Epilepsy in Dogs

There are many golden retrievers who suffer from epilepsy.   Epilepsy is defined as seizure activity that is repeated over weeks, months or years.  A genetic basis is presumed based on pedigree analysis in golden retrievers.   Most dogs with genetic epilepsy will develop seizures between 1-4 years of age.  Golden retrievers can develop seizures as late as 5 years of age.

If your dog has a seizure, you should take your dog immediately to a veterinarian.  Your dog will need a complete physical examination and bloodwork performed.  Dogs with primary epilepsy will have normal physical examinations and normal bloodwork.  Based on this information, a tentative diagnosis can be made of primary epilepsy.  Occasionally, especially in younger or older dogs, further testing will be required.  Tests such as an MRI, a CSF tap or specific blood tests may be recommended by your veterinarian or neurologist.

What does a seizure look like?  It can look like just about anything.  Generalized seizures occur because of abnormal electrical activity in the brain.  You may see a sudden loss of consciousness, paddling or flailing in all the limbs, loss of bowel and bladder control, dilation of the pupils, vocalization, drooling, vomiting or diarrhea. Generalized seizures are the most common and can be extremely disturbing to watch. Focal or partial seizures occur in just a small area of the brain. Signs may include abnormal movement of the limbs, twitching of the eyelids, lips or ears on one side of the body. Some dogs will fly bite, which looks like they are trying to catch invisible flies. Focal seizures are more subtle and can easily be missed. It is always recommended to keep a log of your dog’s seizure activity.  Include information about how long the seizure lasted, what time of day, what was the dog doing before the seizure.  Another important piece of information would be how long it takes your dog to recover completely. Videos of seizures can also help your veterinarian with a diagnosis and treatment plan.

There are 3 stages to a seizure.  The first stage is called the prodomal stage.  This stage includes behavioral changes that occur hours or days before the seizure. The dog may become more attention seeking or show very odd behaviors.

The second stage is called ictus and is the actual seizure event.  It is very important to time how long the seizure lasts.

The third stage is the post-ictal stage.  The postictal period is the period of recovery after a seizure. This stage can be subtle or obvious and involve dementia, pacing, hyperactivity, etc.  Some dogs will be blind for 24-48 hours after a seizure event. Some owners confuse this as part of the seizure and count it when they describe the duration of the seizure. It should not be included in calculation of the seizure duration.

It is recommended to start anti-seizure medication if a dog has 2 or more seizures in a month or any seizure lasting longer than 3 minutes.  If a dog has 2 or more seizures in a 24 hour period, it is a medical emergency. There are many anti-seizure medications to choose from and they each have different requirements and side effects.

• Phenobarbital
• Side effects – drinking a lot of water, eating voraciously, urinating more than normal, sedation, wobbliness when walking
• Increased liver enzyme elevations that can lead to liver disease
• Periodic bloodwork to check phenobarbital levels and liver enzyme values
• Potassium bromide –
• Side effects – wobbliness when walking, sedation, increased drinking, increased appetite and increased urination, pancreatitis, vomiting
• The diet cannot be changed due to the differing amounts of sodium found in different foods
• Periodic bloodwork to check bromide levels
• Zonisamide
• Side effects – liver disease, loss of appetite, dry eye, hypothyroidism, kidney disease and urinary bladder stones
• Drug levels are not routinely measured
• Keppra (Levetiracetam)
• Side effects – minimal side effects
• Must be given every 8 hours
• There are other medications that your veterinarian may recommend
• These medications should not be suddenly stopped. Discuss with your veterinarian how to discontinue the medication.
• Some dogs will require more than 1 medication to control seizures.

There is a relatively new food that may help dogs with epilepsy.  The food is called Neuro Care and is made by Purina.  It contains medium chain triglycerides which can help improve seizure control. The research on this food has been very promising.

It is difficult to predict which dogs will do well with epilepsy and those that won’t.  Dogs that have more than 1 seizure in a 24 hour period (called cluster seizures) are more difficult to control. Anti-seizure medication and frequent veterinary visits may make it challenging as well.  Sometimes the side effects are difficult to live with as well.

Linda Lewiston, DVM