Witnessing your dog have a fit is arguably the most disturbing event an owner will see.
The dog is distressed and you feel powerless to help. More than anything, you want to prevent it from happening again. You visit the vet who runs a raft of blood tests, suggests a scan, and then tells you to “Wait and see if the dog seizures again.”
You’re reassured and yet conflicted. The idea weighs heavy that the dog could fit again at any time. Wouldn’t it be better to do something, anything, other than sit tight and wait?
However, your vet is balancing risks. Whilst there are effective anti-convulsant treatments available, they do have side effects. Therefore the vet wants to be certain putting the dog on meds isn’t a case of “Jumping out of the frying pan and into the fire.” To better understand this, let’s take an in-depth look at how canine seizures are managed.
Are Anti-Convulsants the Right Treatment?
A fit is a symptom rather than a diagnosis. The first thing on the vet’s mind is to find the underlying cause of the seizure.
Seizures can be triggered by problems within the brain or other parts of the body. A whistle-stop tour of the many causes of seizures includes:
- Liver shunts
- Kidney disease
- Low blood sugar levels
- High blood pressure
- High body temperature
- Toxins and poisons
- Pressure inside the skull
- Head trauma
- Brain tumor
Actually, that last point is tricky because a dog is said to be epileptic only when extensive tests (including brain scans) fail to reveal the cause of a dog’s seizures.
What this means to you the owner is blood tests and a brain scan may be necessary to identify the ideal therapy. For example, if a dog has high blood pressure, the best treatment is to remedy the hypertension rather than give anticonvulsant medications.
The tests come back normal or negative…What next?
Why Waiting is a Good Idea
When a dog has a single seizure, waiting is a good idea. This is to see what pattern emerges. For example, it would be foolish to put the dog on lifetime medication if he was never destined to have another seizure.
Your vet will look for a tipping point in the pattern of seizures, which make starting medication a good idea.
This tipping point varies from patient to patient but takes into account factors such as:
- The severity of the seizures
- The number of seizures in a 24 – 48 hours period ( a ‘cluster’)
- The interval between clusters of seizures
Again, there’s no hard and fast rule, but a dog that has a mild seizure twice a year is unlikely to go onto meds, whilst a dog that has severe seizures every month will.
The Aim of Therapy
Anti-convulsant medications do have side effects.
These can include:
- Sedation and character change
- The dog walks as if drunk
- Increased thirst
- Increased appetite
- Liver damage
These side effects are often dose related. With this in mind, the vet’s aim is to get the dog onto the lowest effective dose possible…and this means compromise.
To completely prevent dog seizures would mean the patient taking such a high dose of meds that his quality of life would suffer. Instead, the vet aims to bring the seizure activity down to a manageable level.
The milestones for this include:
- Reducing the number of fits by at least half
- Reducing the severity of the seizures
- Increasing the interval between fits
You’ll notice the aim is not to completely stop all seizures…
To aid your vet it’s helpful to keep a record of your dog’s seizure activity, such as the dates of the fit and how long it lasted. For those times when you aren’t home, then a PetPace collar can help you keep track. This also helps you monitor the effectiveness of therapy. This also helps you monitor the effectiveness of therapy.
Drug Options for Treating Canine Seizures
OK, so no underlying cause is found and your dog has seizures. In this case medication is a good idea.
There are several drugs licensed to treat dog seizures, each working in slightly different ways. Some dogs do well on one medication, but this isn’t always the case and for more stubborn cases a combination of drugs can do the trick.
Those most commonly prescribed medications include:
- Phenobarbitone: One of the most commonly prescribed anti-seizure medications; it takes around two weeks to reach peak effect in the blood stream. Monitoring of liver function is essential.
- Potassium bromide: This drug is a safer option for dogs with liver disease. However, it can take several weeks before potassium bromide reaches blood levels sufficient to reduce seizures.
- Imepitoin (Pexion TM): This is the new kid on the block and at the time of writing is currently available in the UK, but not the US. This drug is a highly effective, fast acting, and relatively side effect free means of controlling seizures.
The drugs above help reduce seizure activity, but sometimes the dog may still fit occasionally. When this happens it’s helpful to have a medication to give to the dog in order to reduce the chance of another fit in the near future (or a ‘cluster’ of fits.) The best options for this include a diazepam (valium) suppository or clorazepate tablets orally.
What of the Future?
Let’s finish by thinking about the future.
Some work has been done looking at the role of diet in triggering seizures in dogs. The jury is still out, but a few dogs do seem to have benefitted from being fed a hypoallergenic diet. As yet nothing is proven, but if your dog suffers from severe seizures, it seems there’s little to lose by trying a change of diet.
And as always, knowledge is key to control. Keeping a record of your pet’s seizure activity allows the vet to be better informed when making decisions about the short and long terms care of your dog with seizures.