These are the chronicles of two Shetland Sheepdogs and their adventures in rally-o, obedience, flyball, agility, tracking and therapy dog work.
Also including information on raw feeding, canine epilepsy, positive training, and lots and lots of Sheltie hair!




Tuesday, September 9, 2008

Canine Epilepsy: Seizure FAQs

What is a seizure?
What are some causes of seizures in dogs?
What is a seizure trigger?
What are some common seizure triggers for dogs?
How do I know if my dog is having a seizure?
My dog had a seizure, should I take him to the vet?
What do I do if my dog has a seizure?
When I visit my vet after my dog has a seizure, what tests should I ask for?
When should I consider medication for seizures?
What are the primary medication options available for my dog?
What precautions should I take after medication is prescribed?
What can I do at home to prevent more seizures?
Additional sources of information regarding canine epilepsy


If there are additional questions that you feel I have overlooked, please leave a comment and I will update this page as necessary.

What is a seizure?

A seizure occurs when there is a misfiring of neurons in the brain, causing an "electrical storm" of brain activity. In response to this brain activity, the dog's muscles react accordingly resulting in the physical manifestation that we recognize as a seizure.

What are some causes of seizures in dogs?


Seizures can be caused by a number of things, including, but not limited to:
- head trauma
- congenital defects such as hydrocephalus
- infectious diseases such as distemper or cryptococcosis
- hypoglycemia
- hypothyroidism
- ingestion of poisonous substances
- reaction to vaccinations or certain medications
- reaction to flea/tick preventatives
- organ disease
- bacterial infection
- brain tumor

These acquired causes may result in singular or multiple seizures. If seizures happen recurrently then the disorder is called "epilepsy". If the cause of the seizures is unknown, then it is termed "idiopathic epilepsy", which basically means that the dog is having seizures but we don't know why. In many breeds, including Keeshond, Belgian Tervuren, Cocker Spaniel, Poodle (all varieties), Rough/Smooth Collie, German Shepherd Dog, Irish Setter, Golden Retriever, Dachshund, Labrador Retriever, Saint Bernard, Miniature Schnauzer, Siberian Husky, and Shetland Sheepdog, epilepsy can be genetically inherited.

What is a seizure trigger?

A seizure trigger is some stimulus that can result in a seizure in certain dogs. What is a trigger for one dog may not be a trigger for another dog. When a trigger exposure level surpasses an individual dog's seizure threshhold, then a seizure results.

Think of it as an empty drinking glass with a small hole near the bottom. With exposure to a specific trigger, the glass fills up with water. If the exposure level is low, then only a small amount of water is added to the glass and it quickly drains out from the hole in the bottom. But if the exposure to the trigger is high, then a larger quantity of water is added to the glass, taking longer to drain out of the hole in the bottom. If exposure to the trigger continues, the the glass may fill up with water faster than it can drain out of the hole. If the glass fills up with water to the point of overflowing, then the result is a seizure. Some dogs have "smaller glasses" for certain triggers than other dogs, so will react differently to varying levels of exposure to that trigger.

What are some common seizure triggers for dogs?

Some seizure triggers are more common than others. They include, but are not limited to:
- vaccinations, particularly Rabies vaccinations
- flea/tick preventatives, particularly Ivermectin (Ivermec)
- nutritional factors including protein levels, grains, chemical preservatives, artificial colors or flavors
- turkey meat
- herbs, plants or fragrances of rosemary or lavendar
- stress such as thunderstorms, fireworks, excitement, visitors, etc.
- changes in weather, air pressure, humidity
- loud noises or flashing lights
- over-exertion
- chemicals such as household or industrial cleaners, detergents, pesticides, herbicides, fungicides, fertilizers
- scented products such as air fragrences, perfumes, deoderizers, detergents/cleaners

How do I know if my dog is having a seizure?

Seizures can manifest themselves in a variety of different ways. They are normally divided into two catagories: general and partial. General seizures result from "electrical storm" occurs everywhere. Partial seizures result when the "electric storm" is limited to one area.

Further, there are a variety of different types of seizures:

Grand Mal (General tonic clonic) - These seizures involve the entire body of the dog. They will go rigid, collapse, and then begin flailing their legs in a characteristic "running" motion. Often also accompanying grand mal seizures is jaw chomping, excessive drooling, uncontrolled urination or defecation, labored breathing, failure to respond/rouse, vocalizations.

Petit Mal (Partial or Focal) - These seizures manifest themselves in one area of the body only. Simple focal seizures affect the area of the brain involved in movement. As such, the dog is often conscious and aware of their surroundings, while presenting twitching in one area of their body, commonly the face. A complex focal seizure affects the area of the brain involved in behavior. This will often result in the dog losing awareness of their surroundings while exhibiting abnormal behavior. Common behaviors are "fly snapping" or senseless running with seemingly little to no control. Complex focal seizures are also sometimes referred to as psychomotor seizures.

My dog had a seizure, should I take him to the vet?

Eventually, yes. But there is generally no need to rush to the vet immediately. If possible, allow the dog to recover from the seizure before adding the extra stress of a car ride and a vet visit.

Situations when you should rush to the vet IMMEDIATELY are:
- if the seizure lasts longer than 5 minutes (status epilepticus)
- if there are multiple seizures within 24 hours (clusters)


If the seizure lasts less than 5 minutes, the dog does not appear injured or in immediate danger, and is recovering safely on their own, then there is nothing that the vet will do at that moment. You would be better off to call your vet and let them know that your dog has had a seizure and follow their directions from there. Generally, allowing the dog to recover on their own and then scheduling a vet appointment for your soonest convenience is sufficient.

What do I do if my dog has a seizure?

Firstly, stay calm! Gently move the dog to an area that is safe. If they have collapsed, move them away from stairs, corners, furniture or other hard objects that they could injure themselves on. If they are on furniture, ensure that they cannot fall off.

Keep your fingers away from the dog's mouth. In humans, there is a risk of the human swallowing their tongue when they have a seizure. This is not a risk for dogs. But there is a risk of your dog unintentionally biting you if you get your fingers in the way. The last thing you need is to have to run to the hospital for stitches and a tetanus shot when your dog is having a seizure.

Lower any bright lights and turn down the volume of any televisions or radios in the area. Limit extra stimulus that may cause undue stress to the dog as they are seizing.

Speak gently and softly to the dog, do not try to stop them from seizing or "wake them out of it".

After the seizure ends, allow the dog to recover at their own pace. Many dogs will be disoriented, confused, or uncoordinated when the seizure ends. Some dogs may be temporarily blind, not recognize you or other family members, know their own name or common commands. Pacing and aggitation is a common symptom after a seizure. Ensure that the dog does not stumble into corners or down stairs or get stuck behind furniture or in tight corners. Allow the dog to pace if they so desire. Once they are SAFELY able, offer the dog some fresh water to drink or a SMALL bite to eat (a single dog cookie, a couple of kibbles, etc.). Blood sugar levels can drop significantly during a seizure, and failing to raise them can result in more seizures. But be careful, raising the blood sugar too quickly can also result in more seizures. So be sure to only offer a small amount of bland food or treats.

The post-seizure (post-ictal) stage can last from a couple of minutes to a couple of hours. During that time, ensure that the dog remains calm, comfortable and safe.

It is important to keep a seizure diary for every seizure that your dog has. This will help you to recognize patterns and hopefully narrow down a trigger for your dog that may help in prevention of more seizures. In the diary, note the date and time of the seizure, how long it lasted, what the dog did during the seizure, any abnormal behaviour you noticed prior to the seizure, the weather of that day, what your dog ate that day and the day prior, what they did that day and the day prior, any changes in environment, any new cleaning products/chemical agents in or around the house, any activity in the neighborhood or places that you have visited with your dog recently, any recent vaccinations, medications or flea/tick treatments, and any other information that you can think of, even if it sound silly at the time.


When I visit my vet after my dog has a seizure, what tests should I ask for?


The general course of action is to order a CBC and a Chemistry Panel. This will screen for infection/immune deficiency and organ health and function.

Something that is often not suggested by veterinarians, but is very important to screen, is a 6-panel thyroid test. There has been significant research into the correlation of hypothyroidism and seizures in dogs. Interpretting the results should take into consideration the dog's age, breed, size, and physical activity level. In many cases, a thyroid test may come back "within normal range", but still be lower than what is recommended when taking into consideration individual variances. If possible, I would recommend sending the blood off to Hemopet for interpretation. Additionally, you can have your regular vet conduct the 6-panel thyroid test and send the results off to Hemopet for interpretation. Hemopet accepts international shipments an their website offers directions for shipping.

If all of those tests come back clear, then you may want to consider abdominal ultrasound and/or x-rays. A final step would include MRI, though this is an expensive option so is often not taken.

When should I consider medication for seizures?

Medication generally becomes an option if there are multiple seizures within the course of a month. If they are occurring less frequently than that, the risks of medication outweigh the risks of the seizures.

What are the primary medication options available for my dog?

There are two primary medications for treating epilepsy: Phenobarbital (Phenobarb) and Potassium Bromide (KBr)

Phenobarb is effective in 60-80% of idiopathic epilepsy and takes 1 to 2 weeks to take effect. Common side effects of Phenobarb include ataxia, excessive thirst, excessive hunger, incontinence, lethargy and exciteability. These symptoms will normally disappear after a couple of weeks. If they persist, contact your veterinarian. Phenobarb is processed through the liver, so close monitoring is essential (see below).

KBr does not have the same liver effects as Phenobarb, though it can be significantly more troublesome to the digestive system so should be given with food. KBr takes up to 3 to 4 months to reach full effect so should not be used if immediate control is required. To get around this time delay, a higher loading dose is often prescribed for the first week. When on KBr, chloride intake food levels must be monitored closely, and any switches in food brand or formula must be taken very gradually so as to not disrupt the levels of KBr in the blood. Common side effects include excessive hunger, excessive thirst, incontinence, exciteability, lethargy, ataxia, nausea, diarrhea, or bromide toxicity. These symptoms should disappear within a couple of weeks. If they do not, contact your veterinarian.

Some dogs require a combination of Phenobarb and KBr to obtain the best control.

Other seizure medication options, that I will not go into detail with here, include Keppra, Felbamate, Primidone, and Gabapentin.

What precautions should I take after medication is prescribed?

Routine monitoring is essential, regardless of which medication is prescribed.

If your dog is on Phenobarbital:
- a blood test to determine the level of Phenobarb in the blood is required 2 weeks after starting treatment
- a blood test to determine the level of Phenobarb in the blood is recommended every 6 months afterwards
- a chem panel to monitor GGT, ALT, and alkaline phosphatase (indicating liver function) is strongly recommended every 3-4 months

If your dog is on Potassium Bromide:
- if your dog was given a loading dose, then a blood test to determine the level of KBr in the blood is recommended after 1 week of treatment
- if your dog was not given a loading dose, a blood test to determine the level of KBr in the blood is recommended after 4-6 weeks of treatment
- subsequent blood tests to determine the level of KBr in the blood is recommended every 6 months afterwards
- a chem panel is recommended every 4-6 months to monitor organ health

What can I do at home to prevent more seizures?

There are a number of steps you can take at home to prevent additional seizures or to lessen the severity of impending seizures.

Nutrition plays an important role in our dogs lives. A home prepared diet, either cooked or raw, is recommended so as to avoid unnecessary fillers or grains, chemical perservatives, flavors, colors, or synthetic nutrients. Preparing meals for your dog takes significant research and effort, so should not be taken lightly. Though it certainly isn't rocket science, so with adequate reading and commitment, it is possible to provide a natural, safe, and balanced home prepared diet for your dog. If you are unwilling or unable to prepare a diet for your dog, then a high quality kibble is essential. For information on how to choose a good quality kibble, consult the Dog Food Analysis website and the Dog Food Project website. In general, if you can purchase the food at your favorite grocery store or at your vet's office, it is NOT a good quality food and is potentially doing more harm than good.

Changing how you clean and treat your home, yard, and garden can make a significant difference in the severity of seizures that your dog may have. Take into consideration the amounts of chemicals that you use around the house. Attempt to replace those chemicals with natural alternatives and limit the use of chemicals to only those that are absolutely necessary.

Consider a minimal vaccination protocol with your dog. Titer testing is an available alternative to vaccinations, so discuss that option with your veterinarian. Also source out natural alternatives to pest prevention. There are a variety of dog-safe natural insect repellents on the market, so check out your options. I have found success with the Super Bug Spray from AnimalWellness.ca. They are willing to provide a "seizure-safe" recipe, without rosemary and lavender, upon request.

Most importantly, do some independent research and reading. As wonderful as veterinarians are, in general, they are not guaranteed to know everything about epilepsy. You know your dog best, and you are the best person to take the initiative to make a difference in your dog's life. Don't rely on everything that your vet recommends without asking questions, making suggestions, or requesting explanations. Take a pro-active stance in dealing with your dog's epilepsy, stand your ground for what you feel is right.

Great sources of information regarding canine epilepsy include:
Epi Guardian Angels
Canine Epilepsy Resources
Canine Epilepsy Network
K9 Epilepsy Yahoo Group
The Shakers Dogster Group

11 comments:

Kim said...

Very interesting information, thanks for sharing it. Many Bernese are known to have "fly snapping syndrome', and it is something that I am always concerned about.

DESERT PUPS said...

Woof, Gio and Romeo

Wow, you pups are really smart. We don't know much about seizures but you pups have educated us. Thanks for sharing the info.

Woof, woof,
Scuba, Keiko, Norman and Toby from Life Inside The Fence

Sarah said...

wow interesting info, there is so much to know thanks for sharing

Cookie & Gray Dawntreader said...

Really helpful.=;

KEY WEST COLLIES said...

Pawtastic blog, we enjoyed reading it.

We would like to post a link to your blog. Is that okay with you?

Essex & Deacon

Anonymous said...

After having Shelties (bred, raised, and shown them) for 35 years, we now have our rist with epilepsy. We thought it was idiopathic, but she suffered her second one in two weeks this morning. She had all the prescribed tests after the first one and they were all normal, including thyroid. I'm not eager to put her on medication, but I guess I may have to.

This is an extremely valuable site and I thank you for it.

Anonymous said...

Can you recommend a commercailly available dog food for my Sheltie who has epilepsy and is slightly overweight?

lariyoung@aol said...

Hi...our sheltie is 16 years old and it appears that he had a seizure or stroke yesterday morning. All appeared normal later in the day, so we dismissed it to him slipping in the grass during a rainstorm.

Then this morning it appeared to happen again. He is now leaning to the left, seems anxious, but is now (hours later) sleeping, which is normal for him.

As you can imagine we are very worried, found your site and decided to send you a quick message. Is this normal for this age...what should we be worried about, ask the vet, etc? Would love your guidance...PJ is a huge part of our family and we truly want to do the right thing for him. If you would like to email us, please do so at lariyoung@aol.com. Thanks to your site...what a blessing it was to find you today.

Lari

Sharon said...

Hi,

Epilepsy has gone from an obscure mental illness, to a serious illness recognized by state foundations. This remarkable awareness, is because of the great work organizations, such as yourself, has done. We here, at Disease.com, fully support the cause your organization stands for and we are dedicated to aiding in your mission statement. Disease.com is a website which features disease and infection preventions/treatments. If you could, please list us as a resource or host our social book mark button, it would be much appreciated. Lets dedicate our time to the welfare of the 3 million individuals with epilepsy.
If you need more information please email me back with the subject line as your URL.

Thank You,
Sharon Vegoe

Helena said...

My Dharma has epilepsy. She's a siberian Huskie, she's had it since she was a pup. We have come to the conclusion that she has a seizure per week, but we can't seem to determine the trigger! About half the times she throws up before the seizure, what we don't know is if it's a cause or an effect (she gets dizzy or something before seizures and so feels nauseous). Has anyone here seen the same?

sar727s said...

Hi, It is about 5:30a.m. and my 5-year old Sheltie just had what I believe to be a grand mal seizure.
He began by waking up and vomiting (something he does occasionally, previously we've attributed this to his sensitive stomache). He then collapsed and I held him while he convulsed and hyperventilated for about 1-2 minutes. He foamed/salivated/continue to vomit and uncontrollably urinated.
After it was over he tried to stand but could not control his legs right away, within 5 minutes he felt strong enough to walk but he was obviously anxious and pacing. He is now resting.
I am so, so scared for my best friend and want to do exactly and everything he needs. I just need to tell a group that loves their animals too, and can maybe help us.

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