Epilepsy: Signs and Treatments
Epilepsy is a condition that can affect most breeds of dogs and some cats.

Sight hounds (Borzois, Greyhounds, Saluki, Irish Wolfhounds, Scottish Deerhounds, Whippets, Italian Greyhounds) and Doberman Pinchers rarely exhibit signs of epilepsy. (Dr Parent University of Quebec, Board Certified Veterinary Neurologist is source for above comment).There is a higher incidence in pure breed dogs than mixed breed dogs, and is therefore likely to be inherited. Dr Cunningham at Michigan State University states
"Mating two known epileptic dogs will result in an incidence of epilepsy greater than the general population. This implies some sort of genetic component."
The primary clinical sign of epilepsy is seizures. These are categorized by source of origin. Intracranial causes of seizures have detectable defects, such as a tumor, inside the brain. Extracranial causes of seizures have metabolic or toxic changes that are outside the brain but affect the brain to cause a seizure.
Seizures in a dog six months to one year of age are likely to be caused by congenital or genetic problems, infections, or toxins. Dogs between 6 months and 6 years of age that are normal between seizure episodes probably have idiopathic epilepsy.  (After rule out test organ system causes like renal or hypoglycemia). Dogs older than six years old are likely to have tumors, infectious, or inflammatory problems causing the seizures.
Epilepsy is a functional abnormality or physiological abnormality in neurons which causes an abnormal neurologic excitation that over takes the whole brain. It is similar to a lightning strike on a house that sends abnormal current through the normal electrical system. All circuits fire at once with out an organized control of impulse or signal.
Recognizing a seizure is important and often difficult. They are now classified as focal seizure, partial seizure or complete seizure. A seizure can be minor and show as only slight loss of muscle control (called a partial motor seizure), or it can be severe, with the dog paddling on the ground completely out of control (complete seizure, used to be "grand mal"). Dogs may lose bladder and bowel control during a seizure, unaware of its surroundings, and may appear abnormal after a seizure. They will act stunned or disorientated in the postictal (after) phase. Videotaping a suspected episode helps to differentiate and classify type of seizure by showing it to your veterinarian. Cluster events where there are multiple back to back daily episodes. These clusters may be 6 - 10 week apart. A seizure log (blog in the current sense) is very helpful to establish the interval and possibly identify the "trigger" event which may predict an ensuing seizure. Some clients log and develop a "sense" when to expect the next wave. This is due to a peculiarity their dog exhibits 24 - 72 hours prior to what in people is called an "aurora". This allows them to adjust dose of phenobarbital or give a diazepam boost to temper and calm dog.

Diagnosing epilepsy is a systematic venture to rule out other causes. Hypoglycemia, kidney issues and liver are three examples that come to mind. Initial test may include blood test, urine analysis, and electrocardiogram.

Treatment of epilepsy does not cure the disorder. The goal is to control the seizures. If untreated epilepsy continues to worsen.  The first line of treatment for epilepsy is usually a barbiturate.  Phenobarbital has anti-seizuring effects and sedation effects. This medication has a 2-3 week adjustment phase, animals are extremely sleepy the first 10 -14 days on the medication. Phenobarbital usually can be used to treat dogs over the long term. This drug mandates periodic liver enzyme testing. If unchecked this medication will "cook" the liver. Cirrhosis and liver failure may result if levels are exceedingly high. The purpose of anticonvulsant medication is to lower the intensity of each episode and increase the interval between events. Your mileage may vary as each case is an individual that has different variables.

 A second-line drug used in the treatment of epilepsy is potassium bromide. This medication may take up to 3-4 months to stabilize levels and allow reduction of amount of phenobarbital needed to control episodes.

Referral to a Veterinary Neurologist for more advanced medications, cerebrospinal fluid analysis and imaging (skull radiographs, electroencephalogram, brain scan (radioisotope or dye contrast studies), MRI, or pardon the pun a CAT scan {CT). These are obviously for a more intense medication refractory case. The more sophisticated a test the larger fee associated with it.It is important to note that an epileptic pet can live a normal life with proper treatment. Monitoring levels definitely will increase the life span of a pet with epilepsy.
 
If you would like further information, contact your veterinarian.

Dr Mike Sweet
734-439-1112