If your dog has to go in the night, how about taking it out an extra time or two in the night?

When our old dog had liver trouble and had to go more often, I took her out several times a night, came back and washed her and we all went back to sleep.
The prescription diet kept he going with a fair quality of life two more years after symptoms started.

You get where you can do it all in your sleep, don't really need to wake up, as you do when foaling mares out.