seems genuinely lost at home. They’ve become noticeably more withdrawn from family interaction. Sleep is disturbed several nights a week, often with pacing or vocalizing. Indoor accidents are happening weekly despite regular outdoor access. You may notice repetitive behaviors like circling or licking that are hard to redirect, and anxiety is more visible, especially after dark.

Advanced stage: significant and daily

Disorientation is constant, even in the most familiar parts of your home. Your dog shows little to no recognition of family members or other pets. Sleep is severely disrupted most nights. House soiling is frequent and unpredictable, and your dog has lost interest in food, water, or movement. Anxiety or distress is persistent and hard to soothe.

How vets diagnose canine dementia

There’s no single test that confirms CDS. Your vet will start by ruling out other conditions that can look similar in senior dogs: thyroid problems, pain, vision or hearing loss, urinary tract infections, and more. This typically involves bloodwork (to check organ function and hormone levels), a urine sample, and sometimes imaging like an X-ray or MRI.

Once those are ruled out, the diagnosis comes from a thorough behavioral history, which is exactly why your symptom tracker is so useful. The more specific you can be about what you’ve observed and when, the better equipped your vet is to assess severity and recommend next steps.

Canine cognitive dysfunction treatment: what actually helps

There’s no cure for CDS, but there’s a meaningful range of options that can slow its progression and improve your dog’s daily experience. Your vet will likely recommend a combination of the following.

Medication

Selegiline (sold under the brand name Anipryl) is the only medication approved by the FDA for canine cognitive dysfunction. It works by increasing dopamine levels in the brain, which can improve alertness and reduce some CDS symptoms. It doesn’t work for every dog, and it takes a few weeks to see results, but it’s often the first medication your vet will discuss.

Canine cognitive dysfunction supplements

• SAM-e (S-adenosyl methionine): A naturally occurring compound that supports brain cell health and has shown some benefit in dogs with CDS
• Omega-3 fatty acids: Found in fish oil, these support brain function and reduce inflammation; your vet can recommend a dose appropriate for your dog’s size
• Antioxidants: Help protect neurons from further damage caused by oxidative stress (think of it as cellular rust)
• Senilife: A supplement blend containing phosphatidylserine and other brain-supportive compounds, available through vets and some pet retailers

Therapeutic diets

Some prescription diets are specifically formulated to support aging brains. Purina Neurocare and Hill’s Prescription Diet b/d are two options your vet might recommend. Both are designed to deliver antioxidants, omega-3 fatty acids, and other brain-supportive nutrients in a complete diet rather than a supplement add-on.

Environmental enrichment and home adjustments

Small changes at home can make a real difference, especially for dogs in the moderate or advanced stages.

• Keep the layout of your home consistent; moving furniture adds to disorientation
• Add night lights in hallways and near sleeping areas to reduce nighttime confusion and anxiety
• Maintain a predictable daily routine for meals, walks, and sleep
• Offer gentle mental stimulation like short sniff walks, food puzzles, or simple training games
• Make sure food and water bowls are easy to find and always in the same spot

Canine cognitive dysfunction life expectancy and quality of life

CDS is a progressive condition, meaning it tends to get worse over time rather than staying stable. How quickly it progresses varies a lot from dog to dog. Some dogs live comfortably for years with early-stage CDS and good management. Others decline more quickly.

The question of when to consider euthanasia for canine cognitive dysfunction is one of the hardest conversations a pet owner can have, and there’s no universal answer. Most vets approach it through quality-of-life assessment: is your dog still experiencing more good moments than hard ones? Are they eating, sleeping, and engaging with the world around them, even in small ways?

A vet who knows your dog well is the right person to help you think through this when the time comes. You don’t have to navigate it alone.

Does pet insurance cover canine cognitive dysfunction?

Yes, canine cognitive dysfunction is eligible for coverage under a Lemonade Pet accident and illness policy, as long as the condition isn’t pre-existing. That means your dog shouldn’t be showing any signs or symptoms before your policy starts or during your waiting period.

The diagnostic workup alone, including bloodwork, urinalysis, and imaging to rule out other causes, can run several hundred dollars. Add in vet visits and medications like selegiline over months or years, and the costs add up. It’s worth knowing that prescription diets and supplements aren’t covered under a Lemonade Pet policy, so those will be out of pocket.

Before we go

Watching your dog change as they age is hard, and noticing these signs can feel scary. But catching canine cognitive dysfunction early gives you more options, more time, and a better chance at keeping your dog comfortable for longer. Use the staged checklist above to document what you’re seeing, bring it to your vet, and take it one step at a time.

And if you haven’t looked into pet insurance yet, now is a good time to do it while your dog is still healthy.

Frequently Asked Questions

A few quick words, because we <3 our lawyers: This post is general in nature, and any statement in it doesn’t alter the terms, conditions, exclusions, or limitations of the policies issued, which differ according to your state of residence. You’re encouraged to discuss your specific circumstances with your own professional advisors. The purpose of this post is merely to provide you with info and insights you can use to make such discussions more productive! Naturally, all comments by, or references to, third parties represent their own views, and Lemonade assumes no responsibility for them. Coverage may not be available in all states. Please note that statements about coverages, policy management, claims processes, Giveback, and customer support apply to policies underwritten by Lemonade Insurance Company or Metromile Insurance Company, a Lemonade company, sold by Lemonade Insurance Agency, LLC.  The statements do not apply to policies underwritten by other carriers.