Canine Epilepsy

Introduction to Canine Epilepsy

Idiopathic or genetic epilepsy is a disease where animals have repeated seizures over the course of their life, but despite extensive testing (including blood work, MRI and spinal tap) we can find no cause for the seizures. Think of it as “faulty wiring” in the brain that makes your pet seizure.

Epilepsy is the most common cause of seizures in dogs. Dogs with idiopathic epilepsy are generally between 1 and 5 years old at the time of their first seizure and should be completely normal between seizures. Older or younger dogs may also have epilepsy, but diagnostics are more important in these patients to make sure we are not missing something.

This is an MRI of a healthy brain.

Is my dog going to be okay?

Most dogs with epilepsy are well controlled with medications. “Well-controlled” can be a little different for every dog, but we generally considered a dog well controlled if they have fewer than 1 seizure every 6 weeks. 75% percent of dogs with epilepsy will be well controlled on one or two seizure medications.

There is no one perfect seizure medication that works in all dogs. This means we sometimes we need to try a few medications to find a good fit for your pet. We judge the success of a medication both by its ability to control seizure and also by the level of side effects your dog has from the medications. We love it when a dog has perfect control with no side effects, but we often have to compromise a bit and find that balance of mild side effects and good control.

Living Your Life With An Epileptic Pet

It’s important to not let a diagnosis of epilepsy rule your and your pet’s life. Your pet can be left alone. You can go to work or the store without your dog! You might miss a seizure now and again, but truthfully most seizures are short and end on their own. Many times there will be a hint that it happened. For example, something is knocked over or there is drool on the floor. It’s important to record any suspicious events on the calendar and alert your veterinarian of any changes. It’s generally more important that your veterinarian know about the overall trend of your pet’s seizures than every event.

Your pet does need to receive their medications on schedule. Some patients require exactly timed medication, but for most patients there is some wiggle room. For instance, for the majority of patients, if you are having dinner out and will be home afterwards it’s okay to be a couple of hours early or late with a pill. The only activity we recommend against for all dogs with seizures is swimming. We cannot predict when a seizure might happen, and having a seizure while swimming could result in drowning.

Will Epilepsy Shorten My Pet’s Lifespan?

Do Dogs Have seizure Triggers?

In people, we know that sometimes there is a trigger that will cause seizures. Sometimes stories will make the news about a person who has seizures when a certain cartoon or piece of music is played. Some owners will recognize a trigger in their dogs. It can be anything- from a certain smell to an event like an owner leaving town. If a trigger is found, it should be avoided whenever possible.

We also recognize that until a dog is well controlled, stressful or particularly exciting things can trigger seizures. So until we have your pet’s seizures well under control, try to avoid things that cause too much excitement. For instance, if playing frisbee drives your dog absolutely wild, switch to another game like tug of war until the seizure medications seem to be working.

When we look at an overall average, dogs with epilepsy do have a shorter lifespan than dogs without epilepsy. However, many dogs with epilepsy will have a normal lifespan.

Unfortunately, there is a group of pets who are not controlled on one or two medications. We call this being “pharmacoresistent.” These pets unfortunately tend to have shorter lifespans, as their seizures are difficult if not impossible to control.

In 2015, the International Veterinary Epilepsy Task Force came out with new guidelines that recommended earlier treatment of epilepsy in the hopes of improving out comes for these pets. At your appointment, we will discuss the pros and cons of starting medication.

We also see that this disease can cause both financial and emotional strain for the family. Honest communication with your veterinarian about your concerns is important. Loving pet owners often get very fixated on their dog’s quality of life and sacrifice their own happiness and security to take care of their pets. While that’s very noble, it’s okay- and important- that you have a good quality of life too. If you are facing significant challenges managing your pet with epilepsy, please talk to us so we can work with you on solutions!

Diagnosis

There is no test for epilepsy. That means to diagnose your dog with epilepsy we must test for everything else and find nothing wrong. This is called a “diagnosis of exclusion.” To look for all of the other possible disease we must perform blood work, imaging of the brain (CT or MRI), a spinal tap, and sometimes an infectious disease panel.

Often, in a patient who fits the “normal” profile of a dog with epilepsy, we will skip the bigger diagnostics like MRI. We assume, because they fit the usual pattern and the disease is so common, that they have epilepsy- but it’s not proven! This is called a “presumptive diagnosis.” If these patients develop new symptoms or are difficult to control with medications, getting the diagnostics done becomes important. About 10% of dogs who we thought had epilepsy based on their symptoms actually have a different problem that is causing their seizures.

Managing Epilepsy Over time

Does my pet need an MRI?

Most pets with epilepsy do not need an MRI. However, if your pet falls in to one of the following categories, an MRI and other diagnostics are recommended.

Younger than 6 months or older than 6 years at time of first seizure
Neurologic abnormalities such as incoordination present in between seizures
Severe forms of seizure including seizures lasting longer than 5 minutes (status epilepticus) or having more than one seizure in 24 hours (cluster seizure)
Inadequate seizure control on a seizure medication at the highest tolerated dose

Does Diet Matter?

This part of science is still evolving. There are sporadic reports of food allergies triggering seizures in people- this has not been reported in dogs. There are some studies in people that show a benefit to some diets, like the ketogenic diet. There is a diet made by Purina called NeuroCare that works on this ketogenic diet theory. It has shown some benefit in helping dogs with epilepsy. This diet is a prescription, and only available through veterinarians. If your pet does not have any food sensitivities, it may be worth it to try this diet. In the study dogs showed benefit relatively quickly, so you will be able to tell if this diet is working for your pet in a short amount of time. If you try this diet, it’s important that your dog not have any other food and treats be kept to a minimum, otherwise the diet will not work.

Managing your pet’s epilepsy is a partnership with your veterinary team. The exact recommendations that a doctor picks can vary a bit from doctor to doctor. It’s like cooking. Everyone uses the same ingredients to make a marinara sauce, however the exact way they put them together can be different. That’s why it’s important to pick one veterinarian to be in charge of your pet’s seizure control. They will be the head chef and we really only want there to be one cook in this kitchen. When multiple veterinarians try to manage the same patient, it can be incredibly difficult to stay organized. Certainly, if your pet is experiencing a medical emergency, you should do whatever the emergency veterinarian suggest. However, when the emergency is over, schedule an appointment with the doctor managing your pet’s seizures so they can adjust things as needed.

Along those lines, it’s important that you contact your veterinary team before making any adjustments to your pet’s medications. Seizure medications are safe medications when used correctly, but we can see very serious problems when pet owners try to make changes on their own. We’re here to help!

Regular Check-Ups and Lab Work

Your veterinarian is an important partner in controlling your pet’s seizures. This means going in for regular check ups. It also means blood work to check for blood levels of medications as well as any side effects. Typically blood work is recommended 2-3 times a year depending on your pet’s medications.

To Ensure A Successful Appointment: