Canine Cognitive Dysfunction Syndrome

ANIPRYL
(SELEGILINE HYDROCHLORIDE)

You may have seen some reports announcing that Anipryl (selegiline hydrochloride) has been approved by the Food and Drug Administration to control the signs of a devastating, newly identified medical condition in senior dogs called Cognitive Dysfunction Syndrome (CDS). The materials included in this kit will provide the rest of the story.

CDS may affect as many as 6.5 million -- or nearly half -- of dogs age eight or older, and their families.(1) The syndrome is characterized by signs in four categories:

• Disorientation or confusion (e.g., appearing lost or confused in the house or yard, staring into space)

• Interaction changes with family members (e.g., not wanting to be petted, not greeting the family at the door)

• Sleep and activity pattern changes (e.g., being awake at night, wandering aimlessly)

• Housetraining problems (e.g., having accidents in the house, even in front of a family member; not asking to go out)

Owners of senior dogs need to know what signs to look for, and bring any behavior changes to the attention of their veterinarian. If the diagnosis is CDS, Anipryl now offers hope, when there was none before. We are pleased and proud to help people find the senior dogs they thought they had "lost."

1 Proprietary market research, 1998. Pet owner sample: 255; data on file, Pfizer Animal Health.

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By Cheryl Jones, DVM. Dr. Jones holds a doctorate of veterinary medicine from the University of California - Davis. She is a member of the American Veterinary Medical Association, and is a practicing veterinarian at State Line Animal Hospital, Leawood Kan. Dr. Jones serves as a paid consultant to Pfizer Animal Health.

Many dog owners place their relationship with their pets on the same emotional level as a human relationship. In fact, according to a 1998 study conducted by the Gallup Organization, three out of five dog owners consider their dog to be one of the most important things in their lives.' We even welcome dogs as members of our families; the Gallup study found that three out of four dog owners strongly agree that their dog is considered a member of the family. Veterinarians have always known of the special bond between owners and their dogs, and we enjoy that special bond with our own pets. Because of this strong bond, people are more aware of and concerned for the health of their pets. Again, according to the Gallup survey, more than three-quarters of dog owners say that the health of their dog is as important to them as their own, and three in five wish there was more their veterinarian could do to help improve the lives of their senior dogs.

(1) A common problem associated with senior dogs is canine Cognitive Dysfunction Syndrome (CDS), an age-related medical condition that cannot be wholly attributed to other unrelated health problems such as tumor, organ failure, or hearing or vision loss. Dog owners and veterinarians may notice a number of signs associated with CDS, including disorientation or confusion (e.g., appearing lost or confused in the house or yard, not recognizing familiar people), interaction changes with family members (e.g., not wanting to be petted, not greetinmedical condition that cannot be wholly attributed to other unrelated health problems such as tumor, organ failure, or hearing or vision loss.

Many owners are unaware that these signs may be effectively managed – so owners need to watch for changes in their older dogs. Some owners may accept the signs of CDS as part of the aging process and tend to ignore them. But a dog diagnosed with CDS is actually suffering from a manageable condition. Owners are, in fact, the best source to help veterinarians recognize signs of change in a dog's behavior. At our practice, we have found success for many dogs diagnosed with CDS, with a medication called Anipryl" (selegiline hydrochloride). Anipryl is the first and only drug approved by the Food and Drug Administration for the control of the clinical signs associated with canine Cognitive Dysfunction Syndrome. Most dogs can be conveniently dosed with a single tablet once a day, helping to restore the relationship between older dogs and their families. In studies, the most common side effects were vomiting, diarrhea or changes in behavior such as hyperactivity and restlessness. Most side effects were mild to moderate. In a placebo-controlled study, most of the adverse events in dogs treated with Anipryl were also observed in placebo-treated dogs, although the rates in placebo-treated dogs were lower. As dogs grow older, they are likely to experience more health problems. Senior dogs should be observed more closely because changes in normal appearance, activity and behavior all can be signs that veterinary attention may be needed. Consult your veterinarian before using Anipryl with other medications or with tick collars. We had about 50 dogs from our hospital in the clinical trials for Anipryl, and we were very pleased with the number of dogs that responded to the medication. One of the best examples we had was an old Brittany spaniel. Before Anipryl, he was staring into space, and didn't know where he was or who his family was. After a short time on the medication, this dog became more like his old self. Simply put, dogs may not have to suffer from the signs of CDS during their golden years -- and you can help your senior canine companion. Veterinarians now have a fantastic CDS management option to make your dog's life happier. If you're seeing signs of behavioral change in your older dog, see your veterinarian. If a history and work up suggests Cognitive Dysfunction Syndrome, your dog may benefit from Anipryl.

NOTE: For more information on Cognitive Dysfunction Syndrome or a copy of the full Anipryl prescribing information, call I-888-ANIPRYL

1 The Senior Dog Survey. The Gallup Organization, Princeton, NJ; 1998.

2 Ruehl WW, Hart BL: Canine Cognitive Dysfunction. In: Psychopharmacology of Animal Behavior Disorders (Dodman NH, Shuster L, eds.). Boston: Blackwell Scientific, 1998; pp. 283-304.

3 Neilson JC, Hart BL, Ruehl WW: Cited in Hart BL, Hart LA: Selecting, Raising and Caring for Dogs to Avoid Problem Aggression. J. Am. Vet. Med Assoc. 210(8.): 1129-1134; 1997.

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Does Your Dog exhibit any of the following signs ?

•Wanders aimlessly?

•Appears lost or confused in house or yard?

•Does not recognize familiar people ?

•Does not respond to verbal cues, such as name ?
•Loss of housetraining ?

•Solicits less attention or walks away while being petted ?

•No longer greets the family?

•Changes in sleeping patterns ?

If you answered "yes" to any of these questions, consult your veterinarian. Your dog's history, along with a thorough physical examination and other tests as needed, will help your veterinarian determine if your dog has a medical problem. Your veterinarian can then prescribe a program that may control your dog's signs, and help restore the relationship you share, thus allowing your best friend to enjoy a better quality of life.

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The Senior Dog and Aging: Recognizing and Controlling Canine Cognitive Dysfunction Syndrome

By Dr. Ilana Reisner, DVM, Ph.D., DACVB, Veterinary Behavior Consultant specializing in the prevention, diagnosis and treatment of small animal behavior problems. Dr. Reisner received her doctorate of veterinary medicine from Oregon State University College of Veterinary Medicine, and her Ph.D. in Behavioral Physiology from Cornell University College of Veterinary Medicine. Dr. Reisner became a Diplomat in the American College of Veterinary Behaviorists in July 1995. Dr. Reisner serves as a paid consultant to Pfizer Animal Health.

In dogs, the medical implications of aging are progressive and irreversible. Dogs in their later years undergo physical and metabolic changes that may cause them discomfort and/or change their behavior. For example, the senses -- sight, hearing, taste and smell -- are reduced.

Metabolism slows, and immune function decreases. Muscle and bone mass decline, and arthritis may affect the joints. There is often an increased risk of heart disease, cancer, and hormonal, kidney and liver disorders.

(1) The brain, too, does not escape the aging process as it undergoes a series of changes that result in cognitive decline. It is generally believed -- and studies have confirmed -- that a dog's cognitive ability tends to decline with age. This cognitive behavior in dogs includes orientation, memory, learning, recognizing and reacting to human family members.

(2) A newly identified syndrome, canine Cognitive Dysfunction Syndrome (CDS), is an age-related medical condition in senior dogs that cannot be wholly attributed to other unrelated health problems, such as a tumor, organ failure, or hearing or vision loss.' If your older dog shows signs of disorientation or confusion, and doesn't recognize you or interact with your family anymore, your dog may not be aging successfully, and may be suffering from CDS.

CDS is believed to be a combination of several age-related changes caused by chemical deficiencies in a dog's central nervous system. In addition, proteins called beta- amyloid accumulate and form plaques in the areas of the brain associated with memory and cognition, and may interfere with communication between the brain and body, and other critical brain functions. In a recent Pfizer Animal Health pet owner study, nearly half of dogs aged eight or older showed at least one sign that could be associated with canine CDS. In addition, in a study at the University of California - Davis, 62 percent of dogs 11 - 16 years of age exhibited signs in at least on category of CDS.

(3,5) Dog owners and veterinarians may notice a number of signs associated with CDS, and should work through a questionnaire about these signs (sample attached), including:

• Disorientation or confusion (e.g., appearing lost or confused in the house or yard, staring into space)

• Interaction changes with family members (e.g., not wanting to be petted, not greeting the family at the door)

• Sleep and activity pattern changes (e.g., being awake at night, wandering aimlessly)

• House training problems (e.g., having accidents in the house, even in front of a family member; not asking to go out)

If you are seeing any changes in your older dog's behavior, talk to your veterinarian. If your dog is showing signs of CDS, it is important that you bring these signs to the attention of your veterinarian because your dog is unlikely to show these signs during a routine physical examination.

To diagnose CDS in dogs, veterinarians rely primarily on taking thorough behavioral and medical histories, followed by a complete physical and brief neurological examination. These can be supplemented, as appropriate, with diagnostic laboratory screening to identify other medical conditions that may be contributing to clinical signs. The management of CDS is aimed at the control of clinical signs, to help restore the relationship between and your older dog and your family.

Management of CDS may include drug or behavioral therapy, as instructed byyour veterinarian. One option your veterinarian may suggest is "lipryl" (selegiline hydrochloride), the first and only FDA-approved medication to control the clinical signs associated with canine Cognitive Dysfunction Syndrome.

Through daily dosing, Anipryl may help regulate brain chemicals, such as dopamine, that are necessary for normal function in the dog. In clinical studies, reported that 69 percent to 75 percent of dogs improved in at least one clinical sign after one month of Anipryl therapy. In the blinded, placebo-controlled clinical study, owners reported that 69 percent of dogs improved in at least one clinical after one month of therapy, compared to 52 percent of placebo-trein the dog. In clinical studies, reported that 69 percent to 75 percent of dogs improved in at least one clinical sign after one month of Anipryl therapy. In the blinded, placebo-controlled clinical study, owners reported that 69 percent of dogs improved in at least one clinical after one month of therapy, compared to 52 percent of placebo-treated dogs.

In studies, the most common side effects were vomiting, diarrhea or changes in behavior such as hyperactivity and restlessness. Most side effects were mild to moderate. In a placebo-controlled study, most of the adverse events in dogs treated with Anipryl were also observed in placebo-treated dogs, although the rates in placebo-treated dogs were lower. Consult your veterinarian before using Anipryl with other medications or with tick collars. It' s important to bear in mind, too that as dogs grow older, they are likely to experience more health problems. Senior dogs should be observed more closely because changes in normal appearance, activity and behavior all can be signs that veterinary attention may be needed.

Before Anipryl, managing CDS was heartbreaking and frustrating for the dog's family. Now, those families have hope. We know that the syndrome has a medical basis and that something can be done to restore a relationship that has grown and been nurtured for a decade or more. With proper diagnosis and therapy, senior dogs with CDS and their owners, can continue to enjoy many happy times together.

NOTE: For more information on Cognitive Dysfunction Syndrome or a copy of the full Anipryl prescribing information, call I-888-ANIPRYL

1 Mosier JE: Effect of aging on body systems of the dog. Vet. Clin. N. Am. Sm. Anim. Pract. 19(1):1-12; 1989.

2.3 Ruehl WW, Hart BL: Canine Cognitive Dysfunction. In: Psychopharmacology of Animal Behavior Disorders (Dodman NH, ShusterL, eds.). Boston: Blackwell Scientific, 1998; pp. 283-304.

4 Proprietary market research, 1998; pet owner sample: 255; data on file, Pfizer Animal Health. 5 Neilson JC, Hart BL, Ruehl WW: Cited in Hart BL, Hart LA: Selecting, Raising and Caring for Dogs to Avoid Problem Aggression. J. Am. Vet. Med. Assoc. 210(8.): 1129-1134; 1997.

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CANINE COGNITIVE DYSFUNCTION SYNDROME FACT SHEET

• Cognitive Dysfunction Syndrome (CDS) refers to an age-related decline in cognitive function not wholly attributable to an unrelated medical condition such as neoplasia, organ failure or infection.(1)

• The prevalence of CDS increases with age. In a University of California-Davis study, 62 percent of dogs between the ages• of 11 and 16 exhibited signs in at least one behavioral category.(2)

• According to a pet owner study, 48 percen~ of dogs aged eight or older may show at least one sign associated with CDS.(3)

• The key signs of CDS include:

-- disorientation
• wanders aimlessly
• appears lost or confused in house or yard
• does not recognize familiar people
• does not respond to verbal cues or name

-- decreased or altered responsiveness to family members
• seeks attention less often
• less likely to stand for petting; walks away while being petted
• less enthusiasm upon greeting
• no longer greets family members

-- changes in sleep-wake cycles or activity levels
• sleeps more during the day
• remains awake at night
• increase in aimless activity, like pacing
• decrease in purposeful activity

-- loss of housetraining
• urinating or defecating indoors, even in view of owners
• no longer signaling to go outside
• having accidents indoors soon after being outside
• Owners are key to recognizing the signs of CDS. They should observe their dog for the signs and bring them to the attention of their veterinarian. Aging dogs experience changes as they grow older. Although the consequences are not yet fully understood, the following changes have been documented in the brain of the aging dog. The brain as a whole atrophies, with a decrease in total weight and size, especially in the cerebral and cerebellar cortices. The size of the ventricles increases.

Some cells in the brain decrease in number, while glial cells increase. Hypoxia often occurs as a result of decreased blood flow, anemia, systemic diseases or arteriosclerosis.(4)
• CDS is believed to be related in part to neurodegenerative changes in the brain related to accumulation of beta-amyloid plaques in the cerebral cortex and hippocampus of the canine brain. Beta-amyloid in the brain differs from amyloid seen in other diseases and in other body sites, such as the liver, kidney or pancreas. It is not known why beta-amyloid is deposited; however, the amount deposited in the brain has a positive correlation with the severity of cognitive impairment." (5)
• It is hypothesized that abnormally elevated MAOB activity, which may result in decreased levels of dopamine, may play a role in the development of canine CDS.(6) Dopamine is catabolized by monoamine oxidase type B (MAOB) in some species. This increase in brain MAOB is in excess of the increase associated with normal aging.
• The diagnosis of CDS in dogs is based primarily on thorough behavioral and medical histories in conjunction with appropriate diagnostic work-up and testing. It is advisable to conduct a physical examination, including a brief neurological exam, and to consider appropriate laboratory tests to establish hematological and serum biochemical baseline data prior to administration of any new medication, especially in older dogs. Periodic monitoring to evaluate both therapeutic response and the presence of concurrent disease is encouraged.

1 Ruehl WW, Hart BL: Canine cognitive dysfunction. In: Psychopharmacology of Animal Behavior Disorders. (Dodman NH, Shuster L, eds) Boston: Blackwell Scientific, 1998; pp. 283-304.

2 Hart BL, Hart LA: Selecting, raising and caring for dogs to avoid problem aggression. J. Am. Vet.Med.Assac. 210(8.):1129-1134; 1997.

3 Proprietary market research, 1998; pet sample size: 255; data on file at Pfizer Animal Health.

4 Mosier JE: Effect of aging on body systems of the dog. Vet Clin. N Am. Sm. Anim. Pract. 19(1): 1- 12, 1989.

5 Cummings, BJ, Head E, Afagh AJ, Milgram NW, Cotman CW: B-amyloid accumulation correlates with cognitive dysfunction in the aged canine. Neurobiol. Learning and Memory 66: 11-23; 1996.

6 Corey-Bloom J, Thal LJ: Monoamine oxidase inhibitors in Alzheimer's disease. In: Monoamine Oxidase Inhibitors in Neurological Diseases. (Lieberman A, Olanow CW, Youdim MBH, Tipton K, eds.) New York: Marcel Dekker, 1994; pp. 279-294.

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•Anipryl (selegiline hydrochloride), from Pfizer Animal Health, is the first and only drug approved by the Food and Drug Administration for the control of the clinical signs associated with canine Cognitive Dysfunction Syndrome (CDS).

•Anipryl is safe and convenient, and helps improve cognition in dogs with CDS. It is a selective, irreversible inhibitor of monoamine oxidase type B (MAOB), an enzyme that catabolizes neurotransmitters in the brain, including dopamine, norepinephrine, epinephrine and serotonin. Anipryl at prescribed dosages is selective because it affects only MAOB.

-- Anipryl may increase dopamine levels in the brain by inhibiting MAOB. In some species, levels of MAOB increase with age, which is proposed to lower levels of dopamine in the brain. Lower than normal levels of
dopamine may be a contributing factor to canine CDS.(1)

-- Anipryl is believed to increase dopamine concentration in the synaptic cleft (the space between two nerve cells where neurotransmitters are released) by increasing the amount of dopamine released and decreasing dopamine reuptake. Each of these actions should restore the dopamine concentration in a dog's brain, decreasing the clinical signs associated with canine CDS.(2)

•In clinical studies, owners reported that 69 percent to 75 percent of dogs improved in at least one clinical sign after one month of Anipryl therapy. In the blinded, placebo-controlled clinical study, owners reported that 69 percent of dogs improved in at least one clinical after one month of therapy, compared to 52 percent of placebo-treated dogs. A second open-label clinical study revealed that 75 percent of dogs improved in at least one clinical sign after one month of Anipryl therapy. Some dogs in both studies increased improvement for up to three months, indicating that some increased improvement may be seen with continued use. However, onset, duration and magnitude of response varied with individual dogs.

•Clinical signs measured included:
-- disorientation or confusion
-- interaction changes with family members
-- sleep and activity pattern changes -- housetraining problems

•Anipryl is an oral medication available by prescription from licensed veterinarians. It is for use in dogs only.

•Anipryl is available in five dose strengths

-- 2, 5, 10, 15 and 30 mg

-- and comes packed in 30-tablet blister packages for convenient monthly dispensing. The recommended dosage for the control of clinical signs associated with CDS is 0.5 - 1 mg/kg once daily, dosed to the nearest whole tablet.

•Anipryl is easily administered -- convenient once-a-day dosing, with food if necessary, makes compliance by owners easy. Most dogs can be dosed with only one tablet once a day. Dosing is recommended in the morning.

•In clinical studies, the most common adverse events were vomiting, diarrhea or changes in behavior such as hyperactivity and restlessness. Most side effects were mild to moderate. In the placebo-controlled study, most of the adverse events in dogs treated with Anipryl were also observed in placebo-treated dogs, although the rates in placebo-treated dogs were lower.

•Concurrent use with ephedrine; phenylpropanolamine; other potential MAO inhibitors such as amitraz, tricyclic antidepressants, tetracyclic antidepressants or selective serotonin reuptake inhibitors is not recommended.

•Abnormal clinical signs may be associated with underlying disease, the advanced age of the patients or the development of unrelated concurrent disease.
•In humans, concurrent use of MAO inhibitors with alpha-2 agonists has resulted in hypertension. While there is no data available in dogs, caution is advised when using Anipryl with alpha-2 agonists.

•Instruct clients to report unexpected changes in their dog's appetite or behavior.

•If multiple medications are required, extra care in monitoring senior dogs is appropriate.

1 Amsten AFT: Catecholamine mechanisms in age-related cognitive decline. Neurobiol. Aging 14:639- 641, 1993.

2 Milgram NW, Head E, Weiner E, Thomas E: Cognitive functions and aging in the dog: Acquisition of nonspatial visual tasks. Behavioral Neurosci. 108(1): 57-69, 1994.

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GROUNDBREAKING MEDICATION CAN GIVE OLD DOGS
A NEW LEASE ON LIFE

All dogs get older, but not all dogs age successfully. As many dogs age, they seem to become disoriented and confused, change their sleeping patterns, begin having accidents in the house and stop interacting with their families, all possible signs of a newly identified, age-related medical condition called canine Cognitive Dysfunction Syndrome (CDS). Such problems are frustrating for dog owners and their pets, and are often incorrectly assumed by owners to be hopeless and inevitable signs of normal aging.

Recent advances in veterinary care, as well as the important role dogs play in the family, have allowed dogs to live longer, healthier lives. But with longevity comes new challenges for dogs, their owners and veterinarians. As more dogs live longer, they begin to display more signs of age-related clinical and behavioral problems in their senior years.

Some changes in older dogs may be signs of CDS. As defined by veterinary behavioral experts, CDS is an age-related medical condition in senior dogs that cannot be wholly attributed to other, unrelated health problems such as tumor, organ failure, or hearing or vision loss.(1) In a pet owner study, nearly half of dogs aged eight or older may exhibit at least one sign medical condition in senior dogs that cannot be wholly attributed to other, unrelated health problems such as tumor, organ failure, or hearing or vision loss.

Aging dogs may display a number of signs that can be attributed to CDS, including disorientation or confusion (e.g., appearing lost or confused in the house or yard, staring into space), interaction changes with family members (e.g., not wanting to be petted, not greeting the family at the door), sleep and activity pattern changes (e.g., being awake at night, aimless wandering), and housetraining problems (e.g., having accidents in the house, even in front of family members; not asking to go out).(1) Introducing Anipryl for Dogs with CDS But now there is hope for dogs with canine Cognitive Dysfunction Syndrome. The Food and Drug Administration (FDA) has approved Anipryl~ (selegiline hydrochloride), the first and only FDA-approved medication to help control the clinical signs associated with canine Cognitive Dysfunction Syndrome.

Anipryl can help restore the bond between senior dogs and their families because the behavior problems associated with CDS can damage or destroy a relationship that is built up over many years.

What is CDS?

As a dog ages, its brain undergoes physical and metabolic changes that can result in the signs associated with CDS. Neurotransmitters in the brain chemical substances that act as messengers between nerve cells -- may be altered in dogs with CDS.

The activity of the enzyme monoamine oxidase type B (MAOB) may increase in the brains of older dogs, as in other species. MAOB metabolizes dopamine, one of several neurotransmitters believed to play a role in the prefrontal cortex, the part of the brain involved in cognition, learning and memory; as well as in the hippocampus, the part of the brain important in transferring information throughout different parts of the brain.(1) Altering neurotransmitter activity by reducing MAOB levels may help control the clinical signs of CDS.

Anipryl's Modes of Action

"Like many medications, the exact mode of action is unknown, but we believe Anipryl works through multiple modes of action to control the clinical signs of CDS," says Dr. Edward Kanara, Director of Technical Services, Pfizer Animal Health. "Anipryl inhibits MAOB and potentially helps restore dopamine activities to normal in the synaptic cleft by first increasing the amount of neurotransmitter released, and then by decreasing their uptake. And it may decrease free radical production by inhibiting MAOB and increasing free radical removal."

Helping Dogs Age More Successfully

In the past, dog owners may have felt a sense of frustration because they did not realize that there was anything they could do to control what they assumed was normal aging in their older dogs. For these owners and their senior dogs, one solution may be speaking with their veterinarians about management options like Anipryl.

"Clients who come in with dogs that have CDS are sad, frustrated, and they feel very helpless," says Dr. Cheryl Jones, State Line Animal Hospital, Leawood, Kan. "With Anipryl, we are able to offer hope to these owners. I've seen dogs, after being given Anipryl, that recognize their family members again. They're more alert, and they recognize their surroundings. These dogs become functioning members of the family again.

"We have had many success stories, but•one that sticks in my mind is an old Brittany spaniel," adds Jones. "Before Anipryl, he was staring into space, and didn't know where he was or who his family was. After a short time on Anipryl, this dog became more like his old self. I know the medication improved the family's quality of life and, I assume, the dog's."

Tell Your Veterinarian about Behavior Changes in Your Dog

Dog owners play a key role in recognition of the signs of CDS. They see the behavioral signs at home, and recognize the changes taking place in their dogs. "The pet owner is the only one who can help us make the diagnosis," says Dr. Gary Landsberg, Doncaster Animal Clinic, Thornhill, Ontario, Canada. "You're not going to pick up on the signs of CDS during a routine examination. They are things that you will pick up on history, and even then, the owner might not volunteer the information without delving right into the specific questions.

"Owners often think of these changes as part of the normal aging process and think that nothing can be done," adds Landsberg. "But the sooner we know about the signs, the sooner we can identify any underlying medical condition, and the sooner we can get the dogs back to being part of their families."

Even if an owner isn't sure about the severity of a problem, it's important to take the dog to the veterinarian more frequently as a dog ages. "Older dogs are likely to experience more health problems," says Kanara. "Senior dogs should be observed very closely by owners and their veterinarians, because changes in normal appearance, activity and behavior can all be signs that something is wrong."

Anipryl Can Give Old Dogs a New Lease on Life

Many dogs have been given a new lease on life with Anipryl.

"A couple of years ago, Holly, my English cocker spaniel, began to get confusebegan to get confused. She couldn't find her way back into the house, she stared into space, she didn't seem to know where she was," says Moira Liskovec, Ellicott City, Md.

"Within a few days of beginning on Anipryl, we noticed some positive changes in Holly, and within three or four weeks, we had the old Holly back," adds Liskovec. Without the medication, I don't believe we would still have Holly here, but with Anipryl, I can see Holly being with us for several years to come, a happy, bouncy dog."

"When our cocker mix Happy's condition was identified as CDS, I was depressed -- I was afraid we were going to lose him. When you have a dog with CDS, you become a very dedicated caregiver," says Brenda Otte, Leawood, Kan. "When I first learned about Anipryl from my husband, a veterinarian, I was thrilled. It didn't take long on Anipryl before the light came back in Happy's eyes. I think the change was miraculous."

"As dog owners, we have learned to accept changes in our senior dogs as part of normal aging," says Dr. Ilana Reisner, veterinary behavior consultant, Brooktondale, N.Y. "That' s no longer the case. Anipryl can be a valuable tool to help people regain the attachment owners have with their senior dogs."

Important Safety Information

Anipryl is available by prescription only from a licensed veterinarian. In studies, the most common side effects were vomiting, diarrhea or changes in behavior such as hyperactivity and restlessness. Most side effects were mild to moderate. In a placebo-controlled study, most of the adverse events in dogs treated with Anipryl were also observed in placebo-treated dogs, although the rates in placebo-treated dogs were lower. As dogs grow older, they are likely to experience more health problems. Senior dogs should be observed more closely because changes in normal appearance, activity and behavior all can be signs that veterinary attention may be needed. Consult your veterinarian before using Anipryl with other medications or with tick collars.

Anipryl Controls the Signs of CDS

The efficacy of Anipryl was evaluated in clinical studies. In these clinical studies, improvement in individual signs was assessed through observations by owners. Because CDS is a syndrome (i.e., a collection of signs), no two dogs will show exactly the same signs at exactly the same severity.

In clinical studies, owners reported that 69 percent to 75 percent of dogs improved in at least one clinical sign after one month of Anipryl therapy. In the blinded, placebo- controlled clinical study, owners reported that 69 percent of dogmonth of Anipryl therapy. In the blinded, placebo- controlled clinical study, owners reported that 69 percent of dogs improved in at least one clinical after one month of therapy, compared to 52 percent of placebo-treated dogs. A second open-label clinical study revealed that 7•5 percent of dogs improved in at least one clinical sign after one month of Anipryl therapy.

Anipryl Usage

Anipryl tablets are available in strengths of 2, 5, 10, 15 and 30 mg, in packages of 30 tablets each, enough for a month's supply. Following a behavioral history and appropriate medical evaluation, Anipryl administration is initiated at a dose of 0.5-1.0 mg/kg body weight orally once daily, preferably in the morning. Initially, dogs should be dosed to the nearest whole tablet. Most dogs can be dosed with only one tablet once a day. Anipryl can be given with food.

For Additional Information

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1 Ruehl WW, Hart BL: Canine Cognitive Dysfunction. In: Psychopharmacology of Animal Behavior Disorders (Dodman NH, Shuster L, eds.). Boston: Blackwell Scientific, 1998; pp. 283-304.

2 Proprietary market research, 1998; pet owner sample: 255; data on file, Pfizer Animal Health.

3 Neilson JC, Hart BL, Ruehl WW: Cited in Hart BL, Hart LA: Selecting, Raising and Caring for Dogs to Avoid Problem Aggression. J. Am. Vet. Med. Assoc. 210(8.): 1129-1134; 1997.

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