Epilepsy In Dogs And Cats

Epilepsy is not uncommon in the dog, but really quite unusual in cats, in my experience. The single most striking feature of this condition is of course “fits”.

Having said that, there are many other causes of fits, which must be considered in any pet presenting with such a history. Other causes include the ingestion of poisons, kidney and liver disease, infections, meningitis, encephalitis, brain tumours, congenital abnormalities and many others. These must all be ruled out before a diagnosis of epilepsy can be arrived at. Many tests may be necessary to rule out such conditions, and the arrival of MRI scanning has added new possibilities (if expensive!) to our repertoire. However, under many circumstances, a diagnosis of epilepsy is often arrived at simply by this process of elimination.

Certain breeds have a predisposition towards epilepsy, and among my patients, GSDs, Collies and Poodles certainly feature highly, but it can occur in any breed, Mongrels included. The first fit can occur at any age, but is often in young to middle aged dogs.

So what is an epileptic fit? Well it is usually described as the uncontrolled release of electrical discharge in the brain. Certain dogs seem to have a tendency to this condition, and an owner will begin to learn certain trigger factors, which are involved in bringing on a fit. This could be the time of day, a loud noise, fireworks, during sleep, following exercise. And there are many more. Every dog seems to be different.

The Fit Record Card: I find this very helpful indeed. On the first occasion a dog presents with a fit, and before any medication is provided, I supply a fit record card or sheet, or simply show the owner how to keep a good record by making a simple table in which the owner completes details of fits as they occur, including the following parameters: Date, Time, Length of fit, Description of symptoms, length of time to return to normal. As long as this is kept up to date, it gives the vet an "at a glance" history of the pattern and severity of the fits in this particular patient.

It is the PATTERN of fits, which matters. In most cases the fits themselves are short lasting, and little can be done at that time. The fit is usually over before action can be taken. Medication will be aimed at IMPROVING THE PATTERN, and making the fits less frequent, and less severe, and perhaps preventing them completely.

Grand mal and petit mal:
Fits involve the patient usually lying on its side, paddling with the paws, shaking and trembling, chattering teeth, and salivating. Sometimes uncontrolled urination and defaecation occurs.

A Grand mal is a severe fit. It may lead into "STATUS EPILEPTICUS" and this is the dangerous one: A fit which doesn't stop, until medication brings it under control. A fit which is left to go on and on, can lead to severe brain damage.

YOUR RULE: when a fit starts, look at the clock.

After 10 minutes, if the pet is still in a fit, you need to take the pet to the vet as quickly as possible. Most fits don't last 10 minutes, and the vet will not be necessary as an emergency measure. But if the fit is on-going at 10 minutes, phone the vet and arrange to take the pet into the vet's practice forthwith. Calling the vet to your house is only likely to waste time. Action in your house will be limited indeed, and the vet will end up being an expensive taxi.

How do you get a fitting dog to the vet?
Lay out a blanket by the dog. Holding its paws, roll the dog over onto the blanket. Beware his teeth!! Dogs in a fit don't know you, or what they're doing! So care and forgiveness is required! Then get 2 people, one on each end of the blanket, to lift the dog by all 4 corners of the blanket, place it in the back of the car, and go quickly, but carefully to the vet's practice.

A dog in status epilepticus needs intravenous injections of sedatives (e.g. valium) or anaesthetics (e.g. thiopentone or propofol) to stabilize its condition. And this can take many hours, or longer on some occasions. A period of hospitalization is highly likely.

Petit mal: these are short fits, or perhaps even mild episodes of trembling with only some of the minor symptoms of fits. They resolve of their own accord, usually in a matter of minutes, but the pattern is all-important if we are to prevent their recurrence. So, if this is the first fit you've seen, even though you don't need the vet as an emergency measure, do take the patient to see the vet at the next convenient surgery, to assess the situation.

**IF IN DOUBT phone the vet's practice and discuss the situation.**

Long-term medication: having established a pattern, your vet will be able to decide if medication is necessary. Drugs involved include Epiphen (Phenobarbitone) and Potassium Bromide. Phenobarbitone is a usual first line drug. Potassium Bromide is often used to support this. Generally, one starts at low dose rates, and builds up whilst monitoring the pattern of fits. Once control is achieved, then dose rates need to be maintained. Active blood levels of both drugs do require monitoring on a regular basis, to ensure that they stay high enough to be active, but low enough to avoid toxicity problems – i.e. that they are within the therapeutic range. Even though the dose rate remains constant on a daily basis, blood levels achieved do vary. Thus your vet will want to carry out regular monitoring blood tests for this purpose as part of the long term control of your pet’s epilepsy.

In the early stages of phenobarbitone treatment, the pet is likely to be quite sedated. And an increased thirst is also possible. However the dog will adapt, and these symptoms usually improve over a week or two.

Once you start medication: DON'T run out of pills! This is a well known trigger to restarting fits again.


**IF IN DOUBT phone your vet's practice and discuss the situation.**