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What anxiety meds help my senior dog with dementia and pacing?

Updated On September 23rd, 2025

Pet's info: Dog | Yorkshire Terrier | Female | spayed | 14 years and 11 months old | 10 lbs

My 15 yo Yorkie has been on keppra for approx 1 year. Her dementia is becoming overwhelming and incessant. Constant circling, pacing, getting lost in corners, etc. Her seizures (small ones) remain under control and non-existent. What anti-anxiety med can I ask the vet about adding to help control her inability to relax? Doggie xanax interacted reversely with the keppra and just made her more hyper!

2 Answers

Most Helpful Answer

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Answered By Katie Sabella, DVM, CCRP

Veterinarian, Certified Canine Rehabilitation Practitioner

Published on June 29th, 2017

I am so sorry you are having to go through this with little Chili. Neurologic disease in elderly pets can be difficult to treat, understand, and very hard to watch, just like with people. It sounds like her seizures are well-controlled with the Keppra, but she is displaying additional neurological symptoms: pacing, circling, confusion. I am not entirely convinced these are all due to anxiety though. Usually neurologic disease in elderly dogs is due to only a few things: metabolic disease (liver, kidney, or diabetic issues), vascular events (strokes), or a brain tumor. If you have ruled out metabolic disease, which I'm sure your vet has, the other two diagnoses carry a very guarded prognosis. My concern is that the symptoms you are seeing are likely the result of progressive disease due to one of those two possible causes. While anxiety medication might help some, I fear that it's not going to give you or Chili the results for which you're hoping. In this case, it's important to think about quality of life for Chili: what's fair to her? If adding in an anti-anxiety medication helps her resume normal activities where she goes back to being Chili and doing the things that make her "Chili," fantastic. If not, it may be time to make some difficult decisions about what's best for her. If you do decide to pursue an anti-anxiety medication, your vet might consider Selegiline (specifically for cognitive dysfunction in people, not a lot of reported success in animals), Clonazepam (in the valium and Xanax family, but slightly different), or Clonidine (a blood pressure medication, also used to treat anxiety) in combination with an anti-depressant, such as Prozac. All of these would require careful monitoring and consideration in combination with the Keppra. Whatever you decide, best of luck to you and Chili!

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    Answered By Emily, DVM

    Veterinarian

    Published on

    You could discuss with your veterinarian using Trazodone for anxiety as well as pheromones such as DAP. You may also discuss changing from Keppra to another antiseizure medication so you could try alprazolam again.

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