Q: Our 3-year-old poodle, Missy, collapsed several days ago and had a horrible seizure. We rushed her to our veterinarian, but before we could even get to his office, she appeared fine. Missy, her tail wagging, walked into the vet’s office, as if nothing had happened. The veterinarian said Missy most likely had epilepsy and that we should monitor her seizures. If they become problematic, he said Missy may have to take medication. We’re terribly worried about her and have spent hours researching epilepsy in dogs. But much of the information seems confusing. What can you tell us about the epilepsy and what recommendations would you have for us.
A: Seizures are the most common neurologic problem seen in dogs and cats. However, regardless of how common they are, seizures are very upsetting to witness. There are several types of seizures. The most common type of seizure is a generalized seizure (formerly called grand mal seizures). During this type of seizure, the animal suddenly loses consciousness and falls, often with the limbs extended. The dog (or cat) often salivates, urinates or defecates. They then progress to paddling or jerking of the limbs, and often display chewing movements. The average seizure of this type lasts 30 seconds to 2 minutes. There is another large class of seizures, called partial seizures, which vary greatly in appearance. They may involve movement of one limb or one part of the body (i.e. the face), may be manifested as “fly-biting” or chewing, and the animal may or may not lose consciousness. These often last seconds, but can last longer. After a seizure, dogs and cats usually display what are called postictal signs. They are temporary and may include disorientation, restlessness, wobbliness, blindness, or deafness. These abnormal behaviors may resolve after several minutes, but may last for days, especially after prolonged/severe seizures.
There are several causes for seizures and it is important to identify any underlying cause of a seizure such low blood sugar, a brain tumor, or inflammation in the brain, so that treatment for the underlying cause can be started. The most common cause of seizures in dogs is idiopathic epilepsy, meaning there is no underlying disease process causing the seizures. The typical dog (there are some exceptions) diagnosed with epilepsy begins to have seizures between 1 and 5 years of age, often seizures at night or when the dog is resting or sleeping, and has normal behavior in between the seizures. Epilepsy can be seen in any breed or mixed breed, but it is known to be inherited in the following breeds: Beagle, Belgian Tervuren, Bernese Mountain Dog, Collie, Dachshund, English Springer Spaniel, Golden Retriever, Irish Wolfhound, Keeshound, Labrador Retriever, Poodle, Shetland Sheepdog and Vizsla.
If you witness your dog (or cat) having a seizure, it is advised you bring him to a veterinarian who will perform thorough physical and neurological examinations. In the typical epileptic dog who has recovered from the seizure, these examinations are normal whereas a dog that is seizuring due to a brain tumor, for example, typically has an abnormal neurological exam. Next, blood work is usually performed, and again is normal in the typical epileptic dog. MRI or CT scan of the brain and analysis of cerebrospinal fluid (CSF) may be indicated in patients where an underlying disease process is suspected. These tests are normal in dogs with epilepsy. It is important to note that epilepsy is a “diagnosis of exclusion” meaning that there is no test that comes back “positive” for epilepsy – all other disease processes must be ruled out. However, often times, if a dog fits the classic description of an epileptic, these advanced tests are not needed.
Fortunately, the average short seizure is not life threatening. However, multiple seizures that occur within a 24 hour period of time (called cluster seizures) or a single seizure that lasts more than 5 minutes (called status epilepticus) are life threatening events and need to be treated as emergencies. If your pet ever experiences one of these situations, you must bring him to a veterinarian/emergency clinic immediately. It is believed that patients treated early in the course of epilepsy may have better long-term control of their seizures, as untreated seizure activity may lead to increased seizure frequency over time. The decision to treat seizures varies among veterinarians and owners. One way to look at it is therapy is started once the risks of additional seizures outweigh the risks of treatment. The risks of seizures include the seizures themselves as well as the emotional effects on the family. The risks of therapy include drug side effects and the cost and effort of daily medication and monitoring. The goal of therapy is to decrease the frequency and severity of seizures. Ideally it would be to eliminate seizures completely, but less than one third of dogs treated for epilepsy become seizure-free. Therefore, therapy is typically life-long. If therapy is ever stopped, it must be done slowly, under the careful guidance of your veterinarian. Seizure medication must never be stopped abruptly. Several drugs are available to help control seizures and fortunately some of the newer drugs carry few side effects. The cost of some of these newer drugs may be significant depending on the drug chosen and the size of your dog. Treatment options are numerous and must be tailored to the individual dog and owner. Because each patient responds to drugs differently, it is very much trial and error in the beginning to establish the best treatment protocol. In some cases more than one drug is needed to control epilepsy. It is important to have a good relationship with your veterinarian and discuss all drug options available. Once medication is begun, future trips to the veterinarian are necessary to monitor how your pet is responding to the drug. It is always a good idea to keep a log of your pet’s seizures to help your veterinarian determine if changes need to be made to the treatment protocol to better help your pet.