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 toward the abdomen. In deep-chested dog breeds this pattern is worth noting given the association with gastric dilatation-volvulus.
Cognitive Decline
Canine and feline cognitive dysfunction disrupt the normal sleep-wake cycle in older pets, producing disorientation, altered nighttime 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 nighttime restlessness and repeated repositioning as the animal seeks to toilet or simply cannot settle due to the associated discomfort.
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 this pattern is worth distinguishing from other causes of restlessness given how quickly the underlying picture can change.
Why timing matters
Early observation
Restlessness noticed for the first time, especially if it is an isolated night or two, often reflects a transient cause such as mild gastrointestinal upset, a specific trigger, or an acute discomfort that may resolve on its own.
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 other abdominal signs, 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)
Produces pronounced restlessness, pacing, and inability to settle as gas and stretching of the stomach cause escalating abdominal discomfort.
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 nighttime 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 nighttime 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 urgent, 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 restlessness and hyperactivity that shows up as pacing, circling, and 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, and this combination benefits from evaluation rather than observation alone given how quickly the underlying picture can change.
A gradual increase in nighttime restlessness in a senior pet, especially alongside disorientation or altered recognition of familiar surroundings, points toward 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.
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: 27 August 2026 · Dr Alastair Greenway MRCVS