Dear Dr. Hershey,
My 15-year-old Schnauzer is restless all night. He won’t sleep through the night and so we are not sleeping! He will sometimes whine to go out, but then won’t go to the bathroom. If we take him into our bed, he will eventually settle down. I just don’t know what’s wrong with him. During the day he seems fine.
There are many different causes of nighttime restless in dogs and cats. It is often difficult to determine the exact cause of the restlessness, and therefore we often need to experiment with different therapies to see if they help.
Below is a list of potential reasons your geriatric dog may experience restlessness. It is important to work with your veterinarian as some of the reasons may require a prescription medication to treat.
— Poor vision: As pets age, their vision will diminish, especially in the dark. Leaving a night light on may help your pet see better at night and make him feel more comfortable.
— Pain: If your pet is experiencing arthritis pain or nerve pain, staying in one position all night might be uncomfortable. He might shift or want to move around to find a more comfortable position. Your veterinarian can evaluate your pet for pain and prescribe appropriate medications. Common medications given for pain are anti-inflammatory arthritis medications (like Rimadyl), pain relievers (like tramadol), or medications that work in the central nervous (like gabapentin).
— Urgency to urinate: Some older animals will have the need to urinate more frequently. This can be due to a variety of reasons. Reducing the water before bedtime can help alleviate this symptom in some patients so their bladder is not as full at night. It is very important to consult your veterinarian before doing this, however, as water restriction can lead to dangerous dehydration in pets with kidney disease. In addition, water deprivation would be harmful if the patient had a urinary tract infection. A urine culture to screen for a UTI may be appropriate for your pet. For some patients, having a litter box near their sleeping area is helpful, and for dogs, if they can be trained to a “pee pad,” this can be helpful so they don’t need to wake you up to go to the bathroom.
— Esophageal reflux: Some older patients will experience “heartburn” at night. As a test, the patient can receive an antacid to see if that helps resolve the nighttime discomfort. Prilosec can be given to dogs and cats. Consult with your veterinarian about dosing.
— Cognitive dysfunction: Older patients can experience dementia type symptoms leading to restlessness. Signs of cognitive dysfunction can include inappropriate vocalization (howling for cats or inappropriate barking for dogs), loss of house training, and “spacing out” or “looking forgetful.” There are several foods on the market that have nutritional supplements in them that have been shown to help cognitive dysfunction. Science Diet B/D, or “Brain Diet” is available for dogs. For cats, you could try Science Diet J/D. This food is meant as a “Joint Diet,” however, it is rich in antioxidants, and may be beneficial for brain health as well. Also, a medication is available for cognitive dysfunction called selegiline or “Anipryl.” This medication increases the amount of dopamine available in the brain and may help improve cognitive dysfunction. (This author has used “Anipryl” for dogs with effects ranging from great results to no significant improvement. I do not have personal experience with it in cats.)
— “Sundowner’s Syndrome” and behavioral causes of poor sleep: “Sundowner’s Syndrome” can be seen in geriatric people. In this phenomenon the patient experiences restlessness and agitation in the evening. Veterinarians report that they have seen this in their geriatric patients. Exercise and attempting to reduce the number of naps during the day can be helpful. There are also a variety of medications that can be tried to see if it helps the patient. Melatonin at a dose of 3-6 mg per animal can be given at nighttime. (Yes, it is odd that the dose is the same for a 6-pound cat as it is for a 120-poundGreat Dane. However, melatonin is safe to try.) Benadryl can be given at night to make the patient sleepy. (The dose of Benadryl for dogs and cats is 1 mg per pound. For example, a 25-pound dog will get 25 mg of Benadryl at nighttime.) Sometimes stronger sedatives, like trazodone need to be prescribed by your veterinarian to help your pet sleep.
Dr. Teresa Hershey is a veterinarian at Westgate Pet Clinic in Linden Hills. Email her your pet questions at firstname.lastname@example.org.