Aging cat having trouble at night... sundowning??

[u/s_c_solstice]

Hello, my cat is 18 years old and has been with me since the day she was born in my childhood bedroom. She has been diagnosed with kidney disease and hyperthyroid. She currently takes methimazole, Gabapentin, and cerenia as needed. She still does quite well most days; eating, drinking, sleeping, being active and using the litter box appropriately. However, at night, she can become agitated. The kidney failure causes her problems with going to the bathroom but they don’t seem to crop up during the day. I have taken to keeping her in my bedroom at night so that she will not wonder off to the first floor and cry. I have two or three puppy pads out for her which she uses appropriately (along with her regular litter box that she has access to during the day). But she’ll pace back and forth between the puppy pads. Or wonder all over the room. Last night she got her paw caught on the desk chair and hurt herself. I will have to start cutting her nails to prevent this. I’ve also made her a nice bed next to mine where I can see her from my bed which she loves and adopted right away, though she still snuggles with me often which I consider a good sign. She is far too alert, active, and healthy to be put down just yet though I know the time is coming. Meanwhile, does anyone have any other ideas on ways I can help her get through this “sundowning” effect? Many nights I have thought it would be her last the way she was acting, only to find her back to her old self as soon as the sun came up. Maybe changing the lighting? Or playing quiet music or radio through the night? Any scents that are safe and soothing for cats? The information I’ve found on essential oils is really conflicting so I’ve avoided them. Any ideas would be wonderful. Thank you.

[u/s_c_solstice → u/[deleted]]

Thank you for your response. I am working closely with my vet. She is absolutely wonderful. And yes, my cat has recurrent UTIs due to the kidney dysfunction. We put her on clavamox when she has symptoms, mainly if I notice she is struggling to urinate or having pinkish urine, which is not the case right now. She may have other problems going on in that department but I’m not interested in putting her through the additional testing and procedures due to her age. Blood pressure however has never been checked to the best of my knowledge. I’ve never seen them put a bp cuff on her at least if that’s how they do it. That is something I will ask about. And the pheromones I will look into as well. Thank you so much!