Seizures are the most common neurologic problem in small animal medicine presented at CGS Hospital. Pet Owners are often emotionally distraught because of the violent, unpredictable nature of the seizure. Optimal management of this syndrome depends on the veterinarian and client working together as a team with the client actively participating in the decisions. With proper treatment, the patient and client can usually maintain a good quality life.
An epileptic seizure is the clinical manifestation of the excessive electrical activity in the cerebral cortex of the brain. Seizures may be “isolated” single seizure in 24 hrs, “cluster” seizure-2 or more in 24 hrs, or ”continuous” in which convulsion lasts 30 minutes or more with no recovery (status epilepticus). Seizures often increase in frequency or severity with time. Seizure is approximately 1% of all canine diseases. It is a rare condition in cats.
There are many causes of a seizure episode like Intracranial disorders, namely caused byviral, fungal, protozoal, bacterial, parasitic and rickettsial infections, neoplasia, trauma, neuronal degeneration, anorexia, congenital malformations, etc. Distemper is the most common cause of inflammatory seizures in dogs. The extra- cranial causes include hypoglycemia, hypothyroidism, hepatic failure, renal failure, toxicities, etc.
A striking form of Canine epilepsy is Idiopathic epilepsy as no known or demonstrable cause is identified. It is most likely genetic or genetically influenced in nearly all breeds. Breeds in which a genetic predisposition has been identified: Beagles, Belgian Tervurens, Keeshounds, Dachshunds, British Alsations, German Shepherds, Border Collies, Golden Retrievers. First seizure occurs between 6 months and 5 years of age. No external triggers for seizures have been able to be documented, although owners and veterinarians often associate excitement, fear, and other possible events with seizure activity.
Diagnostic plan includes accurate history, complete physical, fundic and neurological examination,
Hematology, serum biochemistry, electrolyte panel, hormone profiles and urinanalysis, radiographs, ultrasonography, ECG, CT/MRI and EEG.
The goal of the therapy is to reduce the frequency and the severity of the seizure to a level that does not substantially compromise the quality of life for the pet and family while avoiding serious side effects. Studies say that epilepsy as such is not life threatening but it does have a negative impact on life span of the dog with the condition.
Patients with a single seizure, provoked seizure, or isolated seizure separated by a long period of time generally do not require treatment. Treatment is indicated for patients with any episodes of unprovoked status epilepticus, multiple seizure or underlying progressive disorder responsible for seizure. Patients treated early in the course of the epilepsy may have a better long term control of their seizure than the patients who had multiple seizures before treatment is started. Success of the antiepileptic drug is the reduction of the seizure frequency by atleast 50 % with minimal drug side effect. The client should understand the goal of the therapy, potential side effects and cost and effort associated with the treatment and monitoring.
Treatment failures includeMedication/Dosage Errors, Improper drug choice, Non-compliance of owners (failure to medicate as instructed), Dosages too low, Intervals between administration too long leading to fluctuations in serum drug levels, stopping one drug too soon while adding a second, inappropriately combined drugs, drug Interactions, metabolic abnormalities, etc.
Note to pet parents:
- Do not discontinue the prescribed medications abruptly.
- If a dose of medicine is missed, then administer the medicines as soon as you remember and continue the medication as per next schedule.
- Avoid loud music, horns, loud door bells, crackers, separation anxiety, extreme heat or cold, prolonged hunger, neck/choke collars and excessive stress or restraining.
- Despite of the medications many patients get cluster seizure at home during odd hours. In such cases pet owners can give prescribed medicines per rectally or intranasal.
- Have a proper record of the seizure timings, duration and frequency. A video recording is always helpful for the veterinarians to make decisions in diagnosis.
- For an expected increased chance of seizure the medication can be dosed extra after consulting with the vet to avoid the occurrence of the seizure.
- Do not breed such patients.
- In case of cluster seizure or uncontrolled seizures patient might need hospitalization for few days to weeks.
- Proper monitoring of the serum drug levels and blood examinations and checkups at regular interval is required.
- Always consult your Vet before taking any drastic steps!
By: Dr. Vikash Singh Chauhan (M.V.Sc. Vet. Surgery & Radiology)
Sr. Veterinarian at CGS