Dogs and cats with epilepsy
Epilepsy in our pets is defined as the repetitive seizures of unknown origin occurring more commonly in dogs and, to a lesser extent, cats. Seizures can appear as focal muscle twitching and spasms of certain areas of the body, to more generalized seizures consisting of various levels of loss of consciousness, whole body spasms/trembling, and sometimes loss of bladder or bowel control. Behavioral changes can sometimes be seen including aggression, so animal guardians must be very careful when trying to help or transport their pets to a veterinarian shortly around the time of seizure activity.
There are many possible causes of seizure disorders in our pets ranging from simple trauma or toxin exposure or drug/pesticide/vaccine reaction, to more complex metabolic disorders of the liver, circulatory system, heart and brain. In young toy breeds, many of these pets have very low sugar storage capabilities and these puppies are prone to hypoglycemia or low blood sugar, which can also lead to seizures. Some of these breeds may have a circulatory problem where the circulation is shunted around the liver, preventing the liver from doing its job of filtering poisons and toxins from the blood stream leading to seizures. This condition called a portosystemic shunt of the liver can be genetic in origin or acquired as an older pet.
Various infectious diseases can sometimes cause seizures from viruses like FelV/FIV and FIP in cats, as well as toxoplasmosis, whereas in dogs various tick-borne infections also can be involved. And of course primary brain disease including various inflammatory disorders of the brain, meningitis and in some pets brain tumors can occur. In order to diagnose these brain conditions it’s often necessary to do more technologically advanced tests at a veterinary neurologist or veterinary teaching or university setting, including a CSF tap of the fluid that circulates around the spine and brain as well as an MRI.
All seizuring pets should have at least a complete baseline of blood work and urine to include a CBC/blood chemistry profile, Felv/FIV testing in cats, bile acid liver function testing, thyroid profile, and urine analysis. The additional neurological tests can be done as a second tier of tests in those clients intent on finding out if there is an underlying treatable cause, but these tests are definitely more expensive at a veterinary neurologist. And while in dogs the vast majority of repetitive seizures has no detectable underlying cause (thus the term epilepsy), in cats a thorough diagnostic search, as described above, is more likely to identify a potentially treatable underlying condition.
It is important to note that some pets will have one seizure or very rare or mild seizures, that don’t need extensive workups or medical treatment. My own rule of thumb is that if seizures are not too intense, and not occurring in clusters in a short period of time, and/or occurring at less than once every 4-6 weeks, I will often do the baseline blood work. But I will often choose to monitor the pets to see if the frequency occurs rather than jumping right on anti-epileptic drugs. Once the decision to use anti epileptic drugs is made, it is important for animal guardians to understand that therapy is typically life long, and that periodic monitoring of blood drug levels and organ function testing is necessary to avoid (occasionally) toxic side effects especially on the liver. These are also pets that I watch very closely if animal guardians decide on using oral or topical pesticides ,and I always try and not challenge their immune systems with too many or unnecessary vaccinations.
The two most common drugs used by veterinarians in controlling chronic epilepsy include prescription Phenobarbitol and Potassium Bromide. Most of the time these drugs either alone or in combination can control seizures in the majority of dogs and cats, but it is important for animal guardians to realize that even with these drug therapies, most of the time we are looking at seizure control and not cure.
In recent years veterinary neurologists have been starting to use newer drugs that in prior times were used only in human medicine, such as a drug called Keppra, Zonisamide, and Gabapentin. These drugs rarely by themselves can control seizures adequately and are often used as what are known as “add on drugs” to either of the first two mentioned above, when Bromide or Phenobarbital alone are not effective in controlling seizure activity.
In all of my seizure patients I always try and support the body with nutritional supplements to help reduce the toxic stress on various organ systems, and in some cases allow us to use lower dosages of the prescription medicines. One of my favorite supplements called Vetri-DMG can not only help lower dosages of seizure medications in some animals, but also helps as an antioxidant, immune system booster, and helps with drug processing and oxygen carrying capacity of the blood, thus making it an essential supplement in my opinion in all epileptic pets. I also try and support the liver, especially those dogs on long term Phenobarbital, with supplements like Denosyl. Proanthozone is also an excellent antioxidant useful in all sorts of inflammatory conditions, including epilepsy in my opinion.
Alternative therapies such as acupuncture and Chinese herbs also offer animal guardians nondrug alternatives to help with seizure control. With our increasing arsenal of medications, supplements, and alternative therapies, most dogs and cats with seizure disorders can live normal and healthy lives.