Otto Is Showing Age-Related Dementia Symptoms Often Seen in Dogs


My 14-year-old dog Otto is starting to show signs of age-related dementia. While there are all kinds of ways dementia in dogs can manifest, his symptoms are most similar to what’s often called “sundowning” – where elderly humans seem pretty much okay in the early part of the day, but show increasing confusion, anxiety, and/or restlessness in the later afternoon and evening. It’s not been fun, but my husband and I are trying to adapt and accommodate his need for attention and comfort – but also meet our own needs for sleep! 

It started in early November. A couple nights in a row, Otto woke me up in the middle of the night by coming into my bedroom (he and my 6-year-old dog Woody usually rotate between sleeping on the giant dog bed and the couches in the living room). On those nights, Otto approached my bed, panting loudly and clearly in distress. He’s done this dozens of times before, but always for one of a few reasons:

  • He heard a car backfire or gunshot or firework and he got scared.
  • His digestion was upset and he needed to go outside to relieve himself.
  • He heard cats screaming, or people walking on our rural road (odd in the middle of the night), or smelled deer walking around; he urgently wanted to go outside to sound the alarm and investigate.

But in the case of these nights in early November, he wasn’t trembling in fear, the way he does if he hears fireworks or other loud BANGs, and when I got up to let him outside, he didn’t run off to relieve himself OR go charging off into the night barking, as he would have if had detected suspected intruders on or near our property. He just went outside and stood there, looking around, and then came back inside. And then just stood there, looking at me intently. When I told him to “Go to bed! Go lie down!” he did, but a few minutes later was back in my bedroom, panting loudly in my face, wanting … something! But what? Not food, not water, not to go outside. It seemed like he just wanted attention.

To allow my husband (at least) to get some sleep, I took a blanket to the couch and encouraged Otto to lie down next to the couch (he doesn’t like being on the couch as the same time as anyone else, human or canine). He would be calm as long as I was petting him and rubbing his neck and especially behind his ears (his long-time favorite spot), but if my hand would stop moving as I was falling back asleep, he’d loudly start panting and/or get up and start pacing around the house again.

That happened two nights in a row, and then for several nights, Otto was quiet all night. Then I left town for a few days, and on the last night I was gone, Otto’s nighttime restlessness returned. This time, my husband had to deal with it all alone. He, too, resorted to sleeping on the couch with one hand on Otto, but didn’t get much sleep. We discussed it when I returned the next day, and I called around to see if I could get Otto seen, soon, by any one of the three veterinarians I am currently using (last week, I described my three-vet regimen here).

The first vet who could see Otto suggested we run tests on his blood and urine, to look for clues of anything physical that might be amiss. Only one thing was out of whack, and it was a head-scratcher: Otto had a urinary tract infection (UTI). While these are common in older female dogs, it’s a bit unusual in male dogs. We added a urine culture test, to determine which specific bacteria was in Otto’s urine, and, while waiting for those results (which take a few days), we started him on a course of plain-Jane antibiotics.

The veterinarian also thought it was possible that the non steroidal anti-inflammatory drug (NSAID) that Otto receives wasn’t doing enough to relieve his arthritis pain, so we added gabapentin to his medication list.

When the urine culture came back, it showed that the bacteria in Otto’s urine was e. Coli – the most common culprit in canine UTIs, but again, much more common in females than males. He finished his antibiotic– unfortunately, without any appreciable change in his anxious nighttime behavior. We waited a week after that, and then I took him back to the vet to have his urine tested again. He still had bacteria in his urine! So we started him on another, more aggressive antibiotic,and the vet suggested I make an appointment with our vet who is board-certified in internal medicine, and perhaps do an ultrasound on his abdomen and particularly his prostate. Apparently, bacteria that gets into the prostate of older male dogs can be difficult to budge, and if this was the case, Otto’s prostate would have been inflamed and enlarged.

Nope, the ultrasound found nothing unusual. As before, he finished the prescription, we waited another week, and tested his urine yet again. Thankfully, this time, the infection was gone – but his nighttime restlessness was still present, even with the addition of gabapentin (and an increased dose).

It was then that I remembered I had a copy of a great book about canine cognitive dysfunction. Remember Me?: Loving and Caring for a Dog with Canine Cognitive Dysfunction (2016, Bright Friends Productions), was written by Eileen Anderson, an award-winning dog blogger who writes about canine behavior and learning theory (and a contributor to WDJ). I pulled the book off of my shelves and read the book cover to cover. It helped me realize a few key things:

While Otto is certainly showing some symptoms of this disorder, and while his frequent nighttime perambulations are disruptive, these behaviors are not as severe as they can become. As Anderson describes in the book:

The types of problems associated with canine cognitive dysfunction are often represented clinically by the acronym DISHA. DISHA stands for:

dog accupuncture
Otto being a very good boy during an acupuncture appointment.


Interactions with people and other pets that have changed

Sleep-wake alterations

House soiling

Activity-level alterations

Anderson included a link to a website she maintains for sharing information about canine dementia. On the site is a long checklist of symptoms that dogs with dementia can display; visitors to the website can print out the list and check the symptoms their dogs are having. This can help the dog’s veterinarian understand the full array of behaviors a dog is exhibiting.

As yet, Otto is exhibiting only a few of these behaviors, and only at night – and none of the ones that seem like they would be making him suffer (such as getting “lost” in our home, “stuck” in corners, being unable to eat or drink, or falling off of things). I’m talking to my veterinary team about what sort of enrichment, foods, supplements, and/or medications we can try to preserve his brain function, and have taken him to see our  third veterinarian for some acupuncture.

If your dog is elderly and exhibiting signs of dementia, I’d strongly recommend Remember Me? as an information resource.


  1. Nancy, so sorry that Otto and you, by extension, are experiencing distress. Weirdly, UTIs in senior humans are well known for inducing temporary dementia, which clears up after treatment of the UTI. My senior German Shepherd who passed last year at 15, was pretty frail, and deaf, but not at all senile, thankfully. She continued to accompany me on hikes, although I did put her back in the car after 30 minutes, while the younger two and I completed a longer hike. I thought the exercise was good for her brain as exercise oxygenates the blood.
    Thinking of possible accommodations, I wonder if confining Otto to a kennel on a trunk or something right next to your bed (so that he can see and smell you) might help contain his apparent anxiety at night, and daytime exercise might help him relax. With my old girl, she lagged behind off leash at a slower speed than the younger ones, but she still was game. We stayed on the same route to reduce any possibility of her getting lost.

  2. Selegiline really helped our dog Maxwell who was dealing with this. It gave him another year or so of quality life. He transitioned from 1 am barking marathons to sleeping peacefully for a number of months.
    Eventually his night terrors returned, and mobility challenges and pain management all added up to our decision to euthanize him at ~14 years of age. But Selegiline bought him some time and peace for the whole household!

  3. Would a regimen of Lions Mane help? I understand it is a downhill slope but at this point what would you have to loose? Does the brain chemistry actually change with dementia? I am going through this with my elderly parents. Good luck.

  4. Why not try an herbal or aromatherapy remedy that helps with sleep? I’m not sure what works for dogs, but herbal remedies for people include valerian. For aromatherapy, you need to use a smaller amount because of dogs’ heightened sense of smell or dilute it with a carrier oil. Lavender is the first one I’d try (maybe a drop on his collar about 15 minutes before you go to bed).

    There is also the pherome Adaptil Calm collar, which I’ve used with my Great Dane successfully. This is worn all the time and she is more relaxed and calm.

  5. My 14 year old easy-going Miniature Schnauzer has become anxious since he developed a seizure disorder. My vet suggested that we try a CBD chew Chroniquin. It was tremendously helpful, and the only time he shows anxiety now is during those “bang” times — fireworks on July 4, etc. And surprisingly, referee whistles during sports really freak him out, so I mute my tv then. My vet helped me get a supply, but Texas law doesn’t allow vets to dispense CBD products. Since California is a more sane state, you might check with your vet to see whether it’s available there. A last comment: I found that my dog didn’t need the full dose that matched his weight. The package calls for him to take 1.5 chews a day, but for my guy, 1 chew was enough. Good luck with Otto!

  6. My 14 yr old Westie is going through this. He sleeps in the living room, when I start getting ready for bed he gets Anxious.I leave the t v on with a timer and down low and a lamp dimmed to low.this helps him dose off.I also started putting a diaper on him as he is starting to wet the floor at night. So far this is working.he has congested heart failure too , I give those meds at night to help him sleep.

  7. Hi Nancy. At NaturVet we work a lot with holistic veterinarians. Dr. Ihor Basko formulated Emotional Support which you can administer every 6 hours to Otto. It can be fed long term and also improves cognitive function in senior dogs. This is not a commercial for NaturVet, I just want to help Otto. And you.

  8. So sorry you are dealing with this difficult situation with Otto. Of all the dogs we have had, our sweet Baxter (tibetan terrier mix) was the only one with dementia, while he was going blind and deaf at 14. He circled for hours in the evening, got stuck in corners and under furniture and fell in the pond and was unable to hold himself up so I went in after him. We did our best for about six months until our holistic, intuitive vet told us, he is ready to go – not having fun any more. It was a great comfort to know the decision to let him go was when he was ready.

  9. Hi Nancy,
    My beloved Golden Retriever started showing signs of dementia and sundowning around age 13. Unfortunately, I just had to say goodbye to him on January 4 at 16.5 years old, but we had a great run and life together. I miss him everyday. Anyhow, I had done some research on cognitive dysfunction in canines and found that supplementing with acetyl l-carnitine and alpha lipoic acid helps to stave off symptoms. It sure did for him. He was as sharp as a tack. It was his spine and back end that failed him. Perhaps this can help for Otto?

  10. One of my senior Portuguese Water Dogs, Morgan, struggled with dementia for the last two years of her life. It required a fair degree of extra care, stroking her foreleg at meal time to bring her attention back to her food, toileting misadventures and yes, sleeping on the couch to keep her company. I did not regret a moment of it as she was a sweetheart right to the end.

  11. When my 17 year old pittie rescue Luna started with similar behaviors, I tried CBD oil which was a true miracle for her. Within a week, the middle of the night restlessness stopped. She still had other signs of dementia, but at least this one aspect was controlled.

  12. Hi Nancy,
    I recommend you treat Otto with 10 to 20 mg. of selegeline given once a day. It works pretty quickly to help with canine cognitive decline. I had a dog experiencing this at only 7 years of age. On medication, he was much improved and he lived another 6 years much less confused, no more staring at the floor or getting lost in corners. I got my dog back. Cheryl Hoofnagle M.D.

  13. I am glad to see the majority have used natural remedies instead of conventional man made medicines, and that they worked well. I have copied this page to keep in case I need to refer it it for my girl in the future . Thank you all for the information🐾🐾

  14. The first symptom that my Shih Tzu exhibited was sleeping on my head. Henry would wedge himself between the headboard and my pillow. I looked online and found that other people were reporting this as a possible sign of dementia. The vet did blood work and urinalysis and they were within normal limits. I already cook a healthy diet with supplements for my dogs/foster dogs….my vet thought we were OK on nutrition. The vet did prescribe some medications for him. Henry and I spent nights in another room….me sitting on a couch and holding him and when I fell asleep he would paw me awake. This lasted for 2 years…..but as others have said I would/will do it again if one of my dogs develops dementia. I think there are a lot more options now to treat canine dysfunction….I’m keeping a list so I am ready if there is a next time.

  15. Our lab developed this at around 12 – 13 yrs. It began with confusion over how to use stairs (something quite familiar to her) but worsened after a sudden/severe bout of old dog vestibular disease. Next it progressed to the sundowners symptoms you described for Otto. We tried almost everything mentioned in the comments above and more, including xanax, with no results. For example the xanax made her loopy and lose inhibitions, but didn’t touch the dementia symptoms. Fortunately we had EXCELLENT success with Clomicalm. Her symptoms mostly resolved (though she never used the stairs again), and, importantly, symptoms never progressed. It gave her/us several more wonderful years together. Unfortunately, it’s quite expensive for a large dog, but after some heavy wrangling, we finally got our pet insurance to cover it.

  16. My sweet, gentle shepherd/shiba inu mix paced every night for hours, from the living room to the side of my bed. I would have to close my bedroom door so I could get some sleep. She would cry & scratch at the door. Nothing soothed her. She eventually lost 25% of her body weight, the vet said she was burning tons of calories pacing. She also stopped eating twice a day & ate maybe every 3rd meal. It was heart breaking.

    Eventually I realized the dog I knew was gone & in her place was a fearful, timid creature who was in terrible agony. I couldn’t stand to see the fear & lost look in her eyes anymore & finally had her euthanized. I hope I was a ‘week too early & not a day too late’. It was worth every penny having the vet come to the house, I highly recommend asking your vet if he performs at home euthanasia. It was very peaceful.

    She was just shy of her 13th birthday & the last of my pack. Her name was kelly….😊

  17. I had a dog with dementia and I gave her MCT oil every day. I believe it really slowed the progress of her dementia. She died when she was almost 19. The last couple of years she would wake up in the night. I would take her out for potty and then the only way I could get her to settle and go back to sleep was to lie down next to her and stroke her. When she fell asleep I could go back to bed. It was exhausting but I would have done anything for her. She was very good physically even at the end, but it was the anxiety that got worse and worse. I read and reread the book Remember Me? It was very helpful.

  18. I have a 15 yo Vizsla who began showing signs of dementia about a year ago (staring at the wall in a corner). Now he has more symptoms, accompanied by significant deterioration in coordination: he falls frequently but 98% of the time gets back up on his own, gets stuck in corners, forgets how to use the doggy door, soiling inside, not responding to his name, walking in circles… He has been getting both chiro & accupuncture treatments weekly x a year, but the one thing I wish I had started earlier is Senilife. It has helped dramatically -he makes better decisions now, responds to being called, better potty control..but as he is SO old now, with his progressive musculo & neuro deterioration, sadly his days (weeks? Months?) are numbered. I strongly recommend adding Senilife as soon as cognitive symptoms begin (Senilife XL for dogs 50# and over(.

  19. Nancy,

    My Pops had the exact same thing. Night time anxiety (big time), night time pacing for hours, the UTI infection (e coli – have no idea where that came from, same anti-biotic regime as you), etc. The last three months of his life I was up every night with him for hours – taking him outside to pee, trying to calm him down…usually around 4am I could finally get him back in his bed (which I put on top of my bed so I could keep an eye on him). Then he would sleep until 9-10am and it would take him awhile to be wide awake. He was wobbly, disoriented for the last 3 months of his life. Thank god I was working from home and I didn’t have to leave the house. We had to say goodbye to him a few months ago at age 16. I so miss him. It’s terrible and frightening to watch them go through this. I’m so sorry you are having to watch Otto do the same thing. Also, yes, we tried everything.

  20. Such a sad but promising article. My Callie will be 8 in Feb. now I am wondering if she is starting dementia as she will ask to go out then go sit in the yard and “watch”. At night when she goes out, she will stand for ever just looking into the dark. We have large placed solar lights all around the yard thinking the darkness is what she is afraid of. Of course, there is darkness beyond the lights. It all becomes a guessing game as to what she really wants and why. I too am keeping the article and will get the book since we may be going into this scenario. Thank you.
    Good luck with Otto, precious boy.

  21. Have you tried Cholodin? Much to my surprise, it was amazingly helpful for my dog. I see someone else in this string also recommends it, but couldn’t resist adding a big, enthusiastic 2nd to that recommendation.

    Years ago my dog was showing “sundowning” signs. I happened to notice a couple of posters about this (“Is your dog showing these signs?”) in the vet office where my dog was getting acupuncture.

    When I asked Dr. Riddle (Southampton Pet Hospital in Benicia, CA) about it, she said they found giving the supplement Cholodin (chewable tab) can be helpful to relieve symptoms. She was happy to sell it to me, but she also said it was available for a lower price online (so nice of her to add that!).

    I had *zero* confidence a supplement would help, but thought why not try it. It took several weeks, but my dog’s evening wanderings and confusion completely stopped. My elderly pup lived another two years and the signs never returned.

    Worth a chat with your vet about trying it?

    Cognitive dysfunction is so draining and upsetting to both dog AND human (I went through it with another dog ages ago – it was awful!). I’m hoping this can help dear Otto.

  22. What a tough season to be sharing with your beloved Otto. My heart goes out to you both. I had a large yellow Lab who did experience the walking into corners and not being able to back out as well as nightly incontinence. It just became our new reality and routine. I’d come back from walks with my. younger dogs and I’d say, “Let’s go find Max.” I would gently lead him out of the corner, clean him up (he typically peed while standing there) then spend some time with just him. It is a price we pay for loving our dogs well into their twilight years.

  23. My stray dog — no idea how old she was, but at least 7 — had something like this, but it stopped. Around October, she started going downstairs to the dog door, and then she’d swat at it but not go outside. Being part terrier, she’d continue that ceaselessly until I came downstairs. I’d open the dog door, and she’d stand there. I’d gently push her through the door, and she’d immediately come back in. And then the cycle would start all over. Stopping the cycle at one iteration and then bringing her upstairs onto my bed and doing some TTouch usually stopped the cycle (once we figured out that that would help). I also started her on raw liver (as a source of B vitamins), MCT oil, and Purina’s Calming Care. Eventually — about 3 months later, she stopped doing it altogether. I kept her on those supplements for the rest of her life.

    Unfortunately, in May, I noticed blood in her stool that couldn’t be explained by “indiscretions”. We tried antibiotics, and that helped for a while. But by August, it was clear something else was wrong. Turned out she had spleenic hemangiosarcoma. Due to a “raging” heart murmur, she wasn’t a candidate for surgery. She died in October, about a year after the initial issue.

    I mention this for 2 reasons: 1) Otto may just be going through a phase that, possibly, could be helped with nutrition. MCT oil is particularly good for the brain. I also seem to remember the Calming Care was particularly helpful. And 2) this could be a very early symptom of something more serious. I know you’ll keep an eye on other aspects of his health. Even if this resolves, don’t be complacent.

    All the best. I know your frustration…

  24. Selegiline, plus melatonin and trazodone at night helped my mom’s poodle. There are also several Purina foods (Bright Minds over the counter, plus a prescription version) that are supposed to help.

  25. I am so sorry Otto is going through this. I know you will do your best for him.

    I suspect this may have happened to Goliath when he was around 10. He should stand and stare off into space or circle around. He also became annoyed with a new puppy (I had recently lost my other dog and I thought Goliath was lonely as he had lived with Caesar his entire life) but his snarling escalated and Goliath retired to live with my parents. The vet warned he might get worse, moving from other animals to people. When my parents told me he was starting to snap at people he had known for a long time we decided it was time for him. After the tranquilizer he went into a seizure so I know it was the right thing to do for him. I wonder if he might have had a brain tumor rather than dementia but I’ll never know.

    Thankfully Ramses passed before his dementia got very bad. He was just starting to show signs but he also had cancer and a potassium imbalance that would eventually give him heart failure. His last few months he had started to sleep with me on the bed again and that is where he passed peacefully. He also had arthritis and some bad discs in his back so increasing his pain medication did a lot to relieve many problems.

    Diana pawPrints and Freyja Grey are both very young right now but I am better prepared to give them the care they need as they age. With every dog we learn and gain experience.

    Hold Otto close. (And give him a kiss from me.)