“Dear Dr. T., why is my dog panting and restless at night? He won’t settle down and I can’t get any sleep!” 

–Worried Dog Mom

Panting is a normal breathing pattern in dogs characterized by an open mouth, protruding tongue, and rapid, shallow breaths. This is one of the ways dogs cool down when they’re too hot. But what about when a dog is unhappy, restless and constantly panting? 

Senior dogs are more prone to this sort of behavior than their younger counterparts. Unfortunately, it often happens at night while everyone else is trying to sleep!

Pain, anxiety, cognitive changes and medication side effects are four common causes of excessive panting and restlessness in dogs. Cushing’s disease, heart failure and laryngeal paralysis are common in old dogs and can cause the same unsettled behavior.

This article will explain these issues and go over how to calm a restless dog.

Top 4 Causes of Panting and Restlessness in Dogs

  1. He doesn’t feel good (pain or illness)
  2. He’s worried (anxiety)
  3. Mental changes (cognitive problems)
  4. Medication side effects

Symptoms of each category can appear similar at first glance. In the first part of this article, I’ll discuss subtle differences that will help you understand what’s bothering your pet. Then in the second part, I’ll give you advice on how to calm an unsettled dog. 

As always, you should contact your veterinarian to help you identify your dog’s problem. They can prescribe the best treatment to get him feeling better. This article will help you understand how your vet will analyze the situation and give you some practical tips for short-term home care.

Muscle, Bone & Joint Pain


  • Osteoarthritis
  • Muscle/connective tissue trauma
  • Infection (bacterial, fungal)
  • Cancer

Osteoarthritis is a degenerative disease of the cartilage in joints that leads to pain and inflammation and pain. It is very common in older dogs. You may not be able to see signs of arthritis such as heat or swelling over a joint, but it can still be painful to the dog. 

Other musculoskeletal problems can also cause pain. Muscle strains/sprains, tendon and ligament tears, bone infection and even cancer can cause similar symptoms. 


  • Stiffness
  • Limping
  • Excessive panting
  • Decreased activity
  • Trouble lying in one position
  • Trouble getting up from lying down
  • Fever and poor appetite with infection or cancer

Making a Diagnosis

  • Radiographs 
  • Blood tests
  • Sometimes advanced imaging like CT or MRI


The most common medication used in the treatment of dog arthritis are non-steroidal anti-inflammatory drugs (NSAIDs) such as Rimadyl®. 

Non-prescription supplements seem to help some dogs with arthritis pain. The glucosamine-containing product, Glycoflex 3®, is well-tolerated and may help and lower a dog’s need for NSAIDs. 

Turmeric/curcumin is another natural plant product that may decrease inflammation caused by osteoarthritis. Zesty Paws Curcumin Bites® are a nice option since they come in a treat form.

Glycoflex III for dogs with arthritis pain that causes pacing and panting
My senior dogs take Glycoflex 3 (also available as chew treats).

Stomach Pain

Stomach pain is very common in dogs of all ages. The causes include eating something they shouldn’t have, gastric dilatation and volvulus (GDV), liver disease, pancreatitis, parasites, toxins and stress colitis.


  • Nausea
  • Drooling
  • Eating grass/licking objects excessively
  • Vomiting/gagging
  • Restlessness, pacing and panting
  • Prayer position (front end on the ground, rear end standing)
  • Painful when the belly is pressed
  • Increased or decreased pooping
  • Straining to poop
  • Diarrhea (may contain mucus or blood)
  • Noisy gurgling from abdomen
  • Passing gas
  • Yellow skin (with liver/gallbladder disease)

Making a Diagnosis

  • Radiographs
  • Blood tests
  • Stool test for parasites
  • Advanced imaging such as ultrasound


If a specific cause is identified, treatment can be targeted. In many cases, vets start with symptomatic treatment for nausea, vomiting, diarrhea and pain which may include 

  • Anti-nausea medication (famotidine, maropitant)
  • Anti-parasitic medication (pyrantel, fenbendazole)
  • Pain medication (buprenorphine, butorphanol)
  • Fluids with added electrolytes giving via a vein or under the skin

Back Pain

The most common cause of back pain in dogs is intervertebral disc disease, a.k.a. slipped disc. It can happen in any dog breed but some have a higher risk including Dachshunds, Beagles, Bassett Hounds and Shih Tzus. 


  • Intervertebral disc disease (slipped disc)
  • Infection of bone or soft tissue
  • Tumor
  • Some types of kidney disease


  • Hunched posture
  • Heavy panting
  • Decreased activity
  • Not wanting to jump or climb stairs
  • Crying out in pain randomly
  • Restless, can’t get comfortable lying down
  • Pain when back (or neck area) is touched
  • Pain when lifted
  • Tail held down
  • Head held down
  • Limping
  • Leg weakness or paralysis
  • Fever and poor appetite (tumor, kidney disease or infection)
IVDD in Dogs Symptoms

Read more about IVDD in dogs & how to help them heal…

Making a Diagnosis

  • Radiographs, possibly advanced imaging
  • Blood tests
  • Culture or biopsy in some cases


Strict rest from activity is the most important therapy for IVDD. Other treatment for intervertebral disc disease (IVDD) often involves non-steroidal anti-inflammatory drugs and pain medication. Surgery may be recommended for severe cases in which the dog is paralyzed. 

Treatment for infection, tumor and kidney disease depends on the cause. Antibiotics and anti-fungal medications may be required. 

Bladder Pain

Urinary bladder pain is fairly common in dogs. Most of the time it’s easy to tell that’s where the problem is but sometimes their symptoms are atypical.


  • Bacterial or fungal infection
  • Bladder stones
  • Tumor


  • Frequent urination
  • Straining to pee
  • No/very little urine passed despite straining
  • Pain when belly is touched
  • Licking genitals
  • Scooting bottom on the ground
  • Abnormal appearance or odor to urine

Making a Diagnosis

  • Urinalysis
  • Urine culture
  • Radiographs, sometimes ultrasound imaging
  • Blood tests


Treatment for bladder infection may require a urine culture to find out exactly which bacteria or fungus is growing there. Antibiotics are then given for 10 or more days until recheck testing shows the infection is gone. 

Some bladder stones can be dissolved over a period of weeks with prescription dog food while others can only be removed with surgery. 


The term anxiety is used to describe behavior stemming from apprehensiveness, nervousness or fear. All dogs experience anxiety from time to time as a normal part of behavior. But when anxiety is out of proportion to the perceived danger, it can become a problem. 

The tendency toward excessive anxiety is increased in some dog breeds or certain family lines. The trigger of this type of anxiety may be anything but the following causes are most common: 


  • Noise
  • Strangers
  • New surroundings
  • Storms
  • Separation anxiety (from owners or other pets)


  • Shaking/trembling
  • Drooling
  • Whining, barking, yipping, etc.
  • Excessive panting
  • Won’t settle
  • Hiding
  • Yawning when not tired
  • Destructive behavior
  • Trying to escape
  • Refusing to eat
  • Loss of housetraining
  • Vomiting
  • Diarrhea
YouTube player
Video of dog with thunderstorm anxiety from Cold Nose College

Making a Diagnosis

  • Blood tests and other diagnostics to rule out diseases
  • In-depth behavior consultation
  • Referral to a veterinary behavior specialist in some cases


Treatment for anxiety almost always requires behavior modification techniques and environmental adaptation. Your veterinarian may prescribe anti-anxiety medication for long-term use or for situational use. 

Cognitive Dysfunction


  • Cognitive Dysfunction Syndrome (CDS)–also referred to as senility or dementia. It is a degenerative disorder that causes progressive loss of normal mental processes. CDS usually affects older dogs but it can start as early as 7 years old.  
  • Brain tumor–According to PetCure Oncology, dogs aged five and older have an increased risk for developing brain tumors. Many of the symptoms overlap with CDS, but dogs with brain tumors may also have seizures, head pressing and circling in one direction.
  • Brain inflammation/infection–it’s possible for dogs to develop a viral, bacterial or fungal infection in or around their brain. Inflammation can also occur as part of an immune-mediated process. 


  • Weird behavior
  • Confusion/getting lost in the house
  • Wandering
  • Vocalization
  • Abnormal sleep-wake cycles (panting and pacing at night)
  • Loss of house training
  • Poor memory
  • Changes in social behaviors 
  • Decreased play behavior 
  • Decreased appetite
YouTube player
Video of dog with brain tumor from Southeastern Veterinary Neurology

Making a Diagnosis

  • Blood and urine tests
  • Radiographs
  • Advanced imaging of the brain
  • Spinal fluid analysis
  • Consultation with a veterinary neurology specialist


There is no specific treatment for CDS but special diets, dietary supplements may help some dogs. A dog owner facing these challenges often finds that adapting their houses and routines help improve their dog’s quality of life. 

Brain tumors may be treated with surgery, chemotherapy or radiation. Seizures caused by tumors are controlled with anti-seizure medication such as phenobarbital and levetiracetam. 

Brain infections require identification of the cause and are then treated with an appropriate antimicrobial drug. Dogs with infection as well as those with inflammation will also receive corticosteroids like prednisone. 

Medication Side Effects

Medication side effects can cause nausea, discomfort, hyperactivity and panting. Talk to your vet about side effects of any drugs your dog is taking. Here’s a list of a few medications that might cause abnormal panting and restlessness:

DrugSide Effects
Antibiotics (Amoxicillin, Clavamox, cephalexin)Stomach and intestinal pain, diarrhea, vomiting, gas
Antihistamines (Benadryl, Zyrtec)Paradoxical hyperactivity
Anti-seizure Medication (phenobarbital, gabapentin)Sedation, abnormal panting, wobbly gait
Corticosteroids (prednisone, prednisolone, methylprednisolone)Agitation, aggression, increased thirst, hunger & urination
Non-steroidal Anti-inflammatories (Rimadyl, Deramaxx, Previcox, and Metacam)Stomach and intestinal pain, diarrhea, vomiting, panting and restlessness
Opioids (morphine, buprenorphine and hydromorphone)Hyperactivity & heavy breathing in some dogs
Phenylpropanolamine (brand name: Proin)Increased blood pressure and activity level
Sedatives (Xanax/alprazolam, Valium/diazepam, acepromazine)Paradoxical hyperactivity


Always consult your dog’s veterinarian before changing the dose or discontinuing any medication. If you believe your dog is in danger (respiratory distress, unresponsive, severe vomiting/diarrhea, seizure, etc.), seek emergency veterinary care. 

Other Causes of Panting & Restlessness

I want to briefly touch on some other dog health problems that cause heavy panting and pacing in dogs. Some are common and some are not-so-common but are worth considering during a medical workup.

  • Cushing’s disease–an endocrine disease caused by too much steroid in the body. Other symptoms include increased thirst/urination, ravenous appetite, weight gain, pot-belly appearance and hair loss. The disease occurs in 1-2 out of 1000 dogs per year. (1)
  • Laryngeal paralysis–a medical condition in which the muscles in the larynx become paralyzed when there is damage or degeneration of the nerves supplying the area. Symptoms of laryngeal paralysis include increased panting, noisy breathing, difficulty sleeping, changes in voice and exercise intolerance. 
  • Heart or lung disease–There are many diseases that affect a dog’s heart and lungs including congestive heart failure, bacterial or fungal pneumonia and bronchitis. Diseased organ tissue prevents oxygen and carbon dioxide from moving through the body in a normal way. Symptoms may include coughing, bluish tongue, rapid breathing and exercise intolerance. 
  • Heat stroke–Overheating can occur at temperatures lower than you might expect. When overheating lasts more than a few minutes it can cause deadly conditions in the body referred to as heatstroke. Symptoms include excessive panting, weakness, agitation, dark red or bluish tongue and gums. 

Home Care to Calm a Restless Dog

The most important thing to do when your dog is restless is to determine if they have a health issue. Making an appointment to see a veterinarian is always a good idea, even if you’re not sure it’s an emergency. 

Once emergency health conditions have been ruled out, there are many things you can do at home to help your dog relax. 

Upgrade Your Pup’s Bed

More comfortable bedding can make a huge difference for dogs who are sore or underweight. When it hurts to lie down, it’s tough to relax at night.

I recommend a high-quality, thick memory foam bed that is large enough for your dog to stretch out on. Wash the cover weekly and replace the bed when the mattress starts to sag. 

dog panting and won't lie down (dog on orthopedic dog bed)
One of my dogs on a Furhaven memory foam dog bed

Increase Exercise

Regular, moderate exercise is shown to increase mobility in dogs with osteoarthritis. Start with slow, 5-10 minute walks and work up from there. Watch your dog for signs that he’s tired or sore and adjust exercise duration as needed.

If your dog can’t walk well enough to get exercise, it’s still beneficial for them to get out of the house every day. Outings in a dog stroller, or even a short car ride can often improve a dog’s mood and combat restlessness.

Environmental Enrichment

Boredom is not good for the body or mind of dogs. Here are some ways to get them thinking and moving without leaving the house…

Try some food puzzles and interactive toys. The one interactive dog toy that every dog I know loves is the Orbee-Tuff® Snoop Ball, shown below. 

Orbee Tough Snoop ball for dog pacing and panting, dog panting at night
The most popular interactive food toy: Snoop Ball

Upgrade Your Dog’s Diet

There are many great therapeutic dog foods to help with many of the conditions mentioned above. For example, Pro Plan JM® dog food has high levels of omega-3 fatty acids that are clinically proven to improve symptoms in dogs with arthritis.

Royal Canin Urinary SO helps dogs with a history of bladder infection and stones. And there is even a dog diet that helps dogs with cognitive dysfunction: Hill’s b/d® dog food. 

Calming Anxiety

Here are a few more options I’ve used to successfully take the edge off for restless dogs. Consult your vet before giving any oral supplements. If you’d like links to products, click through to the Resources page.

  • Calming chews–many contain an amino acid called l-theanine which has been shown to decrease anxiety in noise-phobic dogs. (3) The brand I recommend is Composure®.
  • Calming pheromones–Adaptil® is a pheromone-based compound that comes in the form of a diffuser, a spray or a collar. Pheromone therapy has shown promise in reducing symptoms of stress in dogs. (6)
  • Pressure wrap–anxious animals respond positively to steady pressure applied over the large surfaces of their bodies. Thundershirt® is one popular brand shown below. They are clinically proven to decrease restless behavior associated with anxiety. (2)
  • Calming music–there is a line of recordings called Through a Dog’s Ear with music to calm dogs. I’ve played them for many dogs and the music seems to have a beneficial effect. 


The most common causes of heavy panting, pacing and restlessness in dogs are pain, anxiety, cognitive changes and medication side effects. Symptoms and history can help determine the underlying cause.

It is very important to see a veterinarian to get a diagnosis and proper treatment for health issues. There are also many steps you can take at home to make your dog feel more secure and relaxed including better bedding, interactive toys and calming pheromones.

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  1. de Bruin, C., Meij, B. P., Kooistra, H. S., Hanson, J. M., Lamberts, S. W. J., & Hofland, L. J. (2009). Cushing’s disease in dogs and humans. Hormone Research in Paediatrics, 71(Suppl. 1), 140–143.
  2. King, C., Buffington, L., Smith, T. J., & Grandin, T. (2014). The effect of a pressure wrap (ThunderShirt®) on heart rate and behavior in canines diagnosed with anxiety disorder. Journal of Veterinary Behavior: Clinical Applications and Research, 9(5), 215–221.
  3. Pike, A. L., Horwitz, D. F., & Lobprise, H. (2015). An open-label prospective study of the use of l-theanine (Anxitane) in storm-sensitive client-owned dogs. Journal of Veterinary Behavior: Clinical Applications and Research, 10(4), 324–331.
  4. SHIMADA, A., EBISU, M., MORITA, T., TAKEUCHI, T., & UMEMURA, T. (1998). Age-related changes in the cochlea and cochlear nuclei of dogs. Journal of veterinary medical science, 60(1), 41–48.
  5. Tod, E., Brander, D., & Waran, N. (2005). Efficacy of dog appeasing pheromone in reducing stress and fear-related behaviour in shelter dogs. Applied Animal Behaviour Science, 93(3–4), 295–308.