Idiopathic means no-one knows the cause. In these cases, medication is used to manage the seizures. Some humans with epilepsy can be treated with vagal nerve stimulators which deliver a pulse of electricity to the vagus nerve, reducing their seizures, but sadly this is still in the early stages of being studied as a treatment for dogs.
HOW IS EPILEPSY USUALLY MANAGED?
An epileptic dog is most likely to be on lifelong medication. It is important not to miss any doses of the medication as this can cause rebound seizures. So, it is best to always carry it with you and alert kennel owners, dog walkers and family to the importance of the medication. There will be maintenance medication once, twice or three times daily but also there are emergency medications, usually used to reduce the severity of a seizure or prevent it happening. Oral or rectal diazepam is usually used for this.
WHAT ELSE SHOULD I DO?
Keeping a seizure diary is very useful for your vet as it can help to measure how effective treatment is and inform which medications to choose. Include as much information as possible but the essentials are date, length of fit (it is helpful to time a seizure), and how the dog was before and after the seizure. It may also help to find seizure triggers, such as visitors, fireworks, or visits to the vet that may make a fit more likely. If you do recognise a trigger, epileptic medication can sometimes be increased in the short term under the direction of your vet to prevent seizures following exposure to it.
WOULD A CHANGE IN DIET HELP?
Apart from gluten sensitivity in Border Terrier Cramping Syndrome, there is no evidence that diet is linked to epilepsy in the dog. Grain-free diets, raw food, ketogenic diets (high fat, low carbohydrate), fish oils and taurine supplements have all been suggested but, in trials, no improvement has been seen in epileptic dogs. Complete, balanced dog food is wise as they have all the nutrients the dog requires for health. The ketogenic diet, which has had some success in managing human epilepsy, did not produce positive results in trials and caused pancreatitis in a third of dogs, so is not recommended.
HOW EFFECTIVE IS THE TREATMENT?
Fortunately, the medications used are usually very successful in managing epilepsy with no negative effect on the quality of life or significant side effects. Weight gain can occur on some of the medications due to increased appetite, so lower calorie foods should be used. In this way, the dog still feels full but eats fewer calories. Rarely, a dog may be quiet for 4-5 days when first starting medication. Blood tests may be needed intermittently to check blood levels of the anti-epileptic drugs and to test liver function as most of the drugs are cleared from the body by the liver, so function needs to be good.
HOW CAN I PREPARE FOR A SEIZURE?
The seizures themselves can be very upsetting. Some dogs behave oddly before a seizure, they may be quiet, clingy, hide or seem nervous. In these cases, pre-emptive medication can be used. If you suspect a seizure is coming, it may help to reduce stimulation by putting them in a quiet room with curtains closed and keeping them calm. In most cases, there is no warning so it is ideal to protect the dog by seizure-proofing the house as much as possible. A stair gate at the top of the stairs can stop a dog with a sudden seizure falling down the stairs. Covering sharp table corners with protectors used for baby proofing can prevent injury. Glass tables and shelves should not be stored or kept in rooms where seizures may occur.
WHAT SHOULD I DO WHEN MY DOG’S HAVING A SEIZURE?
Duvets and deep beds can be kept on hand if you have time to place them under the dog when seizuring. Never put your hand in or around their mouths, as you could get hurt badly – the dogs usually lose consciousness and can accidentally bite. It is extremely unlikely that they will damage their own tongue, lips or gums. Often fitting dogs will urinate, defecate and salivate so towels and blankets may be useful if kept in an accessible place.
WHAT ABOUT IF I’M OUT AND ABOUT?
If you are travelling with an epileptic in the car, it is wise to contain them in such a way that if they seize, they won’t fall far or get hurt. So, a crate with a deep bed is helpful, ensuring that their collar won’t catch on the bars of the crates reduces injuries to the neck.
As well as a microchip, an identity disc or collar is ideal as a means of identification and information on an epileptic dog. This can include the information that the dog is epileptic and if lost, needs to be returned to the owner as soon as possible or to a vet in case of seizure.
WHEN DO I NEED TO CALL YOU?
Most seizures in a treated dog will be mild and short but sometimes, before treatment or if treatment is unsuccessful, a dog can start a fit which does not stop. If a fit continues for more than 5 minutes, this is called status epilepticus. This may mean that the seizure will not stop without intravenous medication administered by a vet. After trying your emergency medications at home, telephone the emergency veterinary service and get the dog in the car immediately. It is important to have the number available and know where you go out of normal business hours, in case of emergency, perhaps your own veterinary surgery, perhaps a dedicated out of hours service, depending on your vet’s arrangements.
Status epilepticus is rare and most seizures will end quickly. The aim of the treatment of epilepsy is to reduce how often and how serious the seizures are. Mild, infrequent seizures may still occur but neither these or the medications will negatively affect the quality or length of your dog’s life.
If your dog has had a seizure, please call us to make an appointment to be seen. While many seizures are relatively harmless, occasionally they can be an “early warning” of some more serious problem and, if not controlled, they can result in brain damage.