Hello, I'm Dr. Deb.
I recently came online and see that your question about Apache hasn't been answered. I'm so sorry that you've had to wait for a response, but if you still need assistance, I'd like to help if I can.
I'm sorry for these issues with Apache. Given his age, I do have a few thoughts as to why he might be acting as you describe:
1. Senility or cognitive dysfunction (CD). These dogs can present with a variety of symptoms which might include confusion, memory problems, and restlessness/pacing/panting at night where they can't seem to settle down (Sundown Syndrome similar to human).
Since we often do not know which neurotransmitters or neuro-pathways are most affected by CD in each patient, a better response may be seen in our pets if a combination of several supplements and drugs are given as opposed to only one or two. This sort of combination can help to improve the level of neurotransmitters in the Central Nervous System (CNS) and reduce oxidative damage to brain tissue.
There are other modifications which can be made to lifestyle which may be beneficial which I’ve included below as well.
a. Cognitive supplements such as Neutricks, or Senilife
b. Combination of antioxidants such as Golden Years (Sogeval) , Antiox 5000 Ultra (Sovegal), Cell Advance 440 for small and medium sized dogs (Vetriscience)
c. Anti-inflammatory agents such as high dose fish oils (DHA> 300mg… not the total mg on the capsule but the DHA content).
d. Over the counter, human Melatonin which can be especially helpful if sleep issues are present but it also has antioxidant properties. 1-3 mg before bedtime.
e. CNS stimulants such as Selegiline 5-10mg/day which is a drug licensed for use in CD but would have to be prescribed by your vet.
f. Consider a prescription diet such as Hills' B/D diet or Purina senior diet with MCT oil. There’s some evidence that calorie restriction can help some dogs with CD so reduce calorie intake.
g. Evidence exists that daily and sustained exercise has positive effects in reducing progression of CD. Exercise daily: 1/2-1 hour walk twice daily
h. Sensory stimulation such as touching, brushing, and massage therapy may also reduce progression of CD.
2. He could have pain/discomfort somewhere in his body...hips, knees, spine, for example, although you'd actually expect him to have issues during the day as well. Some dogs do but others only seem to be uncomfortable at night. If he is not currently taking any medication and isn't vomiting, you might consider giving Aspirin at a dose of 10 mg/lb twice daily; it should always be given with food.
It is possible that he would need stronger anti-inflammatory drugs or even pain medication such as Tramadol which your vet could prescribe but it won't hurt to try several doses of the Aspirin to see if this helps.
Many of the anti-oxidants which I've mentioned above are helpful for joint issues.
Additional, I often recommend joint supplements such as Dasaquin or Adequan (which is an injectable product from your vet).
3. I always worry about a brain mass when my older patients start to behave in odd and unusual ways although it would take advanced imaging to diagnose such a problem. I don't mean to alarm you by including this on the list but do so just to be complete.
I hope this helps to provide possible explanations for his behavior and possible treatment options. Again, my apologies for the delayed reply. Deb