SYMPTOM
Difficulty getting comfortable
Owners notice a pet that circles repeatedly before lying down, gets up and repositions itself multiple times in quick succession, seems unable to settle into a resting position for more than a few minutes, or paces rather than lying down, particularly in the evening or at night.
Musculoskeletal Pain
Osteoarthritis and other sources of joint or spinal pain can make many lying positions uncomfortable, so the animal repeatedly shifts or gets up again shortly after settling in search of a less painful position. This pattern is often most noticeable at night when compensatory movement during the day is no longer masking the discomfort.
Abdominal Discomfort
Pain originating in the abdomen, whether from pancreatitis, gastrointestinal upset, or gas and stretching of the stomach, can produce pronounced restlessness and an inability to settle, sometimes with pacing, stretching, or looking towards the abdomen. In deep-chested dogs, this pattern with drooling, standing and stretching, unproductive retching or a swelling abdomen fits gastric dilatation-volvulus, a rapidly progressive, life-threatening twisting of the stomach.
Cognitive Decline
Canine and feline cognitive dysfunction disrupt the normal sleep-wake cycle in older pets, producing disorientation, altered night-time activity, and an apparent inability to settle that is behavioural and neurological rather than directly painful, though pain often coexists and compounds the picture.
Anxiety-Related States
Generalised anxiety or noise-related fear can produce pacing and an inability to settle, particularly around triggers such as storms, fireworks, or changes in routine, and this pattern tends to resolve once the trigger passes.
Endocrine Disease
Conditions such as Cushing's disease increase thirst and urination, which can drive night-time restlessness and repeated repositioning as the animal gets up to drink or toilet, and panting, a recognised sign of Cushing's disease in dogs, can add to the unsettled picture.
Cardiorespiratory Discomfort
Reduced ability to breathe comfortably while lying flat, seen with some forms of heart disease, can make a pet reluctant to remain in one position and prone to frequent repositioning or a preference for sitting rather than lying.
Urinary Tract Discomfort
Discomfort involving the bladder or urethra, whether from cystitis or, in cats particularly, a partial or complete urethral obstruction, can produce pronounced restlessness, repeated unproductive attempts to settle, and frequent visits to a litter tray or garden with little result. In male cats, straining that produces little or no urine can mean the urethra is blocked, which is life-threatening and is easily mistaken for constipation.
Why timing matters
Early observation
Restlessness noticed for the first time can reflect a passing cause such as mild gastrointestinal upset or a specific trigger. Sudden restlessness is also among the early signs of gastric dilatation-volvulus in dogs and urethral obstruction in male cats, and a passing cause cannot be told apart from these at home.
Later presentation
A pattern that has persisted or worsened over weeks typically reflects an established, ongoing source, whether that is chronic pain, a progressive cognitive change, or an endocrine process producing increased thirst and urination.
How quickly the restlessness develops and how it evolves helps distinguish between causes: a rapid onset over hours, particularly with retching, a swelling abdomen or straining to urinate, is the pattern of time-critical causes such as gastric dilatation-volvulus and urethral obstruction, and differs meaningfully from a gradual creep over weeks to months that is more typical of chronic pain or cognitive change.
Conditions commonly associated
Osteoarthritis in Dogs
Joint pain can make many resting positions uncomfortable, producing repeated repositioning as the animal searches for relief.
Gastric Dilatation-Volvulus (GDV/Bloat)
The stomach fills with gas and can twist, a rapidly progressive, life-threatening condition. Early signs include an anxious look, standing and stretching, drooling, unproductive retching and a swelling abdomen, often with an inability to settle.
Pancreatitis in Dogs
Abdominal pain from pancreatic inflammation commonly produces restlessness and difficulty settling into a comfortable position.
Canine Cognitive Dysfunction
Disrupts the normal sleep-wake cycle in older dogs, producing night-time restlessness and an apparent inability to settle.
Generalised Anxiety in Dogs
Can produce pacing and difficulty settling, particularly around specific triggers or changes in routine.
Cushings Disease in Dogs
Increased thirst and urination associated with this condition can drive night-time restlessness and repeated repositioning.
Constipation and Megacolon
Colonic discomfort can make cats restless and unable to settle into a normal resting posture.
Urethral Obstruction
Difficulty getting comfortable in urethral obstruction reflects the painful bladder distension and persistent urge to urinate caused by the blocked urethra, driving repeated repositioning and an inability to settle.
Feline Idiopathic Cystitis
Difficulty getting comfortable in feline idiopathic cystitis reflects the pain and frequent need to urinate caused by inflammation of the bladder wall, leading affected cats to shift position repeatedly rather than settle.
Hyperthyroidism in Cats
Difficulty getting comfortable in hyperthyroidism reflects the raised metabolic rate caused by excess thyroid hormone, which drives increased activity, restlessness or irritability that shows up as repeated repositioning rather than settled rest.
When to explore further
Restlessness in a deep-chested dog that includes pacing, repeated unproductive attempts to vomit, or visible abdominal distension is a distinct pattern from restlessness driven by joint discomfort. This combination fits gastric dilatation-volvulus, in which mortality is higher once signs have lasted more than 6 hours, and whether the stomach has twisted cannot be judged at home.
A gradual increase in night-time restlessness in a senior pet, especially alongside disorientation or altered recognition of familiar surroundings, points towards a cognitive component worth considering alongside pain.
Restlessness accompanied by increased thirst, urination, or panting broadens the picture beyond a purely musculoskeletal or behavioural explanation.
A pattern confined to specific triggers, such as thunderstorms or being left alone, sits differently to restlessness that occurs independent of any obvious trigger.
Restlessness alongside reduced appetite or reluctance to lie down at all, rather than simply repositioning frequently, suggests a more significant level of discomfort than repositioning alone.
In a male cat, restlessness with repeated trips to the litter tray, crying or straining while passing little or no urine fits urethral obstruction, which without treatment can cause kidney failure and be fatal within 2 to 3 days.
A log of when restlessness occurs, how long it lasts, and how many times the pet repositions in a set period gives an objective sense of severity and trend over time. Noting water intake and urination frequency alongside this can help separate an endocrine contribution from a purely pain-related one. A short video during an episode captures posture and behaviour detail, such as abdominal stretching or disorientation, that is useful context beyond a verbal description.
Last reviewed: 9 October 2026 · Dr Alastair Greenway MRCVS