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:
Disorientation
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.
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.
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…
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.
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.
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.
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.
P.S. ive also found CBD oil very helpful for his occasional agitation and anxiety.
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(.
These wonderful people have many good ideas, hope you try some out for Otto, he deserves it.
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.