Epilepsy in dogs

The experiences of our clients who have pets with epilepsy are generally excellent.

Therefore, if you notice the symptoms in this article, it is best to seek the help of a veterinarian - possibly a specialist - neurologist.

What is epilepsy? 

Epilepsy is a chronic condition that causes repeated seizures (these include a whole range of symptoms, but typical is falling on the side, legs and neck cramping, with loss of composure). It is the most common chronic neurological disorder in dogs - we don't have statistics for Croatia, but in the UK, 1,000,000 dogs are sick, that is 0.6-0.7% of dogs. In most cases, epilepsy is a lifelong disease. Some dogs have annual seizures (or even less often). In contrast, others seize up to several times a day - depending on the severity and form of the disease.

What happens during a seizure?

A seizure occurs due to abnormal electrical activity in the brain that causes sudden, short-term changes in the dog's behavior (most often loss of body control).

How do I know if my dog is epileptic?

Your vet may suspect epilepsy if a dog has at least two unprovoked seizures more than 24 hours apart. 

We should remember that it can be difficult for vets to tell the difference between seizures and other health problems, so it is best to describe the symptoms to them in detail. It would be best if you are composed enough to record them with a cell phone camera. 

Characteristics of epileptic seizures 

The three main symptoms of epileptic seizures are: 

1. Loss of voluntary control, often seen due to convulsions (convulsions, tremors, and muscle twitching), 
2. Irregular attacks that start and end very suddenly
3. Seizures that appear very similar each time and have repetitive clinical patterns.

Are there different types of seizures? 

There are several types of epileptic seizures, but how they affect one dog may differ from how they affect another. Some dogs have more than one type of seizure, and not all episodes involve convulsions. Most epileptic seizures have a similar pattern:

• They happen suddenly, without warning.
• They last a short time (often just a few seconds or minutes).
• They stop on their own.

Injuries can occur during a seizure, but most dogs are not injured and do not need to see a vet unless epilepsy has already been diagnosed. 

Below are the names of the different types of seizures, along with descriptions of what happens during each type of seizure: 

• Focal seizures (jerks, blinking, drooling, changes in behavior) They occur only in one half of the brain and within a specific region. How these types of seizures manifest depends on where the abnormal electrical activity started in the brain, and the function of that part of the brain. Focal epileptic seizures can manifest as: 

1. 1. episodic movements ("motor" autonomic signs, such as facial twitching, rhythmic blinking, head shaking, or repeated muscle contractions of one limb, or: 
   2. autonomic signs (arising from the autonomic nervous system) e.g., excessive salivation, vomiting, dilated pupils, unusual behavior (episodic changes in dog behavior) e.g., restlessness, anxiety, attention seeking, inexplicable fear 

• Generalized seizures (stiffness, rapid twitching) 

They occur on both sides of the brain. Generalized seizures can occur independently, or they can start as focal seizures (more below) and develop into generalized seizures. During a generalized seizure, the dog loses consciousness, and drooling, urination, and defecation may also occur. Motor movement occurs on both sides of the body. Aspects of generalized seizures are often referred to as tonic, clonic, tonic-clonic, and myoclonic. These terms are defined below: 

1. Tonic: increased muscle contraction (stiffness) lasting several seconds to minutes 
2. Clonic: involuntary rapid and rhythmic muscle contractions (twitching) 
3. Tonic-clonic: sequence of a tonic phase followed by a clonic phase 
4. Myoclonus: sporadic jerks, usually on both sides of the body

Generalized seizures can also be nonconvulsive, such as atonic seizures (also called drop seizures), which result in a sudden and general loss of muscle tone that usually causes the dog to collapse. A focal seizure develops into a generalized seizure. This happens when a generalized seizure follows a focal seizure, and it is the most common type of seizure seen in dogs. The focal seizure is often very short (several seconds to minutes), and secondary generalization follows quickly. A focal seizure can be difficult to detect because of its short duration, and it is important to tell your vet what happened before the convulsions started to help them determine what type of seizure your dog is having. 

What causes epilepsy? 

Several different underlying diseases and other factors can cause seizures that lead to epilepsy. In general, epilepsy can be classified as 'structural' (where an underlying cause can be identified in the brain) or 'idiopathic' (where no underlying cause can be identified and often a genetic predisposition is assumed or the cause is unknown). Epilepsy can develop in dogs of all ages, depending on underlying factors. There are generally three types: 

1. Idiopathic epilepsy (without known cause) 
2. Structural epilepsy (caused by a known problem in the brain) 
3. Reactive seizure (temporary brain changes) 

What should I do if my dog has a seizure? 

It's important to stay calm! Most episodes are brief, and dogs are usually unaware of them. Affected dogs are unlikely to suffer during the seizure, even if they appear violent! Please make sure you and your pet are safe by moving all furniture out of the way so they don't get hurt. Never put anything in their mouth, including your hands. Your vet may prescribe 'emergency medication' to reduce the length of the epileptic episode.

Observing your dog's seizures

Most seizures last only one to two minutes, but it's a good idea to time the attacks to be sure of their length. It is instrumental to observe the seizure. Specifically, what were the first signs? Was one foreign body affected first? What movements did your pet make (did it "swim," tremble, chew on air)? 

Records of these observations and your seizure diary will benefit your vet.

Length, frequency, and severity of seizures

How often a dog with epilepsy experiences seizures can vary greatly between individual dogs and throughout a dog's life. Keeping an epilepsy diary is vital to keep track of how well the medicine is working and whether he is receiving the correct dose. Some dogs experience frequent seizures (e.g., more than one a day), prolonged seizures, or those that immediately lead to new episodes - in other words, they don't go back to normal between seizures. This form represents an exceptionally high risk for your dog's health.

So, attacks that can be life-threatening and urgent are: 

• Cluster seizures (two or more seizures in 24 hours) and 
• Status epilepticus (seizures longer than five minutes or two seizures without the dog returning to "normal" between them). 

What can cause epilepsy in a dog? 

Some dogs seem to have 'triggers' that lead to seizures, while others do not. Recognized triggers can vary from dog to dog. In people with epilepsy, common triggers include fatigue, lack of sleep, stress, and stopping antiepileptic drugs (if prescribed). 

Stress is the trigger most often cited by owners and can be caused by various situations, including changes in the environment, changes in routine, car rides, thunderstorms, and visits to the vet - to name a few.

Sometimes owners claim that certain foods or medications trigger seizures, so here's another reason to keep a seizure diary that can help identify the "trigger"!

How is epilepsy diagnosed in dogs?

Diagnosing epilepsy in dogs is usually a process of elimination.

First, a detailed physical examination and a medical history are taken. Next, the vet will check for the presence of palpable lumps or masses that could indicate a tumor.

The vet must listen to the heart and lungs to eliminate other possible causes.

In addition, you will likely need blood and urine tests to identify abnormal cell counts or unusual biomarkers (e.g., proteins, hormones, electrolytes, etc.).

With the help of magnetic resonance, veterinary radiologists can check for abnormalities in the brain tissue and, by analyzing the cerebrospinal fluid, identify any tumor markers or swellings within the nervous system. 

What treatment options are currently available, and can epilepsy be cured?

In most cases, there is no cure. Maintaining a seizure-free status with no unacceptable side effects is the ultimate goal of antiepileptic drug (AED) therapy. This balance is achieved in 15-30% of dogs.

Therefore, medical treatment aims to improve your dog's quality of life by reducing the frequency and severity of seizures.

Owners should be aware that although medication can significantly extend life expectancy and improve quality of life, dogs with epilepsy usually have a shortened life expectancy. 

Antiepileptic drug (AED) therapy 

If your veterinarian recommends starting AED therapy, have a thorough discussion to understand the importance of this treatment and why it is necessary. After that, you will need regular health check-ups to monitor the side effects of idiopathic epilepsy or medications. Once started, AED treatment is continued indefinitely, in most cases for the rest of your life, with periodic health checks and blood tests to ensure correct drug dosage and effectiveness.

It is important to be consistent with any treatment; therefore:

• Give your pet the medicine at the same time every day. 
• Give the correct dose of medicine. 
• Continue treatment and only stop after first talking to your veterinarian. 

Which AED will my dog get? 

Your veterinarian can advise you on which antiepileptic drug (AED) is most suitable for treating epilepsy. Factors influencing the veterinarian's decision are usually the type of seizures, their frequency, and possible kidney or liver problems. The first drugs your vet can legally prescribe to treat your dog's epilepsy in the EU are imepitoin or phenobarbital. 

Next steps 

If the desired seizure reduction fails with the first choice of drugs, it is possible to add potassium bromide. 

Diet: Always feed your dog the same after diagnosis, as changes in food can alter the blood levels of certain medications. Furthermore, new types of diets are currently being developed in the hope of further improving seizure control. 

How do I know if the medication is working? 

Treatment with antiepileptic drugs is generally considered successful if the frequency of seizures is reduced by at least half. However, the ideal is for episodes to be completely absent. An accurate seizure diary would be very useful to determine whether the drug is working. That is the best way to see if there is an improvement. 

Do these drugs have side effects? 

Unfortunately yes. Side effects may appear shortly after starting treatment or after increasing the dose. These usually disappear or diminish over the following weeks as the body develops a tolerarance to the medication. Sometimes, side effects persist, and the animal must be monitored to ensure their severity does not compromise your dog's quality of life. 

What are the common side effects of antiepileptic drugs? 

Common potential side effects of AED treatment include:

• Sleepiness, 
• Unsteady movement and standing, 
• Increased appetite and thirst, 
• Drooling, 
• Vomiting, 
• Diarrhea, 
• Weakness of hind legs, 
• Weight gain, 
• Excitability, 
• Unrest 
• Changes in behavior. 

Suppose your dog stops having seizures or develops life-threatening side effects. In that case, your vet may recommend discontinuing treatment. Still, it would be best if you did not decide this alone, as this can cause seizures and status epilepticus. 

Consult your veterinarian before making any changes!

And finally, research has shown that CBD (cannabidiol) benefits people with epilepsy and related diseases. In 2018, the US Food and Drug Administration (FDA) approved a cannabidiol-based drug for children and adults called Epidiolex for treating seizures caused by Lennox-Gastaut and Dravet syndrome and tuberous sclerosis complex (TSC). You can read more information about these conditions and how Epidiolex is used to treat them here.

Likewise, CBD has a beneficial effect on dogs with epilepsy, which you can read more about here, and you can see the research conducted on dogs here. 

VetHealth Broad Spectrum oil is a combination of cannabidiol (CBD) and cannabigerol (CBG) without psychotropic molecules and terpenes, so it is entirely harmless for animals. The experiences of our clients who have pets with epilepsy are generally excellent. 

Therefore, feel free to contact us! 

IMPORTANT: This article is not intended to diagnose or treat your pets. If you have noticed any of the symptoms mentioned in it, immediately contact your veterinarian or a specialist - neurologist. 

Your VetHealth

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