My dog and I both need to sleep
November 27, 2019 9:09 AM Subscribe
My 13-year-old dog is in declining health and essentially on hospice care but her issues are well-managed during the day. She‘s increasingly having trouble sleeping at night, though, and I’m feeling like I’m running out of options for managing it.
Dog tax is in my profile.
She’s had 4 clusters of grand mal seizures since January, which the vet thinks is likely due to a brain tumor. She’s on the max doses of phenobarbital and keppra. The last cluster seems to have given her some mild neuro issues, like slight hind-leg weakness and mild vision issues in one eye. She also has mild kidney disease which is well-managed.
I’m planning to put her down the next time she has a cluster of seizures or when the bad days start outnumbering the good days, whichever happens first. My vet agrees that this is a reasonable plan.
Despite all this, she’s energetic, eating and drinking well, doing a bang-up job keeping weight on, and usually in a good mood. The good days vastly outnumber the bad.
BUT. Since her first seizures, she started crying and pacing almost every night for at least a few minutes, probably because of some degree of dementia, neuro issues, med side effects, and/or general aging stuff. She seems to want to go outside but doesn’t always pee when I do take her out, and never does so urgently. These are the options for how it goes:
GOOD NIGHTS (~5 a week): I tell her to go back to bed, and she tucks herself back in (thanks, Metafilter!) and falls asleep.
OKAY NIGHTS (~2 a week, these nights happened daily until she started trazodone): She keeps crying and pacing, so I take her for a middle-of-the-night walk, and she falls asleep right after. I’m used to the walks now and am getting decent sleep despite them.
BAD NIGHTS (these have happened for the first time in the past month, in two episodes): She’s inconsolable, and cries, paces, and sometimes pants all night, even if I take her out. It’s distressing for both of us and nearly impossible to sleep through, even with earplugs.
She’s on the max doses of trazadone and gabapentin. I’ve tried multiple kinds of CBD and it does nothing- it’s everyone’s go-to but I promise it doesn’t work; please don’t recommend it. I just added zylkene, but that doesn’t seem to be helping either. I got a strong sedative from the vet for bad nights, but it was really awful- she still tried to pace but can’t walk well enough to do it and stumbled around moaning all night.
Any other ideas for managing this?
Dog tax is in my profile.
She’s had 4 clusters of grand mal seizures since January, which the vet thinks is likely due to a brain tumor. She’s on the max doses of phenobarbital and keppra. The last cluster seems to have given her some mild neuro issues, like slight hind-leg weakness and mild vision issues in one eye. She also has mild kidney disease which is well-managed.
I’m planning to put her down the next time she has a cluster of seizures or when the bad days start outnumbering the good days, whichever happens first. My vet agrees that this is a reasonable plan.
Despite all this, she’s energetic, eating and drinking well, doing a bang-up job keeping weight on, and usually in a good mood. The good days vastly outnumber the bad.
BUT. Since her first seizures, she started crying and pacing almost every night for at least a few minutes, probably because of some degree of dementia, neuro issues, med side effects, and/or general aging stuff. She seems to want to go outside but doesn’t always pee when I do take her out, and never does so urgently. These are the options for how it goes:
GOOD NIGHTS (~5 a week): I tell her to go back to bed, and she tucks herself back in (thanks, Metafilter!) and falls asleep.
OKAY NIGHTS (~2 a week, these nights happened daily until she started trazodone): She keeps crying and pacing, so I take her for a middle-of-the-night walk, and she falls asleep right after. I’m used to the walks now and am getting decent sleep despite them.
BAD NIGHTS (these have happened for the first time in the past month, in two episodes): She’s inconsolable, and cries, paces, and sometimes pants all night, even if I take her out. It’s distressing for both of us and nearly impossible to sleep through, even with earplugs.
She’s on the max doses of trazadone and gabapentin. I’ve tried multiple kinds of CBD and it does nothing- it’s everyone’s go-to but I promise it doesn’t work; please don’t recommend it. I just added zylkene, but that doesn’t seem to be helping either. I got a strong sedative from the vet for bad nights, but it was really awful- she still tried to pace but can’t walk well enough to do it and stumbled around moaning all night.
Any other ideas for managing this?
Thundershirt for anxiety? Also, go back to the vet to ask for something for agitation. The sedative dopes her but doesn't relieve her anxiety which is probably related to her dementia. You can ask for a referral to a specialist if your generalist vet is out of ideas. Ask about Anipryl. We also find (for our 14-year-old dog with dementia) that daylight really helps him - we open the windows wide and give him as much light as possible in daylight hours, and we think anecdotally that this helps him sleep more soundly at night.
posted by juniperesque at 9:17 AM on November 27, 2019 [1 favorite]
posted by juniperesque at 9:17 AM on November 27, 2019 [1 favorite]
We have an English Bulldog with almost exactly the same health profile, including seizures. We treat with exactly the same drugs, except we use 800 mg/ daily zonisamide instead of keppra. Within the last two years she also has the typical "sundowners" symptoms. We treat ours the same way your vet recommends, except we don't use trazadone. Her night-time meds for pacing/snapping for us are-- up to 300 mg of gabapentin, (AND here is the one thing we do differently which you might discuss with your vet) and if she really needs it up to 10 mg of valium (diazepam). We get the valium in 5 mg pills so she can have either one or two as needed. Valium is also cheap in the USA, like $9 for a month's supply, and vets don't seem to have any trouble prescribing it here in the Pacific Northwest. I hope that helps, and gives you another option. Good luck, this is a hard time, I know, but enjoy your time with her-- for us this stage of life has lasted longer than we thought and despite the challenges we are savoring every minute of it. Just last night Daisy snuggled up against me in bed and I thought how lucky we are to still have her around. This gaba/valium combo has helped SO MUCH. It makes our nights bearable, and we have stopped saying "this is the end for Daisy" and moved back into "let's enjoy her while we can", which is a big mental relief.
posted by seasparrow at 9:22 AM on November 27, 2019 [3 favorites]
posted by seasparrow at 9:22 AM on November 27, 2019 [3 favorites]
We had nights like that in our dog's last month, and for most of that month he was just a lot worse if we were in our bedroom. His preferred spot at that point, 24/7, was on beds on my office floor. So I put a twin bed in here for my husband to sleep on and they didn't even get up much most nights. I would often creep in here and start my workday for an hour or more before either of them woke up. He would often refuse to even go back to the bedroom with us, unless coaxed with treats. Sometimes during the day my husband would play video games back there and the dog would hang out for a little while but ask to come back up front pretty quickly.
He just...that wasn't where he was comfortable, I guess. Even though he had a twin mattress on the floor with a dog bed on it, he wanted to be in my office on similar beds. He also rejected previously-liked beds (these are all the same brand/style of bed) in the living room in front of the couch, and would go in my office alone before he'd hang out there.
Is there somewhere specific your dog prefers to be during the day? Maybe try sleeping there, if you can.
I'm sorry. We waffled several weekends on whether we needed to go ahead and have the vet come, thinking he might rally again as he had done several times to our surprise, but the sleep deprivation (and my near-inability to work because he needed so much attention and I was an anxious wreck waiting for the next thing that needed my intention) was a deciding factor in making the final call. It was taking so much energy to care for him, and it wasn't going to fix him, and it was getting harder for us and surely for him as well. It's definitely a factor in the calculus of when it's time.
posted by Lyn Never at 9:23 AM on November 27, 2019 [3 favorites]
He just...that wasn't where he was comfortable, I guess. Even though he had a twin mattress on the floor with a dog bed on it, he wanted to be in my office on similar beds. He also rejected previously-liked beds (these are all the same brand/style of bed) in the living room in front of the couch, and would go in my office alone before he'd hang out there.
Is there somewhere specific your dog prefers to be during the day? Maybe try sleeping there, if you can.
I'm sorry. We waffled several weekends on whether we needed to go ahead and have the vet come, thinking he might rally again as he had done several times to our surprise, but the sleep deprivation (and my near-inability to work because he needed so much attention and I was an anxious wreck waiting for the next thing that needed my intention) was a deciding factor in making the final call. It was taking so much energy to care for him, and it wasn't going to fix him, and it was getting harder for us and surely for him as well. It's definitely a factor in the calculus of when it's time.
posted by Lyn Never at 9:23 AM on November 27, 2019 [3 favorites]
Outside the box idea: Since your sweet puppers enjoys being under blankets SO much, I wonder if a weighted blanket might be even more comforting for her. Some of them are very heavy, so you'd need to find one that's maybe for a toddler, but some extra snuggle pressure might be helpful at least on the ok nights?
posted by hydra77 at 9:30 AM on November 27, 2019 [2 favorites]
posted by hydra77 at 9:30 AM on November 27, 2019 [2 favorites]
My beautiful Caye had CCD (Cognitive Canine Disorder) - his symptoms ramped up very quickly within five months. The nighttime pacing, panting, whining, inability to get comfortable to relax and sleep took a devastating toll on him and on me. I know others spend a lot of time and energy managing the symptoms, but it just never gets better. I tried everything that everyone usually recommends, but he was never really himself.
It was a terrible, painful decision to let him go. He was 14 and otherwise in generally good health, which made it a more difficult choice.
I miss him every day, but I don't regret the gift I gave him to let him go peacefully before it got worse for him.
I'm very sorry. CCD is a terrible thing.
posted by HeyAllie at 9:31 AM on November 27, 2019 [6 favorites]
It was a terrible, painful decision to let him go. He was 14 and otherwise in generally good health, which made it a more difficult choice.
I miss him every day, but I don't regret the gift I gave him to let him go peacefully before it got worse for him.
I'm very sorry. CCD is a terrible thing.
posted by HeyAllie at 9:31 AM on November 27, 2019 [6 favorites]
Have you tried a heated blanket? Our one dog (not geriatric) always wants to get in bed with us and it's hell to train her not to after any break. Having a heated blanket under her bed has helped alleviate this.
posted by notsnot at 9:37 AM on November 27, 2019
posted by notsnot at 9:37 AM on November 27, 2019
Response by poster: A few clarifications:
The trazadone and gabapentin are for agitation.
This is definitely a consideration for putting her down, but right now it's infrequent enough that it doesn't feel quite like it's time yet.
She seems to get hot a lot easier than usual these days, which might be part of why she can't get comfortable despite loving being under blankets. She sometimes overheats herself under her blanket and wakes up panting (which she never does unless she's REALLY hot) even when she's not agitate. She has two beds in the two spots in my bedroom she seems to prefer to sleep. One has a heating pad in it and one doesn't. She hasn't slept in my bed since she was young and doesn't try to.
posted by quiet coyote at 9:40 AM on November 27, 2019
The trazadone and gabapentin are for agitation.
This is definitely a consideration for putting her down, but right now it's infrequent enough that it doesn't feel quite like it's time yet.
She seems to get hot a lot easier than usual these days, which might be part of why she can't get comfortable despite loving being under blankets. She sometimes overheats herself under her blanket and wakes up panting (which she never does unless she's REALLY hot) even when she's not agitate. She has two beds in the two spots in my bedroom she seems to prefer to sleep. One has a heating pad in it and one doesn't. She hasn't slept in my bed since she was young and doesn't try to.
posted by quiet coyote at 9:40 AM on November 27, 2019
A very low dose of melatonin would knock my dog out within about half an hour and keep him sleeping deeply. would that be helpful here? he had similar problems at the end of his life, although that wasn't why i started giving it to him. the CBD and the sedative from the vet also just made him stumble around but otherwise didn't slow him down at all.
posted by gaybobbie at 3:52 PM on November 27, 2019
posted by gaybobbie at 3:52 PM on November 27, 2019
Seconding melatonin. It is what we are using for our CCD dog.
posted by LikeaDogwithTwoTails at 5:45 PM on November 29, 2019
posted by LikeaDogwithTwoTails at 5:45 PM on November 29, 2019
This thread is closed to new comments.
posted by quiet coyote at 9:14 AM on November 27, 2019 [1 favorite]