Does your dog suffer from doggy dementia? Take this survey to find out! The estimated prevalence of Canine Cognitive Dysfunction (CCD) generally varies between 14% and 35% of the pet dog population. CCD is likely more common than what these numbers suggest due to many undiagnosed cases. The incidence of CCD is likely underestimated because many pet owners “suffer in silence” or consider senility to be a normal part of aging - but it doesn’t have to be. Ask your veterinarian if CogniCaps is right for your dog. At night, is your dog awake and seem restless or pace? 0 0Never 1 1Once a week 2 2Several times a week 3 3Every night None Has your dog become more vocal at night? 0 0Never 1 1Occasionally 2 2Often 3 3Every night None Does your dog defecate or urinate inside or doesn’t properly signal to go outside? 0 0Never 1 1Once a week 2 2Several times a week 3 3Daily None Does your dog have a decreased interest in normal activities including greeting you or showing affection? 0 0None 1 1Mild 2 2Moderate 3 3Severe None Does your pet show anxiety or fear when entering a new environment? 0 0No fear 1 1Mildly fearful 2 2Moderately fearful 3 3Severely fearful None Does your pet become anxious when you leave it alone? 0 0Not anxious 1 1Mildly anxious 2 2Moderately anxious 3 3Severely anxious None Has your dog become more irritable/fearful/aggressive with visitors, family or other animals during social interactions? 0 0No 1 1Slightly 2 2Moderately 3 3Severely None Have you noticed that your dog gets distracted more easily? 0 0No 1 1Occasionally 2 2Often 3 3Always None Does your pet display a lack of interest in playing with toys, family members, or other pets? 0 0No 1 1Sometimes 2 2Often 3 3Always None Do you find your pet aimlessly pacing or wandering? 0 0No 1 1Sometimes 2 2Often 3 3Always None Has your pet become more reactive or fearful to visual or audio signals? 0 0No 1 1Sometimes 2 2Often 3 3Always None Has your dog become less responsive to its name and basic commands? (Score as 0=No , 1=Sometimes, 2=Often, 3=Always) 0 0No 1 1Sometimes 2 2Often 3 3Always None Does your pet exhibit repetitive behaviors, e.g., circling, getting “stuck”, chewing, licking, star gazing? (Score as 0=No , 1=Sometimes, 2=Often, 3=Always) 0 0No 1 1Sometimes 2 2Often 3 3Always None How old is your dog? Gender Male Male Female Female None Is your dog neutered/spayed/castrated? Yes Yes No No None What is the breed of your pet? Regarding your pet's weight, which of the following is true? My dog is under weight My dog is at it's target weight My dog is over weight None Please describe your pet's diet Daily Exercise/Activity Extremely Active 2+ hours of activity a day Very Active 1-2 hours of activity a day Active 30-60 minutes of activity a day Not Very Active 10-30 minutes daily activity Sedentary (goes on walks to go to the bathroom) None How would you describe your pet's health given it's age? Unhealthy Generally healthy Perfect bill of health None I agree to terms and conditions of this website. *Your Name *Your Email Check this box to create a free account and track your pet's results over time. (Results cannot be tracked over time if you uncheck this box.) Time's up
