If your senior dog has anxiety at night, which might include panting, pacing, and whining, help is here. Integrative veterinarian Dr. Julie Buzby shares how you can get to the bottom of you senior dog’s anxiety at night. Learn the causes and get nine solutions, so everyone in your household can rest, relax, and recharge once the sun goes down.

How a senior dog’s nighttime anxiety affects quality of life

My new client was eager to talk about acupuncture for his senior dog, who was experiencing anxiety at night. As he shared what he and his wife were going through, I heard a mix of desperation and exhaustion in his voice. He was at the end of his rope, unsure where to turn for help.

His wife, who was the dog’s primary caretaker, was on the verge of a “nervous breakdown.” Those were his very words. Like many women, she was a light sleeper. She was also deeply devoted to their beloved dog and determined to provide him the best care at any price.

Every night she awoke to their dog’s panting and pacing. The doting dog mom would get out of bed and do her best to settle her dog down by taking him outside, offering him water, turning on a fan, and moving to another room in the home — usually to no avail.

Night after night the pair would go through their ritual until the exhausted dog and mom finally collapsed together in the early morning hours.

Sadly, this is not a rare, isolated case. Senior dogs experiencing anxiety at night is all too common. Just like my new client and his wife, the problem can have a profound negative impact on everyone’s quality of life.

You are not alone

Just recently, I received an email from Monica sharing her heart on the matter…

…I’ve been struggling with my 17-year-old chihuahua… I related so much to your YouTube video about dog cognitive disorder. I almost cried that someone had recognized and also understood what I’ve been experiencing day in day out (seemingly alone unable to even explain the despair from lack of sleep and lack of having any normal kind of social or work life due to my dog’s needs now).

Needless to say, it has brought me to the brink so many times in recent months due to lack of getting a proper night’s sleep and being unable to help my beloved boy who I rescued as a senior 7 years ago, and who has given me and my family and friends such tremendous joy. And who I now feel I’m letting down each time I lose my composure and because he’s wanting something and I just don’t know what else to give him…“

Can you relate to Monica’s story? You’re not alone. As a practicing veterinarian, I’ve heard many versions of this story from my clients. It’s common for a client to casually mention that he or she is routinely up at night with the beloved senior dog. Often this has been going on for months. These dedicated dog parents “take one for the team,” assuming this is their new norm.

Take, for example, one of my favorite patients, Lacey, who just turned sweet sixteen. At her recent appointment, Lacey’s mom described how she and her husband take turns every other night getting up in the wee hours with Lacey.

“After we get her settled, she’s able to fall back to sleep. But for me, I end up having to read a book for two hours before I can fall asleep again!”

She confessed, “This just isn’t working too well.” I had no idea this was happening, but what she shared was extremely helpful to me helping Lacey.If, like these pet parents, you find yourself dreading the evening hours, I want you to know there is hope and help. By communicating with your veterinarian and persevering toward a diagnosis, you and your dog can achieve more peaceful nights.

The importance of a proper diagnosis

Clients count on veterinarians to make their dogs better—to “fix” the symptoms. They want a treatment plan with precise action steps. They want to know what to expect and what’s going to happen. Makes sense, right? As a dog mom myself, I get it.

However, as a veterinarian, it’s difficult, if not impossible, to create an informed treatment plan without first understanding the “why” behind the “what.” Your dog may not be sleeping at night, but before prescribing the best treatment, we need to first figure out why.

How do vets diagnose anxiety at night in senior dogs?

To begin, your veterinarian and their staff will ask questions and take detailed notes on what’s happening at night with your dog. We call this “taking a history.” He or she will then perform a thorough physical exam and run some tests. Here’s how this might look at your veterinary visit…

The interview

Your dog’s veterinary team will listen to you share information about your dog’s personality, habits, nighttime routine, changes you’ve noticed, symptoms you’re observing, and potential triggers.

I recommend that you organize your thoughts in advance of the appointment and bring those notes. Ideally, you would even start a journal and jot down notes as you make observations. (This is a great exercise if you have a dog who suffers from nighttime anxiety, seizures, allergies, or any other chronic health issue.)

Questions to consider before you meet with your vet

• When did your dog’s anxiety start?
• Do you see symptoms during the day or just at night?
• Can you identify any triggers for the anxiety?
• What seems to help the situation? What seems to make it worse?
• How frequently is your dog having anxiety at night?
• Have there been any changes in the house or in your dog’s life?

Your specific observations are important and will be even more vital when you are tasked with gauging the effectiveness of various treatments. You have the ability to gather specific “daily life” data about your dog that your veterinarian will never observe. Remember, you are advocating for your dog. He or she needs your support, and detailed notes or a journal will help you do that.

The physical exam

Next, your veterinarian will perform a careful physical examination. It will be a meticulous head-to-tail exam. Don’t be surprised by this. Your vet needs to make sure she or he is not missing the bigger picture. Because health conditions often leave clues in multiple parts of the body, your vet will be diligent.

As an aside, if you’d like to learn how you can complement your dog’s annual wellness exam at home with your own hands, please learn my five-minute, tip-to-tail dog wellness scan.

The lab work

Next, your vet will likely order dog lab tests consisting of bloodwork and a urinalysis as a starting point. These tests will provide your vet with baseline information. Also, there are some diseases that can cause or worsen a dog’s anxiety. Certain diseases can be diagnosed with these lab tests. But pending those results, further tests may be recommended.

What causes anxiety in a senior dog in at night?

Now it’s time for your vet to do what he or she does best — play detective and put the pieces together to figure out why your dog is panting and restless and anxious.

For senior dogs, anxiety at night is often caused by a handful of conditions. Let’s take a brief look at each one.

1. Canine Cognitive Dysfunction

The most common reason for anxiety in senior dogs is canine cognitive dysfunction syndrome (also abbreviated CDS or CCD). It’s a long name that essentially means your dog’s brain isn’t functioning properly. Dog parents notice this condition as it relates to their dog’s mental faculties and awareness. In fact, canine cognitive dysfunction syndrome is often likened to doggy Alzheimer’s.

Dogs suffering from this syndrome may:

• Ignore or lose interest in playing or receiving affection.
• Forget previously mastered training and tricks (even house training).
• Show less interest in food and/or eat with difficulty.
• Appear confused or disoriented, sometimes getting lost or “stuck” somewhere in the home.
• Vocalize inappropriately (such as yelping or howling during the night).
• Pant excessively.
• Sleep more (often during the day) and/or become more active at night due to a disrupted sleep-wake cycle. In humans, this pattern of anxiety and restlessness at night is called “sundowning” and occurs in 20 percent of people with dementia. Our canine companions may display the same type of disturbance, which is commonly referred to as sundowners in dogs.

CDS is very prevalent in senior dogs. One study showed that one out of three dogs in their early teens exhibit signs of CDS, and two out of three dogs show signs by their mid-teens. As your dog ages, it will be something you and your vet will want to keep a close eye on.

2. Pain

If there are no signs of cognitive dysfunction, your dog may be anxious at night because he or she is in pain. If pain is the culprit, a careful vet exam coupled with your observations should help your vet identify your dog’s source of pain.

While arthritis and musculoskeletal pain are common, pain may also occur in the nerves (called neurogenic pain). Neurogenic pain is treated differently than musculoskeletal pain, so it’s always best to have a diagnosis to which treatment can be tailored.

Remember, pain in dogs is often not obvious. One of the most concerning yet common things that I’ve heard owners tell me over the years is, “My dog’s not in pain, because he’s not whining or crying.” However, that’s not the typical way a dog manifests pain. They usually suffer in silence.

PRO TIP: If you want to know more about how to recognize when your dog is hurting, please see my article: Signs Your Dog Is In Pain.

Sometimes the pain isn’t even evident to the veterinarian despite performing a complete exam. For this reason, I often recommend a short trial on pain medications to see if there’s an improvement to rule out pain as a cause of the behavior.

This practice was inspired by a colleague of mine. He told me about a client who was at her wit’s end with her senior Border Collie. This dog would pace incessantly at night. Border Collies are very smart, but they also tend to be very stoic and don’t show pain very often. This veterinarian was the owner’s third opinion — she was so desperate she was considering canine euthanasia.

My colleague couldn’t find any evidence of pain or discomfort, but he cleverly prescribed a combination of two different pain medications. Believe it or not, the pain medications cured the dog’s anxiety at night, to the delight of all involved. This poor senior dog had been suffering from chronic pain that escalated at night.

3. Other reasons for senior dog anxiety at night

Here are other common conditions in senior dogs that can contribute to restlessness and anxiety at night. Basic diagnostic tests would point to these conditions:

• Hypothyroidism in dogs (low thyroid)
• Diabetes
• Hypertension in dogs
• Cushing’s disease in dogs
• Urinary tract infection in dogs

Remember my patient Lacey from the beginning of this article? I found a few additional clues on her exam that led me to believe she had a urinary tract infection. She was very tender on palpation of an acupuncture point associated with her bladder. And a distinct odor around her hind end also served as a red flag. When I asked about it, Lacey’s mom agreed that the smell of her urine had become much “stronger” lately. Lacey was diagnosed with a UTI. Once it was treated, her anxiety at night improved and resolved.

4. Intracranial disease

In addition to the reasons listed above, there is one more to mention: intracranial disease. Intracranial disease is a condition that originates in the head (such as a brain tumor or other type of inflammatory brain disease).

This type of disease can cause pain that makes it difficult for your dog to sleep or get comfortable. Therefore, he or she becomes anxious at night. Also, some intracranial diseases can interfere with the natural chemicals and hormones that help us fall and stay asleep.

A definitive diagnosis of intracranial disease requires an MRI or a CAT scan at a veterinary referral center or veterinary school. Not every dog parent can pursue these advanced diagnostic imaging options due to cost or travel distance to a veterinary center. But it’s reassuring to know these options are available if necessary.

How do you treat a senior dog who has anxiety at night?

Once you know the “why” behind your dog’s nighttime anxiety, it’s time to talk about how to calm a dog with anxiety at night. Remember, a diagnosis can be tricky. Don’t give up if you don’t have a definitive answer on your first vet visit. It may take several visits, treatment methods, and lots of detailed observations on your end to unravel the full story.

Here are a few treatment options that you and your veterinarian may discuss:

1. Speak with your veterinarian about changes to your dog’s diet.

Because it is an easy change that can pay big dividends, many veterinarians will recommend switching to a brain-boosting prescription diet. Although I’m typically the one recommending a custom-formulated, home-cooked diet over a prescription diet, in this case, I stand in the corner of prescription diets. Options include Hill’s® Prescription Diet® b/d Canine for “brain aging care,” Purina® Neuro Care, and Purina® Bright Minds (which represent the Purina veterinary prescription diet and the over-the-counter version, respectively). It may take several months to see results, but these diets are touted to improve cognitive dysfunction. I have heard several reports from clients and colleagues about Bright Minds helping nighttime anxiety in certain dogs, perhaps because the underlying issue in those cases was CDS.

2. Increase exercise and mental stimulation during the day.

Some dogs are restless at night because they are bored or have a lot of extra energy. So, another simple recommendation is to increase your dog’s exercise regimen and mental stimulation during the day. Make an extra lap around the neighborhood, but also think brain teasers and puzzles for dogs. A simple online search will yield hundreds of ideas and products designed to challenge your dog’s mental acumen.

3. Stick to a routine or schedule (especially at night).

Sometimes senior dogs exhibit anxiety when their schedule is disturbed. Just like senior people, keeping a healthy, consistent nighttime routine can be helpful. If your senior dog has suddenly developed odd anxiety-related behavior at night, start by looking for “triggers.” Have there been any recent changes? Also, make sure your dog has convenient access to their preferred resting place and a super comfortable bed. I’m a big fan of oversized memory foam beds for creaky old joints.

4. Ask your veterinarian about natural supplements for your dog’s nighttime anxiety.

There are many natural supplements for dogs that may be helpful for senior dog anxiety at night. These are worth looking into and discussing with your veterinarian. Often they will be used in combination:

• Omega 3 fatty acids for dogs — essential fatty acids the body needs for brain health
• Melatonin for dogs — the hormone of darkness (rest). Always check to ensure the melatonin supplement you pick (especially if it is gummies) does not contain xylitol (i.e. birch sugar), which is toxic for dogs.
• S-Adenosylmethionine (SAMe) — a supplement for CDS support, osteoarthritis pain, and liver health
• Vetriscience’s Composure™ — calming support
• Vetriscience’s Cell Advance™ 880 — antioxidant support
• Senilife® — supplement to reduce brain aging behaviors
• Purina Calming Care — calming probiotic supplement
• Solloquin® — calming soft chews
• Zylkene® — calming supplement containing a milk protein
• CBD oil for dogs—reported by many to help with anxiety, though I think it’s safe to say the jury is still out on this solution

PRO TIP: If you’d like to learn more about supplements, please see my article: The Ultimate Guide to Supplements for Senior Dogs.

5. Use medications recommended by the vet.

There are several pharmaceutical options for CDS and/or anxiety in dogs. Though the list is long and growing as pharma companies develop new options, here are some of the traditional choices. These are often used as “combination therapy” with each other, and also in combination with supplements and other adjustments:

• Selective serotonin reuptake inhibitor (SSRI) and serotonin modulating drugs, like fluoxetine and trazodone, increase available serotonin — a naturally-occurring substance in the brain. Serotonin boosts mood and helps maintain mental balance.
• Anipryl® (selegiline)—another drug which affects the chemicals transmitting signals in the brain, such as dopamine, norepinephrine, and serotonin. This medication can be helpful for managing the symptoms of CDS.
• Benzodiazepines—Some dogs respond well (but some really don’t!) to medications like Xanax or Ativan. Remember, it’s critical that you only give your dog veterinary-prescribed medications and dosages.
• Antidepressants—Drugs like amitriptyline or clomipramine may have value in treating your dog’s anxiety at night.
• As a side note, acepromazine, which is used as a sedative for animals, is not thought to be helpful for anxiety in dogs.I probably don’t need to tell you that this is serious stuff. Certain combinations may make things worse. Gabapentin, a medication commonly prescribed for neurogenic (originating from the nervous system) pain in dogs, can make some dogs with CDS even more symptomatic. And though I’ve never seen it in clinical practice, there’s a condition called “serotonin syndrome” that I always keep in mind when prescribing medications. This can occur with specific combinations of drugs (and even drugs + supplements). It is caused by having too much serotonin in the brain. For dogs, the symptoms can manifest as “mental distress.” Here’s a list of the more common symptoms:
• vomiting/ diarrhea
• agitation/restlessness
• tremors/seizures
• depression
• elevated respiratory and heart rate
• high blood pressureBecause every dog is different, a trial and error period will likely be needed to see what “combination therapy” works best for your dog. So let me underscore the importance of working closely with your veterinarian when starting, adjusting, or stopping your dog’s medications. And please remember to be patient. Some of these medications can take up to 30 days to begin to work and have positive effects on your dog.

6. Consider pheromones to reduce your dog’s anxiety.

Pheromones are natural chemicals that are released by dogs (and other animals/people). They are used to help animals communicate with one another and can trigger different chemical reactions in the brain.

Recently, pheromones have become very popular with behavioral veterinarians, because they are a natural and easy way to help dogs with anxiety. Not only can pheromones reduce anxiety, but they can also lower fear, distress, separation anxiety, urgency/panic, and other negative emotions.

There are many reasons that I love recommending pheromones to clients, including:

• They are natural and have no known side effects
• Humans can’t smell dog pheromones—only dogs can.
• They are easy to use in conjunction with other treatments
• There are options available that don’t require administering every day

On such option is ADAPTIL, which is available as a diffuser or collar that can be used throughout the day and night to help reduce your dog’s anxiety.

7. Create a safe and comfy space for your dog.

If you are like me, nothing compares to sleeping in your own bed. Here you have the perfect number of pillows that are arranged just right. The blankets are soft and the right thickness to keep you warm at night.

The same is true for our dogs. A familiar, comfortable space may that is comforting for your dog may help him or her achieve a good night’s sleep.

To help your dog relax for the night, establish a bedtime routine and make sure your dog has a comfy bed where your dog relax for the night. It is also important to place your dog’s bed in a location where he or she feels safe. Does your dog like to sleep near you or near the front door? Also, does your dog like silence or would he or she prefer background noise like calming music? Is there a special toy that could go to bed with your dog to help him or her feel more relaxed?

By creating a safe and comfortable zone around your dog’s bed, he or she might be more relaxed and willing to sleep through the night.

8. Try using calming “dog wraps.”

Calming “dog wraps” such as the Anxiety Wrap® or ThunderShirt® are sometimes used to help dogs feel relaxed. The wraps are designed to simulate a hug by putting gentle pressure on your dog’s mid-section. Placing one of these wraps on your dog before bedtime (like pajamas) might help keep him or her calm at night.

While I have some clients who swear by them, dog wraps seem to be more helpful for some dogs than others.

9. Ask your vet if alternative therapies are right for your dog.

As a holistic veterinarian, I am a big fan of alternative medicine. I believe that prescriptions and medications have many advantages and uses, but taking a holistic approach can also be very beneficial.

For example, Chinese herbs could be an option for your dog. Try seeking the advice of a veterinarian trained in traditional Chinese veterinary medicine (TCVM). They have an additional “tool box” full of options for senior dog anxiety at night in the form of herbal remedies.

Also, I have found acupuncture for dogs appropriate and helpful for canine anxiety. There are several calming points that could be used to reduce anxiety and hopefully balance your dog’s energy.

Your dog needs sleep — and so do YOU!

Speak with your vet about your dog’s night time anxiet

If you can relate with the exhausted dog parents in this article, I urge you to reach out to your veterinarian. You don’t have to suffer in silence. Sleepless nights are not sustainable. They will take a toll on your health, your dog’s health, the human-animal bond between you, and your overall well-being. It’s definitely not as black and white as diagnosing a lameness or dental issue, but nighttime anxiety and restlessness for your dog is something your veterinarian is prepared to help you address.

What helps your senior dog settle down at night?

Please share in the comments below. Sleepless nights are no fun, and we need one another’s encouragement and support!