Epilepsy Task Force

Photo Credit: MKRiedel, Far and away, epilepsy is the most common neurological disease affecting dogs and cats. Within the United States, it is estimated that approximately 780,000 dogs are diagnosed with this disorder every year (sorry, no numbers available for cats).

In spite of the prevalence of epilepsy in small animals, relatively little is understood about its cause and treatment. That’s why it’s a great thing that a recently created task force aspires to improve care for epileptic dogs and cats. The task force is comprised of very smart people from around the world and includes veterinary and human neurologists, neuroscientists, neuropharmacologists, and neuropathologists. Task force member Dr. Karen Munana was quoted as follows:

Lack of consistency among epilepsy researchers concerning classifications, definitions, and therapeutic outcome measures makes it difficult to draw comparisons and significantly limits the scientific impact of the studies. This affects the development of effective professional guidelines which, in turn, hinders clinicians when they are diagnosing the disease and advising owners on treatment options for the pet’s condition.”

Members of the task force have worked to identify a “chain of care” for animals with epilepsy including the animal’s breeder, caregiver, family veterinarian, veterinary neurology specialist, and neuroscientist. Thus far, the task force has released seven consensus statements (information and recommendations agreed upon by the task force members).

Epilepsy consensus statements

Listed below are the seven consensus statements along with their web site locations so you can access any of the articles that are of interest to you. Be forewarned- they contain a good amount of medical jargon. Don’t hesitate to contact me (dr.kay@speakingforspot.com) if you need some help with interpreting what you are reading.

  1. Consensus report on epilepsy definition, classification, and terminology in companion animals – http://www.biomedcentral.com/1746-6148/11/182

Over the years there have been many epilepsy classification schemes used in veterinary medicine. Unfortunately, a term one veterinarian uses to describe a type of seizure might mean something altogether different to another veterinarian. The goal of this consensus statement is to provide a common language that is widely accepted within the profession.

  1. Proposal for a diagnostic approach to epilepsy in dogs – http://www.biomedcentral.com/1746-6148/11/148

A multitude of issues besides epilepsy can cause seizures. When an animal has seizures, the primary diagnostic goal is to identify the underlying cause. Differentiating true epileptic seizures from those caused by other things can be quite challenging. The goal of this consensus proposal is to improve consistency in accurately diagnosing epilepsy in dogs.

  1. Current understanding of epilepsy of genetic or suspected genetic origin in purebred dogs – http://www.biomedcentral.com/1746-6148/11/175

This is a review of epilepsy in predisposed dog breeds. It highlights breed-specific clinical features (age of onset, type of seizure, gender predisposition), response to treatment, prevalence rate, and mode of inheritance.

The breeds discussed include Australian Shepherd, Belgian Shepherd, Bernese Mountain Dog, Border Collie, Border Terrier, Cavalier King Charles Spaniel, Collie, Dalmatian, English Springer Spaniel, Finnish Spitz, Golden Retriever, Hungarian Vizsla, Irish Wolfhound, Italian Spinone, Labrador Retriever, Lagotto Romagnolo, Petit Basset Griffon Vendeen (PBGV), Shetland Sheepdog, Standard Poodle, German Shepherd, Beagle, Dachshund, Keeshond, and nine Dutch breeds.

  1. Consensus on the medical treatment of canine epilepsy in Europe – http://www.biomedcentral.com/1746-6148/11/176

The goal of this consensus protocol is to provide consistency in the management of canine epilepsy using antiepileptic drugs. Recommendations are based on current evidence-based research and experience of the authors. While this specifically considers the legal ramifications associated with prescribing necessary medications in Europe, the recommended treatment protocols can be applied universally.

  1. Outcome of therapeutic interventions in epilepsy in dogs and cats – http://www.biomedcentral.com/1746-6148/11/177

This consensus proposal provides a common language and understanding when describing an animal’s response to antiepileptic drugs. For example, standardization of what constitutes an adequate response will guide veterinarians in the diagnosis of drug resistance as a basis for altering therapy. Not only will this benefit individual patients, it will create a common language when interpreting results of research on dogs and cats being treated for epilepsy.

  1. Recommendations for a veterinary epilepsy-specific MRI scan protocol – http://www.biomedcentral.com/1746-6148/11/194

Use of magnetic resonance imaging (MRI) scans plays a key role in arriving at the diagnosis of epilepsy, primarily by ruling out other causes of seizures. There are oodles of different types of images (referred to as sequences) a state of the art MRI scanner is capable of creating. This consensus paper provides a standardized epilepsy-specific MRI protocol.

  1. Recommendations for systematic sampling and processing of brains from epileptic dogs and cats – http://www.biomedcentral.com/1746-6148/11/216

One of the most important ways to learn more about epileptic seizures is by harvesting and examining brain tissue after the epileptic animal has passed away. This consensus protocol provides guidelines for processing the brain tissue.

I’m so pleased that this task force was created. I believe that the information it generates will be wonderfully positive next step in guiding our abilities to diagnose and treat dogs and cats with epilepsy.

Have you ever cared for an animal with epilepsy? If so, I’d love for you to share your experience.

Wishing you and your four-legged family members good health and happiness throughout the holiday season,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.




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9 Comments on “Epilepsy Task Force

  1. Hugo, a Belgian Shepherd, at 10 months of age seizured. During the preceding day, the owner and the dog were at their new home for several hours while they were apply polyurethane to the floors. (I found out later that polyurethane contains the same chemicals as antifreeze). When I asked for the dogs medical history & blood work to forward it to an immune system expert, I noticed that the dog 30 days prior to that had been given vaccines and then neutered (which of course involved anesthesia). Dog was put on a potassium bromide regime, but continued to have grand mal seizures at least once every 10 days. Thyroid test came back normal. Finally, the owner agreed to do a Elysia test (yes, I paid for it) – it came back that the dog was “sensitive” to chicken. At my urging, they changed the diet to a salmon based diet. Seizures immediately lessened and within 2 months had stopped. Owner continued to give seizure meds for another 3 months, then stopped the meds.. The dog has now been completely seizure free for 18 months. (This is not a case of just not seeing a seizure, the dog is with one or the other owner constantly since they work from home). Bottom line, the young dog suffered a toxic insult while still in growth phase – it took time with no more insults for the immune system to recover.

  2. Viper who hadn’t had a seizure since he was 10 months old, started seizuring again at the age of 8. The owner again tried the anti-seizure drugs, but nothing was working. I suggested she have the thyroid tested. The local lab results came back as thryoid normal. I asked permission to send the results off to Dr. Jean Dodds of HemoPet for her evaluation. The fax ink hadn’t dried, when Dr. Dodds had the owner’s vet on the phone with the words GET THE DOG ON THRYOID MEDS. The veterinarian who read the lab results didn’t realize that a false normal reading could happen when there is an imbalance of T3/T4/TSH. Viper got put on thyroids medications, seizures stopped within a month, and he was seizure free until his death. In addition, I learned it was wise to send the blood sample to a specialty school (like Michigan State, Tufts, or Cornell /or/ HemoPet increased the probability that a valid test was done.

  3. I am a Belgian Shepherd breeder who stays in touch with puppy owners. At twelve weeks of age, the owner called me to say the puppy named Viper had seizured. My immediate question was what had they done within the last 24 hours. The answer was the veterinarian in one visit had given the 12 week old puppy a rabies shot, a 5 way distemper-parvo-leptospirosis shot, given him a heartworm pill with dewormer. Within 8 hours the puppy seizured. Not two weeks had passed and that one seizure progressed to cluster seizures. The vet recommended they destroy the puppy. Instead the owner went to my vet who had experience with seizuring, the puppy got put on first on Potasium bromide but that was too strong for him, and they went with phenobarb instead. The owner changed foods to a product with minimal preservatives. The seizures lessened. The seizures lessened in duration and frequency and finally stopped by the time the dog was 10 months of age. The owner never increased the dosage levels and got the hunch that maybe he was fine. She the completely stopped the meds. No seizures. In retrospect, I think the puppy got an immune system insult from all the inocculations piled on him in that single vet visit. So now I recommend my puppy people spread out shots, do separate vet visits separated by 2 weeks, and even avoid giving inocculations around the time they administer heartworm. I also suggest they not do a flea treatment on the developing puppy for fear of weakening the immune system. He was seizure free until 8 years of age. That will be a separate post.

  4. Hi Jennifer. Thanks for sharing your experiences in response to my blog post. I’m sorry you are dealing with such a difficult case of epilepsy. I strongly encourage you to work with a veterinarian (ideally one who specializes in neurology or internal medicine- http://www.acvim.org) who has experience with other anti-seizure medications such as levetiracetam and Keppra. These newer medications are often effective at controlling epileptic seizures when phenobarbital and/or bromide have failed. Best of luck with this.

  5. I have a 7.5 year old neutered male Aussie who expressed his epilepsy at 2.25 years of age. We have treated him with the combination of phenobarbital and potassium bromide since then, but we have never completely stopped his seizures and have had to continually adjust the doses upwards despite the side effects of incoordination and lethargy. He is now at the top of the range for phenobarbital before liver toxicity becomes an issue, and he is currently suffering from bromide toxicosis when an increase from 750 to 875 mg daily dose raised his blood level from 1 to 4.4 ug/ml over a five-month period. We have backed off his potassium bromide dose and are waiting for two months for the excess bromide to clear and will then retest blood levels and liver function. He was having trouble just standing up, but he still often falls on the stairs from the bromide toxicosis. His drugs and blood level and liver function tests are costing us $1500 a year and climbing quickly, and we still don’t have a handle on this. We’ve tested thyroid and it is solidly normal. I am very careful with his diet and exposure to chemicals and medications. It is heartbreaking. He is such a good dog… I don’t know what we should do next.

  6. Grand Mal seizure onset in an intact male Belgian Sheepdog at the age of 4 and a half years. Within a month, he progressed to cluster seizures about twice a month. He was put on the combination of both potassium bromide and Phenobarb – medicated him 3 times a day so his dosages stayed as level as possible. Neutered him in the hopes that would help (it did not). Ruled out liver shunt, spinal tap did not show any anormalities,MRI showed brain liesions consistent with evidence of cluster seizuring. When he had a seizure, he had to be given IV phenobarb immediately within an hour of the first seizure, otherwise he would escalate to cluster seizures and continue to seizure about every 2 hours for 3 days. Monthly, he seizured consistently around the NEW MOON. ELISA food allergy study showed he was “sensitive” to dairy. Moving him to a lamb diet showed no improvement. However, once he was moved to a turkey based diet and not given any foods on his ELYSA “sensitive foods” list, the seizures started lessening in intensity and number. After having read that low thyroid could be evidenced with seizures, a thyroid test done at Michigan State when he was 8 year old, found he had practically no thryoid function – yet showed no overt signs (coat lush, weight excellent, alert, active). By this point in time, he had been grand mal cluster seizuring for 4 years. (Slamming to the floor, banging head during the seizure, salivating, urinating, no sight or hearing, rapid mouth movements even biting his tongue). Put on thyroid meds, the turkey based diet, and spread out any absolutely required inoculations (never more than one at a time), no cleaning toxins used in the house or on his bedding or crate. Within 3 months of being put on thyroid meds, his seizures COMPLETELY STOPPED. He was seizure free to the day he died at the age of 12 (quietly had a heart attack – I heard him say “Humph”, and I went over to where he had laid down next to my bed. He was gone – with a whisper).

  7. I had a German shorthair pointer who had seizures. My doctor put her on phenobarbitol and she did very well on it for years. She lived to be 16 1/2 years old.

  8. My Sheltie/dachshund mix got seizures at 10 years. Pheno and knowing to allow him to awake on his own, and recognize where he was got us thru another two years.

    Our Dobie cross began having “grand mal” seizures at 7 years. Following MRI, and evaluation at a specialty hospital. Diagnosis was unclear, a mass at base of skull, but no prognosis.I decided not to send her to Davis for six months. She was on pheno for 8 months but this provided minimal control of seizures. I will never get the sound of her screams as she seized out of my head.

    I am so glad this study is being done.

  9. I’ve attached my web page on my epileptic Border Collie, Moss. I bred Moss myself, so it was particularly poignant to me that he developed epilepsy. He was 2.5 years old when he had his first seizure. Throughout his life after that, I kept a chart on all his seizures. I could find no pattern, nothing specific outside of himself that triggered them. He usually had them when he was at rest. They occurred randomely, and became worse as he grew older until at 10-years-old he went into status. We were living in NYS at the time and using Cornell Veterinary College for our vet care. They pulled him through it, but he went in again as I was taking him home, and I turned right around and brought him back. They pulled him through again, but said there was nothing more they could do for him. One vet, however, told me that for humans with epilepsy, Vitamin E sometimes worked. Up until then, he was on phenobarbitol, and then potassium bromide, for many years. He was extremely ataxic, and I believe he was mentally impared from years of medication and seizures. I immediately put him on Vitamin E and he never had another seizure in his life. I was able to back him off his meds, and he would have been completely free of them if he lived longer, but he died at 14 years of age of liver cancer in 1999.

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