This week my colleagues and I treated a lovely beagle called Emily, who was rushed to the surgery in a state called “status epilepticus”. This means that she was not just having an epileptic seizure, but was having continuous repeated seizures with no real recovery in between. This is an emergency situation, and fortunately Emily’s owners knew exactly what to do: they phoned the surgery first to let us know, so that we could be ready for her arrival, and then they brought her straight in. This is not something that can be treated in the home, so although it was a bit frightening for them to have to move her, they knew that it was in her best interests.
Emily has suffered from epilepsy for some time and takes tablets to prevent seizures. Since she was stabilised on her tablets she has had very few, very short seizures only, but this one was different.
On arrival Emily was immediately prepared for some drugs to be given into the vein, which is the fastest route. She was first given a sedative drug, then fluids and then an anaesthetic drug. Her temperature was very high so she was also being cooled with wet towels, whilst trying to keep noise and light levels to a minimum to avoid any unnecessary stimulation to make the seizure worse. Within minutes of arrival, Emily’s distressing condition was coming under control.
Emily received intensive treatment for about an hour and was admitted overnight for continuing fluids and observation. Fortunately, she was back to normal by the morning and went home looking like her old self, much to the relief of her owners. She will now have some routine blood tests to check whether her doses of medication need any adjustment.
Seizures are not uncommon in dogs, and can be very frightening, especially when first seen. Seizures are caused by abnormal electrical activity within the brain causing increased and uncoordinated muscular movements. Some possible causes are: trauma to the head causing bleeding or scar tissue, low blood sugar, poisoning or brain tumours. However in most cases the cause is unknown and if all the other possible causes have been ruled out then a diagnosis of Idiopathic Epilepsy is made (meaning epilepsy of unknown cause). In dogs it tends to run in families, with some breeds being more likely to have it than others. If epilepsy is diagnosed, it is advisable not to breed from the dog. It often starts in young adulthood, about 1-5 years old.
Seizures vary from a “petit mal”, lasting just a few moments, to a generalised seizure. These may start with unusual behaviour from the dog as they anticipate that something strange is about to happen. The teeth may chatter before the muscles of the legs and body are affected. Typically in a generalised seizure the dog will go off its legs and shake or twitch with the legs making jerky paddling movements. Urine and faeces may be passed and the dog will probably be unconscious for a time. Most will then gradually recover within a few minutes but will be left feeling tired afterwards. Having a seizure uses up a lot of energy.
If a seizure occurs it is important to try to diagnose the cause in order to give the best treatment. Blood tests may be useful, sometimes combined with head x-rays or scans. If there is no sign of any head damage or tumours or haemorrhages, and no abnormalities in the blood test results, the treatment may well be anti-convulsant tablets or medicine. These are not always needed after a single seizure, but if seizures are frequent then drugs will be started at a low dose and built up slowly to minimise any side-effects. The treatment will need to be given at the same time each day, and the levels in the blood checked every few months. Records of any seizures should be kept so that any change in frequency, or pattern of clusters of seizures can be seen.
Most epileptic dogs can then lead a very normal life, with just a few extra routine visits to the surgery. Treatment is usually needed for life, although a few cases will go into remission and may be gradually weaned off treatment. Anti-convulsant drugs should never be stopped suddenly and only under the supervision of the vet. If complications like status epilepticus do occur, the answer may lie in using a combination of drugs instead of just one.
Cats can also suffer from epilepsy but it is not as common as in dogs. They are treated in much the same way as dogs. They can be more difficult to medicate than dogs and their independent lifestyle may make it difficult to give them their medication when they need it, but I have known several treated very successfully.
If your dog or cat has a seizure for the first time, it will be very frightening for the owner, but panic will make the situation worse, so try to do the following:
1. Reduce noise and light levels e.g. switch off TV or music, dim the room lights, ask unnecessary people to leave the room. Remain as calm and quiet as you can.
2. Make a mental note of the time, this is important because the vet may need to know how long the seizure has been going on, and minutes can seem very long.
3. Do not move the animal (unless told to do so by your vet), but move away any nearby objects which might injure them.
4. Do not open the mouth, put anything in the mouth or try to pull the tongue forward. An animal having a seizure may bite without meaning to.
5. If your dog is recovering to nearly normal within 10-15 minutes, they may not require any immediate treatment but of course you should ring your vet surgery for advice if you need to. They might suggest leaving it until your dog is fully recovered to examine them.
6. If your dog is still fitting after 15 minutes, or if he or she has repeated seizures without proper recovery in between, then they need urgent attention and you should ring your surgery at once.
7. If asked to bring a fitting dog to the surgery, spread out a large thick towel, blanket or bedspread beside the dog, slide them on to it and lift by the corners like a stretcher. Several people will be needed for a larger dog.
In summary, epilepsy is a very frightening condition, particularly for the owner. Treatment is aimed at managing the condition and keeping the number of seizures to a minimum, rather than cure. Treatment is usually lifelong and requires some commitment from the owner. Most dogs and cats with epilepsy will lead a very happy life in spite of their condition. Emily continues to do well.
If you are concerned about fits or any other problems in your dog or cat, please contact your vet or use our Interactive Symptom Guide to help you decide what to do next.