DISHAA – Tool for assessing cognitive dysfunctions in dogs

The DISHAA Cognitive Dysfunction Tool for dogs was developed to help pet owners and veterinarians identify and assess age-related behavioral changes in dogs. Cognitive dysfunction in dogs, similar to Alzheimer's disease in humans, is common in older dogs and manifests as a progressive decline in cognitive abilities. The DISHAA tool allows for the recording of specific behavioral patterns to determine the severity of cognitive dysfunction.

what is cognitive dysfunction in dogs?

Cognitive dysfunction, also known as Cognitive Dysfunction Syndrome (CDS), is a progressive and irreversible degeneration of the brain that goes beyond normal age-related changes. Affected dogs often exhibit behavioral changes such as disorientation, altered social interactions, changed sleep patterns, house soiling, and increased anxiety. Studies estimate that approximately 141,000 dogs over the age of 8 show symptoms of CDS (DISHAA assessment tool).

What does DISHAA stand for?

DISHAA is an acronym for the six main categories of behavioral changes that can be observed in dogs with cognitive dysfunction:

• Dorientation
• IInteractions (Social)
• Ssleep/wake cycles
• Himpurities, learning and memory
• Aactivity
• Aanxiety

How does the DISHAA tool work?

The DISHAA tool consists of a series of questions and assessments that guide pet owners in observing and evaluating specific behaviors of their dog. The observations are recorded according to severity (none, mild, moderate, or severe) using a score (0-3). This score helps assess the dog's cognitive health.

Categories of the DISHAA tool in detail:

1. DisorientationDogs with CDS often become disoriented, get stuck on objects, or stare into space seemingly for no reason. They may also have difficulty recognizing familiar places or people.
2. Social interactionsChanges in reaction to people or other animals are an indication of CDS. Dogs might be more anxious, aggressive, or less interested in social contact.
3. Sleep/wake cyclesMany dogs with CDS exhibit disturbed sleep patterns, become restless at night, vocalize, or wander aimlessly.
4. House uncleanliness, learning and memoryAnother sign of CDS is incontinence, as well as the inability to respond to previously learned commands or to learn new tasks.
5. activityAn affected dog might either decrease in activity (less play, less exploration) or exhibit increased aimless wandering and repetitive behaviors such as circling or licking.
6. FearDogs with CDS often exhibit increased anxiety, especially when separated from their owners or in new environments. They may also be more sensitive to noise and visual stimuli.

Here is a detailed explanation of the different categories of the DISHAA tool, which helps dog owners better recognize and assess cognitive dysfunction in their dogs. Practical examples will help you more easily perceive and evaluate changes in your dog.

1. Disorientation

Disorientation in dogs often manifests as a loss of bearings, even in familiar environments. Dogs with cognitive dysfunction may have difficulty finding their way around their home or navigating simple tasks like going through doorways.

Examples:

• Getting stuckYour dog often gets stuck behind furniture or stands on the wrong side of the door (e.g., the side with the hinge) because he no longer recognizes the exit properly.
• StaringAnother clear sign is when your dog stares motionless at a wall or into space for an extended period without reacting. It may seem as if he is lost in thought, but in reality, he is no longer able to properly assess his surroundings.
• Familiar places are often confusedA disoriented dog might appear „lost“ in its own garden or on a regular walk and not know how to get back.

Observation tips:

Observe whether your dog frequently gets stuck or seems confused in such situations, especially if this occurs in familiar surroundings. If this happens more often, it is important to inform your veterinarian.

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2. Social interactions

Dogs with cognitive dysfunction often change their behavior towards other animals and people. They may become more anxious, irritable, or lose interest in social interaction.

Examples:

• Aggressive or fearful interaction with visitorsA dog that previously enjoyed receiving visitors might suddenly become nervous or even aggressive towards guests.
• SeclusionYour dog withdraws more often, shows less interest in being petted, or ignores offers to interact with familiar people or other pets.
• Changes in behavior in familiar peopleDogs may also no longer immediately recognize familiar people or react more indifferently to their presence, which can also indicate cognitive problems.

Observation tips:

Pay attention to whether your dog shows less enjoyment of social interaction, becomes stressed more easily, or even aggressive. Such changes are often subtle but can intensify over time.

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3. Sleep/wake cycles

Disrupted sleep patterns are a common sign of cognitive dysfunction in dogs. If your dog suddenly becomes restless at night, stays awake, or paces around, whereas previously they slept soundly, this could indicate CDS (Cognitive Dysfunction).

Examples:

• Restlessness during the night: Your dog runs restlessly through the house at night or keeps waking up, even though he used to sleep peacefully.
• VocalizeSome dogs suddenly start barking, howling, or whining at night for no apparent reason.
• Changes in sleep patternsA dog with CDS may sleep more during the day, but be awake and restless at night.

Observation tips:

If your dog used to sleep well but is now frequently active or noisy at night, you should keep a close eye on this. Note when and how often this happens so you can report it to your veterinarian.

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4. House uncleanliness, learning and memory

A dog that suddenly becomes house-trained, despite having learned to go outside, could be suffering from a cognitive impairment. Similarly, difficulty learning new tasks or following old commands can be a sign of CDS.

Examples:

• IncontinenceYour dog has suddenly started having accidents in the house again, even though he used to be house-trained. It could be that he's no longer signaling when he needs to go outside.
• Memory lossYour dog seems to be forgetting previously learned commands or his name. Commands that were once simple, such as "sit" or "come," might now be difficult for him.
• Learning difficultiesA dog with CDS would no longer be able to learn new tasks or tricks, even with simple training.

Observation tips:

If your dog starts soiling the house again or no longer responds to simple commands, you should discuss this with your veterinarian to rule out any underlying medical conditions.

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5. activity

Changes in activity are another sign of cognitive dysfunction. Dogs may become more apathetic or wander aimlessly more often, without any real purpose.

Examples:

• Reduced activityYour dog no longer plays with toys, shows no interest in walks, or frequently withdraws.
• Excessive wanderingA dog might constantly wander around the house or garden without any purpose or reason. Sometimes it exhibits repetitive behaviors such as circling or licking.
• Repetitive movementsFrequent circular movements or constantly licking a specific spot on the body are typical signs.

Observation tips:

Pay attention to any changes in your dog's behavior, particularly regarding activity levels. A dog that suddenly becomes inactive or exhibits unusual movements should be closely observed.

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6. Fear

Many dogs with CDS develop increased anxiety, whether it be fear of separation, new environments, or loud noises. This anxiety can intensify if the dog feels insecure in its surroundings.

Examples:

• Separation anxietyA dog that previously could easily stay alone suddenly becomes anxious and restless when you leave the house.
• Sensitivity to noiseYour dog is more easily startled by loud noises or becomes nervous when it is noisy outside.
• Anxiety in new environmentsEven places that were once familiar could suddenly frighten your dog. He might refuse to go for walks or stay outside.

Observation tips:

If your dog is more nervous than usual or reacts unusually fearfully to everyday noises or situations, this could be a sign of cognitive problems.

DISHAA – Online Analysis

DISHAA tool for assessing cognitive dysfunction in dogs

Behavioral issues

Please rate your dog's behavior:

• 0 points: Behavior was never observed
• 2 points: Behavior occurred at least once in the last 6 months
• 3 points: Behavior occurred at least once a month
• 4 points: Behavior occurred 2-4 times per month
• 5 points: Behavior occurred several times a week

1. Is your dog disoriented in a familiar environment (indoors/outdoors)?

2. Does your dog have trouble recognizing familiar people and animals?

3. Does your dog exhibit abnormal behavior towards familiar objects (e.g., chair, basket)?

4. Does your dog wander around aimlessly/disoriented?

5. Does your dog have difficulty performing familiar tricks?

6. Does your dog exhibit any changes in behavior when interacting with people or other dogs?

7. Is your dog showing any changes in play or exploration behavior?

8. Does your dog have difficulty learning new commands or performing commands he has already learned?

9. Is your dog easily irritated or excitable?

10. Has your dog recently started showing aggressive behavior?

11. Does your dog exhibit unusual behavior at night? (Score x2)

12. Does your dog's behavior alternate between sleeplessness and drowsiness? (Score x2)

13. Does your dog relieve himself (urinate/defecate) in unusual places at home?

14. Does your dog relieve himself in his crate or on his bed/basket?

15. Is your dog changing the way he signals that he needs to relieve himself?

16. Does your dog relieve itself immediately after you return from a walk?

17. Has your dog recently started defecating on surfaces that are unusual for him (e.g., grass, asphalt)?

Total score: 0

Interpretation of the result: Not rated

Point system and evaluation:

Once all behavioral characteristics have been assessed, a total score is calculated, which provides an indication of the severity of the cognitive dysfunction:

• 30–40 points: Mild cognitive dysfunction
• 40–50 points: Moderate cognitive dysfunction
• Over 50 points: Severe cognitive dysfunction

This assessment serves as a useful tool for monitoring the dog's condition and taking timely veterinary action that can improve the dog's well-being. Veterinarians use the DISHAA tool as a basis for suggesting further diagnostic tests and treatment options after assessing the dog's behavior.

Why is the DISHAA tool important?

Since cognitive dysfunction in dogs is often underdiagnosed, this tool offers a simple way to detect symptoms early and provide the best possible support for the dog in its age group. Close communication between pet owner and veterinarian is crucial to maintaining or improving the animal's quality of life.

Early detection of symptoms allows targeted measures, such as dietary adjustments, behavioral modifications, or specific medications, to slow the progression of the disease and enable the dog to live a more comfortable life.

The DISHAA tool is a valuable aid for anyone who wants to monitor and support their dog's cognitive health in old age.

Frequently asked questions about DISHAA:

Summary DISHAA - Tool

The DISHAA tool is a valuable aid for identifying and assessing cognitive dysfunction in dogs. DISHAA stands for the six categories considered when evaluating a dog's cognitive health: disorientation, social interactions, sleep/wake cycles, house soiling, activity, and anxiety.

Using the DISHAA tool, dog owners can systematically observe changes in their pet's behavior. For example, if dogs show signs of disorientation, DISHAA helps determine how often they appear confused. In social interactions, DISHAA can be used to assess whether dogs are more aggressive or withdrawn.

The tool also supports the assessment of disrupted sleep/wake cycles. If a dog suddenly becomes active at night, DISHAA provides guidance. House soiling, learning, and memory problems are also part of the DISHAA assessment and are clarified through questions such as "Is the dog soiling the house again?".

DISHAA also detects changes in activity, such as aimless wandering. Furthermore, DISHAA helps identify increased anxiety levels that occur in dogs with cognitive dysfunction. Overall, DISHAA provides a comprehensive assessment of the health status of older dogs.

Regular use of the DISHAA tool allows dog owners to monitor their dog's cognitive development. If any decline is observed over time, DISHAA provides valuable clues as to when a veterinarian should be consulted. DISHAA is particularly useful because it helps dog owners document behavioral changes, which are often gradual and subtle.

With DISHAA, even minor abnormalities that initially seem insignificant can be systematically recorded before they develop into larger problems. Furthermore, DISHAA promotes close cooperation between dog owners and veterinarians, as the information gathered with DISHAA provides a sound basis for veterinary diagnosis. For every dog owner whose dog is older than eight years, DISHAA offers a simple yet effective way to protect their canine companion's mental health.

You can also download the tool here: https://www.purinainstitute.com/de/centresquare/nutritional-and-clinical-assessment/dishaa-assessment-tool