Feline Epilepsy

Introduction to Feline 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.

This condition is more common in cats younger between 3 and 6 years old, but can happen in any age of cat. Cats can very commonly have what are called partial seizures with their epilepsy. In a partial seizure, only part of the brain has a seizure, and therefore only part of the body shows abnormal activity. For instance, face and ear seizures are very common in cats. Some cats will have generalized seizures, where the entire brain, and therefore entire body, will be seizing.

Birman cats get epilepsy more frequently than other types.

Is my cat going to be okay?

Many cats do well with treatment. 40% percent of cats even become completely seizure free on medication, another 40% have significant improvements on medications, while the final 20% can be very difficult to treat. Cats with difficult to treat epilepsy can have decreased quality of life, and unfortunately a shorter life span. Treating earlier with seizure medication has been shown in research to get better results, so if your cat is having seizures, we recommend you discuss a medication plan with our team.

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 cat! 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.

Do cats 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 cats. 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 pet 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 with the laser toy drives your cat absolutely wild, switch to another game like playing with a feather toy until the seizure medications seem to be working.

Diagnosis

There is no test for epilepsy. That means to diagnose your cat 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 an infectious disease panel.

As many as 2% of all cats will have a seizure in their lifetime. However, only about a quarter of cats who have had a seizures have epilepsy- so this testing is important to make sure we are not missing another disease. Other diseases that cause seizures include cancers, strokes, and rarely, infections. Some of those conditions are very treatable- some even curable. Some of those conditions are very dangerous. This is why diagnostics are so important in cats.

Managing Epilepsy Over time

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!

Other types of epilepsy in cats

There are few other causes of epilepsy in cats. It’s unclear if these are a subset of idiopathic epilepsy or represent their own diseases. In addition to these disease, a variety of other diseases include metabolic and structural diseases can also cause seizures in cats.

Feline Audiogenic Reflex Epilepsy

This form of epilepsy tends to happen in older cats, often older than 10 years old. It also is more common in the Birman breed. In this form of epilepsy, cats have seizures triggered by certain sounds. These seizures tend to be a single or a few repeated jerking motions of the head and body. This form of seizure tends to respond better to keppra than other medications.

Feline Hippocampal Sclerosis aKA Feline Temporal Lobe Epilepsy

In this form of epilepsy, cats have seizures that are limited to their face and mouth. They will often drool, twitch, their eyes might dilate, and they make make chewing motions with their mouth. On MRI, we often see they have changes to a part of the brain called the hippocampus. Cats with this condition may benefit from steroid therapy in addition to seizure medication.

Will my cat ever be cured?

A small number of cats, about 25%, can eventually be weaned off their medications. However, this takes months, if not years, of therapy. Most cats will be on seizure medication life long.

Flea and Tick Medications

There is a good deal of unfortunate and inaccurate information online about flea and tick medications and seizures. The first and most important thing to remember is that if your cat has been on a flea and tick medication long term, it is still safe for them to be on this medication.

Technically, any medication for fleas and ticks can cause seizures. However, it is a very rare reaction. That is because your pet has something called a blood-brain barrier, which keeps things like these medications out of their brain. If your pet has a mutation which makes this barrier leaky, the medication can get to the brain and cause seizures. Should this be the case, they would have a seizure within 24 hours of getting the medication for the first time. If your pet’s seizures are not directly after getting these medication, they are not the cause of your pet’s seizures.

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 officially reported in dogs and cats. My clients have occasionally found a food switch to help with seizures, but we recommend that all diet changes be done slowly. There are some studies in people that show a benefit to some diets, like the ketogenic diet for children with epilepsy. We do have some new data on this type of diet for dogs, however there is not research on a diet like this yet for cats.

Regular Check-Ups and Labwork

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.

Keys to a successful appointment:

1) Bring your pet’s seizure log.

2) Bring all medications with you.

3) Ask when you make the appointment if your pet should be fasted and if the timing of the appointment relative to medications matter. Some blood tests require the pet have no food for up to eight hours before the appointment, other test require your pet to have taken their medication at certain times before the appointment.

4) Ask when you make the appointment how long the appointment will take. Some blood test can take several hours to perform.