Old dog is panting and restless - what's going on?

Old dog is panting and restless. If your old dog is panting persistently and pacing restlessly, he may need immediate veterinary attention. This is because the symptoms are often associated with shortness of breath, which can be caused by heart disease, for example. We explain everything you need to know about this and how to help your dog in the long run.

Why is my old dog panting and restless?

When a dog pants, its breathing is shallow and accelerated. The mouth is open and the tongue is visible, sometimes even hanging out of the mouth. Dogs usually pant to cool themselves down, as panting replaces sweating. Heat and moisture are released through the air they breathe, which cools the body after exercise or in hot temperatures.

However, especially in older dogs, panting can also be caused by illness, usually advanced heart disease with congestive heart failure. Any part of the heart can be affected by pathological changes, including the heart valves, the heart wall, the pericardium or the major outgoing vessels. Degenerative changes in the heart valves (endocardioses) or changes in the heart muscle (cardiomyopathies) are the most common.

Causes of heart failure:

• Mitral valve endocardiosis

• Dilated cardiomyopathy

• Inflammation of the heart valves (endocarditis)

• Thickening of the heart wall (hypertrophic cardiomyopathy)

• Blood in the pericardium (pericardial effusion)

In some heart conditions, a lack of pumping capacity causes fluid to build up in the lungs (called pulmonary oedema), which cannot be expelled and makes breathing difficult. This is why panting also occurs on hot days and when the dog is at rest, i.e. without having exercised.

The signs of heart disease become more pronounced if the panting persists or the breathing becomes pumping. You can tell when this happens because the chest and abdomen move a lot when your dog breathes. In severe cases, you may also hear rattling or bubbling sounds. Another characteristic symptom is restlessness. If the dog lies down, the breathing problems will get worse. The feeling of not being able to breathe is extremely uncomfortable and can cause anxiety and even fear of death in affected dogs. They may become aggressive as a result.

Symptoms of heart failure:

• Gasping, accelerated and pumping breathing

• Restlessness

• Poor performance

• Coughing (usually at night, sometimes with foam)

• Brief loss of consciousness (syncope)

• Pale or bluish mucous membranes

• Weight loss

Other possible health problems that can cause panting include fever, pain and endocrine disorders such as Cushing's syndrome and oedema. However, these are associated with symptoms other than restlessness.

Restlessness and panting - what to do?

If your dog is restless, panting and showing any of the above symptoms, you should visit your vet immediately. Your dog needs to be seen and treated as soon as possible, otherwise he may suffocate or his heart may fail. A dog with respiratory distress will also suffer severely.

However, the symptoms may be less obvious or there may be a problem other than heart disease. To make sure you know what to do, we'll look at other possible behaviours and give you tips on what to do if they occur.

Dog is constantly changing places and is restless

If your dog is restless without showing respiratory or other symptoms, he may be stressed or under-exercised. Very active breeds in particular need lots of activity and exercise to release their energy. However, the general rule for all dogs is that you should include long walks and playtime in their daily routine.

It is also possible for a restless dog to have abdominal or other pain. He may be defensive when touched, have a tense abdomen, or have unusual behaviour. This may include licking the affected limb or a wobbly gait.

Dog is particularly restless in the evening

Older dogs can develop dementia just like humans. Their physical and mental abilities decline, they become forgetful and behave strangely. For example, they may start begging for food shortly after eating, stop responding to familiar commands, or stare at things that are not there. They may also become disoriented and wander restlessly in the evening or at night. Dogs with dementia are also often incontinent and leak faeces or urine

There is no cure for dementia and affected dogs need special care. There are things you can do to make everyday life easier for your dog and reduce moments of confusion. For example, leaving a small light on at night can help your dog find his way around.

Dog panting and drinking a lot

If your dog suddenly starts panting and drinking a lot without the weather being warm or the dog being active, they could be suffering from an endocrine disorder. These conditions affect the hormone-producing organs and lead to changes in the body's metabolism.

Cushing's syndrome, an overactivity of the adrenal cortex, is common. This results in increased production of the hormone cortisol, leading to the development of various symptoms over weeks and months. Typical symptoms of Cushing's syndrome, in addition to panting and increased drinking, include truncal obesity with a pot belly. Affected dogs are often described as barrel shaped. Other symptoms include loss of fur, thinning of the skin with translucent blood vessels, increased pigmentation, skin inflammation, apathy and muscle weakness. Cushing's syndrome can be diagnosed with a blood test and must be treated with medication.

How is heart disease diagnosed and treated?

If your dog is showing symptoms of heart disease, you should have him examined immediately. It is best to choose a practice or clinic that offers cardiac ultrasound or has a specialist veterinary cardiologist. Your dog can then be thoroughly examined and given the appropriate treatment. This is because different treatments are recommended depending on the underlying heart condition and its severity.

Heart failure in dogs, as in humans, is classified into 4 stages from mild to severe. They are based on the results of imaging tests, electrocardiography (ECG), blood tests and symptoms. X-rays can be used to measure the heart and show fluid build-up in the airways. Ultrasound scans assess blood flow, the heart valves, the heart wall and the outgoing blood vessels. An electrocardiogram (ECG) shows whether the conduction through the heart, and therefore its pumping function, is impaired. Blood tests can also detect changes in the body caused by heart disease.

Treatment for heart failure targets both the cause and the symptoms. It is therefore important that the condition is accurately diagnosed. There are several classes of drugs available for treatment. Medication usually needs to be taken for the rest of the dog's life. Regular visits to the vet are important to monitor the progress of the disease and to adjust the medication if necessary.

Medications for heart disease:

• Dehydrating agents (diuretics, e.g. furosemide, torasemide)

• ACE inhibitors (angiotensin converting enzyme inhibitors, e.g. ramipril, enalapril)

• Beta-blockers (e.g. atenolol, propanolol)

• heart-strengthening cardiac drugs (e.g. pimobendan)

• Calcium channel blockers (e.g. verapamil, diltiazem)

• Antihypertensive medication (e.g. amlodipine)

• Digitalis and cardiac glycosides (e.g. digoxin)

• Antiarrhythmic drugs (e.g. sotalol)

How can I tell if my dog has a heart condition?

It usually takes months to years for heart disease to develop and cause visible symptoms. In the early stages of the disease, there are only minor changes to the heart, which may only be noticed as an incidental finding during a veterinary examination. The first sign is usually a heart murmur, which is caused by the blood being pumped not flowing evenly but swirling around. 

The first clinical symptoms often appear years later. These usually include loss of appetite, a dry cough, usually nocturnal, and an increasing lack of energy, which means that the dog tires more quickly on walks, for example. Another sign is weight loss with constant feeding. As heart failure progresses, water accumulates in the airways and other parts of the body, causing rapid breathing, restlessness and swelling.

Take your dog to the vet at the first sign of heart disease. Even if no medication is needed in the early stages, the progression of the disease should be monitored at regular check-ups. Sooner or later, medication will be needed to relieve the heart and circulation. If you wait too long, the disease can progress quickly and your health can deteriorate rapidly. If the changes to your heart are very advanced, medication will only help to a limited extent.

Early signs of heart disease:

• Loss of appetite

• Dry, mostly nocturnal cough

• Increasingly poor performance

• Weight loss

What to feed a dog with heart disease?

A diet tailored to the early stages of heart disease can help slow its progression. Affected dogs should be fed a low-sodium, in other words low-salt diet. There are special diets for dogs with heart disease that take this into account. Remember that human food and dog biscuits are often relatively high in salt. Avoid feeding these to your dog.

Another problem for dogs with heart disease is obesity. It is very hard on the heart, so overweight animals should lose weight gradually. Dogs with advanced heart failure often lose weight uncontrollably and lose muscle mass. This is usually because their appetite is reduced. To help restore their appetite, dogs with heart failure should be given the most appropriate medication for their condition, as well as a palatable diet containing salmon oil as an added ingredient. To make the food more appealing, it may be helpful to add natural flavour enhancers. For example, try adding small amounts of cooking fat, liver sausage, lard, tuna water or low-salt meat broth.

Conclusion

An older dog that is panting and becoming increasingly restless may be suffering from advanced heart failure, but there may also be other underlying conditions. You should take your dog to the vet immediately if these symptoms occur. Several tests can be used to diagnose the condition and begin life-saving treatment.

The confidu magazine is written by our veterinarians according to current scientific standards. The articles do not replace a veterinary diagnosis, but are intended to provide you with initial information on many topics related to your animal. If you have specific questions about your pet, our vets will be happy to advise you via the confidu app.