My 13-year-old dog paces and stares at walls at 3am — is this just old age?

It might be canine cognitive decline, but just old age is the answer that gets treatable things missed. The same night-time pacing comes from pain that is worse when she lies still, failing vision, high blood pressure, hearing loss, and hormonal or kidney disease — all worth finding, because several of them are manageable. Ask for a senior workup: a full exam, blood pressure, bloods and urine.

Something concrete: keep a one-week night diary — the times she wakes, what she does, how long it lasts — and video an episode. A vet watching her circle in one direction is getting information you cannot type into a form.

In the meantime, the environment does a lot of the work. Keep the furniture exactly where it is (a dog with fading sight has memorised the room), leave a low nightlight on, keep the last toilet trip late, keep the routine rigid, and let real daylight into her day so her body clock has something to lock on to.

Go now, not tomorrow, if she circles only one way, presses her head into a wall or a corner and stays there, has a seizure, or suddenly cannot stand. Those are neurological emergencies, not old age.

Whether this is cognitive decline or something else is decided by the exam and the tests, not from a distance — and knowing which it is changes a great deal about what you can do for her.