Canine Epilepsy

My 10-year old Golden Retriever was just diagnosed with epilepsy, so it seemed like a good time to do a little research on the topic for Straight Poop.

What exactly is epilepsy?

Epilepsy is most easily defined as the presence of repetitive seizures over time.  Seizures may be the result of a specific brain injury such as a stroke or brain tumor, or they may arise by themselves for no apparent cause, a condition known as idiopathic epilepsy.  It is possible that some cases of idiopathic epilepsy are genetically caused.

Seizures, in turn, are described as electrical storms in the brain.  The nerve cells in the brain begin to shoot off indiscriminately, and don’t shut down as they normally would.  A seizure may be generalized, involving all areas of the brain, or focal, contained to a specific area.  Focal seizures are generally more common when there is a specific brain injury.  Depending on where the seizure starts and how it affects the dog, it may be a simple or complex focal seizure.

In a simple focal seizure, a small area of the dog’s brain causes muscle twitches, often on the face.  Your dog will likely be awake while this is happening, but will probably be confused and scared by the episode.  The seizure may stop after a few minutes, or it may become generalized, as will be discussed below.

A complex focal seizure involves the areas of the brain that control emotions and behaviors, causing the dog to run in circles or fly into a rage.  The dog may lose control of his or her bowels and bladder.  This type of seizure is generally very short-lived.

Generalized Seizures

Generalized seizures also come in two types:  grand mal and petit mal.  A grand mal seizure is what people typically envision when they think of seizures.  The dog will become unconscious and his or her whole body will stiffen and twitch.  The dog may bark or howl, lose control of his or her bowels and bladder, and empty the anal glands.  After this “tonic” portion of the seizure passes, the “clonic” phase begins.  The dog will clench the jaws together and move his or her legs as if running.   This is a classic tonic-clonic seizure.  The tonic phase usually lasts about 30 seconds, with the clonic phase ending after about two minutes.

A generalized seizure may be preceded by an “aura” where the dog’s behavior changes slightly.  If you are alert, you may be able to sense your dog becoming anxious or you may find the dog hiding in some out of the way location immediately before the onset of a seizure.

After a generalized seizure, the dog will enter a “post-ictal” state where he or she will likely be motionless and quite tired.  The dog may be disoriented and bump into things while moving throughout your home.  The post-ictal phase usually lasts for a few hours, during which time the dog should be kept from children, as dogs sometimes (rarely) become aggressive during this stage.

Usually, a dog will have just one seizure at a time, but large-breed dogs may have clusters of seizures, where they never fully emerge from the post-ictal state before a new seizure begins.  In extreme cases, the dog will have a continuous seizure, a condition known as status epilepticus, which is a true emergency.  A status lasting longer than 30 minutes can cause permanent brain damage or can put the dog into a coma.

Petit Mal seizures

The second type of generalized seizure is the petit mal seizure, also known as an absence seizure.  During a petit mal seizure, the dog simply appears to be “absent”, staring vacantly into space.  There is no twitching or jerking as is seen in grand mal seizures.  Petit mal seizures occur in humans, but it is unsure whether or not they occur in dogs.  It is thought that similar behavior may be due simply to focal seizures.

Epilepsy Treatment

For most cases of epilepsy, the underlying cause isn’t found, meaning you can’t treat the cause to affect an all-out cure.  It is only in rare cases that a brain tumor or some other injury is found where removing the tumor or treating the injury will cause the seizures to stop for good.

In most cases, medication is given to improve the dog’s quality of life by reducing the number and severity of seizure episodes.  With medication, as many as 65 – 70% of dogs can be given a good quality of life, with just a few break-through seizures and few drug-related side effects.  Finding the right dosage of the right medication or mix of medications often involves trial and error, and more than a little patience.

In most cases, treatment will be required for the rest of your dog’s life, unless an underlying cause is subsequently identified and treated.  Deciding on the proper treatment your dog is a big decision because all of the commonly-used medications have side-effects.  The most commonly used medication is Phenobarbital, which can be used to stop a seizure in its tracks, as well as to prevent future seizures.  This drug can cause the dog to be a little groggy and unsteady while walking, but these side effects usually go away with time.  The medication can also cause the dog to eat and drink more, as well as to have to urinate more frequently.

Bromide and diazepam (valium) are also sometimes used.  The new anti-epileptic drugs used in humans, such as Tegretol and Depakote, are not suitable for use in dogs because they are eliminated from the dog’s system very quickly and would have to be given several times a day.  In addition, they carry a higher price tag than the older drugs.

Alternative Treatments

Special vegetarian diets have often been touted as the “cure-all” for epileptic dogs, although there is disagreement as to what, if any, physiologic effect a special diet has.  Many sources recommend avoiding wheat, dairy, soy, corn, beef, and tuna, as well as preservatives in your dog’s food to reduce the number of seizures.   One home-made dog food recipe suggests cooking chicken breasts with zucchini, carrots, green beans, potatoes, and sweet potatoes in a crock pot for an anti-seizure diet. Although these ingredients are undoubtedly wholesome, they do not provide much variety nor many of the vital nutrients your dog needs such as calcium or omega-3 and omega-6 fatty acids.

Others recommend giving your dog supplemental milk thistle, as it helps to protect the liver from damage caused by Phenobarbital digestion.  If you choose to give this supplement to your dog, make sure your vet knows about it, and be aware that it can cause loose stools, which may not be something you want to deal with when your dog loses control of his or her bowels during a seizure.

If you are interested in ancient Eastern practices, you might want o learn about ancient Chinese practices said to help with epilepsy.

For more information on Western medicine’s approaches to epilepsy, check out  Canine Epilepsy.com and Canine Epilepsy.net

What do I do when I find my dog having a seizure?

The most important support you can give your pet is to keep yourself calm.  Your dog will likely be disoriented and confused; your panic will not help.  Although it might seem like even a short seizure goes on forever, most episodes last less than two minutes.  Check the clock to time the seizure, as this can be an important indicator of when immediate veterinary care is needed.  If a seizure goes on for longer than 5 – 10 minutes, you should go immediately to the nearest emergency clinic for treatment.

Your role during your dog’s seizure is to keep the dog from being hurt.  Make sure he or she can’t fall down the steps while seizing, and that there is nothing he or she might bang the head against.  Your dog is in no danger of swallowing his or her tongue, so do NOT reach into the mouth to try to prevent it.  You’re likely to get bitten accidentally if you put your hand near the dog’s mouth.

Can my dog live a normal life with epilepsy?

An epileptic dog can generally do anything a non-epileptic dog can do.  You will have to keep up with medications and will spend a very small percentage of your time watching the dog have seizures, but the rest of the dog’s life (and yours!) can be basically the same as anyone else’s.

Most seizures occur while the dog is sleeping or resting, so there is no need to restrict the dog’s activity level or sports participation.  Just have fun with your dog, and cherish the times when his or her seizures are well-controlled.  When your dog does have a seizure, keep a log so you can tell the vet exactly what happened.  Your vet may never observe your dog’s seizures, so it is important that you be able to describe what you see in the event medication adjustments are needed.