One of the most common dilemmas in veterinary neurology is the question of how to address the concept of medicating epileptics. Do we ply them with meds to soothe the seizures or treat them with the benign neglect of a drug-free existence?
Seizure disorders are common in pets, perhaps more common than we know given that not all are of the obvious falling, paddling, convulsive variety (a grand mal seizure). “Chewing gum” seizures (where the jaw convulses independently of the rest of the body) fly under the radar regularly, while sensory seizures (where a certain odor might nag at their brains for a length of time) will never be detected.
Any stimulus that triggers neurons (brain cells) to fire randomly throughout the whole brain will produce a grand mal seizure whereas localized reactivity will generate the petit mal variety (like the so-called “chewing gum” seizures). These brain storms may be initiated by poisons, drugs, liver diseases, infections, tumors, blood clots and, often, for no clear reason. We tend to lump these latter cases into the disease category designated “epilepsy.”
I’m sure you know this but it’s important to consider any pet’s seizure a medical emergency until a diagnosis has been established. This is one of those times when it’s imperative you see a veterinarian immediately—in the middle of the night if need be—to assuage the seizure activity with drugs if necessary and to begin to determine what went wrong in the animal’s brain.
A vet must first undertake an initial series of tests to rule out the more obvious causes of an abnormal nervous system. Diagnostics range from the simplest blood work to the complex (and expensive) CT scan now available at many veterinary specialist centers. Only once other abnormalities are ruled out is a diagnosis of epilepsy rendered.
Epilepsy can be frightening for owners and dangerous for pets. But not all concerned suffer to the same degree. Some epileptic dogs will experience very frequent, intensely stressful episodes which can leave their bodies ravaged by fever and use up their crucial blood glucose, while others convulse infrequently and seem completely unfazed by the disease. Similarly, some owners are less unnerved by seizures than others.
Hence, the decision to medicate a dog with anti-epileptic drugs is based on seizure duration, frequency and intensity of episodes, and the overall level of stress the seizures induce—in both humans and their pets. Because all drugs can have side-effects (especially with long-term use) to medicate or not is an important decision best undertaken with the help of a trusted vet who understands both the pet’s condition and his household’s limitations.
And here’s where vets differ. How we handle the dilemma is based not always on research and clear science but on the individual pet and family circumstances. If seizures are occasional (or rare) and the severity of the episodes mild, she may well live a full, comfortable life without medication. But not every vet offers this choice (many believe that failing to medicate a potentially medicatable disease is the height of cruelty).
However, if a family is stressed out beyond belief by any sign of a seizure (months apart though they may be) every effort is often made to ensure a minimal disease experience for all involved through the use of seizure-blunting meds like phenobarbital and potassium bromide (by far the most prevalent daily-use seizure drugs used in vet medicine).
I like the option of choice, believing that seizure drugs are riddled with liver-toxifying side effects some might choose to eschew—not to mention the cost of the drugs (though they’re relatively inexpensive) and the frequent testing to ensure drug levels are controlled and evidence of liver toxicity monitored. In any case, my take is that informed consent is impossible without offering options.
Nonetheless, I caution animal parents not to skimp on their pets’ safety and comfort. If thorough consultation with any patient’s regular vet should leave any lingering doubts as to course of action, you should always inquire about a referral to a veterinary neurologist. Newer (read: more expensive) drugs are available here and thorough diagnostics are typically offered only at this now-common resource.
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Having lived with an epi dog for years, I can appreciate all you wrote on the subject. Smokey was a rehomed greyhound & a known epileptic. But in his previous home, his mild seizure activity didn't upset any of the other dogs in the household.
When he came here where there were already 3 other greyhounds & 2 borzoi & had his first seizure, WWIII broke out. He seizured out in the backyard with me watching through the kitchen window. The minute he went down the dogs attacked. Fortunately a fellow next door (who jumped my fence to help) & I were able to get the dogs off Smokey.
I rushed him to the vet hospital where his wounds were sutured & we came home. This episode didn't make him fearful of the others but his episodes began to kindle so I opted to start him KBr - which he was on until an emergency splenectomy.
He had an encapsulated hematoma on his spleen which ruptured when he slipped on the ice & his body torqued. Although he lived for a year or more beyond the surgery he never again had even a minute breakthrough seizure.
Having read thisr blog entry I had to think perhaps that mass on his spleen was at the base of all his problems for years. Great article. I do enjoy reading what you write...Ellie
Ellie August 14th, 2007 12:57:00 PM
And I'm in the other camp- choosing not to medicate my Great Dane who rarely, but does, have grand mal seizures. He was diagnosed about 6 months ago and he might have one seizure during the month- and then he might not have any at all. He's already suffering from deafness (Okay- he's not suffering, but genetically- he's a mess from BYBing)- I wasn't surprised when he was diagnosed with epilepsy.
At this point in time, I think it would do more harm medicating him then anything else- after all, those meds are NOT easy on a dog's system. For the time being, he will remain free of daily meds- we'll see what the future holds.
Trish August 14th, 2007 02:25:00 PM
What about hyperthesia type seizures in cats? I have an over 10 cat who will sieze if I don't keep up with the flea meds and then pet (or he licks) around the base or tip of his tail. It has the skin rippling, noisy hyperthesia-ness that I finally reasearched about myself. And there seems to be a critical mass of nerve activity that sets him off. So I keep up with the flea meds.
p.s. I mentioned it to my vet with no response about managing or not....
heather August 14th, 2007 02:38:00 PM
Our dog, Pulga, never had seizures until we moved to Miami from another country. We think that what set off the first seizure was the stress caused by the trip and our temporary living situation. After the first seizure they started happening once or twice a month, completely depleting her of all energy immediately afterwards. That’s what we decided to put her on meds. It’s been 13 years. She takes her meds every day. She started with the phenobarbital and eventually had to be switched to potassium bromide because the other wasn’t having any effect on her anymore. We take her to the vet regularly and she’s doing great even though she’s almost 14 years old now! We know that she would have died many years ago had those medications not been available.
Ana August 14th, 2007 03:50:00 PM
I had a dog who started having grand mal seizures at age five. My vet said she didn't recommend meds unless the dogs was seizing more than once a month, went into stasis, or the family couldn't handle the seizures. She knew I preferred to avoid meds when possible, so we did without. She gave me liquid valium I administered rectally to stop an episode. At first he seized about once every four to five months. They gradually increased in frequency until they were almost monthly. When he was ten I put him on a raw diet with no grains and the seizure frequency went back to about once every six months - gradually increasing in frequency until his death at 13 1/2. He never did go on meds and remained a bright, lively, happy dog. Still, it wasn't easy to live with the disorder.I slept lightly, ready to leap up and treat him in an instant. It would have helped if someone had suggested I put a male incontinence wrap on him at night.
Linda H August 14th, 2007 05:25:00 PM
I now have a seven-year old and after having a dog with grand mal seizures I get nervous if I see him snapping at a fly, chewing, or doing something unusual. I am always able to interrupt the behavior easily by calling his name, which I figure means it's not a seizure. Is that right? I know a grand mal seizure can't be interrupted (except medically) but is that also true of other types?
Linda H August 14th, 2007 05:32:00 PM
in the grooming salon i've witnessed three different breeds having seizures. one was a fellow student's pet pomeranian at grooming school. the other two were clients of mine. the first was an 8 year old greyhound... i had been working at the salon for maybe a month and had been forewarned about keeping the stress level down as much as possible for aging greyhounds... another salon associate had lost a greyhound a year prior to that during a routine bath.
anyway, my greyhound and i hit it off, i thought. i adore the breed, and she was my first. i spoke with her softly throughout the bath, massaging her gently,trying to keep her calm... but halfway through rinsing her off she sank to the ground and began seizing. i tried to calm her and began calling for my manager when i couldnt. i didnt want to leave her but after calling for my manager three times i ran to the front of the salon and blurted something unintelligable to the other associate there, the one who had warned me about greyhounds, and ran back to the poor little girl.
the in-store vet came and carried her out on a stretcher and my manager and the other associate went with them to discuss the event. i basically sat in the bathing room and cried over the whole thing. i know now that i didnt cause the seizure, but at the time i knew very little about dogs and nothing about seizures. my nickname was Sissy LaLa for a reason and that episode was enough to traumatize me for several weeks. i now have quite a few greyhounds as requests, but that memory haunts me still...
charity August 15th, 2007 04:37:00 AM
Generally speaking, if you can interrupt or elicit the behavior (as with Heather's cat above) it's not considered a true seizure, seizure-like though it may be. Seizure meds won't work in these cases.
Dr. Patty Khuly August 15th, 2007 10:49:00 AM
I have three beagles, two of which have been diagnosed with ideopathic epilepsy. Epilepsy runs in my (human) family, so their seizures don't bother me as much, but part of the reason we medicate them (with phenobarb) is because my husband freaks out every time they have one. One thing I have noticed with my pack is that they seem to get used to the seizures over time. The first time one of the dogs had a seizure, the other two were very hostile. Now, after two years, all they do is whine and come to me.
Katie August 15th, 2007 11:17:00 AM
Charity ~ It's a greyhounds phenomenon for some to sink to the ground & be rather lifeless while water is being put on their backs. I've had a number of greyhounds over the years who did this & as soon as you stop rinsing & let them relax they get up & are fine. Don't know what it's all about but if that's what the dog you were grooming did, it's not unusual...Ellie
Ellie August 15th, 2007 12:12:00 PM
I had a cat that would sieze- his legs would lock straight and his head would turn to one side and he would begin frantically licking for several seconds. The head movement was so abrupt, it would knock him over from a standing position. And because his legs were locked, he could not catch himself when he fell off things, like the top of the high bookcase. The vet had him on prednisone only for the situation, which did not change his seizures. He had them daily and we could trigger them by touching his back in any fashion. He was a longhaired cat and we were afraid to brush him because it would set off another seizure. Always. I always feel terrible when I think about him, because there wasn't anything I knew that we could do for him.
Georg August 15th, 2007 12:37:00 PM
ellie ~ really! and since then i've seen real seizures on smaller dogs (a pomeranian and a poodle) and i've always wondered if what my greyhound did was a real seizure, per say. yes, she basically sank to the floor, and fell onto her side halfway through, scaring the bejeezus out of me. i assumed it was a seizure because i'd been warned about them from one person and because our (terrible, crappy, unprofessional, never-referred-to-by-the-salon) veterinarian said it was a seizure 'caused by stress or shampoo'. considering this dog had been in at least 10 times in the past several years and never had a shampoo reaction, i dont know if that was it. as a cautious groomer who values her dogs, however, since then i use hypoallergenic shampoos on greyhounds, even going so far as to buy my own shampoo for my requests...
thanks for the info!!
charity August 18th, 2007 05:31:00 AM
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Mr.cool October 12th, 2009 03:24:39 AM
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