Seizures
What is this condition?
A seizure is an episode of uncontrolled electrical activity in the brain that can result in a range of clinical signs, from involuntary tremors in a specific part of the body to full body convulsions.
What are some common signs of this condition?
You might notice some or all of the following in your pet:
Prior to a seizure, your pet may show subtle behaviour changes like restlessness or engage in attention-seeking behaviour.
Focal (or partial) seizures involve abnormal movement or function of only part or one side of the body (such as mouth biting, facial twitching, or salivating). Typically, no loss of consciousness occurs.
Generalised seizures involve the whole body and are the most serious form of seizure activity. Pets experiencing a generalised seizure often lose consciousness. You will see fast, repetitive paddling or jerking of all 4 limbs, and drooling or foaming at the mouth. Pets may urinate, defecate, or vocalise.
Status epilepticus is seizure activity that lasts for longer than 5 minutes, or a series of generalised seizures that occur without a break in between. This is a medical emergency.
Following seizure activity, pets may experience a postictal period, appearing disoriented, agitated or uncoordinated.
What causes this condition?
Epilepsy is the most common cause of seizures in dogs. It is far more common in young dogs, often presenting at the age of around 2. It is unlikely to first present in a dog older than 6. Epilepsy is often idiopathic, meaning there is no known cause. Cats can also get epilepsy, although it is not as common.
Seizures can also result from underlying conditions such as:
Topical exposure to or ingestion of a toxin
eg snail pellets, 1080, methamphetamines, mould
Metabolic diseases
such as low blood sugar, low calcium levels, or liver problems
Structural abnormalities in the brain
including tumours (more common in dogs over the age of 6), issues resulting from trauma or infection, and defects present at birth.
How is this condition diagnosed?
Pets with epilepsy behave normally between seizures and may not have abnormal findings on a physical examination. If your pet shows other neurologic abnormalities during a physical examination, it may help your veterinarian determine the cause of the seizures. Video of the episode can also help your veterinarian confirm that what you are seeing is a seizure.
Your veterinarian might recommend one or more of the following tests to help confirm your petʼs diagnosis:
Serum chemistry profile. A blood test that assesses the status of internal organs, such as the liver and kidneys, measures electrolytes, and identifies the levels of certain enzymes.
Complete blood count (CBC). A CBC evaluates red blood cells, white blood cells, and platelets in your petʼs blood. It can also identify anaemia and signs of infection, inflammation, and some cancers. These blood tests may uncover clues to the cause of your petʼs seizures.
Seizure panel. This is a blood test that is sent off to a pathology laboratory to investigate infectious causes of seizures such as toxoplasma, neospora, and cryptococcus. Please allow 2 weeks for results.
Your veterinarian might recommend one or more of the following tests to help rule out any other conditions:
Magnetic resonance imaging (MRI) scan. This imaging technique uses a magnetic field to create a detailed image of your petʼs spinal cord and brain to look for signs of disease.
Computed tomography (CT) scan. This imaging technique uses x-rays to create a detailed image of your petʼs brain or spine to look for signs of disease.
Cerebrospinal fluid (CSF) analysis. A CSF sample is taken from the spinal cord and checked for abnormal inflammatory or infectious cells.
Electrocardiogram (ECG). An electrocardiogram displays the electrical activity of the heart and can provide information regarding its rhythm, structure, and function.
Holter monitor. A heart monitor, worn for days to weeks, that displays the electrical activity of the heart and can provide information regarding its rhythm, structure, and function, especially for intermittent abnormalities. This test is frequently used to help determine if episodes are seizures or syncope (passing out), which can often be confused for each other.
What are some of the treatment options?
Your veterinarian might recommend one or more of the following, based on your petʼs specific needs:
Not all seizures require treatment. If the seizures are mild and/or infrequent, your veterinarian may only recommend keeping a log to monitor your petʼs seizure activity.
If a clear cause for your petʼs seizures has been identified, treating the underlying condition is often the best course of action to reduce or eliminate seizures.
Anti-seizure medications may be prescribed if seizures are frequent or prolonged. We hope for a 50% reduction in seizure frequency with medications, rarely do seizures completely stop.
Many of the medications used to treat seizures have side effects, such as sedation or increased appetite. These side effects may improve once your pet has been on medication for some time. Keeping a log of side effects and your petʼs behaviour can help your veterinarian assess and adjust medications over time.
What does this mean for my pet?
Prognosis greatly depends on the cause of your petʼs seizures. Epilepsy is a lifelong condition with signs that can come and go over time, but, with appropriate medical management, most pets can live a normal life.
In the case of toxins and certain metabolic diseases and infections, successful treatment of the underlying condition may stop the seizures. While brain tumours can sometimes be surgically removed or treated with radiation, many tumours or structural abnormalities cannot be corrected.
If your pet has had seizures, make sure your pet is in a safe space when you arenʼt home. Consider confinement to one floor of the house away from stairs.
Keeping a log of when your pet has seizures, how long they last, how long after the event it takes for your pet to return to normal, and any other potential factors (such as stressful events) can help to identify any patterns or trends in your petʼs seizure behaviour.
If medications are prescribed for your pet, it is important that they are given exactly as directed. Your pet may need regular blood testing to make sure that the dose is appropriate and that your pet is tolerating the medication well.
When do I need to call the veterinarian?
If your pet shows any of the following signs, or if you are concerned about your pet, call your veterinarian as soon as you can:
A single seizure that lasts longer than 3 to 5 minutes
Multiple seizures in a single day
An increase in seizure frequency or duration
Abnormal behaviour between seizure episodes
Prolonged postictal period
If your pet develops status epilepticus (continual or prolonged seizure activity), see your veterinarian as soon as possible for treatment, as this can be a life-threatening condition.
Are there any human health concerns to consider?
Do not attempt to put your fingers or other objects into your petʼs mouth during a seizure, as your pet may bite you accidentally. If you see your pet having a seizure, clear a space around them if possible. If they are in a location where they might fall (on the couch, at the top of the stairs) use a large blanket to cover their head before attempting to move them.
If you pet has a seizure;
We have sent you home with midazolam. If your pet has a seizure please squirt the entire contents of the syringe into the nostril. This syringe is good for 36 days.