Epileptic Seizures in Dogs

Epilepsy refers to a disorder of recurring seizures. Seizures in dogs are brought on by an abnormal level of neuronal brain activity resulting in brief episodes of uncontrolled jerking movements, momentary loss of awareness and/or loss of consciousness. Seizures can occur in all dog breeds. Certain breeds are genetically predisposed to epileptic seizures, including Beagles, Belgian Tervurens, Golden Retrievers, Keeshonds and Labrador Retrievers. Left untreated, seizures may become more frequent and the severity can become life-threatening.The characterization of recurrent seizures is a neurological disorder, commonly referred to as "Epilepsy." The cause for seizures is broad, in some cases correlated with trauma, toxins, brain tumor(s), or an infection. It can also be chalked up to an issue with your dogs blood, kidney, or other key organs. Don't be discouraged if your veterinarian is unable to identify the cause, in some cases, the condition can be "idiopathic" which means there is no identifiable cause.

Epilepsy can begin as early as 6 months or as late as 5 years of age. A seizure can occur at any time of day while the pet is awake, resting or sleeping. On average, seizures may persist for between 30-90 seconds.

The initial “prodrome and aura” stages of a seizure may include:

• Startled or panic behavior
• Confusion
• Hiding
• Clinging to owner

The seizure or “ictal” stage may include:

• Collapse
• Stiffness
• Teeth grinding
• Vocalization
• Drooling/foaming saliva
• Kicking/paddling limbs
• Shivering/jerking movements
• Urination
• Defecation

Types

Seizures can be categorized as follows:

• Generalized – Pet falls down, loses consciousness, and becomes rigid. Breathing stops for 10-30 seconds. Pet may begin to paddle or kick, chew or grind teeth, salivate, urinate and defecate. Milder forms may not involve rigidity, kicking or loss of consciousness.
• Absence/Petit Mal – Short period of unconsciousness, may or may not collapse, blank stare. May be difficult to observe.
• Partial – One part of the body or face may twitch, move or contort. Can progress to the entire body (a generalized seizure).
• Complete Partial – Abnormal behaviors such as chewing, biting at a limb, biting the air, vocalization, hiding, vomiting, diarrhea, salivation, blindness. May last minutes to hours and may be followed by a generalized seizure.
• Cluster – Multiple seizures in a row with short periods of consciousness in between. To be considered a life-threatening emergency.
• Status – One continuous seizure lasting 30 minutes or longer (may be many small seizures with no consciousness in between). A life-threatening emergency.

Epilepsy in dogs can be the result of a number of conditions including:

• Ingestion of a toxin
• Head injury
• Liver disease
• Kidney disease
• Anemia
• Stroke
• Brain tumor
• High blood glucose
• Low blood glucose
• Congenital abnormality
• Hyperthermia
• Idiopathic epilepsy (no known cause)
• Genetic predisposition

There is no identified trigger of the seizure itself. Seizures may occur during periods of excitability, rest or sleep.

If you feel your pet is exhibiting symptoms of epileptic seizure, you will want to schedule an appointment to bring her to the veterinarian for an examination. Video recording of the seizure activity can be helpful for the veterinarian (if possible). As seizure times are short, your pet may be over the episode by the time you reach the clinic. An examination is still important to identify the cause of the seizure and rule out any life-threatening possibilities.

Your veterinarian will need a detailed history including when the seizure occurred, how long it lasted, the behaviors of the pet during the seizure, and how many (if any) seizures have been observed in the past. Note any possible toxins the pet may have been exposed to, recent vaccinations, behavioral changes, and any recent injuries or falls.

A physical and neurologic examination will be performed. Depending on the pet’s history, a number of laboratory tests will rule out possible causes, including a complete blood cell count, blood chemistry and urinalysis. These tests will evaluate liver and kidney function and look for anemia and blood glucose levels.

Your veterinarian may order a CT scan or MRI of the brain.

If no cause of the seizure can be identified, the condition is diagnosed as primary idiopathic epilepsy (epilepsy of no known cause).

If an underlying cause of seizure is determined, the veterinarian will treat the pet according to the diagnosis. If this is your pet’s first seizure, and no cause of seizure was identified, the veterinarian will likely ask you to continue to monitor your pet for future seizures and report back if one occurs. Treatment is not begun for epilepsy until multiple seizures have occurred or are so severe that treatment is warranted.

Each single seizure is not necessarily an emergency requiring a veterinarian visit. During each seizure:

• Remain calm
• Note the time of onset
• Place your pet on the floor, on his side, away from sharp objects or furniture
• If outdoors, bring your pet in the shade to prevent hyperthermia
• Keep hands away from your pet’s mouth
• Speak quietly and gently to your pet
• Note the time the pet has recovered
• Record any specific seizure behaviors observed

Notify the veterinarian when possible to give them the date, time of onset, and duration of any seizure. This information will help the veterinarian determine the treatment protocol.

If your pet does not come out of the seizure within a few minutes or if you have other concerns for your pets safety, always visit the veterinarian.

The usual treatment for epilepsy is oral phenobarbital, potassium bromide (KBr), or Gabapentin given daily, often for life. A blood test may be required prior to beginning treatment to examine kidney and liver function. Blood tests every 2-4 weeks will determine blood concentration of the medication. The veterinarian will increase or decrease the dose as needed until an optimal treatment protocol is determined.

If a pet is having a long or severe seizure, the veterinarian may give intravenous diazepam to bring the pet out of the seizure. The veterinarian may supply you with valium to be given rectally should your pet have a seizure at home.

Follow your veterinarian’s instructions closely. Never skip a dose of seizure medication or stop medication abruptly as this can result in severe seizures. Keep your home environment safe. Swimming can be particularly dangerous for an epileptic pet. Pets on potassium bromide may need to eat a reduced salt diet.

Blood tests for certain seizure medications including phenobarbital will need to be conducted every 2-4 weeks until a proper dose is determined and then every 6-12 months to ensure safety and effectiveness.

Treatment for epileptic seizures is not curative. It is an attempt to decrease the frequency and severity of the seizures. Once your veterinarian decides to begin treatment, it takes time and trial and error to find the correct medication dose. Follow your veterinarian's instructions closely, keep a record of seizure activity, and notify your veterinarian when seizures occur.