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2595 Portage Avenue Winnipeg, Manitoba R3J 0P5
(204) 832-1368


If your pet is showing signs of aging and you are unsure what you can do to improve his/her quality of life, this online assessment will provide some insight and allow us to help guide you with suggestions tailored to your pet's specific needs.

This checklist will identify behaviour changes signaling any deterioration in alertness and health. Revealing potential problems early can greatly rejuvenate your pet both mentally and physically, often with simple changes in environment or medication.

Pro Tip: If your pet is due for an annual examination it is helpful to submit this information prior to your visit!

Client Information

Patient Information


Please identify signs that have arisen / progressed since 8 years of age (and older) to help evaluate your pet's mental acuity.

SCORE: 0-none, 1-mild, 2-moderate, 3-severe


Social Interactions

Sleep / Wake Cylcles

Housesoiling, Learning



A score of 4 - 15 is consistent with mild, 16 - 33 is moderate, and 33 or more is considered severe cognitive dysfunction syndrome.

Once this form is completed your veterinarian will discuss with you the cause of these signs and recommend appropriate treatment or diagnostic testing. Please allow a few days for our veterinarians to compile the necessary information and contact you.

Veterinary Topics