Introduction
When a dog has a seizure, its owner is typically and understandably scared and confused. Watching a loved one have a seizure is heartbreaking, but fortunately a number of treatment options are available, depending upon the seizure’s cause. Treatment protocols for dogs with seizure disorders are evolving, and there are many new medications in development to help manage these difficult medical conditions in companion animals. The goals of treating seizure disorders are to reduce seizure frequency and severity and to increase the time between seizure episodes (called the “seizure-free interval”).
Treatment Options
The precise treatment will depend upon the underlying cause of the dog’s seizures. Dogs can suffer from seizures for a number of reasons, including allergic reactions, fever, exposure to toxins, trauma, infection, developmental abnormalities and primary neurological disorders such as epilepsy, among other things. In order to treat seizures effectively, the attending veterinarian must figure out why they are happening.
Treating seizures can be as simple as changing the dog’s diet, taking steps to reduce a high fever, treating a poisoning event or helping the dog heal after a traumatic injury. However, most seizure disorders require treatment with medication, especially if the dog experiences more than one or two seizures a month, has “grand mal” or generalized seizures, has been diagnosed with epilepsy or has “cluster seizures” that occur multiple times in a 24-hour period. A seizure disorder called “status epilepticus” is a true medical emergency that requires hospitalization; this condition involves continuous seizure activity for more than five minutes, or a prolonged series of seizures without a return to consciousness.
Status epilepticus and cluster seizures require immediate intravenous administration of anticonvulsants to prevent permanent brain damage or death. If blood glucose and/or calcium levels are low, intravenous dextrose and/or calcium may need to be administered on an inpatient basis.
Once the patient is stabilized, chemotherapeutic treatment usually involves administration of phenobarbital and/or diazepam (Valium), both of which are anti-seizure drugs. Propofol can also be administered to hospitalized dogs with persistent seizures. The appropriate dosage, route and length of treatment depend upon the severity and cause of the dog’s seizures. A newer anti-seizure medication in humans, Neurontin, has been used to treat seizures in dogs with very good results and reduced liver side effects. These medications all require a prescription and must be administered and supervised by a veterinarian. New treatments are constantly under development. Of course, any drug, including anti-seizure medications, can have adverse side effects. Moreover, anticonvulsants are not 100% effective.
Dogs with primary epilepsy probably will require lifelong treatment to control their seizures. Currently, treatment for chronic canine epilepsy involves use of medications such as phenobarbital and/or potassium bromide, in addition to many other drugs. Regular blood tests are important for dogs on long-term anticonvulsant therapy, to monitor blood drug and liver enzyme levels. Alternative therapies, such as acupuncture and dietary changes, have been suggested as being potentially helpful for dogs with seizure disorders.
What to Do During a Seizure
If an owner thinks that his dog is having a seizure, there are some general guidelines to follow. It is very helpful to the attending veterinarian for the owner to keep a log of the time and length of the episodes. Owners should not attempt to grab their dog’s tongue, as they may be unintentionally bitten. Dogs normally do not swallow their tongues during a seizure, although infrequently they can catch their tongue between their teeth and cause minor injuries.
If a dog has fallen on a hard surface, such as a cement, ceramic or hardwood floor, it is helpful to place a pillow between the dog’s head and the floor to minimize physical injury from the seizure. Animals generate a great deal of body heat while seizing, so they should not be wrapped in layers of warm blankets, even if they appear to be shivering. The shivering associated with most seizures is not caused by low body temperature. If the dog is coming into contact with a chair or another object during a seizure, it is best to move the object rather than the dog, if at all possible. Otherwise, there normally is no need for human intervention. Once the seizure is over, the owner should contact a veterinarian promptly.
Prognosis
The prognosis for dogs with seizure disorders ranges from good to grave, depending upon the underlying cause of the condition. Primary epileptic seizures usually carry a good prognosis and typically can be well-managed with long-term use of oral anticonvulsant medications. Unfortunately, dogs with inoperable brain tumors are at the other end of the prognostic spectrum.