Night time walking is common in senior dogs. But it's not just your dog who is having disrupted sleep – the whole family can be affected.
Let's look at how everyone can get a good night's sleep.
Why is my old dog having difficulty sleeping at night?
Interrupted sleep occurs for many different reasons. Here are some of the most common causes.
Cognitive dysfunction (dementia)
Yes, dogs can get cognitive dysfunction as their brains age. This is similar to dementia in people, but less understood.
The key features of dog dementia are:
- progressive confusion
- reversal of day-night wake-sleep patterns
- poor adaptability to new situations/change of routine
There is no test for dementia in dogs (we can't get them to do the cognitive tests that people can do). Other brain diseases (eg tumours, meningitis) can also disrupt the sleep-wake cycle. It's also possible for night time seizures to be mistaken as just confused pacing – by the time you get woken up and find the dog, the seizure is over and the post-seizure disorientation is all you see.
We may be able to diagnose other brain disease with advanced imaging and/or cerebrospinal fluid (CSF) testing, but we need to weigh up the benefits and harms to your pet of doing these tests.
Pain
Some types of pain become worse, or at least much less ignorable, at night. So while your dog may seem to get around okay during the day, it's still possible that he can have trouble sleeping due to discomfort.
Night time pain can result in:
- restlessness
- pacing
- panting
- vocalising
Spinal, joint or muscle pain can usually be identified on a physical examination. However, sometimes it can be difficult to identify a pain source (eg headache) or be sure what we have found is the cause of the night walking. In this case, we might do further investigation or an analgesia trial (or both).
Needing to go to the toilet
Depending on what we eat and drink, all of us have occasional night time toilet urges. As we and our pets age, it becomes more common that a medical condition may be increasing the need to urinate or defecate or decreasing the control of these functions.
Common medication conditions include:
- urinary tract infections
- kidney disease
- hormonal disease (eg Cushing's disease, diabetes)
- gastro-intestinal disease
- neuro-muscular disease
Most medical conditions can be ruled in or out during a consultation and possibly blood/urine testing.
Anxiety
Anxiety due to noises can cause night time walking. The noises may only occur at night (eg possums) or be more noticeable at night when everything else is quiet. It's also possible that day time pacing due to anxiety is not so easy to recognise.
This one can be tricky to diagnose if your dog doesn't have a history of anxiety.
How can I help my dog sleep through the night?
The first step is identifying the cause of the sleep problem (if possible). If we are dealing with pain or another medical condition, there will often be an effective treatment.
Non-drug options
Simple things you can try include:
- an orthopaedic bed – this needs to be easy to get in and out of and provide adequate support for older joints
- a bedtime routine – this may include a late toilet trip, a massage and some quiet time before settling into bed
- some soothing sounds – quiet music might help some pets
- a night light – this may help older dogs with poor night vision
- your company – some dogs just sleep better with their owners, so if this works for you too, you can try keeping your pet close at night
You can also try pheromone therapy, which dogs make some dogs feel better. It's available as a plug-in diffuser you use in the dog's bed area or as a collar if your dog is anxious all the time.
Supplements and neutraceuticals
There are lots of claims made about various supplements (eg vitamin E, gingko bilboa, selenium) slowing down brain ageing. At this stage, there isn't much really high-quality evidence to prove they work.
If you want to try something, you might consider S-adenosyl-1-methionine (SAMe). This is most commonly used for liver disease but is potentially beneficial for osteoarthritis and cognitive dysfunction. There are 'pet' versions of this, but as people use it too, it's pretty widely available. It appears safe, well tolerated and their are no contraindications. The dose is 18 mg/kg once daily on an empty stomach. Here are the dosages rounded to the nearest 'pet' tablet sizes:
- Dogs under 5.5 kg – one 90 mg tablet per day
- Dogs 5.6 – 11 kg – two 90 mg tablets per day or one 225 mg tablet if easier
- Dogs 11.1 – 16 kg – one 225 mg tablet per day
- Dogs 16.1 – 29.5 kg – two 225 mg tablets per day
- Dogs 29.6 – 41 kg – three 225 mg tablets per day
- Dogs over 41.1 kg – four 225 mg tablets per day
Hill's® have a prescription diet called b/d (aka brain diet), which has been developed to help with age-related behavioural changes in older dogs. We have some clients who swear by this.
You may hear about the use of melatonin for sleep problems. While it's true that natural melatonin levels tend to drop as we (humans and dogs) age, there isn't great evidence to show that supplements help all that much.
While there are human products that can be used safely in pets, please do not use human pain medication in pets without seeking veterinary advice.
Prescription medications
Prescription medications should first be used to treat the underlying condition (eg pain). If no underlying condition is identified or it has no specific treatment, sleep medications may be used. The most common type of sleep medication given to pets is diazepam (Valium®), although longer acting benzodiazepines may be used (eg temazepam).
The symptoms of cognitive dysfunction are sometimes treated with a drug called selegiline. This is a type of drug called a mono-amine oxidase B (MAO-B) inhibitor. It's an expensive treatment and may require 2–6 weeks of administration before you see any improvement. It does have a range of possible side effects so we need to carefully weigh up benefits and harms before prescribing this drug.
There's something very special about old dogs, and we want your senior mate to have a long, healthy and good life as much as you do. If you'd like a 'senior check', just give us a call.