FUNCTIONAL HEALTH GUIDE -- COGNITIVE DISEASE

FUNCTIONAL COGNITIVE HEALTH FOR DOGS AND CATS

A Longevity-Focused Worksheet
By Dr. Kevin Toman, The Longevity Vet

WANT THIS AS A DOWNLOADABLE PDF?  Here You Go. 

Why cognitive health belongs in Functional Medicine

Brain aging is rarely sudden. In most pets, metabolic strain, inflammation, pain, sleep disruption, and sensory loss start shifting the brain months to years before a family realizes “something is off.”

Functional Health asks:

  • What is changing before severe confusion?

  • Which drivers are modifiable right now?

  • What’s the next best test so we don’t guess?

This worksheet is decision support—not a diagnosis.
If your pet is unsafe, rapidly worsening, or having seizures, skip the worksheet and escalate.

1) NEXT BEST TEST

Use this section to decide what to test first and what to track at home.

Step 1 — Confirm it’s “cognitive-like” and not a look-alike

Circle any changes you’ve noticed (even if mild):

  • Disorientation (stuck in corners, staring)

  • New anxiety, clinginess, or agitation

  • Sleep-wake reversal (up at night, sleeping all day)

  • House soiling / litter box accidents

  • Aimless pacing, wandering, getting “lost”

  • Less interest in play, family, routine

  • New vocalization (especially at night)

  • Reduced grooming (cats), new irritability

If none apply, consider a different worksheet first (pain/mobility, metabolic, senior screening).

Step 2 — Baseline medical screen (the minimum that prevents years of guessing)

Ask your vet for:

  • CBC + chemistry

  • Urinalysis

  • Blood pressure

  • Thyroid testing (especially dogs)

  • Review of medications/supplements that can sedate or confuse

Why these matter: kidney, liver, thyroid, hypertension, infection, anemia, electrolyte shifts—and medication effects—commonly masquerade as “brain decline.”

Step 3 — Pain and sensory screen (often the real driver)

Because chronic pain and sensory loss accelerate cognitive decline, add:

  • Pain assessment (arthritis, spine, dental pain)

  • Vision/hearing check (especially in seniors)

  • Oral exam/dental evaluation if breath/chewing changes exist

Step 4 — Home tracking (this is your “functional data”)

Track for 7–14 days:

  • Sleep: bedtime, wake time, night waking (yes/no)

  • Resting breathing rate (if anxiety / pacing overlaps)

  • Accidents: frequency and time of day

  • Triggers: after naps, after meals, evening, noise, visitors

  • Activity: willingness to walk/play; new reluctance

  • Appetite / thirst changes

  • Short video clips of concerning behaviors (helps diagnosis)

CTA (in-text, linkable phrase):
If you want the fastest, cleanest baseline plan, start with Functional Health Foundations (Start Here) and then return to this worksheet.

2) WHAT IT MEANS

Use this section to interpret patterns. This is where most pet parents get stuck—so we make the “forks” obvious.

Pattern A — Night pacing + vocalization + sleep reversal

Most common drivers:

  • Pain (arthritis, dental, spine)

  • Anxiety + disrupted circadian rhythm

  • Hypertension

  • Early cognitive dysfunction

What it suggests:

  • Don’t jump to “dementia” first. Rule out pain + blood pressure early.

Pattern B — Sudden onset or rapid decline (days to weeks)

Red flags:

  • Seizures

  • Head tilt, circling, falling, one-sided weakness

  • Sudden blindness

  • Very rapid personality change

What it suggests:

  • Structural/neurologic disease (stroke, tumor, inflammation) or metabolic crisis
    This pattern deserves urgent veterinary evaluation and often imaging.

Pattern C — “My pet seems mentally slower” + weight gain, low energy, coat changes

Often points toward:

  • Metabolic dysfunction

  • Thyroid issues (dogs)

  • Chronic inflammation / pain limiting movement

What it suggests:

  • Brain support works best when the whole-body drivers are treated.

Pattern D — Increased accidents + confusion

Could be:

  • Cognitive decline

  • Urinary infection, kidney disease, diabetes

  • Arthritis/pain preventing normal posture

  • Litter box aversion (cats)

What it suggests:

  • Don’t assume cognition. Urinalysis + pain assessment first.

What Cognitive Dysfunction really is (simple, accurate)

Cognitive Dysfunction Syndrome is progressive brain aging associated with:

  • Inflammation + oxidative stress

  • Mitochondrial decline (energy production)

  • Reduced glucose utilization

  • Changes in brain signaling and sleep regulation

Functional Health cares less about labels and more about:
What’s driving the decline—and what can we change now.

3) NEXT BEST STEP

Choose the most appropriate next step for your pet today.

Step 1 — Decide your level: Monitor, Support, or Escalate

A) Monitor with intention (appropriate when)

  • Changes are mild, stable, and slow

  • Baseline labs and blood pressure are normal

  • No red flags, no sudden decline

Your plan:

  • Track symptoms monthly

  • Recheck labs and BP on a schedule (often every 6–12 months; sooner if trends shift)

B) Add targeted support (appropriate when)

  • Mild-to-moderate cognitive changes

  • Sleep disruption, anxiety, or reduced engagement

  • Pain or inflammation is present

High-yield supports (sequence matters):

  1. Pain control first (mobility = brain fuel)

  2. Omega-3 (EPA/DHA) foundational brain anti-inflammatory support

  3. Curcumin / Longevity Plus for systemic inflammation signaling

  4. MCTs (when appropriate) for alternative brain fuel

  5. Daily enrichment: short training, sniff walks, puzzle feeders, play bursts

  6. Routine + light cues: consistent schedule, nightlights for seniors

CBD note (kept practical):

  • Consider CBD primarily for anxiety/sleep/pain tone, not as a dementia “treatment.”

  • Use vetted products; monitor sedation and liver enzymes when appropriate.

Step 2 — When to escalate (this is the “don’t waste months” line)

Escalate to a PET LONGEVITY CONSULT when:

  • Multiple systems are involved (pain + kidney + anxiety + weight, etc.)

  • Sleep reversal is persistent

  • You’re considering prescription options

  • You want an integrated plan and monitoring schedule

Escalate to a PET LONGEVITY PROTOCOL when:

  • Cognitive signs are part of a bigger aging picture and you want ongoing oversight, adjustments, and tracking, not one-time advice.

 

Quick “Start Here” decision guide

  • Not sure what to do first? → Foundations Worksheet

  • Cognitive changes + pain/mobility decline → Arthritis/Mobility Worksheet + Cognitive Worksheet

  • Cognitive changes + weight/metabolic concerns → Metabolic Health Worksheet

  • Cognitive changes in a senior pet → Senior Screening Worksheet

  • Rapid decline or neurologic red flags → Urgent veterinary evaluation

Optional: What to ask your vet - A copy/paste checklist

  • “Can we run CBC/chem/UA and measure blood pressure?”

  • “Can we screen for pain sources (arthritis/dental) that could be driving behavior?”

  • “If labs are normal, what’s our plan for cognitive support and follow-up timing?”

  • “At what point would imaging or neurology referral be appropriate?”

 

About These Worksheets


This worksheet is part of the Functional Health system developed at PetFunctionHealth.com, designed to identify early decline and guide long-term longevity strategy.