My dog can't settle at night

(28 Posts)
Blutopia Fri 20-Sep-19 21:54:28

I have a female Patterdale terrier. She's 12 and suffers with chronic spinal pain after an injury and surgery when she was 4. She's on a pain management program - gabapentin, amitriptyline, prednisone and Pardale-V.

In the last few months she's had repeated episodes where she's increasingly restless at night, seemingly unable to lie down and sleep comfortably (although she'll cheerfully sleep anywhere in the house all day). Sometimes she's distressed to the point of panting.

She's been fine all day today, she's been for her two short walks, eaten normally, even played with a toy for a while and was laying with me on the sofa until we came up to bed.

She typically has a final wee and a bedtime biscuit, stays downstairs in her own bed for most of the night, tending to come up and ask to come under the covers with us when the room temperature drops in the early hours.

But recently, once we're in bed she's up and down, up and down, walking into all the rooms in the house and scratching, laying down but then leaping up with a growl again and moving to another room. While I've been typing this post she's jumped up on the bed, tried to lay down but snarled/barked and jumped up again, four times. She's been scratching in another favourite spot and has just come back in here again, panting and staring at me.

I'm sure it's pain, but don't really understand why she's fine during the day but not at night. She's on as much pain relief as they can give her long term, on top of the steroids. She's shaking badly but that's normal for her, there's some nerve damage from her spinal injury.

Could it be dementia? She doesn't stare into corners or anything odd, she's just extremely restless and distressed at pretty much the same time every night. This will either continue through the night until we get up again, or she'll eventually exhaust herself and curl up somewhere to sleep. My poor girl, I don't know what to do for her - there's no lore pain relief options. sad

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Blutopia Fri 20-Sep-19 21:57:06

*No more pain relief options, that should say.

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Wolfiefan Fri 20-Sep-19 22:01:55

We had a cat on tramadol. Not sure if that’s an option.
Have you tried hydrotherapy or acupuncture? Heated whelping pad at night? Does she sleep in a crate? Can you cover it?

Blutopia Fri 20-Sep-19 22:13:57

She's certainly had tramadol before Wolfie, and we've got some in reserve - probably wouldn't give it to her on top of the Pardale-V though (dog formulated paracetamol!)

Hydrotherapy and acupuncture would be tricky as she can't abide being touched - after her op the physio had to stand by the door and give me instructions to teach me the movements!

No she isn't crate trained. She's got several heating pads but seems unmoved by them.

I've managed to get her to stay laying beside me in bed for the last 10 minutes by making very small, t-touch style massage movements on her shoulders. She growls at me periodically but hasn't sprung up yet.

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Blutopia Fri 20-Sep-19 22:22:31

Just had a read up on canine cognitive dysfunction. She does seem to fit the profile and some symptoms (age, hearing loss, disrupted sleep/wake cycle, increased hunger, anxiety at night. sad

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FranklySonImTheGaffer Fri 20-Sep-19 22:44:37

I'm in a similar situation (without the spinal issues / pain management).
My patterdale (bitch) is 15 and has cognitive dissonance - she is very similar to yours by the sounds of it (she is currently Very slowly walking around the living room and has been doing so on and off all evening).
She has minimal hearing and her eyesight is also failing.

We used to put her to bed downstairs but she would whine / howl which we figured was distress at being on her own and lights & radio on didn't help so we've resorted to crate in the bedroom. This has helped somewhat, mostly because I think she knows we're close by. We also have ddog 2 which I think helps.

No real answers I'm afraid. Mine still randomly wakes up but now she's close, simply brushing my hand on her tends to reassure and settle her.

FranklySonImTheGaffer Fri 20-Sep-19 22:46:49

Reading that back, it sounds like she's miserable so I should clarify this only happens in the evenings and is worse the later it gets if we don't go to bed at a decent time.
In the day she's perfectly happy, she eats, drinks, runs around, even plays etc. She just doesn't want affection the way she used to - at her last vet appointment they described her as 'surprisingly sprightly' for a dog her age and with her condition!

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Blutopia Fri 20-Sep-19 22:57:26

Another Patterdale! grin

Sorry to hear you're going through similar, it's awful not really knowing how to comfort them. Mine has never been much one for physical affection but a positive touch seems to ground her when she's caught up in her internal panic.

She has now been laying with me for 40 mins, and her breathing has slowed...her body still feels rigid to touch though. She is obsessively licking a foot, but that's something she does to self-soothe so I'm not trying to stop her, for once.

It does match quite closely with some of the symptoms of CCD. I'd better speak to the vet again.

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Lyingonthesofainthedark Fri 20-Sep-19 23:22:38

Prednisolone causes major sleeplessness in humans, if that helps.

HappyBumbleBee Fri 20-Sep-19 23:41:41

I think it's wise to speak with your vet OP. It could be there's been some resistance builtd up to the medication. Possibly it needs tweaking, or maybe altering the time it's given to give a bit more help at night.
All of this would need to be under strict vetinary supervision though so definitely talk to them and see what they suggest x
The other thing you could try is a hot water bottle? Also, although she is used to having the house to wander, maybe limiting her to one particular room may help?
Really hope you get some answers and help soon xx

RedHelenB Sat 21-Sep-19 10:34:52

I'd pts in your situation. She's had a happy life but the pain isnt being masked by the medication by the sounds of it

Blutopia Sat 21-Sep-19 19:37:41

She's not doing well this evening either. sad

We were going to be out most of the day so dropped her at my MILs to save her being home alone (not that she really minds) - collected her just about the time she'd normally be fed, which is about the time the restlessness starts. She'd been normal all day according to MIL and had 2 short walks whilst there.

Even in the car it started, growling and jumping up, unable to lie down comfortably, scratching at the seat mindlessly then panting and looking in pain (I know my dogs face when she's in pain, she had a ruptured disc for 10 weeks before it was identified). We've just got in and I fed her and gave her painkillers - she ate all her dinner plus some leftover breakfast, had a big drink and a wee outside. I encouraged her to play a little but she's not interested in her favourite toys, only wants to stand and bark at me (then did her usual sudden growl and dash away, looking at me like I'd hurt her).

She's currently sitting up with me on the sofa and I've tried to distract her with a chew, which she only chewed for a minute or so. She has curled up now, I'm hoping she's tired after a day away from home and will sleep.

Oh, she's woken up and sat staring for a bit, now she's gone back to chewing her foot.

I just feel sick with worry - I absolutely don't want her to suffer a day longer than necessary and we've been preparing for her demise for several years, expecting her to rupture another disc and being unwilling to put her through the hell of surgery again. But equally, a change of medication and/or timing might get her past this phase? I should try shouldn't I - after all, her daytimes seem to be ok, she's still enjoying her food and her walks?

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Floralnomad Sat 21-Sep-19 19:50:11

I would see what the vet suggests all the time she is ok during the day .

Blutopia Sat 21-Sep-19 20:34:04

I'll call first thing Monday - they often do a telephone consultation as she is so difficult to handle and gets so frightened.

Fingers crossed, she's gone an hour and a half without leaping up and growling, and seems fairly relaxed although her breathing is a little fast.

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user1471465525 Sat 21-Sep-19 22:18:40

Unfortunately this is often a sign that ddog in not coping well with her discomfort. The kindest thing we can do for our ddogs is take thar pain and misery away when they cannot deal with it.

Blutopia Sat 21-Sep-19 22:35:46

I totally agree. But DH won't entertain letting her go until we've exhausted every effort to maintain her quality of life, and she hasn't had a change in meds for two years other than adding in a low dose of steroid (which IMO was a last resort anyway). There may be other options yet.

Plus, it's hard to assimilate euthanasia with the dog who happily goes for her walks (if short), eats well and moves around ok for at least 20 hours out of 24. It's those few hours each evening - sometimes less - that she seems to struggle, and then she re-sets.

I adore her and will be devastated when she goes, but if the vet said there's nothing more to do to relieve her pain and she will spend every evening, eventually stretching to longer and longer periods, in miserable discomfort, I would wave her off tomorrow very sad but knowing she had a good life.

DH thinks I'm writing her off too soon. sad

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Floralnomad Sat 21-Sep-19 23:06:14

I think it’s reasonable to explore all the options when the dog is happy for most of the day , perhaps she could have a small dose of diazepam to help her settle at night .

Blutopia Sun 22-Sep-19 07:12:52

Yes she's had diazepam before Floral for extreme pain (pre and post surgery), obviously it makes her a bit floppy and more wobbly than usual but that won't matter if she has it at bedtime.

It's pity she is so sick on NSAIDs, she can only handle a few doses before she starts vomiting miserably so I won't give them to her. We have tried increasing the dose of gabapentin, but that made her very drowsy and uncoordinated during the day which subsequently made her anxious so we reduced it again.

She's tried Onsior which gave her violent diarrhoea; tramadol which the vet switched out 3 years ago; and another potent drug based on ketamine that I've forgotten the name of, but the vet switched that out too.

She's ended up on the current combination of gabapentin, amitriptyline, low dose steroid plus paracetamol, which from what I've read is a common strategy in dogs with chronic spinal pain.

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RedHelenB Mon 23-Sep-19 22:03:09

Sorry but I think it sounds horrendous for her. I know how you feel but having put my elderly cat through surgery ( she lasted another year but was never quite the same) I swore I'd never do it again. I really think it time, she wont improve.

Crustyjugglers Mon 23-Sep-19 22:10:05

I'm not sure where in the country you are but there are vets who specialise in pain management. They may be able to suggest something that your normal vet hasn't although what she's on does seem pretty comprehensive. Worth a try at least. Best of luck.

HappyBumbleBee Mon 23-Sep-19 23:42:08

@Blutopia How did you get on today with vets? Been thinking of you and your beautiful girl xx

Blutopia Tue 24-Sep-19 18:49:11

I booked a call but they can't give you a time - he called me twice yesterday, once when I was without my phone in a petrol station and then when I was wrestling my bags and cases up some stairs and couldn't get the phone out in time. I tried calling straight back but couldn't get through.

Then he called again today but I was in a meeting and couldn't take it!

I've had a cancellation tomorrow so I'll call again and say to try me any time, the phone will be glued to me.

In the meantime, she was absolutely fine on Sunday evening, and even last night when I was away and DH had her on his own, she was okay too. Maybe she was just having a bad few days, but I'll talk to the vet still.

He originally consulted with one of the neuro vets at Fitzpatricks (where she had her original op) who specialises in chronic spinal pain, I believe it was she who suggested this current pain management programme but I can't remember her name.

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HappyBumbleBee Tue 24-Sep-19 20:30:55

Thanks for the update @Blutopia it sounds like you've had a pretty manic couple of days but it's good that she's been a bit more settled - fingers crossed it can be sorted with a tweak of medication.
Give her a gentle hug from me and good luck xxx

Blutopia Tue 24-Sep-19 21:08:19

Thanks Bumble.

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Blutopia Wed 25-Sep-19 17:42:23

Spoke to vet today...he thinks it's gut pain!

We talked about a new anti-inflammatory on the market that she could try, and about her general ageing etc.

But he asked me a few pointed questions about the particular evening behaviour and hit upon something - it always seems to happen just after she's eaten in the evening, never at any other time. AND, she has been golloping down her dinner like a starved piglet lately (steroid effect perhaps), taking big gulps of air as she tries to breathe and stuff her face simultaneously. She doesn't trough her breakfast the same way because it's dry (boring) food, and she's always been a very fussy and slow feeder until she got older and started on steroids. He asked if she is hunched during these episodes - she is - and pointed out that if she's taking in air and gulping down huge mouthfuls of food on her tiny empty stomach, she's probably got indigestion! We had idly wondered if it could be gut pain/cramps - she has had a mucousy poo on a few occasions, sorry if TMI - but we tend to always be drawn back to her chronic back pain.

She's been ok for the last three evenings so it may not happen every time she bolts her dinner, but we'll start spacing out her food so she can't take on too much at a time, and maybe swap breakfast and dinner around. Or get an anti-gulp dish.

Indigestion! Who knew!

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