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Epilepsy

General Information

Epilepsy is relatively common in dogs, but much less common in cats. Nerve cells in the brain function by transmission of electrical impulses. Epilepsy is a sudden, excessive discharge of electrical energy in groups of brain cells, causing a seizure or convulsion. Why this spontaneous discharge occurs we do not know, but in many cases the condition is hereditary in dogs.

Epilepsy usually becomes apparent between 6 months and 5 years of age. Nearly all breeds, including mixed breeds, have been affected.

Treatment for epilepsy does not cure the disease. Instead, treatment controls the condition by decreasing the frequency, duration and severity of seizures.


Characteristics of Seizures

Epileptic seizures seldom last more than 5 minutes, but to the unprepared observer they are extremely alarming and seem to last much longer. Handling the mouth of an animal should be avoided because you may be accidentally bitten.

Most seizures occur in 3 distinct phases. The first phase is called the aura and is the period before a seizure during which the affected animal seems overly anxious. It may scramble from behind a piece of furniture or jump down from a chair, with its eyes widely dilated. This phase generally lasts less than 1 minute.

The second phase is the actual seizure. Each attack may be different and can range from a mild muscle spasm to a severe convulsion, with defecation and urination. Loss of consciousness may or may not occur.

The third phase occurs immediately after the seizure and is characterized by confusion, weakness and rapid breathing. The severity of this phase depends on the severity of the convulsion. Blindness (temporary) and total exhaustion may follow a severe episode.

Our General Approach to Epilepsy.

If you have seen one seizure or have seen a single seizure or several widely separated occurances we usually do not address it as an emergency. We do want to let you know about what to expect with seizures. It is also very important to watch for any sign that there is something else going on besides epilepsy. There is no simple test for epilepsy. In general we come to the diagnosis by "ruling out" other causes of seizures. This is usually done with blood chemistry testing. Unfortunately, when a dog or cat has a seizure many changes occur in the blood chemistries that make it difficult to tell if the abnormality present represents a potential cause of the seizure or if the abnormality is a result of the seizure. This is why doing lab test at the time shortly after an animal has had a seizure may be a poor choice. It is better to wait at least 48 hours to allow the effect of the seizure on the laboratory results to disappear. If you prefer we may not need to do lab work after the first seizure. In general, if your pet has had 3 seizures that occured as single events we should do laboratory work to rule out other possible causes of seizures and this should be done at least 48 hours after the seizure. The cost of this lab work is usually less than $50.

If your pet has more than one seizure in one day it would be wise to go ahead and work up the case up immediately. Epilepsy that occurs in "clusters" of seizures the first time it occurs is more likely to require medication to control and sometimes proceeds quickly. Also, any time you have seen more than one seizure in a short period you must consider the possibility that the seizures are occuring as a result of a toxin (poison) or a medical condition that needs to be identified to prevent it's progression.

If we determine that your pet does have epilepsy we will want to discuss whether medications should be given to try to control them. In general once it becomes necessary to give medications to control the seizures you can expect that it will be necessary to give the medications for the rest of the animals life. Since most dogs and cats that have seizures are places on phenobarbiatal we want to make sure that the use of the medication for life is justified. Usually we consider having less than 6 mild seizures per year less harmful than the use of phenobarbital. However, if the use of medication becomes necessary most pets live fairly normal lives and the effects of the medication are usually minimal. In most cases the cost of the medication is not high.


Status Epilepticus

Status epilepticus is a constant seizure state. Each seizure seems to stimulate another, resulting in one seizure immediately following another. Since this condition can be fatal, call the doctor immediately! Status epilepticus is a medical emergency.