Epilepsy is the most common disorder of the nervous system seen in dogs.
Idiopathic Epilepsy = repeated seizures with no identified underlying cause
It is usually diagnosed between 6 months and 6 years of age
some breeds are predisposed to epilepsy - Schnauzers, Border Collies, Basset Hounds, Labrador and Golden retrievers, and Cocker Spaniels
The symptoms of an epileptic seizure can be scary to witness, but it is important to stay calm, and safe
There are several treatment options for dogs with epilepsy now - your dog may need just one, or a combination
The outlook for dogs with epilepsy very much depends on how often they have a seizure, how severe they are, and how well the seizures respond to medication
What is epilepsy?
Seizures and epilepsy are not the same thing. Seizures are episodes of abnormal electrical activity in the brain. Epilepsy is defined as repeated episodes of seizures, i.e. a seizure is the event, and epilepsy is the disease that involves recurrent seizures.
What causes epilepsy?
The cause of epilepsy is mostly unknown, but we can establish that it is an inherited disorder. Repeated seizures in dogs from 1-5 years of age, that have no known structural abnormalities, are otherwise neurologically normal, and have no underlying disease are presumed to have a form of ‘idiopathic epilepsy,’ meaning that the cause is unknown.
In some cases, there may be a structural abnormality, due to either damage or malformations of the brain. Examples include a brain tumour, brain trauma or inflammatory disease of the brain.
What are the symptoms of epilepsy?
Typical symptoms of epilepsy seizures are often identical to seizures caused by other conditions. They include:
Collapsing
Jerking
Stiffening
Foaming at the mouth
Muscle twitching
Jaw chomping
Loss of consciousness
Leg padding
peeing and/or pooing
These are symptoms of more generalised seizures, but we can also see focal seizures with epilepsy. Focal epilepsy symptoms include:
blinking
facial twitching or twitching in another specific part of the body, such as a leg
going vacant
odd behaviour
How is epilepsy diagnosed?
Epilepsy may be suspected if your dog has had two unprovoked seizures more than twenty-four hours apart. It is normally diagnosed between 6 months to 6 years of age and is more prominent in Schnauzers, Basset Hounds, Collies, Labradors, Golden Retrievers and Cocker Spaniels.
Finding the cause of seizures can be difficult, and is often a diagnosis of exclusion - meaning that tests show the seizures are not caused by anything else, so epilepsy is the most likely cause. Your vet will take a complete history, and conduct a physical examination. Blood and urine tests may be recommended to make sure the liver is functioning well, and to rule out other illnesses that can cause seizures.
Sometimes more specialised tests are required, such as CT and MRI scans of the brain, and testing of the cerebrospinal fluid to look for inflammation, infection and cancer. This usually requires referral to a neurology specialist.
Treatment
If an underlying condition is discovered, your vet will discuss an appropriate treatment for this, although your dog may still require seizure medication as well.
For dogs diagnosed with Idiopathic Epilepsy, your vet will discuss seizure management options.
Treatment is usually recommended when:
Your dog has more than one seizure in a month
Your dog has cluster seizures (one seizure immediately following another)
The seizures are severe/ prolonged in duration.
There are several treatment options available, and it may take some time to find the best drug, or combination of drugs, for your dog. Your dog will need regular check ups and blood tests with your vet.
Medications
Phenobarbital (Epiphen)
This is often the first medication prescribed to control seizures, and many dogs who receive this medication experience a decrease in seizure frequency by 50% or more. Phenobarbital can be used alone or in combination with other seizure medications. But it does have side effects, and so your dog will need to have frequent checks and bloods tests to ensure that the drug is at an optimal level in the body (fine balancing act between it not being too low or too high), and that the body is also coping with the medication. It can take some time to reach a level in the body that is therapeutic, but at too high levels it can lead to liver disease, so it is important that this monitoring is undertaken.
Potassium Bromide (Libromide)
Potassium bromide is another widely recognised anti-seizure medication. Like Phenobarbital, it can take some time to reach therapeutic levels in the body, so frequent monitoring is required. In some dogs, Potassium Bromide is linked to the development of pancreatitis, so it is important to watch out for any signs of vomiting, change in eating habits and fatigue, and to report any concerns with your veterinarian.
Imepition (Pexion)
This medication has less effect on liver and kidneys than phenobarbital, and causes fewer side effects. It takes some time to reach therapeutic levels and some dogs may fail to respond to treatment, like the other medications. It can be used in combination with both phenobarbital and potassium bromide.
Levetiracetam (Keppra)
This medication is often prescribed if your dog has not responded to phenobarbital or potassium bromide, and if their seizures are difficult to control. It is often used in combination with other anticonvulsant drugs and typically has minimal side effects.
Zonisamide (Zonegran)
Zonisamide is a newer medication that is usually a well-tolerated and safe drug, and is the drug of choice when side effects have been seen with other seizure medication.
Please note that with all seizure medication, it is really important that you are never without medication, and that you don’t miss doses. Suddenly stopping the drugs, or missing doses, can cause withdrawal seizures.
Emergency treatment is sometimes required if the seizure continues for longer than a few minutes or if multiple seizures happen within a short time period. Your vet may prescribe you rectal Diazepam tubes to use in these circumstances.
If a seizure lasts more than five minutes it can cause irreversible brain damage and even death, so you must seek veterinary attention immediately. Your vet will need to give emergency seizure medicine intravenously (into a vein through a cannula), and your dog may need to be kept sedated to reduce the likelihood of further seizures..
Long-term Outlook
The outlook for dogs with epilepsy depends on a number of factors; the cause, the frequency and the severity of seizures, and the response to treatment..
Treatment is likely to be needed for the rest of your dog’s life, and most dogs will still have seizures from time to time - the aim is to reduce the number and severity of seizures. In some dogs, epilepsy can worsen with time, so treatment may need to be adjusted. Rarely, some dogs may only have one seizure, and never have another again.
Unfortunately dogs diagnosed with epilepsy may have a shorter life expectancy, but this isn’t always the case - it depends how severe and frequent the seizures are, and how well medication controls them. Most dogs with epilepsy can have a good quality of life once a suitable medication is found for them..
It can be really helpful to keep a “seizure diary” for your dog, which includes the date, time, severity and length of the seizure(s) and your dog’s behaviour before and after.
Remember, if your dog has a seizure:
Stay calm
Move any furniture/ items out of the way so that they don’t hurt themselves
Turn off television, radio and music, close curtains and turn off lights, to provide a dark quiet environment
Do not put your hand in your pet’s mouth and take care with them as they are recovering from their seizure, as they are likely to be confused and disorientated.
Give any emergency medication (if previously prescribed by your vet) to reduce the length of the seizure
If your dog doesn’t come out of the seizure, or if they continue to have several seizures in a row, contact your vet for emergency advice
We understand how scary it can be when your dog has a seizure, and that it can be really confusing and worrying when your dog is diagnosed with epilepsy. The vets at MyDogDoc are always happy to talk to you about your concerns and to answer any questions you may have.
