Featuring Demian Dressler, DVM and Susan Ettinger, DVM, Dip. ACVIM (Oncology), authors of The Dog Cancer Survival Guide.

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Signs of Brain Cancer In Dogs

Tumors in the brain are very tough for us in veterinary medicine today. There are two reasons for this.  One is that they are hard to diagnose without advanced imaging like CT or MRI.  These are not available to everyone, since many do not live within a reasonable distance, and they are not cheap.

The second reason is they are hard to treat.

Let’s look at both of these topics.  First, how would a vet suspect a brain tumor in a dog without the use of one of these imaging tools?

I would like to introduce some words to you.  One is “unilateral.”  When a medical problem is unilateral, it means it is occurring on only one side.  There is a phrase that you should know as well: “space occupying lesion”.  A space occupying lesion means that the problem takes up space and most commonly displaces or puts pressure on the surrounding tissue.

One of the very first things a vet will do is try to decide where in the body the problem is going on.  This is called the “anatomical diagnosis”.  We try to pinpoint the organ, tissue or system that we believe is the location of the issue in the body.

Next,  vets will usually come up with a list of possible disorders that could affect that area.  These are the “differential diagnoses,” which means a list of different possibilities that are ranked in order of what is most likely to what is least likely.

When we create these possibility lists, we will use information about the dog to help narrow them down and rank them.  Age is a big one.  Certain diseases are more common in young dogs and certain are more common in older dogs.  Breed is another since certain breeds are more prone to certain problems.

Sex is another, and whether a dog has been spayed or neutered.  All of these things impact probabilities.

The history you give a vet will also help. Did the problem start suddenly or slowly?  What about appetite, thirst, and other signs of illness? Is it worsening?

Is there weight loss?

The physical exam helps a lot.  Here is where the rubber meets the road with brain cancer, and the words you learned above come into play.

When we think about brain cancer, most of the time the dogs will have some sort of brain sign.  These include seizures, blindness, and other obvious signs like that.  (Note that other body parts can be diseased and produce these signs.)

Now, one key point your vet may pick up is that the brain signs in a dog are unilateral- they issue seems to be affecting one side more than the other.  When this occurs, there is some assymetry going on.  One side is different from the other.

Perhaps we have a loss of coordination, but it affects the left side more than the right side.  Or maybe a pupil is dilated or constricted in the right eye but not the left.  Possibly the retina (seen by looking in the eyeball) looks different on one side.  Could be there is a droop or weakness in the muscles of the face.

These all point to things that are assymetrical.

If it looks like the problem is in the brain (which is concluded after laboratory testing), there are not many common brain problems in dogs that affect one area of the brain but not other areas.  One of the most common is a space occupying lesion, or a tumor.

But wait!  Other things can do it too.  For example, a stroke (vascular accident) can sometimes happen in dogs.  A common one is a problem with the vestibular system, which is responsible for keeping balance. This is called geriatric vestibular syndrome. Rarely, inflammation or infections can do it.  These all can have signs that affect either the left or right side of the body.

Now, more information can be gathered to help sort these things out.  A critical piece of information for us is what is happening with the problem over time.  Strokes most commonly stay the same severity or get better.  Geriatric vestibular syndrome almost always gets better.

Tumors however do not.  They progress.  Inflammation and infections in the brain get worse too.

Most of the time one can rule out the majority of the brain inflammation and infections with blood work and a spinal tap.

So if the problem is pointing to brain (the organ), in an older dog, and it seems like it looks assymetrical (affecting a single area but not the adjacent area), it is progressing over time, and lab testing rules out the other things that can look like it, we are left with brain tumor as number one.

This is how vets will sometimes talk about brain tumors without the benefit of a CT or MRI. They are talking about the highest probability.

As far as treatment is concerned, doing brain surgery on dogs is not routinely done simply because most of the time the technique has not been well worked out.  There are some rare neurosurgeons out there that have done it successfully but they are few and far between.

However, there is a new technology out there in New York that can help.  Dr. Sue Ettinger, an oncologist who is working with me on the second edition of The Dog Cancer Survival Guide, works at The Animal Specialty Center. The facility houses the most sophisticated tool for treating brain tumors in dogs in the country.

It is called the Cyberknife.  The apparatus is capable of directing many small doses of radiation at brain tumors in dogs from multiple directions during the treatment, in an effort to destroy the tumor without harming the patient.

Other approaches I discuss with my clients in the Guide include diet, supplements like Apocaps, life quality enhancement, touch therapies, and considering homeopathy.  A closer look at homeopathy in brain tumors, in particular gliomas, can be found here.

Please keep your vet involved in all steps in your dog’s treatment plan.

Best,

Dr D

About the Author: Demian Dressler, DVM


Dr. Demian Dressler, DVM is known as the "dog cancer vet" and is author of Dog Cancer Survival Guide: Full Spectrum Treatments to Optimize Your Dog's Life Quality and Longevity. Visit his blog and sign up free to get the latest information about canine cancer. Go to http://www.DogCancerBlog.com.

  • LisaT

    I recently lost my girl to what we think was a brain lesion, most likely a brain stem tumor.

    Three years ago she had a mast cell tumor removed from her shoulder. It was actually a cluster of 5, Stage II, with low mitotic figures. The margins were clean, but not as wide as the vet would have liked.

    Can a mast cell tumor metastasize to the brain?

  • http://DogCancerBlog.com DemianDressler

    Dear Lisa,
    it is possible that a mast cell tumor would spread to the brain. Usually they go elsewhere though. At this stage the truth is that it is really very difficult to know for sure without some further testing, or (and this is pretty hard to think about for many) a necropsy.
    Thinking of you during this difficult time,
    Dr D

  • Nadine

    I lost my beloved heart & soul doggie Keelee to a brainstem tumor in 2008. As you mentioned above, the analysis first indicated vestibular syndrome – but after a couple of weeks went by with no improvement, we went to a neurologist who did some neurological testing. Her diagnosis – brainstem tumor. We could have done the MRI, but it was felt that surgery was not an option at age 12 1/2. Keelee & I shared one more month together (after the diagnosis) and I made the painful decision on 5/22/2008 to give her peace.

    Run free my sweet Keelee…

  • LisaT

    Thank you both so much for the feedback. My girl went quickly downhill in a matter of about a week and a half. I suspect that other measures I was doing may have kept things in check until it just grew too large. She was already on an anti-cancer regimen, received chiropractor care, etc. But in hindsight, there are always regrets, and always the feeling that there was something else that could have been done.

    Dr. D, as always, I appreciate the ongoing information in the blog.

  • Jason

    Hi there,

    I have a miniature schnauzer by the name of Sumo. 4 days ago, he started getting really lethargic and slow. Though his bowel movements were still good and he had good appetite, we noticed a couple of disturbing behavior. He wouldn’t pick up food from the floor and would retract back when we tried to pat him on the head… something he has never done in the past 10 years. He would lie down a lot and would yelp occasionally when we tried to move him. His nose was leathery and dry and he would lick the air periodically. 2 days ago, as my mum was coaxing him to get some food, he arched his back and stiffened his neck and rolled over. We rushed him to a vet. He rolled over again just outside the vet. The vets there manage to stabilize him and diagnosed him as having a very low potassium levels. (1. something I think when the usual is three). He was stabilized and is resting at the vet’s clinic now. He was much better yesterday but didn’t look to good today. He had shows head tilt (but he is suffering from a slight ear infection on that side) and walks really slowly. what’s worrying is that my mum is certain that is right eye isn’t focusing. He had a toe (right back) removed because of a tumor (myeloma) there. The vet there thinks that it might be something to do with the spine or abdomen but I think something is more sinister at work… is there anything else I need to look out for?

    • http://DogCancerBlog.com DemianDressler

      Dear Jason
      Sounds like a seizure or geriatric vestibular disease…If it is the latter, they usually resolve given time. If no resolution you will need more diagnostics. I would imagine X-rays of the chest and an abdominal ultrasound were taken? Was a urine specimen evaluated? If there is indeed a brain or inner ear problem, unfortunately we need skull films, CT and/or MRI… We need more information at this stage if things are going downhill.
      Good luck
      Dr D

  • Andi

    My dog is a Beautiful Golden Retriever named Bilbo, He has recently started acting different. He will lay and wine and we do not know what is wrong. He has stopped looking at us in the face. He used to live to play catch but now he can’t play with out tripping and falling. He paces in the yard as if he does not know what he wants. He sleeps a lot. He still is eating but has lost 8 lbs. We took him to the vet and they took blood, did X-rays and a urine test. They said they did not see anything out of the ordinary. They also suggested we have a cat-scan and MRI. They said it could be a brain legion. We do not have the money for the treatment. Is there anything else we could do?

  • SueC

    My dog Barney has had 2 seizures in 4 months the last one only a week ago he doesn’t see the same little dog anymore he won’t jump on the couch he doesn’t use the dog door he lies down a lot and seems to have no energy he’s been to our vet and has had blood taken they came back normal could this mean he might have a brain tumor he’s 6/12 years old

  • http://www.google.com flower

    You must consult your veteranarian if your dog:
    * becomes weak
    * stops eating
    * repeatedly vomits
    * walks in circles in only one direction
    * seems oblivious to its surroundings
    * tilts its head
    * excessively drools
    * loses bladder and bowel control

  • http://maxck.blogspot.com Christine

    HI Dr. Dressler
    Thank you for posting this! My dog Max was diagnosed with a couple of inoperable brain tumors (meningiomas) last year. His symptoms were 1) getting slower on walks, 2) a little lethargic and less interested in what was going on 3) he started to lose his hearing 4) he started to lose his eye sight 5) then one day he was starring at his reflection in the window at night and his head suddenly tilted sideways and he could no longer walk straight. He walked in circles and they’d get tighter and tighter until he fell over. We treated him with homeopathy, chinese herbs, acupuncture and diet and prednisone at first after seeing our neurologist and holistic vet, and it helped tremendously, but only for a period of time. In Sept, we took him up to the Animal Specialty Center to undergo Cyber knife treatments. He is doing fantastic now! He’s 19 and is now chasing bikers, joggers and wrestling with puppies and is back to walking a couple of miles a day! When we decided to try the Cyber knife treatments, I couldn’t find any information out there about dogs who underwent it. I had met a woman 3 or 4 years ago at the neurologists office when another one of my dogs was getting a check up for something else and her dog had undergone Cyber knife and she was amazed at the results, but that was all I knew. I ended up starting a blog to document what Max had gone through and is and will go through. It includes photos and videos if anyone is interested and wondering about Cyber Knife. Based on my experience, without a doubt I made the right decision for Max to undergo Cyber knife. It’s a non-invasive procedure (despite the word “knife”), If anyone is considering Cyber knife, please feel free to see what Max has gone through /is going through http://maxck.blogspot.com

    Thank you for posting this blog posting!

    Chris

  • Heather

    Hi,
    My dog Rosie, recently had a seizure. We brought her to the vet and they had suspected Insulinoma because her blood sugar was low, had chest xrays, U/s done and all looked good. I was finally referred to a neurologist where she had an MRI done, they found hydrocephalus and Cerebral Edema, she said she saw something in the cerebllum but could not distinguish whether it was a tumor or not???? She also did not know why her blood sugar was low, although it was fine in her office that day. I thought by getting the MRI they would be able to distinguish a tumor???. She sent her home with prednisone and she did great and felt much better for a few days but seemed a bit fatigued and not herself after that. A couple of weeks later she yelped out a couple of times one of the times she was going up the stairs to get on the bed and froze on the bed and cried then ran off the bed got on her bed on the floor, peed in it and laid down with heavy respirations all night. I made her comfortable and took her to the neurologist the next morning, she thought maybe she might be having joint pain because she said Rosie looked good, I know my Rosie and she did not look “good”. She manipulated her joints but Rosie never yelped out, she prescribed her tramadol for the pain. Once we left and she jumped in the car she cried and laid down with a faraway look on her face.
    I thought the tramadol was helping because she did not cry out yesterday but rather was really knocked out from it. Last night she laid in the kitchen on the tile and did not want to get up, I coaxed her over to her bed with a treat and she got up, once she got to her bed she became wobbly and drooled a bit and walked out of her kennel kinda like a clidesdale. Then she went and laid down on the tile again. She seems very dizzy, holds head down like she did before we had taken her to neurologist and cant walk around for too long without getting dizzy (Im guessing dizzy because thats what it looks like) Im not sure if that was another seizure or what or just a dizzy spell…I am at a lost and don’t know what to do…any advice would be appreciated, she means the world to me and I don’t want to see her suffer. Please Help.

  • fiona

    I have a 5 year old cavalier king Charles spaniel, 2 years ago he had a fit and we have not seen it happen again till last week, he has had four fits in one week, though the vet is clueless at the moment as to what it is exactly. he will lose control of his limbs, unable to stand, he sometimes can’t move one side of his body suggesting stroke..but once he comes out of the fit hes back running around like nothing has happened, he hasn’t wet himself or vomited during or after though he did have a high temp…could he have a tumor? And this be a deterioration ?

  • Lisa

    I have a 10 y/o boxer. Within the last 3 months she has gone completely blind. The mobile vet said he thought it was nulelar schlerosis. However, she has become so anxious acting within the last two weeks that he has now put her on a depression medication. I am afraid I am prolonging the inevitable by not having her put down. She shakes and tremble including twitches of her head. The medication just makes her sleep for hours on end and when she wakes up she still so pitiful. Her appetite has dramatically decreased as well. I just have to coax her to go to the bathroom or eat anymore. What is your opinion? Should I go ahead and allow her to be at peace? Do you think she will last much longer and do you think might be cancer? I am just really upset and feel like I have no where to turn. Thank you!

  • Karen

    I just found out that my dog of 10 years probably has brain cancer and I am going to assess every week and as long as she is not in pain she will stay with me. I would never let her feel pain and at the first sign of anything I will look after her with love and let her go.

  • Helen Bradbury

    I had a 9 year old white boxer called poppy who was put to sleep yesterday following a brain tumour diagnosis,I wasn’t aware of a treatment called Cyber Knife-is this treatment available in the U.K?,my vet prescribed a trial treatment of steroids but poppy’s symptoms remained the same but when she started whining + smacking her head into doors I didn’t want her to suffer any longer. I was also concerned to further problems affecting poppy from the tumour: seizures or blindness. I keep questioning my decision + hope I have done right by my. Dog?

    • Dr. Susan Ettinger

      HI Helen,
      Sorry about Poppy. I am not aware of CyberKnife or another form of radiosurgery in the UK, but I would check with an oncologist to be sure. If not conventional radiation may still be a good option. Again, I recommend consultation with and oncologist or a neurologist.
      Good luck! All my best, Dr Sue

  • Susan

    Dear Dr.
    I have a 12 year old female boxer. She has a Metastasis on her side about the size of a small cantaloupe or extra large grapefruit. Last night @ 2:30 am, she had a grand Mal seizure which lasted about 10 minutes, but at least 20 more to be somewhat coherent. Once we got her up to go outside, she just wandered outside and when she came in she continued to pace, run into things, pant heavily, and would not lay down . I thought of giving her a Benedryl to maybe help her sleep and it did work after about 40 minutes. This was about 4:20am by then. Just 2 days ago, she was eating, actually running outside since it has been cooler, moving her bowels, etc. What can I expect at this point? I am so afraid of having her longer with me and that she could be in pain, etc. I had to put down my last dog of 15 years and it practically destroyed me. I just do not want to have to do that again. I always hoped she would just pass away on her own. I hope you have some words of wisdom for me. I did refuse to have the tumor removed since she is up there in years, and she seems to stress so much just going to the vet.
    Thank you,
    Sue

  • Elle T.

    Dear Dr. Dressler,

    My dog became aggressive towards my other pets and me about six months ago. He was always sort of curmudgeonly, and had also bitten on a couple of occasions (when he was startled – not just indiscriminately.) His new aggression also seemed to be fear-based but was more extreme. He is approx. 11 years old but could be older (when I adopted him 8 years ago they estimated his age to be 2 -3.)

    Blood tests and the like showed there was nothing wrong with him, although he has not, I feel, been thoroughly examined otherwise because of his aggression. I took him to two different vets and a neurologist. No-one checked his eyes, and I now believe he is at least partially blind, which I am wondering might not be a cause of the aggression. I think he is also partially deaf. No-one checked his hearing either. He has gotten lost in the garden and stands sometimes at the hinge side of the door, that sort of thing. But I haven’t observed any “brain tumor-y” symptoms. He has fallen off the dog stairs up to the couch because he has veered off the steps – I now believe that is because he can’t see them. One thing he does that really stresses me out is he will stand for long periods of time, almost falling asleep on his feet. Sometimes I am successful in getting him to lie down; other times he gets angry so I have to just let him stand and try again later. He can be standing around, swaying on his feet, and then when I get the leash to take him for a walk, suddenly he’s energized and perfectly co-ordinated (not that he isn’t co-ordinated otherwise, but he looks weird just standing there.) He walks fine, although he stumbles when he doesn’t see certain things, and when we get home he puts on the brakes and refuses to move. He was put on prozac a couple of months ago and that has helped with his aggression I feel, but he still has issues. When I went to the neurologist, he said the only way to tell if he had a brain tumor was an $1800 MRI, which I don’t have the money for. He said he could not, of course, make a diagnosis without that but he seemed to think it was probably a brain tumor, based mostly it seems on the “change in behaviour” – that is, the aggression. Because they couldn’t touch him, they said they couldn’t do a proper neurological exam and they really didn’t tell me anything else. He doesn’t have any unilateral issues – the word “unilateral” didn’t even come into it, so they didn’t even know that. I just feel that he has not been properly examined. I’m not convinced he has a tumor – I’m wondering if the eye issues precipitated the aggression instead of a brain tumor causing the aggression and the eye issues. Do you have any suggestion as to what I should do next? I have considered taking him to a different neurologist and getting his eyes and ears looked at. I have also considered seeing a vet. behaviourist to find out if perhaps we should try anipryl for dementia instead of prozac. Or perhaps it really is a brain tumor. I just want to make him feel as safe and comfortable and happy as possible, and I don’t feel I can do that until we get to the bottom of this. Thank you so much in advance!

  • Linda

    Heather: Your dog may indeed have insulinoma. If you haven’t already done this, you must get a paired glucose/insulin test to check what her insulin level is when her blood sugar is low. High insulin when the blood sugar is low indicates insulinoma. That would account for the seizure and the “dizzy” behavior – when a dog has a hypoglycemic episode it will act “drunk”, stagger around, have glassy eyes – that sort of thing. Insulinoma is not curable but is treatable. I highly recommend checking this yahoo group out: http://pets.groups.yahoo.com/group/insulinomadogs/
    I cannot recommend this more highly. All the information and advice you need is here as well as incredible help and support from dog owners whose dogs have or have had insulinoma. My other dog has insulinoma and with surgery and now palladia she is doing well 2 years post-diagnosis. But there are several other options as well. However, you must get on it right away! Insulinoma is not common and many vets don’t know how to recognize it, never mind how to treat it properly. Read the info. on this insulinoma dog group page and get a vet/oncologist who knows what to do.
    When my dog was showing symptoms, my vet first thought it was probably a brain tumor, but she realized pretty quickly from my dog’s blood sugar (and a subsequent glucose/insulin test) that it was insulinoma. So it’s not uncommon for vets to mistake insulinoma for brain tumors.
    You posted a couple of months ago so you’ve probably figured this all out by now, but if that’s true perhaps this info will help someone else…

  • Emily

    Dear Dr. Dressler,
    My beagle, Toby, approx 12, suddenly had muscle atrophy on the left side of his head close to the top of his scull and below his eye. His bloodwork, abdominal X-ray, and abdominal ultrasound were all normal. He did have a slightly large liver. He is taking prozac( which he started about 3 months ago). He has always been schitzy dog but had an emotional breakdown when we were evacuated due to Hurricane Sandy. The vet put him on the Prozac then. Since the muscle atrophy about 3 weeks ago, he has been banging his head into everything, rubbing it everywhere he goes. He is currently taking prendisone, Prozac, and tramadol. He was very lame before the prendisone now very ravenous and aggressive. He did take a round of antibiotics too. Looks like he has a brain tumor, maybe a trigeminal nerve sheath tumor. I just want him to be comfortable. What can I do to help him?

  • Natalie

    We lost our baby boy Bubba to what we were told was advanced brain cancer :( there were no signs or symptoms, he had seizures back to back for days and they were getting closer and lasting longer each time, he was almost 8 years old :( we were told there was nothing we could do for him so we had to make the hardest decision ever to let him cross to the rainbow bridge 3-27-12 I will never forget that date :( we still miss him so much! He was a golden retriever male and we were told golden retrievers are prone to different cancers. We were told there was nothing we could do since we live in Alaska there isn’t any surgeries to treat brain cancer in dogs here, we all still miss him so much.

    • Dr. Susan Ettinger

      Natalie,
      Thinking of you. Sorry for your loss of Bubba.
      With sympathy, Dr Sue

  • Emily

    It’s me and Toby again. It’s been a month since my last post. Toby has been pretty good on steroids and tramadol daily but his left eye cornea is starting to cave in slightly with a large white hue covering most of his pupil. Any thoughts, anyone out there, please?

    • Dr. Demian Dressler

      Emily, I am sorry to say there are a variety of issues that could cause this. If it is really his cornea, it could be an ulcer of his cornea, uveitis (which has different causes), or there may a problem with the orbit (where the eye sits). I am sorry but this is impossible to diagnose over the internet…sorry…you’ll have to get someone with hands on the dog to help directly…
      Best D

  • http://www.facebook.com/savemyjill Lester Kwok

    Dr D;

    Most vet in Singapore has given up hope on Jill (please see her scans at https://www.facebook.com/media/set/?set=a.328650887261266.1073741831.298306850295670&type=1&l=a15502729b)

    All vets treating her only want to put her to sleep except for Dr Ly. He has taken a personal interest in her (see http://www.facebook.com/savemyjill).

    He is puzzled with why Jill has not been showing any sort of pain, signs and symptoms of brain cancer. Jill is on most supplements recommended for cancer treatment and also BARF diet. One additional thing Jill is on is O2 therapy. I am a diving instructor and I have access to medical grade O2 used for decompression treatments. I have placed Jill in O2 cages and “helmets”. Using a the calculation of 100% exposure of O2, I have derived a short formula for her without risking her to Oxygen toxicity.

    Dr Ly is now wondering about it. Is it O2, or the Nanodiamond treatment for cancer that I am putting Jill on, or is it the supplements. He has advised not to go for any more MRI or CT scans but I am rather skeptical about not sending her for scans. Without the scans, I will not be able to judge or gauge her condition anymore.

    What do you suggest?

  • Margo C

    Our 10 year old lab has been diagnosed with dementia or a brain tumor. We ruled out everything else with blood work, and because of his age, CT/MRI is too risky for him to go under anesthesia. The dog just constantly walks around and paces. He won’t lie down unless you force him to. He just walks around in circles for hours at a time. He is starting to go to to the bathroom in the house, as well as lose his ‘perception’ of things by putting his paws in his water bowls. He doesn’t bark nor wag his tail and stares into corners, we aren’t sure he even recognizes us. We were going to try Anipryl, but have decided to try some homopathic remedies, since we only know it’s one of the two. This all started happening within the last 5 to 6 weeks. Any one else’s thoughts/opinions would be greatly appreciated.

  • Vlatko

    Hi guys, mby i m on wrong session but i realy need help !!
    My dog started to bide the root of the tail near anus and made small wound. He s ok but on a moments he start to run like in house without control and than sit and breath like he s afraid of something. Sometimes when he walk he got problem with moving going on side without stabilisation (his right leg doesent work well and falling on that side). Idont know is this problem with anal sacs or a neuro problem. Please give some advise soon as u can and i m sorry about language. Thx in advance

    • Susan Kazara Harper

      Hello Vlatko,
      I understand your concern. There’s no way to diagnosis anything online. Something is definitely bothering him, and the best thing you can do is to make an appointment with your vet and get him checked out. It may be a very easy fix, so please don’t waste time worrying about the worst possible diagnosis. Please don’t wait. This will not get better, and might get worse. A vet visit is needed here, and you will both be much happier when you know what it is, and get some help. Good luck!

  • amy new

    My dog is a Golden Retriever. He has never really played fetch but he always ran after what I threw and sniff it then come back with out it. He was jumpy and loved running round the garden. Recently I noticed he looks in the direction we throw something as if he saw me throw it but cant see it in the air or land. He no longer jumps. He has never barked. he isn’t eating or drinking as much s he used to. And just walks round the garden slowly then just goes to sleep then he just strolls around. I know there is something wrong but my parents and sisters other relatives and friends think he is fine but I have always spent more time with him and I know he’s not ok. I also often think he is limping but then I look at him again and he’s not. Is he just getting old or is there something wrong.

    • Susan Kazara Harper

      Amy, It sounds like you know your dog better than anyone, and it also sounds like you’re best bet it to take your dog to a vet. It might be “getting old”, but getting old doesn’t have to mean we stop playing. Please make an appt with a good vet, and before you go I suggest you take short videos on your phone of your dog walking, getting up, all the things that you think have changed. What are his poos like? Solid and well shaped, or runny? Take the short videos to your bet and explain your concerns. It may be that your dog just needs a little help with something, but you won’t really know until you go. Waiting will not make anything better. Go to the appt with a list of what you are concerned about, and your videos to show. Good luck!