Dear Dr. John,

Our Portuguese Water Dog is 14 1/2 years old. He has been increasingly agitated and aggressive. He even bit my husband when he reached for something he was eating, something he would have never done before. The dog has also been very restless at night. Could this all be due to old age even though he otherwise seems quite normal?

He has been slower getting around and on the stairs to our bedroom on the second floor. We had our vet take a look and had been given some Gabapentin 300 mg and it seemed to work at relaxing our dog. Could he take it long term? Our vet did some bloodwork to check everything out. Our dog had a high platelet count and slight anemia. Our vet indicated that it could be a sign of various disorders including cancer. Further diagnostics could be done but we are opting out at this time. What could be the possible causes for his behavior and are there any better choices to calm our old boy down? J.L.

Dear J.L,

High platelet count is known as thrombocytosis. The cause is often unknown and can be due to cancer, disease in the bone marrow, iron deficiency, blood loss, infections, inflammation, and more. Blood clots can develop that can cause severe issues and even death. Further diagnostics could include bone marrow evaluation.

If his physical examination was otherwise unremarkable, the changes found might be an incidental finding and taking a wait and see approach might be considered with a recheck of the bloodwork in 3-6 months. Opting out of a more extensive workup is a fair consideration given his old age. While I have seen many dogs that have gotten less tolerant and more ornery as they age, the level of agitation and aggression that you have seen is not typical or due to old age. The correct steps have already been taken in getting an evaluation and bloodwork done.

Gabapentin is safe to use but I would also consider Trazodone which I believe would have more of a calming effect. They can even be used together and both can be used safely for longer periods. Work with your veterinarian and good luck!

Dr. John de Jong owns and operates the Boston Mobile Veterinary Clinic. He can be reached at 781-899-9994.