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SEIZURES

 
What is a seizure?

Seizures are one of the most frequently seen neurological problems in dogs. A seizure is also known as a convulsion or fit. It may have all or any combination of the following:

  • 1)Loss or derangement of consciousness
  • 2)Contractions of all the muscles in the body
  • 3)Changes in mental awareness from non-responsiveness to hallucinations
  • 4)Involuntary urination, defecation, or salivation
  • 5)Behavioral changes, including non-recognition of owner, viciousness, pacing, and running in circles
What are the three phases of a seizure?

Seizures consist of three components:

1) The pre-ictal phase, or aura, is a period of altered behavior in which the dog may hide, appear nervous, or seek out the owner. It may be restless, nervous, whining, shaking, or salivating. This may last a few seconds to a few hours.

2) The ictal phase is the seizure itself and lasts from a few seconds to about 5 minutes. During this period, all of the muscles of the body contract strongly. The dog usually falls on its side and seems paralyzed while shaking. The head will be drawn backward. Urination, defecation, and salivation often occur. If it is not over within 5 minutes, the dog is said to be in status epilepticus or prolonged seizure.

3) During the post-ictal phase, there is confusion, disorientation, salivation, pacing, restlessness, and/or temporary blindness. There is no direct correlation between the severity of the seizure and the duration of the post-ictal phase.

Is the dog in trouble during a seizure?

Despite the dramatic signs of a seizure, the dog feels no pain, only bewilderment. Dogs do not swallow their tongues. If you put your fingers into its mouth, you will do no benefit to your pet and will run a high risk of being bitten very badly. The important thing is to keep the dog from falling and hurting itself. As long as it is on the floor or ground, there is little chance of harm occurring. If seizures continue for longer than a few minutes, the body temperature begins to rise. If hyperthermia develops secondary to a seizure, another set of problems may have to be addressed.

What causes seizures?

There are many, many causes of seizures. Epilepsy is the most common and of least consequence to the dog. The other extreme includes severe diseases such as brain tumors. Other problems that can cause seizures or episodes that look like seizures may be caused by Hypoglycemia, electrolyte imbalances, Cardiovascular problems, Central Nervous System infections and a few other causes. Fortunately, most are due to epilepsy.

Now that the seizure is over, can anything be done to understand why it happened?

When a seizure occurs, we begin by taking a thorough history concentrating on possible exposure to poisonous or hallucinogenic substances or history of head trauma. We also perform a physical examination, a basic battery of blood tests, and an electrocardiogram (EKG). These tests rule out disorders of the liver, kidneys, heart, electrolytes, and blood sugar level. A heartworm test is performed if your dog is not taking heartworm preventative very regularly.

If these tests are normal and there is no exposure to poison or recent trauma, further diagnostics may be performed depending on the severity and frequency of the seizures. Occasional seizures are of less concern than when the seizures are becoming more severe and frequent. In this instance, a spinal fluid tap and fluid analysis may be performed. Depending on availability, specialized imaging of the head with a CAT scan or MRI might be performed. Fortunately, these additional tests are usually not needed.

What can be done to prevent future seizures?

The specific course of treatment depends on the severity and frequency of the seizures. Frequent, severe seizures require higher doses of more potent drugs that have the best chance of stopping the problem, then we gradually decrease the dose to the minimum required. Occasional mild seizures may require no preventive therapy at all.

If we decide to treat we base the anticonvulsant therapy on frequency and severity of the seizures, age of the patient, general overall health and bloodwork results and any special needs of the patient or the owner. The dose will be adjusted until we get the lowest dose of the drug with the least side effect potential that does the job. We don't recommend treatment for every dog that has a seizure. Every patient and owner are different.

It is important to avoid sudden discontinuation of any anticonvulsant medication. Even normal dogs may be induced to seizure if placed on anticonvulsant medication and then abruptly withdrawn from it. Your veterinarian can outline a schedule for discontinuing the medication.

The most commonly used drugs for seizure control include Diazepam, Phenobarbital and Potassium Bromide.

You mentioned status epilepticus. What does that mean?

Status epilepticus bears special note. It is characterized by a seizure that lasts more than 5 minutes. When it occurs, the dog's life is endangered. The seizure activity can actually drive the body temperature up to life threatening levels and deplete energy stores. Unless intravenous medication is given promptly, the patient may die. If this occurs, you should seek treatment by a veterinarian immediately.

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