COMMONLY ASKED QUESTIONS ABOUT SEIZURES
Is my pet having a seizure?
A generalized or “grand mal” seizure is characterized by a loss of consciousness; purposeless, flailing leg movements; mouth chomping and salivation; and often urination and defecation. In contrast, a focal seizure (also called a “petit mal” seizure in people) will not involve a loss of consciousness, but you may see rhythmic movements on one side of the face of body.
What causes a seizure to happen?
Seizures are caused by aberrant electrical activity in the brain. In the simplest of terms, it is similar to a short circuit in an electrical system. Sometimes there is an underlying cause for the irregular electrical activity, such as meningitis or a tumor. When no underlying cause can be found, the seizures are referred to as epileptic seizures.
Does my pet feel any pain?
The loss of consciousness and large amount of electrical activity in the brain prevent your pet from having any awareness of pain during the seizure. Pets and people often cry out during a seizure, but we know from human epileptics that there is no perception of pain. Pets can hurt themselves during a seizure, however, by falling, biting the tongue or, rarely, breaking a bone.
What should I do when my pet has a seizure?
There is not much you can do, except wait, and make a note of the time the seizure began. If the violent, flailing part of the seizure goes on for longer than ten minutes, you should get help and transport your pet to a veterinarian’s office. You should not hold your pet during or after the seizure, or make any attempt to put something in your pet’s mouth. It is impossible to swallow the tongue, but very easy to be bitten by a seizing dog. Also be sure the pet will not fall down stairs, bang their head on cement or otherwise damage themselves while seizuring. Pull the pet to a safer place if necessary.
What should I do after my pet has a seizure?
If the seizure has occurred at home, you should call us to report what has happened. Avoid contact with your pet until he initiates attention in a positive way. (Tail should be up and wagging, not tucked.) Pets may be terrified when they are in the immediate post-seizure period, and may react aggressively to your attempts to console or comfort. The temptation to hold your pet post seizure is overwhelming, but resist the temptation! If possible, gently usher the pet into a confined area, such as a crate or small room, while you make the phone call to us.
Is my pet going to die during a seizure?
Thankfully, it is rare that a pet or person dies during a seizure. If a seizure goes on for longer than thirty minutes (called status epilepticus), complications can occur, and these complications are fatal in approximately ten percent of the cases. Most seizures are short-lived, lasting less than five minutes, and complications of these short seizures are extremely rare. Try to remember to time each seizure; it seems like it lasts forever, but it is usually only thirty seconds to three minutes long. Do not count the post-seizure period, only the seizure itself. Log the date and length of each seizure or note it on a calendar so we can monitor the frequency and severity of the seizures.
What is wrong with my pet?
It is impossible to determine the cause of a seizure without diagnostic tests. A pet who has had a single short seizure should see us for routine testing. Simple blood tests will help determine if the seizure was caused by low blood sugar, toxicity, or organ failure. Normal blood tests will help to rule out the possibility of some diseases. Most of the time these tests will be normal and we will assume the pet has epilepsy if it is a dog.
Does my pet have epilepsy?
Epilepsy is the most common cause of seizures in dogs. Epilepsy simply means that there is not a serious or progressive underlying disease causing your pet’s seizures. In order to determine if your pet is epileptic, a series of tests must be done to eliminate
other causes of seizures. Epilepsy is uncommon in cats. Seizures in cats are much more likely to be due to a serious disease or problem.
Does my pet need medication?
When a pet appears to be developing a pattern of seizure, and no underlying disease has been found, antiepileptic drugs may be ecommended. In general, if a pet is seizing more often than once a month, or if the seizures are prolonged (greater than five to ten minutes), it may be time to start anti-seizure medications.
What medication does my pet need?
Phenobarbital has been the mainstay of epileptic management for decades. It is still almost always the first choice for epilepsy. Potassium bromide has come into favor in the past few years, especially for large breed dogs. Because phenobarbital is metabolized and then distributed to fat and muscle tissue, the bigger the dog, the less likely it is phenobarbital will control the seizures on its own. Often potassium bromide,
alone or in combination with phenobarbital, will control seizures better in large breed dogs.
What are the side effects of medication?
Phenobarbital will increase your pet’s appetite for food and water. If you allow your pet to eat more food, your pet will gain weight. In the first few weeks of phenobarbital therapy, you may notice that your pet is excessively quiet, seems weak in the hind legs, or, strangely enough, is hyperactive and pacing. These side effects will generally subside with time, as your pet becomes accustomed to the medication. If they do not
subside within two to three weeks, an adjustment of dose or change in medication may be necessary. Phenobarbital has a potentially toxic effect on the liver, so pets on the phenobarbital therapy will require lifetime monitoring of liver enzymes and drug levels. Potassium bromide has fewer side effects in general, but it may cause a pet to vomit if given on an empty stomach. Pets with sensitive stomachs should be given a tablespoon of yogurt or cottage cheese with their bromide liquid or capsule. Potassium bromide is not toxic to the liver or other organs.
How often do I need to see the veterinarian?
If a pet has been recently started on phenobarbital, he or she should be seen in ten days for a phenobarbital level and a chemistry profile. In general, it is best to bring the pet in before the morning dose of phenobarbital has been given, and to tell the veterinary staff the time the last pill was given. Potassium bromide levels should be checked three weeks after starting or changing medication. Once therapeutic blood
levels of phenobarbital or potassium bromide have been reached, blood levels should be checked every three months, when there is an increase in the frequency of the seizures, or if the dose has been recently changed. After a year or more of good control, checking every six months is usually acceptable.
Can my pet be left alone after having a seizure?
If at all possible, it is best for a pet to be observed for the first twenty-four hours after his first seizure. Once a diagnosis has been stablished, and your pet is on medication, it is unlikely he will require any special supervision.
Can I discontinue my pet’s medication if the seizures stop?
Most epileptics require medication for life. Occasionally, the seizures decrease in frequency and intensity, and the medications can be reduced. It is very important that this be done only under your veterinarian’s advice, as lowering the medications too rapidly can cause the seizures to get much worse.
Does my pet need to see a specialist?
If your pet has been determined to have other neurologic or behavioral signs in addition to the seizures, he should probably see a specialist. Most cats with seizures have an underlying disease that should be diagnosed. The average epileptic dog is young, has short seizures, and is completely normal in between them. These dogs rarely need to see a specialist, unless you are especially concerned. If the seizures are difficult to control, a specialist can often help to adjust medication. This is most often the case in large breed dogs. If you are feeling frustrated with your pet’s seizure control, or are not sure if there is an underlying problem, a specialist may be able to help. It is extremely rare that epileptic seizures cannot be controlled enough to allow good quality of life for you and your pet.
Handout courtesy of: Mimi Noonan, DVM, DACVIM