3572 Shoreline Drive, Wayzata MN 55391

Call or text (952) 471-0911

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2125 Commerce Blvd. Mound, Minnesota 55364

Call or text (952) 472-4900

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Senior Canine Cognitive Assessment Form

All required fields are marked {*}

  • DISHAA is a tool to help you and veterinarians assess the mental acuity of your dog, and for veterinarians to potentially diagnose Cognitive Dysfunction Syndrome (CDS).
  • MM slash DD slash YYYY
  • Please complete this canine senior pet cognitive assessment. If you’ve noticed changes in multiple behavioral categories, be sure to talk to your veterinarian today about the health of your pet’s aging brain.
  • Behavioral Signs

    Identify signs that have arisen or progressed since 8 years of age and older. Score as 0=none, 1=mild, 2=moderate, 3=severe
  • Social Interactions

  • Sleep /Wake Cycles

  • Housesoiling, Learning and Memory

  • Activity

  • Anxiety

  • This field is for validation purposes and should be left unchanged.

Once this form is completed, your veterinarian will determine the cause of these signs through a physical examination and recommended diagnostic tests. However, even if your senior pet is experiencing multiple health issues associated with aging, there may be some degree of CDS.

A score of 4-15 is consistent with mild, 16-33 is moderate, and >33 is severe CDS.