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Understanding Canine Epilepsy:
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Epilepsy is a symptom of an
underlying neurologic dysfunction occurring within the brain. Toxic
substances, metabolic or electrolyte abnormalities or imbalances cause
an uncoordinated firing of the neurons located within the section of the
brain known as the cerebrum. These episodes of uncoordinated firing
manifest themselves in the form of convulsions or seizures in which the
dog may experience mild tremors to severe thrashing movements. Epilepsy
may occur secondary to many diseases such as distemper, brain tumors,
liver or heart failure, diabetes, or as a result of exposure to toxic
substances or trauma. However, "true" epilepsy as that which
occurs in hereditary syndromes within certain breeds of dogs manifests
as a symptom of primary neurologic dysfunction of which the cause is
still unknown. As such, from a clinical standpoint, in cases of true
epilepsy, only the symptom is treatable.
WHAT ARE THE SIGNS OF EPILEPSY?
There are three components of an
epileptic seizure. The first is termed the "aura" in which
certain signs indicative of an oncoming attack include restlessness,
nervousness, whining, shaking, salivation, affection, wandering and
hiding. These indications may persist only for a few seconds or for
several days, thus they may or may not be noticed by the owner. The
second stage is termed the "ictus" at which point the seizure
occurs. The attack may endure only for a few seconds or for several
minutes. During an episode, the dog usually falls on its side and there
is involuntary motor response demonstrated as kicking or paddling
motion. The dog will salivate excessively and lose bladder and bowel
control. He will be unaware of his environment or his actions. Some
clinicians may classify seizures in terms of their severity as either
Petite Mal or Grande Mal, the latter being the more severe form.
However, the occurrence of Petite Mal seizures, as determined by
electroencephalographic diagnosis (an EEG which records and detects
irregular brain activity) have not truly been established in animals.
Immediately following the ictus stage is the "postictal phase"
characterized by a period of confusion, disorientation, salivation,
pacing, wandering, restlessness, unresponsiveness and in some cases
transient blindness. This condition is believed to result because the
neuronal cells are exhausted and cannot utilize required metabolites.
The endurance of this stage is dependent on the severity of the ictal
episode and may last for days.
AT WHAT AGE DOES EPILEPSY OCCUR?
Seizures can occur at any age,
however, true epilepsy does not usually present until the dog is around
2 years or older.
HOW IS TRUE EPILEPSY DIAGNOSED?
When a dog first experiences a
seizure, no matter what the age, it is essential to rule out causes
other than true epilepsy. As previously stated, this is because many
other diseases or disorders can result in seizures.Therefore, blood
tests, radiographs (x-rays), physical examination, and history leading
up to the seizure are necessary for accurate diagnosis. When, and only
when, the clinician finds no identifiable cause of the seizure based on
clinical evaluation, then the dog is considered to have true epilepsy.
WHAT IS THE TREATMENT FOR EPILEPSY?
Many times, dogs having true
epilepsy experience short, infrequent, non-violent attacks which do not
require anticonvulsant therapy. However, when the seizures become more
severe, longer in duration, or more frequent, or if the dog initially
experiences severe attacks then the necessity for therapeutic
intervention is indicated. There are several anticonvulsant drugs
available for treatment of epilepsy which work to sedate the neurons of
the brain. The following are some of the most commonly used
anticonvulsant drugs and their advantages and disadvantages.
Dilantin
indication uses: generalized major
motor seizures
advantages: absence of sedation,high rate of effectiveness, absence of
side-effects
disadvantages: poorly absorbed in dogs, rapidly cleared from blood,
increase in thirst and urination
Phenobarbital
indication uses: generalized major
motor seizures
advantages: high efficacy, rapid action, can be administered by several
routes, most effective drug in status epilepsy
disadvantages: long-term sedation, restricted drug, increased thirst and
urination, irritability and restlessness
Primidone
indication uses: generalized major
motor seizure
advantages: high efficacy, rapid action
disadvantages: severe sedation, great variability in dose tolerances,
only tablets available
Valium
indication uses: control of
exacerbation of seizures, control of status epilepsy
advantages: effective at stopping status epilepsy, rapid action, safety
disadvantages: short action, cannot control violent status epilepsy,
restlessness, irritability.
CAN EPILEPTIC SEIZURES BE
PREVENTED?
The purpose of using
anticonvulsants is to completely stop occurrence of seizure activity.
However, actual success of treatment is often dependent upon many
exogenous, as well as, endogenous factors. For example, though the
actual events which bring on an epileptic seizure are unknown, episodes
can be initiated by periods of stress or excitability. It is, therefore,
recommended that dogs afflicted with the disorder abstain from sources
of stress which may include sporting competition events and breeding. In
regard to breeding, because physiological changes such as hormonal
fluctuations in a bitch during her seasonal cycle or during pregnancy,
or stress in the male during mating may bring on episodes of seizure
activity, spaying and neutering of epileptic dogs is recommended.
IS TRUE EPILEPSY AN INHERITED
DISORDER?
Because epilepsy has been found to
occur in related individuals and with preponderance in certain
bloodlines, it is considered to be a genetic disorder. However, the mode
of inheritance is still unknown. Some breeds of dogs such as the German
Shepherd Dog, Beagle, St. Bernard, Irish Setter and Poodle have a higher
incidence of the disorder than other breeds. Though the Labrador
Retriever is not among the highest ranking breeds for risk, epilepsy
does occur within the breed. Currently, there is no method for screening
potential carriers of the disorder, however, breeders seeking to produce
physically sound puppies should not breed dogs known to be afflicted
with true epilepsy.
WHEN SEIZURES DO OCCUR, WHAT SHOULD
THE OWNER DO?
On the average, with the exception
of status epilepsy, an epileptic seizure is not life-threatening to the
dog. During the episode, the dog will not be aware of its owner or its
surroundings. Though viciousness is uncommon, to avoid personal injury
the owner should not attempt to interceed or move the dog. However, if
the dog is in danger of injuring itself on furniture, objects, etc.,
then the owner should remove those items in the immediate area of the
dog. Many veterinarians will ask that the owner keep a record of the
date and length of time of the seizure in order to make judgements
regarding treatment doses and frequency. Once the seizure has ended, the
dog will usually seek out the owner. It is at this time when the owner
should provide comfort and assurance. In the case of status epilepsy (a
condition in which a seizure progresses for more than 5 minutes or the
dog experiences two or more seizures within a short period of time for
which the dog never regains full consciousness between each seizure)
immediate emergency medical attention must be provided. In such an
instance the owner will need to transport the dog to the veterinary
hospital. Because a seizuring dog will often thrash about, a large
blanket can be fashioned into a stretcher upon which the dog can be
laid. Two people will be needed to hold the blanket by the corners at
either end, creating a sling-like stretcher. In this manner, the dog can
be carried into the car and into the hospital.
COPING WITH EPILEPSY: A FAMILY
PERSPECTIVE
To an adult, an epileptic seizure
occuring in the family pet can be a very unnerving experience; to a
child, the episode can be terrifying. Fortunately, when seizures do
occur they frequently do so during the night and may go unnoticed by
younger members of the family. However, seizures may also occur during
the day and in the presence of children. In cases where the owner can
detect the "aura" stage and know that a seizure is imminent,
then she may have the opportunity to distract the child or separate the
child from the dog. At some point, however, a child will probably
witness their pet seizuring. If the child is three years or older, an
explanation may help to calm the child's fears. For instance, one of the
reasons that witnessing a seizure is so frightening is because the child
will know that something bad is happening and fears that he may lose his
beloved pet. Telling the child that his dog will be sick sometimes and
there will be times when his dog will behave oddly, rolling about and
twitching, and although it may be scarey to watch, the dog will be okay
after awhile but will need alot of love and comfort, may arrest these
fears. Many children when assured that their pet will be okay, deal very
well with the situation. However, in situations where a dog owner feels
uncomfortable having an epileptic dog around the children, the breeder
or a breed rescue service may assist in finding a placement home for the
epileptic dog.
REFERENCES:
W.J. Kay and W.R. Fenner,
Epilepsy, In: Current Veterinary Therapy VI (R.W. Kirk, ed.)
Philadelphia, W.B. Saunders Co., 1977.
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