It’s never easy watching the ones we love struggling through epilepsy; the seizures are frightening to watch and the confusion and disorientation following a seizure are heartbreaking – and that is true regardless of whether your loved one is an epileptic child, parent or dog.
Epilepsy can affect our beloved pets, but seizures are more common in dogs than cats. Epilepsy or seizure disorders in dogs and cats are similar to the disease in humans, which means there are various types of epilepsy and various types of seizures.
First, though, let’s look at what epilepsy is.
Epilepsy is characterised by recurrent seizures or convulsions caused by random electrical impulses that travel the nerve circuits of the brain and affect muscles throughout the body. Ron Hines (DVM PhD) compares what happens during a seizure to a snowball starting an avalanche. A few electrical impulses start off a chain reaction that excites other nerve cells and so on and so on until the muscle contractions cause your dog or cat to have either a grand mal seizure or a petit mal seizure.
What causes epileptic seizures in dogs and cats?
Seizures can have a range of causes, including:
- Consuming toxic substances, including toxic plants, chemical substances, chocolate, lead
- Liver/kidney disease
- Low/high blood sugar – hypoglycaemia or diabetes mellitus
- Electrolyte problems
- Physical trauma – head injuries
- Viral infections, for example, encephalitis
- Diseases, including brain cancer and canine distemper
- Brain tumors
- Congenital defects
- Low oxygen levels
- Excessively high or low body temperature
- Certain types of medication
- Genetic predisposition
Epilepsy can have a genetic component, which means seizures can be hereditary. Seizures can occur in all breeds and mixed breeds, but they are more common in certain dogs, including:
- Golden retrievers
- Labrador retrievers
- Cocker spaniels
- German shepherds
- Irish setters
- Staffordshire bull terriers
- Belgian tervuren
- Shetland sheepdog
- Irish wolfhound
- Finnish spitz
- English Springer spaniel
According to Dr. Hines, cat breeds most commonly affected by epilepsy include Persians and Siamese.
Seizures can also have no known cause. The condition is called idiopathic epilepsy. Bear in mind that “no known cause” doesn’t mean there is no underlying condition at all; it simply means that even after comprehensive tests, veterinarians can’t find a physical reason for the seizures in your dog. Most often dogs with idiopathic epilepsy have small areas of damaged brain tissue that contributes to the seizures.
Types of epilepsy in dogs and cats
We’ve already mentioned idiopathic epilepsy, when seizures have no known cause. Studies have found that idiopathic seizures are more common in male dogs. Even there are no known causes idiopathic epilepsy can still be treated. In fact, it’s essential that you get treatment as soon as possible; otherwise seizures can occur more often and become much more severe.
Idiopathic epilepsy is also called primary epilepsy, genetic epilepsy, inherited epilepsy and true epilepsy. The first seizure usually occurs when dogs are between 6 months and five years old.
Secondary epilepsy is when seizures have a known cause (see the list above). Secondary epilepsy usually first occurs when dogs are 4 years old or older.
Types of seizures
In addition to the different types of epilepsy, dogs (and cats) can also suffer from different types of seizures, including:
Generalized seizures are also referred to as tonic-clonic seizures and they can be grand mal or mild. There are 2 phases: a tonic phase and clonic phase. In a grand mal seizure, the tonic phase is characterized by your pet falling on her side, losing consciousness, and rigidly extending her limbs. It lasts for 10 to 30 seconds. The clonic phase follows and is characterized by paddling/running movements in the limbs and chewing or snapping motions. Both phases may also include salivation, urination and defecation.
In mild seizures, the paddling and limb extension may not be present at all, or may be subtle. Pets don’t lose consciousness either.
Generalized seizures are most common in primary (idiopathic) epilepsy.
Petit mal seizures (absence seizures)
Petit mal (or absence) seizures are quite rare and because the signs are so subtle, pet parents don’t notice them. Signs of petit mal seizures in dogs include a very brief period of unconsciousness, brief blank state, eyes rotating upward and loss of muscle tone.
Partial seizures (also called focal seizures)
Grand mal seizures affect the whole body (from an electrical storm or avalanche of nerve impulses in a large part of the brain), partial seizures affect only one area of the body (the electrical storm of avalanche occurs in an isolated area of the brain), so only one limb might jerk and twitch, your dog’s face might twitch, or your dog could turn her head in one direction. Partial seizures can progress to generalized or grand mal seizures if left untreated.
Partial seizures are most common in secondary epilepsy.
Simple focal seizures (minor motor or focal motor seizures)
These seizures occur in the parts of the brain the control movement, the area in the body that correlates to that part of the brain will twitch or develop a tic, for example, excessive blinking or right front paw twitching. Dogs are usually aware of and confused by what is happening. They can develop into generalized seizures.
Complex partial seizures (psychomotor or behavioral seizures)
These seizures originate in the emotion and behavior areas of the brain. Odd or repetitive behavior characterizes these seizures, stemming from different visual, olfactory, auditory and gustatory sensations (almost like hallucinations). Your dog might smack her lips, snap at flies, run hysterically, cower, hide, vocalize, or cower during a seizure. Dogs are usually completely unaware of what they are doing during a seizure. Other characteristics may also be present, including vomiting, diarrhea, salivation, temporary loss of vision, and flank biting.
These odd behaviors may last only a few minutes or they may last a few hours and they can culminate in a generalized seizure.
Complex partial seizures (behavioral seizures) are most common in secondary epilepsy.
Cluster seizures are multiple seizures that occur within a short period of time – usually within 24 hours. The seizures don’t last long – only about 30 to 60 seconds – and there are periods of consciousness between episodes. Cluster seizures are more common in large breed dogs than small breeds.
Cluster seizures can be fatal.
Status epilepticus seizures are particularly scary because they are a series of multiple seizures in episodes that can last for 30 minutes or longer. There is no period of consciousness between seizures, but there are brief periods of inactivity before seizure activity begins again. They are similar to cluster seizures, but can occur in primary and secondary epilepsy and they can occur in dogs with no history of epilepsy, for example, due to brain trauma, ingestion of toxins and onset of certain diseases.
Status epilepticus seizures can be fatal.
Stages of a seizure
Most seizures consist of 3 stages:
Promodal (warning) stage
The warning stage can occur anywhere between a few minutes to a few hours before a seizure hits your dog. You may notice mood or behavioral changes, anxiety, pacing, licking and trembling.
Ictus (ictical) stage
This is the seizure stage and includes the tonic and clonic stages (see above).
Post ictal stage
This is the recovery stage, when your dog (or cat) is tired and just wants to sleep. They’re dazed and uncoordinated, and stumble or bump into things. This stage may last a few hours, but some dogs have an amazing ability to bounce back quickly.
Some people insert an extra stage between the prodrome (warning) and ictus stages. The aura stage occurs just a few minutes before a seizure and is characterized by behavioral and physical changes.
What you can do when your dog (or cat) has a seizure
The most important thing is to stay calm. It may seem like an eternity, but most seizures only last 1 – 3 minutes. Talk to your dog soothingly, make sure there are no objects, corners or hard edges around that can hurt her, and make sure that she continues to breathe. Place a pillow or folded blanket under her head, so she is comfortable. Keep the room quiet and dark afterwards, so she has a safe place to recover. If you know she urinates or defecates, have some warm water and towels to clean her gently when her seizure ends.
Do not put your hand in your dog’s mouth as she might accidentally bite you. If you need to keep her tongue out of her airway, use two towels to separate her upper and lower jaws.
If her seizure continues for more than 5 minutes, you might need to inject your dog with an emergency dose of diazepam (valium) to stop the seizure. Call your veterinarian when it’s over to see if she thinks it’s necessary to see your dog. Call your vet if your dog has another seizure.
If the seizure is within the 1 – 3 minute timeframe, you don’t need to phone your veterinarian but you should record the episode in a ‘seizure log book’. Record the time and date, as well as warning signs, the duration and severity of the seizure and how long it took your dog to recover.
Get her to your vet immediately if the seizure is severe, for example, it’s ongoing or there are multiple seizures. You need a transport plan, so that you can carry her from the house to the car, keep her secure in the car and transport her into the surgery.
Treatment for epilepsy and seizures in dogs (and cats)
The earlier you start epilepsy treatment the better, because the longer the disease goes untreated the more frequent and severe the seizures can become and the more damage to the brain. As a rule, your veterinarian may start prescribing anti-seizure or anti-epilepsy medication if your dog or cat has had 2 or more seizures within 2 months, or has had two or more cluster seizure episodes within 3 months.
It’s handy to know that the younger your dog is when epilepsy first presents, the worse the condition is likely to be. So if your puppy has seizures or shows any of the signs or symptoms of epilepsy, best you consult your vet and start treatment right away. The good news is that even though your puppy has started having seizures early, epilepsy responds very well to medication from an early age, so the prognosis is good.
Medication is the most common treatment prescribed for seizure disorders and epilepsy, but it depends on the cause of the disease. If a brain tumor causes your dog’s epilepsy, then surgery to remove the tumor is often the best treatment.
Advances in veterinary science have vastly improved the quality and safety of anti-epilepsy medicine, so now you can treat seizures on a long-term basis without nearly as many side-effects or risks for long-term health damage as a decade or so ago.
Medications commonly used
Remember that medication does not cure epilepsy, but can manage the disease and lessen the frequency and severity of seizures. It may take a while for your vet to find the right combination of drugs in the right dosages, which is why keeping a log book is so important. It provides your vet with important feedback regarding your dog’s (or cat’s) seizures.
Phenobarbital can be used on its own to treat epilepsy in pets, but it is often combined with potassium bromide to mitigate the side-effects that cause liver damage. Other side-effects include sedation, increased appetite and weight gain, and increased thirst and urination. It’s essential to regularly test liver function (test liver enzymes) to ensure there is no damage.
Another side-effect is physical dependence on the drug, so you can’t simply stop the medication when you want to take your dog off it; you need to work to a schedule given to you by your veterinarian.
Potassium bromide is often given with Phenobarbital to lessen liver damage and is seldom prescribed on its own. Remember to always give potassium bromide with food and reduce your dog’s salt intake. Too much salt will eliminate the potassium bromide from your dog’s system, giving it less time to take effect. Possible side-effects include behavioral changes, muscular twitching and staggered gait.
Potassium bromide works better in dogs than in cats, in whom causes lung inflammation and feline asthma.
This drug is very similar to Phenobarbital and, in fact, it is converted into to Phenobarbital in your pet’s body. Expect similar side-effects.
Diazepam is not used as a long-term treatment; instead it is used to stop long seizures. Resistance is a risk with prolonged use. It appears to be more effective in cats than dogs.
Most of the side-effects for epilepsy medicines last only a week or two while your dog gets used to them. Don’t ever make any changes to your pet’s medication or stop providing treatment with the advice of your veterinarian. As a general rule, you might be able to start weaning your dog or cat off epilepsy medication once they have been seizure-free for a year.
That is not to say that your dog will never have another seizure, but hopefully they will be very few and very far between. If the seizures become more frequent or severe, you’ll need to go back to your vet.
Changing your pet’s diet might also help manage seizures. Low (or no) carb diets that are high in protein are effective in treating epilepsy in humans. The good news is that dogs and cats thrive on low-carb, high-protein diets.
Alternative treatments, like acupuncture, may alleviate some of the side-effects of medication or some of the lingering stress in your dog’s body after seizures, but they should only ever be used after consulting with your veterinarian and a qualified holistic vet. They aren’t a substitute for medication, but a complementary treatment option.
Epilepsy in cats
Dr Hines talks about his experiences with epilepsy in cats, saying that only about 33% of cases are idiopathic. The remaining 66% percent include encephalitis, toxic substances, brain trauma, metabolic disorders and brain tumors. Progressive, acquired brain disease is the most common cause of seizures in cats. The prognosis is also not as good for cats as it is for dogs, but medication can still manage the disease and allow your cat to live a relatively normal life.
In fact, focusing on living a normal life is the most important tip for living with your pet’s epilepsy, according to Dennis O’Brien (DVM, PhD) (Canine Epilepsy). Make sure you still have fun with your pet, go for walks, play, train some tricks, go for picnics, invest in a cat playroom – do whatever it takes to make your pet’s life count.