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Sundowner’s Syndrome in Senior Dogs

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In the past few months, Jet has begun to display signs of Sundowner’s Syndrome.

If you have experience working with the elderly or with someone with dementia, then you may have heard of this term before.

Sundowning is a term that was known in the Alzheimer’s and dementia circles, but a few years ago, veterinarians began to recognize that it could also exhibit in animals as well.

 

Sundowning

What is Sundowning or Sundowner’s Syndrome?

Sundowning is a term that is used to refer to a group of behaviors that are seen in individuals affected by illnesses or processes known to cause dementia.

Sundowning is called “sundowning” because these behaviors begin to appear at sundown. Sometimes “sundowning” is referred to as “late-day confusion.”

Most often, sundowning is seen in people affected by Alzheimer’s disease.

Doctor’s believe that the reduction of light seen in the afternoon and evening plays a role in triggering the symptoms seen in sundowner’s syndrome.

Individuals exhibiting sundowner’s syndrome seem to have significant improvement or even a seeming resolution to their symptoms in the morning.

Symptoms of Sundowning

Symptoms of sundowning that are seen in humans include:

  • Anxiousness
  • Irritability
  • Restlessness
  • Disorientation
  • Confusion
  • Suspicion
  • Demanding behavior
  • Pacing
  • Hallucinations
  • Mood swings

Triggers of Sundowning

As mentioned above, it is believed that the reduction of light plays a role in the onset of sundowning symptoms. Increased shadows in the home caused by the sun going down can cause increased anxiety and confusion. Tiredness and disorientation can be caused by a blurring of the lines between wakefulness and dreaming states.

 

Treating Sundowner’s Syndrome in People

When a human suffers from sundowner’s syndrome, their loved ones and caretakers are often advised to take certain steps to help lessen the effects of sundown on their loved one’s wellbeing. These steps include:

  • Looking for patterns in sundowning behavior to try and identify triggers. Knowing what causes a symptom can assist in reducing or eliminating exposure to that trigger.
  • Maintaining a regular schedule. Scheduling activities can help to set routine, but also help to avoid demands on a sundowner when their symptoms are likely to be exacerbated.
  • Eliminate shadows by using light and closing curtains and blinds.
  • Maintain a comfortable room temperature to avoid cause for agitation.
  • Avoid loud noises that might be shocking.
  • Take part in relaxing and anxiety-reducing activities.
  • Be calm and reassuring.

 

Cures for Sundowning

Unfortunately, there is no “cure” for sundowning as it is a symptom of a disease or process rather than a disease itself.

Sundowning syndrome is usually managed through making environmental changes as mentioned above.

Since researchers have yet to pinpoint the exact mechanism at work in sundowning behavior, medicinal treatments are still very much experimental. Some medications and alternative treatment, however, have shown promise in soothing sundowning syndrome in humans. These medications and other treatments include:

  • Light therapy
  • Melatonin
  • Acetylcholinesterase inhibitors
  • N-methyl-d-aspartate receptor antagonists
  • Behavioral modifying therapies
  • Anti-psychotics

 

Old Dog

 

Sundowning in Dogs

So, now that you have an understanding of what sundowning is in humans, how does sundowning apply to dogs?

Just like with people, sundowning in dogs is related to dementia or “canine cognitive dysfunction.”

Like many cases of dementia in people, CCD in dogs is a result of the effects of aging on the brain. As a dog gets older, they may or may not develop signs of canine cognitive dysfunction, but research estimates that some 68% of dogs who are 15 years old exhibit signs of CCD.

Canine cognitive dysfunction tends to begin with mild symptoms that progress over time. This is a disease that is associated with aging, however, some veterinarians believe that there is a genetic factor that may predispose a dog to developing CCD in later life.

Symptoms of CCD can be exhibited throughout the day as well as at night and they include:

  • Confusion
  • Disorientation
  • Anxiety
  • Restlessness
  • Irritability
  • Decreased playfulness
  • Increased licking
  • “Forgetting” or “ignoring” training or rules of the home
  • Slowed learning of new skills
  • Confusion pertaining to well-known routines
  • Neglect of self-grooming
  • Incontinence
  • Decreased appetite
  • Wakefulness at night
  • Increased sleeping during the day

Canine cognitive dysfunction is not the same thing as sundowner’s syndrome, rather it is what causes sundowning symptoms.

Just like people who exhibit sundowner’s syndrome, dogs with sundowner’s syndrome exhibit their symptoms in the late afternoon or evening and those symptoms seem to ease or disappear completely the following morning.

Symptoms of Sundowning in Dogs

We know the symptoms of canine cognitive dysfunction, but what are the symptoms of sundowning associated with CCD?Symptoms that are seen in dogs that are associated with sundowning include:

  • Increased daytime sleeping
  • Increased wakefulness at night
  • Anxiety
  • Pacing
  • Confusion
  • Disorientation
  • Inability to get comfortable
  • Incontinence
  • Seemingly getting lost in the house
  • Hesitance even with familiar things and people

Triggers of Sundowning

As with humans, sundowning symptoms present when light diminishes. In older dogs existing physical conditions can also worsen the symptoms of sundowning, for example, a dog that is losing their sight AND experiencing confusion can easily become more anxious at night when their sight is worse.

 

Treating Sundowner’s Syndrome in Dogs

When a dog suffers from sundowner’s syndrome, there are some things that can be done to alleviate their symptoms. Some of these things include:

  • Looking for and eliminating or limiting triggers that seem to cause symptoms. For example, if your dog’s symptoms are worsened in the dark, add a night light or better lighting to their sleeping area.
  • Keeping a regular structure can help, as well as surrounding your dog with familiar scented things.
  • Leaving music on or the TV on at night to mask noises that could be startling.
  • Maintain a comfortable room temperature using blankets or fans if necessary.
  • Avoid loud noises that might be shocking.
  • Try relaxing activities like massage, a slow walk before bedtime, a quiet meditation CD. (Jet loves Thomas the Tank Engine so when he gets worked up I put Thomas on TV and he usually settles down a little.)
  • Be calm and reassuring. When you become distressed, your dog will too.

 

Cures for Sundowning in Dogs

 

As with people, there is no cure for sundowning in dogs. In addition to the environmental changes mentioned above, there are some things that can be done to help manage the symptoms of sundowning, however. These things include:

  • Incorporating omega fatty acids into your dog’s daily diet.
  • Treating exacerbating conditions if possible.
  • Accommodating exacerbating conditions if they cannot be treated. For example, announcing your presence to a blind dog and talking to them soothingly to reassure them of what is happening.
  • Take potty breaks more often if needed and use incontinence supplies if needed.
  • Talk to your vet about melatonin or samE use.
  • Talk to your vet about dietary changes that could be beneficial to your dog, for example, a diet higher in fatty acids.
  • Talk to your vet about Anipryl (a generic version IS available), a prescription medication shown to slow the progression of CCD.
  • Other medications that are utilized in Europe for CCD include nicergoline, propentofylline, and adrafinil, it is worth looking into alternatives to these and discussing them with your doctor if Anipryl is not right for your dog. DO NOT order these medications online without your veterinarian’s knowledge.

 

Prevention of Sundowning in Dogs

While aging cannot be prevented and therefore, CCD can generally not be prevented, some veterinarians recommend rigorous mental stimulation beginning in middle age for all dogs as a way to prevent cognitive decline. Some veterinarians also recommend omega fatty acid supplementation at middle age to help to promote better cognitive health.

 

What to Remember about Dementia, CCD, and Sundowning

If there is one thing that it is crucial to know about dementia, canine cognitive dysfunction, and sundowning, it is that the person or dog suffering from these conditions is suffering. The symptoms that they are expressing are symptoms of genuine fear, anxiety, and concern and while you may be able to determine whether something is worth being afraid, anxious, or concerned about, they cannot. Be patient, be kind, and most of all, know when you need a break. Even caretakers of senior dogs need a respite once in a while, don’t be afraid to ask someone that you trust to help you so that you can care for yourself.

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