← The Cone of Shame Veterinary Podcast
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- [00:01]
A
The Uncharted Veterinary Conference Medical Director Summit is coming up. It is happening on September 15, 2026. It is a virtual event. It is meant to minimize your time off the floor if you're a medical director and maximize your skill growth and your ability to implement what you're learning into your practices. I love to be a supporter of medical directors. I've gotten to work with medical directors all over the world and I am thrilled to be hosting this year's Medical Director Summit. REG registration is open right now, $199 to register and you can use the code MEDICAL to get 20% off on your registration. That is MEDICAL as your promo code. I would love to see you there. I love this event. That's September 15th. Medical directors head over to unchartedvet.com to get signed up today. Welcome everyone to the cone of shame Veterinary PODC. I am your host, Dr. Andy or guys. I'm here with my good friend, veterinary behaviorist, Dr. Lisa Radosta, and we are talking about cognitive decline in dogs, or cds. This is a fantastic episode. Talking about senior pets. Lisa walks through and breaks down how she looks at older dogs. She talks about how she tracks mentation in every patient, every canine patient that she has over the age of seven and what she looks for and how she. What she does with this information. And then also she gives her top three supplements for brain health for dogs, which is really great. And anyway, this is just a really, really good episode. I just. I took a bunch of notes. I just really appreciate Lisa and her insight. She's so. She's so wonderful. So anyway, guys, this is a great episode. It's absolutely overflowing with pearls of wisdom. Let's get into it. Hey, guys, I just want to jump in real quick and let you know that if you're an Uncharted member, you should be coming to office hours with me. Every other week I meet with our members online at a Zoom. It's usually on Fridays and we cover whatever topics are on the minds of you guys. And so I usually try to have a topic ready in case we don't have a lot of questions. Last time we were together, we talked about best practices for running your practice when you're not in the building and how to be off and away from your practice and not come back to a raging fire. That's what we talked about last week and it was lovely. We had a nice small group and we got to talk about what that looks like in their specific practices. It was a really good time. I love Doing these sessions. I love working with our members. If you think it would be valuable to have some one on one time with me, this is the best way to do it. Join Uncharted. See what we're about. Get involved, guys. Let's make you and your practice better.
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This is your show. We're glad you're here. We want to help you in your veterinary career. Welcome to the cone of Shame with Dr. Andy Roark.
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A
Welcome to the podcast. Dr. Lisa Radosta. How are you, my friend?
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B
I'm amazing. How are you?
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A
I'm really good. I love to sit down with, first of all, I love to sit down with people who are doing fascinating things. And you check that box. And I also really love to sit down with people who are enjoying their work. And every time I talk with you about your practice and you are a board certified veterinary behaviorist for people who don't know you. And I see you online doing interesting things and you just, you're always so creative and I just, you fill my cup in a lot of ways and sort of just creatively you inspire me. And so I am. I was so glad when I saw something that you posted online and I thought, I really want to talk to Lisa about this. And so online you posted this social media post and it started off, it says, is my dog aging normally or is there something wrong? New expert guidelines finally give us a framework for diagnosing dog dementia. And I thought that's fascinating. And so I get that question all the time. I have a senior dog myself and I start to look at him and he's a bit of an odd bird. And so I always won, you know, is, is, is he aging normally? And so let me go ahead and just kind of open this up to you. Talk to me a little bit about, about, about dog dementia and, and sort of the, the questions that people have around is my dog aging normally?
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B
I don't think people have enough questions. Okay, right.
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A
I like that.
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B
I think that there's too many assumptions and the assumption is, and I think I will say as I got, as I get older, I understand older people better. Because when I was younger and they would say, my dog or my cat is just, is getting old. This is about old age. I'd be all, you know, I don't know if you like this, like as a young doctor, age is not a disease. Yeah. But now I'm 56, sometimes I get up and I'm dang painful. And I was like, did I run a marathon overnight? Like, what is happening?
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A
I turned my neck the wrong way, and now I can't, you know, I can't move my head, you know, what's going on.
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So I do understand better how people come to that conclusion that it's aging. So what I hope that my social media post and this podcast does is bring awareness to veterinarians and to pet parents that, yes, you're right, things change when you get older. Things just don't work as well. Things wear out. Just like my mom says, just like a car, things wear out. But that doesn't mean every problem is related to aging. And, and our patients are voiceless and they're members of our family. Like, now more than ever, they are our kids. I call my clients pet parents. I consider myself a pet parent. But we cannot project onto them knowledge of how they feel because that's just inaccurate. Right. And so we don't want to presume that they have, let's say, doggy dementia or that they are just getting older and it's normal aging when they're suffering inside, whether it's cognitive dysfunction or systemic disease or whatever. So I'm hoping people will start to ask themselves and their doctors more questions.
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A
How does cognitive dysfunction interface with your role as a veterinary behaviorist? Like. Like, how does this present. Do people come to you and say, I think my dog has doggy dementia. Do they present to you for behavioral issues? And you say, I, I think that there's a cognitive issue. Like, like, how do you see this in your practice?
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B
Well, I do somewhat of what the consensus statement that was published in Java that I did the social media post on what they recommended, which is, I screen my patients, I screen Everybody over 7 years old, which is directly in line with the consensus statement from the experts. And so everyone gets, I use the CDS screening tool from Purina. But there are other screening tools. The one that I use is the most commonly used in private practice. Let's face it, it's the easiest one. It's color coded. You can easily figure out the score. There are several other ones that are amazing that have research behind them, but they would require my clients to do more work. And I want to make it easy. I want to reduce friction. So I start tracking my patients early. That is one of the things I do as a vet behaviorist, regardless of why they're coming to me. So age seven. The second thing is that when I get referred cases that are older, usually the primary care has tried a lot of things, and I'm coming in as, like, either the last resort or I'm Coming in as like, we're just. We don't know what else would be next for this patient. And sometimes we have to have some quality of life conversations. Right? Yeah.
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A
Right. So when you start to sort of track at age 7, I think that's really interesting. What are sort of the. What are the metrics that you find the most value in? Like, what are the things that have really served you well? And you say, yeah, this is. These stand out to me as data points that maybe, maybe GPS aren't asking for or people don't recognize the value in.
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B
Yeah. So I think we're looking for traditional stuff. And if you're looking as a gp, that's good. You're taking the first step. Right. So disorientation, changes in interaction, sleep, wake cycle, house training, changes in learning and memory, and then changes in anxiety and aggression. But if you think about that, that's a lot.
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A
Yeah.
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B
And that can be caused by almost anything, systemic disease or other behavior problems. So I think that kind of what I. What I'd like is for people to do, for vets to do and pet parents is to track against the baseline. That's why I want you to start tracking when they're seven. And any pet parent can go online and search Purina CDS scoring. You can do it at home. You don't have to wait for your vet to do it. If you're tracking against a baseline now, you will see when things change. Right. That's the first thing I want people to do. And the second thing is I want to people to think about, what was my dog like before I started tracking? So if a dog presents to me at 12 for urinating in the house, I ask people, was your dog ever house trained? And they say, yes. And I say, okay, so you're telling me you could leave your house for eight hours during the day and your dog would not urinate? Oh, no, he would sometimes urinate. Okay. He wasn't house trained. Is this that getting worse versus systemic disease versus cds. Cds. House training lapses. They look really distinctive. They look like they're related to loss of learning and memory. You take your dog out, your dog's like, I'm ready. You go out. And your dog's like, yeah, okay, here you. Here we are. Good. So good. And you're like, go potty. Go potty. Lonnie's got to go to work. Go potty. He's like, you go in and he's like, oh, dang it, I forgot to potty. And the keys right on your rug. It's pretty distinctive. Doesn't have to always be that way, but when I'm first looking, I'm looking for that. So that's kind of what I want people to do, is track against baseline for your dog.
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A
Is that sort of going out in the yard and then kind of getting lost, if you will? Is that the primary way that you see changes in what you call learning and memory? So when you first said, have you seen changes in learning and memory? My thought was, what does that look like? And so I really like the idea of he went out in the yard and forgot why we were here. And, oh, no, that's a great example. Is that the primary learning and memory you're thinking about? What are some other examples?
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B
Another example, I used to watch my sister's elderly Samoyed, and I used to grow little cactuses in tiny, little tiny.
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A
Okay.
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And they would all be in the corner. And Lacey, that was her name, she truck around my yard. She was like 100 years old, and she would always walk right into my tiny pot, and she couldn't find reverse.
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A
Okay.
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B
So it wasn't abnormal, but Lacy was like a dinosaur in my yard, knocking everything over. But she couldn't. Once she was there, she didn't know how to move. Right. It's like she was stuck. So she would bark for me. I'd just turn around and she's like, there I go. So just that? Yeah, so just that. Kind of like, I knew how to do this, but I don't. I just don't know how to do this anymore. And we also want to think about. I'm not talking only about the things you've taught your dog. Like you taught your dog to sit, and now your dog can't sit. Because by the time your dog has dementia, 11, 12, 13, 14, he probably has arthritis or back pain as well. Right. So I'm not just using that. I'm using, like, basic stuff. You knew how to tell me you had to go outside. Now you don't tell me you knew how to potty outside. Now you don't know how to do that. You knew how to find, you know, turn your body to get around. Now you can't do that. So that loss of, like, basic knowledge that your dog had.
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A
Yeah. Lisa, are you running them through these questions once a year? Are you running through every time that you see them, even if it's been one week since the last time? Like, how often are you kind of. Kind of running through this checklist?
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B
Yeah, we want to be screening dogs about once a year until they're around 10 or 11. And then we try to do it every six months because at that point, so that, that information from dogs 7 to 10 basically comes from research dogs. And when you are a research dog, you are under the microscope. Right. When you are a pet dog, you would think that pet dogs are under the microscope, but they're not. Just like my husband is a part of my life. I'm not examining the way he walks every day. Right. I'm not measuring how much force he puts on his leg. Right. Okay. So that's kind of what happens. And then all of a sudden we realize our dog is so different. So pet dogs, we're starting to see 10, 11, 12. And by the time you're getting to 15, 16, about 2/3 of those dogs have some signs of cognitive dysfunction. But I need people to think about CDS or CCD or whatever we're calling it now, either canine cognitive dysfunction syndrome. CCDS or cds. Right, Cognitive dysfunction syndrome, whatever. I want you to think about it as a spectrum of signs. I'm 56. I can tell you that I've lost some sharpness. I don't know how you're doing, but I got to read some things several times and, and I don't know what my daughter's saying half the time. And like you're losing a little bit. That is normal aging. And so you want to think of CDCDs or CCDs as a spectrum of signs. And you have to start to decide when is my dog's quality of life affected? Right.
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A
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B
Yeah. So the first thing we do always is work the dog up for systemic disease. But I want to remove, you know, how I feel about ruling out medical before behavior. We're going to do it all at once. We're going to do our workup. And even though that workup might take days or even weeks, if we bring that patient back for radiographs or an ultrasound or whatever, today we're going to start something. So we're going to find the biggest sign we're worried about today. Maybe it's sleep wake cycle. That's probably going to be the most common thing people are going to bring their dog to the veterinarian for, let's say, is staying awake all night and then sleeping during the day. Right. And so we're going to take that sign and we're going to treat it. We're going to treat it with a medication to help the dog sleep. But we're also going to support brain health. And so there are three supplements that have research behind them that I use to support brain health. I do use them all at once. I don't start them all at once because old dog guts, I don't have to tell you, they can be real sensitive. Right. So one of them is Leap Years. Leap Years is the newest of the ones that I recommend. I want to say three years old, two years old, something like that. So Leap Years is going to attack cellular senescence. And this is basically the way that our cells age and these cells become, let me just put it this way, worthless cells in your body. They are just arrested. They are not helping you, and they are linked to all kinds of dysfunctional metabolic changes. Right. So Leap Years has a great study from NC State. And it needs to be used in a specific way. So always follow the directions. So there's that. I also recommend Denimarin, which is not Denimarin advanced according to Nutrimax, after talking to some of the representatives there, the actual Dennamarin goes across the blood brain barrier better than Dennamarin Advance. So while Dennamarin doesn't have a study, no V fit, which if you're an older veterinarian. Remember Novfit from Virbac had Sami in it. Double blind placebo, controlled study. Right. So I'm going to start Denimiran and I'm going to start it at 10-20mg per kilo of Sami. So you got to turn the bottle over, you got to look at the weight. Just like you would prescribe a medicine. You're going to prescribe. And then I also recommend Senolife. Stenalife had a white paper years ago. I cannot find that paper anymore. So I remember reading the research. I have notes on it, but I can't refer people back to a paper. So those are my three supplements. I'm going to start that today. I'm going to support brain health spacing, the initiation of supplementation out by about a week to give the gut a chance to kind of absorb and get used to those products. But there's more. We're going to try to keep the dog busy using his brain. So we all know the older lady who comes to see us and plays pickleball three days a week and does sudoku versus the older lady who comes to see us who's at home alone. You can tell the difference even in their interactions with you. Right. And what is very cool is that a couple of years ago, a researcher did a study in old dogs with an old dog obedience class. Oh, my God.
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A
Okay.
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So she takes old dogs and she's like, okay, we're going to teach you a trick. We're going to teach your parents about food toys. We're going to teach you how to use puzzle toys, and we're going to take these other old dogs and we're just going to have a good time with you. We're not going to teach anything. Yeah. And she measured cognition before and after. I think you already know the punchline. The dogs that went to the old dog class had improvements in their cognition. Of course, this is common sense. So I want people to do something with their dog five days a week. I don't think they need it doesn't need to be rocket science. One of my clients pulls his 80 pound obese pit bull in a red wagon. An old fashioned red wagon in the neighborhood. Yeah, we need to do something with our dogs. Teach them a trick. I don't even care if they learn it. It's the act of learning that keeps the brain young.
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A
That's awesome. I feel better about the world knowing that there are old dog behavior classes that are happening. That makes me really, really Happy. What do you know now about CDS that you wish you knew earlier in your career? So as we start to unlock more, what have you seen as the biggest changes from what we knew were kind of how we addressed cases? I don't know, 10 years ago.
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B
Yeah. I think the difference 10 years ago is I was very focused on CDS is one thing. And there's selegiline, which is Anapro, and that's for cds, and that's how we treat it. Now I'm thinking about the spectrum. Where is my patient? I know now a lot more as a doctor who's been a doctor a long time about how increased blood pressure, hypertension, can keep a dog awake at night, can look like cds. So I'm really focused now and people who follow me on social media know I'm obsessed with pain. I'm obsessed with it. And so I'm also very much focused on relieving pain. I just saw a dog yesterday, actually an older dog, and I focused a lot of the consult on pain management.
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A
Pain management. Oh, man, Lisa, that's amazing. I love the stuff that you do online. I love the content that you put out. I really appreciate you taking time to come and talk with me. Where can people follow you online and how can they keep up with what you're doing?
- [19:33]
B
They can follow me on Instagram, LinkedIn and Facebook or YouTube. Dr. Lisa Radosta and I have a website with free resources if they're looking for handouts or videos where they can learn more.
- [19:44]
A
I'll link all that stuff up in the show notes. Thank you so much for being here, guys. Thanks for tuning in and listening, everybody. Take care of yourselves. And that's what I got, guys. Thanks for being here. Thanks to Lisa for being here. I always enjoy her on the podcast and I just get so much out of her. Take care of yourselves, everybody. If this episode was valuable, please like it, share it. And honestly, if you know other pet owners or doctors who are looking at cognitive dysfunction in their dogs or this is a great episode to send over to people to help them kind of understand what maybe what they're looking at and maybe what could be helpful and beneficial at home. So anyway, take care of yourselves. I'll talk to you later on. Bye. Are you an early career veterinarian, a new graduate or a vet Student? This is Dr. Andy Rourke. And guys, I wanted to put something together just for you. I've got a brand new totally free newsletter. It only comes out once a quarter. It's definitely not meant to fill up your inbox but I wanted to go ahead and just consolidate all of the information that me and the Uncharted Veterinary Conference are doing for early career veterinarians into one place. I'm going to be writing especially for this newsletter. We're going to have podcast episodes that are in here specifically for early career vets, new grads, vet students. We're going to have training resources, we're going to have certificate courses. We're going to have special discount codes that are just for you guys. And so if you're in this boat and you want some content that's going to help you have an easier career, enjoy your time in practice, be more effective and happier as a veterinarian. Guys, this is for you. It's totally free. I'm happy to give it to you. Head over to Drandy Rourke.comcareevets that's DrandyRourke.comcareevets or you can find the link in the show notes. I hope this is really valuable for you. I hope that you'll check it out.