Veterinary Medicine - July 2008 - (Page V6)

S-adenosylmethionine (SAMe) and cognitive dysfunction in dogs Table 2. Study results: Improvement in total mental score and geriatric disability index as measured on Day 60 depression exhibit abnormalities. Although right now we don’t have a good test for depression or for predicting whether SAMe will be e ective, the current investigations are promising. In a few years, I think we will start seeing practical data that we can use to manage our patients. Clinical and behavioral examinations were performed on Days 0, 30, and 60. A standardized behavior questionnaire with 12 items was completed by the attending veterinarian on the basis of information given by the owners. The most common clinical signs reported are listed in Table 1, page 5. Each clinical sign was scored using a scale of 0 to 3 according to the intensity and all scores were added to calculate a total mental score. In addition, a case-speci c disability questionnaire was developed with each dog owner, who identi ed up to four unique observable problems. These clinical signs were assessed by the dog owners and also scored 0 to 3 points according the gravity of the problem on Day 0 and each following week during the two-month study period. The sum of these scores was called the geriatric disability index. The average age at which agerelated problems appeared was 10.4 years. Ten dogs had a stable chronic condition that included one or more of the following behaviors; separation anxiety, storm phobia, tendency to run away, di culty interacting with other pets, or epilepsy. Five dogs had a history of previous treatment for cognitive dysfunction with vincamine, papaverine, clomipramine, or selegiline. Five di erent dogs had low levels of free T4 on Day 0 that was not treated because of lack of attributable clinical signs. More dogs being treated with Novi t responded favorably than those being treated with a placebo tablet, as measured by improvement in total mental score and geriatric disability index (Table 2). For the dogs treated with Novi t, 11 out of 17 dogs (64.7%) showed a fair or good response to treatment (Table 1, page 7). Only seven out of 19 dogs (36.8%) treated with the placebo showed a fair or good response to treatment. After two months of Novi t supplementation, the average improvement in the level of activity was 57.1%. The average improvement in the level of awareness was 59.5%. The improvement in number of learned behaviors, most notably elimination behavior was Noviﬁt Total mental score Geriatric disability index 44.1% 49.0% Placebo 24.7% 23.9% the apathetic state. However, more commonly we see signs of agitation, sleep-wake cycle changes, and lack of responsiveness to their owners. Could SAMe be able to target these areas? Mischoulon: Absolutely. All of those signs are common in major depression and in dementia. Because people with depression can have their symptoms alleviated by SAMe, I would expect similar bene ts in animals with those signs. Landsberg: Is there is any clinical or laboratory test that might indicate depression or when SAMe might be of bene t for people or animals? Mischoulon: One of the holy grails of psychiatry has been to develop an objective test for depression. But Application of SAMe (Novi t®) in clinical practice Landsberg: Novi t is licensed as a SAMe product in Europe. Dr. Dramard, please describe your recent clinical study of Novi t. Dramard: One clinical trial was conducted in 2005 in France, Belgium, and Spain to evaluate whether Novi t could be used to manage declining cognitive function in senior dogs. Thirty-six dogs over 8 years of age were chosen for the study. All dogs displayed two or more of the following behavioral signs: disorientation, confusion, learning de cits, decreased alertness, decreased activity, decreased social interaction, changes in sleep-wake cycle, housesoiling, and anxiety for at least one month. Exclusion criteria were incapacitating disease, clinical infections, and the use of psychotropic “More dogs being treated with Novi t responded favorably than those being treated with a placebo ” - Dr. Valerie Dramard for now the gold standard is still the clinical interview. Throughout the years, di erent biochemical approaches have been tried, such as the dexamethasone suppression test or measurement of the metabolites of serotonin, dopamine, and norepinephrine. All of these tests lack sensitivity and speci city. A lot of people with depression have normal pro les, and a lot of people without drugs, pheromones, or nutraceutical speci c diets to improve behavior in the previous months. Study dogs were administered one weight-appropriate Novi t tablet per day directly by mouth or with a small quantity of food. The minimum SAMe dose administered was 18 mg/ kg/day. Any other modality to address behavioral problems was forbidden. 6

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Veterinary Medicine - July 2008 Contents Leading Off Practical Matters Idea Exchange Clarification Dental Corner The Diagnostic Approach to Hematuria Guidelines for Evaluating Hypercalcemic Cats CE Form Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - July 2008

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