In young adult dogs, the majority of epilepsy is the non-progressive, idiopathic, form. If your dog has common epilepsy, it is very likely that it inherited it from its parents. The causes in cats are less clear. In dogs, veterinarians think that it is often a genetic disease, Usually, a parent or a close relative of your pet also had epilepsy. Epilepsy is known to effect specific dog and cat blood-lines more frequently than others.
Ron Hines DVM PhD.
I have seen more idiopathic or common epilepsy in pure-bred than in randomly-bred housecats.
In humans this form of seizure is called frontal lobe epilepsy. Your pet may bite or snap at you if you disturb it during one of these episodes. During this altered period of consciousness your pet may show fear, aggression, hyperactivity, or repetitive nonsensical behavior. Some seizures affect portions of the pet's brain that control thought rather than motion. When an area of the brain that controls the conscious thought process is affected the seizure is called a psychomotor seizure or hallucination. Some pets hear imaginary noises.
This drug is sometimes effective in blocking seizures and has few side effects that we know of. When it is used, it is usually an add-on therapy for dogs already receiving phenobarbital. When this drug is used, the phenobarbital dosage can sometimes be drastically reduced or, perhaps, entirely eliminated.
These can be fatal. Status epilepticus is a term used for severe seizures that occur again and again with little or no rest between convulsions. Seizures that put the whole body into severe muscle contractions, are called grand mal seizures. Seizures that are less severe and only affect a few muscle groups are called petit mal seizures.
The toxicity of this drug is very low but it has to be given several times a day. The primary advantage of felbamate is that it does not cause drowsiness. Blood samples should occasionally be taken to check for liver toxicity and bone marrow suppression, which are uncommon side effects. It is often given along with phenobarbital to lower the phenobarbital dose.
During an epileptic seizure random electrical impulses are sent from the nerve cells of your pet's brain to muscles throughout its body. During a complete epileptic seizure the pet looses consciousness and has no memory of the event ever occurring. In idiopathic epilepsy, the source of these abnormal brain impulses are small areas of abnormal or damaged brain tissue.
They can also occur when the brain is inflamed or when brain tumors are present. When a defect within the brain can be identified as the source of the abnormal impulses, we call the condition symptomatic or secondary epilepsy. Secondary seizures often occur when pressure within the brain is too high ( intracranial pressure ).
Stages Of A Seizure.
What Pets Get Epilepsy ?
Seizures in our pets can have a number of causes - Not all seizures or convulsions are due to common epilepsy. Epilepsy is a disease in which your pet is subject to recurrent seizures or convulsions. It is quite similar to the epilepsy that occurs in people.
This medication has been used in dogs in combination with phenobarbital and potassium bromide to lower the daily dose of phenobarbital received and in cases where phenobarbital was not able to control the seizures alone. Rare side effects in dogs include stiff wobbly gait, vomiting and salivation. It's cost is high and it requires frequent dosing. The drug appears quite safe.
Epilepsy In Your Pet.
A seizure event of epilepsy can be broken down into three distinct stages. It is a very ancient disease, so the event has been divided in many ways using many confusing terms.
Cats do not seem as prone as dogs to liver damage while on this drug, but they do tend to gain weight. The side effects of phenobarbital are sedation, increased appetite, weight gain, increased thirst and urination and harm to the liver over time. Phenobarbital works well in both dogs and cats. These problems can be minimized if the dose is closely regulated or if a combination of medications is used.
Might My Pet's Diet Affect The Number and Intensity of Its Seizures ? Perhaps.
What Tests Will My Veterinarian Run To Confirm That My Pet Has Epilepsy ?
What Should I Do During The Seizure ?
Valium ( diazepam ).
Sometimes muscles of the face just go into a jerky motion. Sometimes the pets appear to be snapping at invisible flies or chewing gum or running round and round in circles. Focal simple seizures or partial epilepsy are often misinterpreted by owners as just a periodic quirky behavior. Frontal Lobe Epilepsy.
What About Epilepsy In Cats ?
It is available in regular and time-release form. This drug can be used in conjunction with phenobarbital. Side effects of clorazepate are sleepiness and a wobbly gait. In dogs, both forms seem work the same. Clorazepate is similar in structure to diazepam ( Valium ) and like diazepam, it works well in emergencies. It is moderay effective, but serum levels of the drug need to be monitored every 4-6 months as they tend to drift downwards. Because dogs vary greatly in how they absorb this drug, blood levels should be frequently checked.
Zonisamide ( Zonegran ).
Phenobarbital is the most commonly used drug to treat epilepsy in dogs and cats. The second most common treatment used by veterinarians is phenobarbital combined with potassium bromide. But some veterinarians determine a good dose through trial and error. Your pet's ideal phenobarbital dose is best determined through measurement of your pet's blood serum phenobarbital levels after it has been on a trial dose for some time. Ideal trough phenobarbital serum levels are thought to be 10-20 micrograms/ml.
When In Life Does Epilepsy Usually Start And What Does A Real Seizure Look Like ?
Have your veterinarian provide you with an emergency dose of injectable diazepam ( Valium ) if you pet has experienced such seizures in the past. Seizures that last longer than 5 minutes can become medical emergencies if these pets have trouble breathing. Give nothing by mouth.
These include clorazepate, felbamate, gabapentin, levetiracetam and zonisamide. ( ref ). (Some newer drugs used in human epilepsy show promise in dogs. However, the dog's Liver enzymes need to be monitored closely, particularly if the dog receives zonisamide ( ref ) Unfortunay, with the exception of clorazepate in small dogs, all of these medications are quite expensive.) A recent study found that a variant of gabapentin, pregabalin, showed promise in hard-to-regulate epilepsy in dogs.
Because many of these underlying causes increase in severity over time, the long-term prognosis ( outlook ) for epileptic cats is not nearly as good as it is for dogs. As I mentioned earlier, unlike dogs, cats often develop seizures because of some progressive, acquired brain disease. But even in these cats, your veterinarian can often control these seizures for a time. Idiopathic epilepsy is much less common in cats than in dogs.
You may carry the pet in a blanket to a tiled area so as not to soil the carpet or rug. My first concern for my clients is that they NOT TO BE BITTEN. If your pet or a neighbor’s pet develops a seizure, begin by placing the pet’s head on a soft folded towel or pillow.
Their first inclination is to rush the pet to an emergency veterinary center. When a seizure occurs, owners tend to over-react. One to three minute seizures are most common. Luckily, most epileptic seizures last only a few minutes. Those that last five to ten minutes are less common and more serious.
What Medications Are Available To Treat Epilepsy In Pets ? Phenobarbital (Phenobarbitone).
Veterinarians rarely use them when a pet's seizures can be adequay controlled using these two better-known, traditional medications. Veterinarians have less experience using these newer anti-seizure medications than phenobarbital or potassium bromide. So use the newer ones all with caution and with frequent monitoring of your pet's blood blood chemistry. These newer medications were developed for human use and it is yet unclear what their long-term effects might be in dogs and cats. Periodic monitoring of all anti-seizure medication serum blood levels as well as their effects on your pet's liver and kidney function is always a good idea.
This drug alone is only good to end dangerous long-lasting seizures until another medicine can take effect. It can be an effective "add-on" medication for epileptic cats because it seems to persist longer in the blood stream of feline than canine patients. In dogs and cats, it is quite good at breaking a persistent, dangerous seizure; but when it is given over longer periods of time the body becomes resistant to its effects. Newer Medications.
Levetiracetam ( Keppra ).
It is just before and after the seizure that your pet will be frightened and need your reassurance. It is very frightening to watch your pet experience a seizure. But you need to keep in mind that during the seizure your pet is not in pain. The pet may vocalize and thrash around, but it does not experience painful sensations.
How Soon Should I Start To Think About Continuous Medications For My Pet ?
Seizures In Dogs And Cats.
Secondary Epilepsy and Seizures:
Partial seizures have much more variable signs. Most pets maintain their legs rigidly extended but some paddle as if they were running. Pets may whine - although they are not in pain. During a complete seizure, the pet falls on its side with its legs outstretched and it’s back arched. Most pets have their first seizures between 1 and 5 five years of age.
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Once we have eliminated all possible other causes, we are left with a diagnosis of common ( simple, true or idiopathic ) epilepsy. Idiopathic means that we do not know the cause.
Epileptic seizures are a bit like an electrical storm. Their primary origin within cerebral cortex of the brain and the target tissues of their nerve cell impulses define the type epilepsy that occurs.
Owners that have experienced "break-through" seizures in their pets often have injectable diazepam issued to them to break seizures. In emergencies, some pet owners have been instructed in how to insert a diazepam tablet rectally to break a seizure. ( I have not attempted that procedure myself so I do not know if it is effective. ) Do not give tablets by mouth while a pet is having a seizure or subsequent to a seizure.
This medication does not work as well in dogs and cats as it does in people with epilepsy. It can cause drowsiness, sedation, nausea and vomiting. It can cause the pet to loose hair and it can be toxic to the liver. It is best given with food. It can be quite toxic to cats. It is occasionally used to supplement other anti-seizure medications in pets.
Gabapentin ( Neurontin ).
When the diagnosis is not that evident, the vet can go on to order more specialized tests, such as an MRI, CT scan or even a cerebrospinal tap ( vets generally obtain that fluid higher up at the base of the pet's skull ) - usually in that order - until the diagnosis is made. If your pet has simple or idiopathic epilepsy, these tests will probably all come back normal. Your veterinarian will want to begin with a complete blood chemistry panel on your pet as well as a urinalysis on the pet's urine. ( T4 could be low if the pet is already taking phenobarbital ) If your veterinarian is reasonably certain of the diagnosis at that point, the vet might begin the pet on an anti-epileptic medication.
Some common signs are restlessness, wandering, pacing, licking, trembling and vomiting. During this stage, the pet may have changes in its mood and behavior and may appear anxious. This stage usually lasts several minutes but can last much longer. In epileptic people, therapy dogs have been trained to warn their owners during this stage that a seizure is eminent. The first stage is called the prodromal, or warning stage.
Felbamate ( Felbatol ).
Then remove all objects that surround the pet so it will not injure itself. Do not put your hands into the pet’s mouth.
Valproic Acid ( Depakote ).
Potassium Bromide. It can also be toxic to the liver of dogs. It should never be given to cats. This drug rarely controls seizures on its own.
In some instances seizures will be a one-time episode never to occur again. Because so many areas of the brain can give rise to epileptic seizures, no two pets exhibit exactly the same signs. In other pets the problem reoccurs at regular intervals of from every several days to several times a year. Common medications to treat epilepsy can damage your pet's liver over time. Only you, not your veterinarian, can decide if the number and severity of seizures your pet experiences, justify the risks of continuous, lifetime medication.
Increases in the pressure within your pet's brain, liver and kidney disease, low blood sugar, brain tumors, vitamin B-1 deficiency, feline immunodeficiency virus ( feline AIDS ), rabies, insecticides, antifreeze and migrating parasites ( like baylisascaris ) account for almost all of the other cases of seizures in cats. Another rarer cause is infection with toxoplasmosis. Another common cause of epileptiform ( epileptic-like ) seizures in cats is infection with the virus of feline infectious peritonitis ( "the dry form" of FIP ).
( ref ). But Golden Retrievers, Beagles, Cocker Spaniels, Dachshunds, German Shepherds, Irish Setters, Schnauzers, and Huskies seem to have the problem a bit more than other breeds. Any breed of dog or cat can develop epilepsy. Seizures also occur more frequently in staffordshire bull terriers than in many breeds. But those seizures are often related to a specific neuro-metabolic disorder seen in this breed.
But medical diagnostic equipment is becoming more an more sophisticated so it is probably only a matter of time until we will be able to see what the physical or chemical problem actually is in these pets. Veterinarians can not find physical problems in pets that have idiopathic epilepsy when they are not in the process of a seizure. All the blood tests, all the x-rays and examinations come back normal.
What Is Happening To My Pet When It Has A Seizure ?
In cats, brain inflammations ( encephalitis ), exposure to toxic substances, traumatic injuries, abnormal body metabolism and brain tumors account for the other two-thirds. Your cat is more likely to be among the fortunate third if it is less than 3.5 years of age when the problem first begins and is also negative for Feline AIDS and Feline leukemia. In cats however, only about a third of the cases are the non-progressive, idiopathic form.
Phenytoin (Dilantin, diphenylhydantoin). In your pet's body, much of the primadone is converted to phenobarbital which accounts for most or all of its anti-seizure effects. The effects and side effects of primadone are the same as phenobarbital.
You can gently stroke and speak calmly and softly to your pet; but the pet will not know you are present until the seizure begins to subside.
Do not change or discontinue medications without the knowledge of your veterinarian and schedule any changes so that seizures are unlikely to occur on weekends, holidays or periods when your regular veterinarian is not likely to be available. But if your pet had multiple seizures that were determined to be idiopathic epilepsy, I suggest not attempting to lower or discontinue medications until your pet has been free of seizures for a year. If seizures frequently reoccur, your pet will probably need its medications for its lifetime. Pets that were put on long term phenobarbital because their pet had one or two seizures probably shouldn't be on it at all.
They need to be careful with the salt levels in their diet and whenever their brand of dog food is changed. Dogs taking potassium bromide should receive it with food. It is rarely used at this time as the primary seizure-control medication. ( ref ). The most common side effects of this drug are behavioral changes, muscular twitching and staggered gait. Most veterinarians rely on phenobarbital to get your pet's seizures under control and then add potassium bromide as a second line medication to keep the pets phenobarbital dose as low as possible. This drug is compounded by a number of special order veterinary pharmacies ( It should be approved by the FDA as a prepackaged product in 2012 ) It can be used to lower the amount of phenobarbital your pet is given to hopefully decrease the likelihood of liver damage. Their T4 levels and serum bromide concentrations need to be periodically monitored. You can read in detail about these side effects and others here.
Never use supermarket "flea-drops" (permethrin products, spot-on) on cats. Even exposure of your cat to canine pets in the same household that have those products applied to them has been enough to cause severe seizures in felines. Read about the problem here.
Their jaws are clenched during the first phase of the seizure. These pets often void their bowels and bladder during their convulsions. Those pets do remain consciousness but often mentally impaired. If only a portion of the body is affected the seizure is called a focal simple seizure or a partial seizure.
You can read them in their entirety here: Short 2011 Thomas 2010 Pakozdy 2010 Dewey 2009 Kluger 2009 Bailey 2009. From time to time, new articles are published on epilepsy in pets.
Despite its numerous side effects, it has been used to control seizures in humans since 1912. Combining phenobarbital with a second drug, such as Potassium bromide, may protect your pet from this liver damage. Silymarin is one of the two "active" ingredients in Denamarin ) Phenobarbital is an old medicine. Pets on Phenobarbital need to have their Liver enzymes tested periodically to check for possible liver damage. You can read the NIH product description here. Some owners give their epileptic pets milk thistle to try to protect the liver. ( unfortunay, the only recent scientific study of milk thistle's "active" ingredient, silymarin, found it of no value in humans with one form of chronic hepatitis ref.
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Things outside the brain can cause secondary epilepsy too. Poisons and toxic chemicals can also cause seizures. Things like overheating ( hyperthermia ), low blood glucose ( hypoglycemia ), intestinal inflammation or liver and kidney failure. ( ref ). For example, certain flame retardant chemicals, when eaten, have the ability to cause seizures. Thiamine -deficient diets have also caused seizures in cats. ( ref ).
When using Neurontin, always try to stay at the lowest possible dose. A few veterinarians have found it helpful but many have not. You can read an article on it's use here. This drug also causes little to no sedation. It is sometimes given successfully to pets to supplement to other anti-seizure medication such as phenobarbitol and bromide when they do not control seizures well enough on their own.
Keep the room darkened, cool and keep other family members away. You can already position some paper towels and warm soapy water on a wash stand beyond the pet’s reach to help clean up any mess.
Primadone (Mysoline, Mylepsin, etc.).
Clorazepate ( Tranxene ).
Dogs and cats that show unusually severe ictal or post ictal periods should also begin medication. How frequently, if ever, that owners can tolerate the sight of seizure behavior in their pets is also a major factor for many pet owners. I generally suggest that dogs and cats receive anti-seizure medications if they have had two or more seizures within an 8-week period or two or more cluster seizures within a 12-week period. This is a difficult question to answer.
The use of this medication in cats has also been frequently associated with a type of lung inflammation called pneumonitis. ( ref ) When pneumonitis occurs, it can produce signs quite similar to feline asthma. Cats do not respond as well to potassium bromide as dogs do.
Your pet doesn't recognize you during seizures and its jaws can clench forcefully on your hands. If this is not sufficient, and the dog is still having difficulty breathing, open the mouth by passing two towels through the mouth and pulling on them – one up, one down in opposite directions - to force the mouth open. It is quite rare for a dog to “swallow” its tongue but if the pet should turn bluish you can use an inverted spoon to manipulate the tongue.
In cats, I see the common ( idiopathic ) form most frequently in Persians and Siamese.
If it is a partial seizure, the pet may realize that something is occurring. This results in a chain reaction in which the surrounding nerve cells are stimulated to fire off a shower of signals of their own to various muscles of the body. In cases if idiopathic epilepsy, nothing can be found that is physically wrong with the brain. If the seizure affects the whole body, the pet looses consciousness. These abnormal electrical signals constitute a seizure. In this respect, a typical epileptic seizure is much like a single snowball setting of a great avalanche. During a seizure, these tiny areas begin sending out electrical impulses that are received by the nerve cells that surround them.
Can I Ever Stop Giving My Pet Medications ?
The final stage of an epileptic seizure is called the post ictal stage. Paddling or swimming movements, clenched teeth, and arched back are common during this stage. This is the stage of gradual recovery. During this stage, the pet is unconscious. Dogs and cats in the post ictal stage appear dazed or hung over. They may bump into objects. This is the time of the seizure itself when the body is subject to uncontrolled movement and thrashing. In cases where partial seizures occur, the pet may run in circles, or appear blind or deaf. They may have a blank expression or appear to stare out into space. The next stage is called the ictus or ictical stage. These pets are exhausted and sleep a lot.
Epilepsy tablets for dogs