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Dr. Kara
Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 8575
Experience:  23 years of experience treating dogs, cats, mice, rats, rabbits, guinea pigs, hamsters, & iguanas
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For over a month my 9 year old dog has been restless at night. It seemed to start suddenly

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For over a month my 9 year old dog has been restless at night. It seemed to start suddenly. He will lay down but then get up and pace and then just stand there, like he is spaced out. Sometimes he jumps out of bed like something bit him. He tucks his tail between his legs and his respiratory rate is not always, but usually high (often 80-100 breaths per minute). His heart rate is 50 bpm. He lays on his belly and elbows, like he is resting, not sleeping (though he will lay on his side if he is really tired). He licks his anus and expresses his anal glands (something he has never done on his own before), though this may not be related and may just be due to his skin allergies. His blood work is normal and x-rays of his back and hips only show mild arthritis in his "lower" back. I showed a video of him "spacing out" to the vet, and he was put on phenobarbital. He slept at night for about 5 days but once his system got used to the meds, he's been up again. He will dig at the floor but not
Submitted: 6 months ago.
Category: Dog Veterinary
Expert:  Dr. Kara replied 6 months ago.

Hello, my name isXXXXX and I have over 20 years of experience as a veterinarian.

I'm sorry to hear about Rowdy's night-time restlessness.

In some dogs as they age their organ systems don't work as well as they once did,
and waste products that their organs usually filter out build up in the blood stream and that affects brain function. They may behave much differently because their brain function isn't normal. I am glad to see that Rowdy has had some blood tests that show his organ function is normal and that is not his problem.

The other possibility given his confusion which seems to worsen at night is that he is experiencing senility, not uncommon at as dogs age although he is a little young. These dogs often forget their housebreaking, seem more confused at night when it is dark, cannot seem to remember whether they have eaten or not, and seem to pace, looking for something they cannot find. They may all of the sudden get into the garbage or chew up things when they never displayed these habits before.

If his organ function is normal there are medications that can help with senility and the associated anxiety, such as Anipryl (L-deprenyl or selegiline). There is also a diet formulated for older dogs high in the particular trace minerals and supplements needed for healthy brain function in older dogs called Hills b/d.

 

There are anti-anxiety drugs such as amitriptyline or fluoxetine that can be used as well if Anipryl doesn't work for him.

 

I must warn you that these medications and the b/d diet doesn't work for all dogs
and they may not work for long but they may allow him to rest and relax at night and help with his confusion

 

Because we know he has some spinal arthritis it may help to treat that as well so he is more comfortable.

Long term for joint pain/arthritis I do recommend using a combination of a glucosamine/chondroitin product (examples are Dasuquin or Cosequin) and an
omega 3 fatty acid (like 3V Caps or Derm Caps). These work synergistically and
improve cartilage health and joint fluid quality and quantity as well as reducing inflammation. They can take several weeks to see full improvement but some dogs do very well with them alone. They are available over the counter.

Another option is a product called Duralactin. This is an anti-inflammatory product derived from milk proteins and it also has omega 3 fatty acids incorporated into it which can be very helpful. See this link for further information: http://www.duralactin.com/products_canine.htm

If that's not enough his veterinarian can prescribe drugs that are more potent. Veterinary drugs we can add include a nonsteroidal like Metacam, Deramaxx, Previcox or Rimadyl. If those aren't enough we can add another drug in the opiod family called Tramadol and/or another drug called Gabapentin.

I also recommend night lights and playing soft music at night as a way to comfort him. Sometimes when vision and hearing acuity are decreasing the dark and quiet at night can be disorienting for them.

 

Please let me know if you have any further questions.

Customer: replied 6 months ago.


Dr. Kara,


Thank you for your reply. He was actually prescribed some Vetprofen as well, just in case. I gave him his first dose this morning, and will give the second dose tonight and see if that helps him. I bought some Phycox joint chews as well, but he refuses to eat them (luckily we have another older dog who likes them).


 


As far as the jumping out of bed and tail-tucking, pacing, and reluctance to lay back down, I assumed it was because of physical discomfort or pain. But then again, he's fine during the day from what we've seen. Do you think that it's a physical thing, or could senility do that too? (Or both?) Before I first took him to the vet, I was reading on senility, but was unsure since it was pretty much an overnight change.


 


A side note, even after being on prednisone and still on antibiotics, he his still chewing on himself like crazy, and looks moth-eaten. He sees a dermatologist for allergies, and usually clears up on those meds. Do you think that allergies come into play with this, other than the obvious itchiness/discomfort? We bathe him once a week with chlorhexadine shampoo.


 


Other thoughts I've heard are thyroid issues (for the spacing out/partial-seizure like episode) and brain tumor (yikes), but of course MRIs are pretty pricey so we haven't gone that route yet.


 


I received a call from the vet tech just a little while ago, and she's going to relay the information to our regular vet. So we'll see what he wants to try next ...


 


Thanks! Caitlyn :)

Expert:  Dr. Kara replied 6 months ago.

Caitlyn, with as bad as his allergies sound it is possible that his discomfort is driving at least part of his behavior. I didn't realize he was affected that badly. It is possible that he is distracted enough during the day so he is less uncomfortable then, but at night when all is quiet and he isn't distracted then he gets restless because he is more aware.

 

The same can be said of senility though, in that when there is activity and stimulation during the day they tend to be better. At night when many environmental cues are gone, they are tired, and lighting is dim we tend to see more symptoms.

 

We can try treating his allergies more aggressively, though we cannot use steroids if he is on Vetprofen, we can add antihistamines and omega 3 fatty acids, and see if that helps. I would bathe him more frequently too, twice weekly if you can. The cool water will remove allergens and soothe his skin. Make sure to use a conditioner to add moisture back to his coat.

As far as antihistamines you can try:

1) Benadryl (diphenhydramine only don't use the combination products with acetaminophen or decongestants as they can be toxic) at 1mg to 2mg per pound or one 25mg capsule per 25 pounds of dog orally every 8 hours.
OR 2)Claritin (loratidine) at 5mg per 25 pound dog once or twice daily.

OR 3)Hydroxyzine at 1mg per pound orally every 8 hours.

OR 4) Chlorpheniramine at 4mg to 8mg per dog once or twice daily.

Some dogs do better on one antihistamine rather than another.
Give the one you pick a week to 10 day trial and if it isn't working try another. Be
aware antihistamines can cause sleepiness or hyperactivity in some dogs. These
side effects do wear off with repeated use.

You can use a combination of antihistamines and high doses of omega-3 fatty acids to help with inhaled allergies (they also help with the symptoms of flea allergy). In combination fatty acids and antihistamines work synergistically, much better than either one alone.

Omega-3 fatty acids are fish oil products. 3V by DVM or Derm Caps ES are good brand name products. Use the high end of the dosing schedule for your pup's weight.


Hypothyroidism can certainly lead to poor skin and coat condition and would explain his poor response to what usually works to relieve his allergic symptoms. We can see neurologic symptoms with hypothyroidism but it isn't very common and we usually see things like incoordination and seizures. I don't think it's a bad idea to evaluate his thyroid function. I would recommend a full thyroid panel be done, not just a T-4.

Customer: replied 6 months ago.

Thanks again. We have tried several different antihistamines, but not all. Normally his allergies are relatively well controled, but I guess something lately has just been extra bad. Maybe it's time to try another type of antihistamine. We feed him high-quality food with salmon, but I imagine that doesn't provide that much oil, so maybe we'll give that a go as well.


 


He's a 65 lb dog, but sometimes I wish he was a lap dog because bathing would be so much easier! We have tried so much for him; he's even done Atopica, allergy shots, and two different drug trials. I guess he is just a special dog. I know it's difficult to get the big picture and all the information from this type of forum, but I appreciate your help. Maybe we'll try the thyroid test as well, just to rule that out.


 


Thanks again!
Caitlyn

Expert:  Dr. Kara replied 6 months ago.

My nose tells me that this has been a bad fall for allergies so it is possible that your pup is suffering more then usual. While fish based diets are great they don't usually have enough omega 3's to be useful in skin conditions so I would add more.

If he's had any stomach upset as well (vomiting, reflux, loose stools or gas) then perhaps a switch to a true hypoallergenic diet is worth a try. Food allergies could certainly cause skin symptoms not consistently helped with steroids. You could try Hills z/d or Purina Veterinary Diets HA. No treats, flavored medication or bones while on the diet and it must be used for a least 12 to 16 weeks to see the full effects.

I feel your pain on bathing a big dog, my pup is a 70 pound greyhound.

I think a thyroid profile is a good idea.

 

Dr. Kara, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 8575
Experience: 23 years of experience treating dogs, cats, mice, rats, rabbits, guinea pigs, hamsters, & iguanas
Dr. Kara and 9 other Dog Veterinary Specialists are ready to help you
Expert:  Dr. Kara replied 6 months ago.
Hi Caitlyn,

I'm just following up on our conversation about Rowdy. How is everything going?

Dr. Kara

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