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R. Koh1
1Veterinary Teaching Hospital, Louisiana State University School of Veterinary Medicine, Baton Rouge, USA
2Veterinary Medical Center, University of Florida College of Veterinary Medicine, Gainesville, USA
I. Introduction
With increasing age, dogs and cats may develop cognitive impairment or cognitive dysfunction syndrome (CDS), a form of neurodegenerative disorder, which shares some analogies with Alzheimer’s disease in humans.1-3 Although a declining of learning and memory may begin in dogs as young as 7 years of age, clinical cases of CDS are seldom identified until the age of
11 years or older, when dogs started to show signs of DISHA (Disorientation, Interaction changes, Dleep/wake disturbances, House soiling and Activity changes).4,5
In a study of 180 dogs aged 11 to 16 years with no identifiable health problems, 28% of dogs aged 11-12 years, and 68% of dogs aged 15-16 years showed at
least 1 sign consistent with CDS.6 One study reported that 50% of cats older than 15 years of age had possible CDS.7 CDS can adversely affect the quality of life in both dogs and their owners. Treatment is aimed at slowing the advancement of neuronal damage and cell death and improving clinical signs. Drugs, diet, and supplements are often used concurrently to improve neurotransmission and reduce oxidative damage and inflammation.1
Acupuncture and Chinese herbal medicine can be
an excellent adjuvant to conventional therapy CDS patiens, as it has been used in animals for thousands
of years in China.8 Clinical anecdotal evidence
indicates acupuncture and Chinese herbals may
greatly benefit patients with CDS.9,10 Acupuncture has shown to significantly improve cognitive impairment
and showed to be effective in improving intelligence
and ameliorating depression and anxiety in various pathological conditions in humans and lab animals.9,11,12 Many Chinese herbs or herbal formulas have been found to posses calming effect and are able to enhance stimulate blood circulation in the brain and to promote adult neurogenesis in the dentate gyrus in animals. Thus, these herbs may be beneficial for patients with CDS.10,13
II. TCVM Etiology And Pathology
In Traditional Chinese Veterinary Medicine (TCVM), CDS is due to a loss of Shen. The Shen is the Spirit or Mind. Shen rules mental activities, memory and sleep. Shen also refers to the outward appearance of the vital activities of the whole body. It provides an animal with awareness and mental clarity. When Shen is healthy,
25-28 September, 2018 | Singapore
monitoring. It is common to see aspiration pneumonia in elderly patients. So, create the habit of aspirating the esophagus and stomach of these patients before endotracheal extubation. Maintain an open airway
via intubation until the animal is swallowing, provide proper nursing care for recumbent animals with soft beds and frequent changing of decubitus, add a source of heat, provide human touch, and compassionate verbal encouragement. It is ok to wait for the pet to recover from anesthesia, rushing will not make it better. However, sometimes reversing the effects of drugs that are not analgesics (e.g. benzodiazepines and alpha2- agonists) can help to speed up the recovery time. The AAHA senior care guidelines for dogs and cats also recommends that clients should receive postoperative instructions with clear, concise, verbal and written take-home instructions that includes information about possible complications, drug effects, nursing care, nutritional management, home monitoring, and after- hours veterinary phone contact.
In conclusion, the anesthesia of geriatric patients is related with higher risks however, safe anesthesia can be performed if these guidelines are followed.References are available upon request.

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