Last Fact Check: 09/13/2020 02:01pm
If your pet just had a seizure..
IMPORTANT:
First, take some deep breaths and do your best to calm yourself down. Try to remind yourself that a seizure is scarier for you than it is for your pet. Also remember, your pet is not conscious during a seizure, even if they appear to be, they are not aware of whats happening, and are not experiencing pain or fear. We've assembled the most comprehensive guide to navigating seizures in your beloved pet. Below is a Quick Directory to find exactly what you're looking for.
- If pet is actively seizing for more than 5 minutes, transport immediately to the Closest Animal Hospital (click for google maps)
- If pet is actively seizing for less than 5 minutes - jump to Ictal Phase now - you can finish reading this later.
- If your pet has just come out of a seizure - jump to Post-Ictal Phase now - you can finish reading this later.
First, take some deep breaths and do your best to calm yourself down. Try to remind yourself that a seizure is scarier for you than it is for your pet. Also remember, your pet is not conscious during a seizure, even if they appear to be, they are not aware of whats happening, and are not experiencing pain or fear. We've assembled the most comprehensive guide to navigating seizures in your beloved pet. Below is a Quick Directory to find exactly what you're looking for.
Index
|
Getting Veterinary Care
At-Home Care & Mitigation
|
If this Seizure Guide has helped you and your pet, please consider making a donation to The Opal Fund.
Pre-Ictal Phase - Before the seizure
The Pre-Ictal Phase is often referred to as Aura. While not obvious in every pet, the Pre-Ictal phase is a period of altered behavior several minutes to hours before a seizure. An otherwise social or needy pet may go off to be by themselves or vice versa, an otherwise independent pet may suddenly nervous and seek attention or comfort. Some pets may display symptoms of anxiety such as; shaking, crying, yawning, licking, salivating, and general restlessness.
Since each pet is different, these cues are usually picked up by owners after experiencing many seizures. Don't beat yourself up over not noticing them, even after almost 30 seizures we never identified Opal's Pre-Ictal cues.
Since each pet is different, these cues are usually picked up by owners after experiencing many seizures. Don't beat yourself up over not noticing them, even after almost 30 seizures we never identified Opal's Pre-Ictal cues.
Ictal Phase - During the seizure
- Keep your hands clear from their mouth, you can easily be seriously bitten.
- Keep your pet safe from bodily injury by carefully moving them away from stairs or carefully sliding pillows between their head and the ground / walls / furniture.
- DO NOT place anything in their mouth.
- Begin timing the seizure as soon as you can. Most will last 1 minute, some may be more. Record the date and time as well.
- Your pet may begin to foam at the mouth, this is normal during a seizure.
- Your pet may empty their bladder or bowels due to involuntary muscle contractions.
- Try to film the seizure to show your Veterinarian to identify the type of seizure. If you can't, take note of what your pet's body is doing.
- If actively seizing for more than 3 minutes, prepare some cold wet towels.
- If actively seizing for more than 5 minutes immediately transport them to the Closest Animal Hospital (click for google maps).
- Once convulsions stop, you may begin to comfort them speaking softly and petting them but use caution.
- Once conscious, your pet will be very confused and may try to bite or escape. This is known as the Post-Ictal Phase.
Post-ictal Phase - After the seizure.
- Your pet may be very confused.
- Depending on the type of seizure they experienced, your pet may be extremely uncoordinated.
- Some pets may become vocal as they regain consciousness.
- A generalized seizure is like running a marathon in under a minute. You can offer your dog some vanilla ice cream (free of artificial sweeteners) to restore blood sugar and bring down body temperature. Watch your fingers.
- If you prepared cold wet towels, they can be applied to the armpits, groin, paws, or head to help bring their body temperature down.
- Begin a seizure log; detail the Date, Time, Duration, Type of seizure, What your pet was doing last.
- Phone your primary Veterinarian to let them know what happened. If after hours, you may call your local Animal Hospital. Typically, a seizure that ends within 5 minutes, and is not part of a cluster, is not an emergency.
- If your pet experiences a second seizure within 24 hours, they require immediate Veterinary attention. See; Cluster Seizures
- Try to identify the type of Seizure your pet experienced.
Types of Seizures
Generalized Seizures - Grand MalA Generalized (Grand Mal) seizure is what most people will picture when they hear the word "Seizure". This type of seizure affects the entire body, due to misfires in both hemispheres of the brain.
Pets experiencing a Generalized seizure typically present with one or more of the following;
Video below is of a Generalized seizure. |
Generalized Seizures affect the entire brain.
|
*WARNING: VIEWERS MAY FIND THIS VIDEO DISTURBING*
Focal Seizure - PartialA focal seizure affects a small area, or lobe, of the brain. Symptoms and level of consciousness depend on which area of the brain is being affected. Pet's will typically remain consciousness, however consciousness may alter leading to confusion or strange behavior.
A Focal seizure will present with only a few, or as little as just 1 of the following;
Complex Partial / Focal Seizures: are another form of a Focal Seizure and are typically the most challenging for pet owners and veterinarians to recognize. Complex Partial / Focal seizures manifest as behavioral abnormalities including;
Video below is of a focal seizure, note the dog appears to be consciousness and aware that something strange is happening. |
Focal Seizures affect one area of the brain.
|
*WARNING: VIEWERS MAY FIND THIS VIDEO DISTURBING*
Petit-Mal SeizurePetit Mal seizures, sometimes called absence seizures, can be easily mistaken for Focal seizures - and vice versa. Petit-Mal seizures typically present as an altered mental state. Your pet may stare off into space, or appear to see something you can not see. Petit-Mal seizures are notably brief, lasting less than 1 minute.
A pet suffering from a Petit-Mal seizure may present with some of the following;
Video is of a Petit-Mal seizure, note the dog appears to be seeing or experiencing something that isn't there. |
*WARNING: VIEWERS MAY FIND THIS VIDEO DISTURBING*
|
Cluster Seizures
The term Cluster Seizures describes two or more seizures (of any type) that occur within 24 hours of each other. Seizures can occur within just seconds of each other, or as long as 23 hours apart, so long as the seizures are within 24 hours of each other it is considered a Cluster Seizure episode.
Cluster seizures are a true medical emergency, and your pet should be taken to your local Animal Hospital as soon as possible.
Cluster seizures are a true medical emergency, and your pet should be taken to your local Animal Hospital as soon as possible.
Status Epilepticus
When a pet experiences a seizure that lasts more than 5 minutes, they are in Status Epilepticus. Status Epilepticus is a extremely dangerous and can quickly result in death. The prolonged seizure activity can overheat the body, and the combination of seizure activity and increased body temperature causes brain damage rapidly. Medication such as Intravenous Diazepam is usually required to get the patient our of Status Epilepticus.
Status Epilepticus is a true medical emergency, and your pet should be taken to your local Animal Hospital immediately.
Status Epilepticus is a true medical emergency, and your pet should be taken to your local Animal Hospital immediately.
About Seizures
What is a Seizure?
A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behavior, movements or feelings, and in levels of consciousness. If you have two or more seizures or a tendency to have recurrent seizures, the patient may be diagnosed with epilepsy. There are many types of seizures, which range in severity. Seizure types vary by where and how they begin in the brain. Most seizures last from 30 seconds to two minutes. A seizure that lasts longer than 5 minutes is a medical emergency.(1.) (See; Status Epilepticus)
References:
(1.) Mayo Clinic; https://www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-20365711
Accessed: 03/05/2020
References:
(1.) Mayo Clinic; https://www.mayoclinic.org/diseases-conditions/seizure/symptoms-causes/syc-20365711
Accessed: 03/05/2020
Toxic Causes of Seizures in Dogs
Dogs can suffer from seizures as a result of poisoning or accidentally consuming toxic chemicals. Its important to rule out toxicity as the cause for your dog's seizure.
|
Toxic medications to consider;
Some toxic plants to consider;
|
Toxic controlled substances;
Some toxic chemicals found in food;
Rodenticides, Pesticides and Insecticides;
It's important to note, this is not a complete list, rather the most common toxic causes of seizures in dogs. |
Toxic Causes of Seizures in Cats
Cats can suffer from seizures as a result of poisoning or accidentally consuming toxic chemicals. Its important to rule out toxicity as the cause for your cat's seizure.
|
Toxic medications to consider;
Some toxic chemicals found in food;
|
Rodenticides, Pesticides and Insecticides;
Misc. Toxins
It's important to note, this is not a complete list, rather the most common toxic causes of seizures in cats. |
References:
The Veterinary Journal: Reactive Seizures in Cats: A Retrospective Study
Accessed: 05/12/2020
The Veterinary Journal: Reactive Seizures in Cats: A Retrospective Study
Accessed: 05/12/2020
Potential Medical Causes For Seizures
Seizures are a symptom, not a diagnosis. After ruling out chemical toxicity, its time to explore some potential medical causes for seizures. Your Veterinarian will need to rule out all possible causes before confirming an Idiopathic Epilepsy diagnosis. We'll split these medical conditions into two categories;
Intracranial, conditions inside of or directly on the brain.
Extracranial, conditions originating outside of the brain.
Intracranial, conditions inside of or directly on the brain.
Extracranial, conditions originating outside of the brain.
|
Intracranial Causes of Seizures
|
Extracranial Causes of Seizures
|
Potential Environmental Seizure Triggers
Seizures of unknown origin, Idiopathic Epilepsy, can have certain environmental triggers. Be ready to discuss potential triggers with your Veterinarian. Below are some common environmental triggers - consider any recent changes in your home.
|
Environmental triggers to consider;
|
Continued..
|
References:
American College of Veterinary Internal Medicine: Seizure-precipitating factors in dogs with idiopathic epilepsy
Accessed 05/11/2020
American College of Veterinary Internal Medicine: Seizure-precipitating factors in dogs with idiopathic epilepsy
Accessed 05/11/2020
Getting Veterinary Care
Before Seeing Your Vet
If your pet has not suffered a Cluster Seizure episode or Status Epilepticus, you can pass on an Emergency visit to the hospital, but you should make an appointment with your primary Veterinarian as soon as possible. Its important to come prepared to this Vet visit, so you can quickly make progress towards a diagnosis.
Try to bring the following to your Veterinarian;
- Seizure Log (Date - Time - Duration - Seizure Type)
- Video of seizure. Tip: Could the seizure have been caught on interior security cameras?
- If no video available, provide a detailed description of the seizure.
- Document any recent changes in your home.
- Consider any potential instances of chemical toxicity.
- Photograph the labels of any Food, Treats, or supplements your pet is consuming.
What To Expect At Your Vet Visit
The time between your pet's seizure and their first visit with their Vet can feel like an eternity. Stress levels are high and your mind is full of "What Ifs?". Try to remind yourself that the cause of seizures - and neurological disorders in general - are not solved or treated in one day. If you go into this appointment expecting to leave with a diagnosis and a full regiment of medications, you will be very disappointed. This is why it's so important to do your due diligence and prepare to answer many lifestyle questions.
Your Veterinarian will spend most of this visit talking with you about the seizure. This is why its so important to make sure you have everything you need before seeing your Vet. This is where your seizure log and video (or detailed description) will come in handy. Your Vet needs to make sure what your pet experienced was truly a seizure, and If so, they need to first rule out Poisoning and Medical Causes. Your Vet should run a diagnostic blood test to verify blood levels of Calcium, Blood Sugar, Thyroid Hormone. They will also check for signs of infection, and Electrolyte imbalance. Depending on the technology available, results from this test may take several days. Your Vet will hold off on prescribing Anti-Epileptic Drugs until your pet experiences more seizures, and blood tests return normal. Once a pet starts Anti-Epileptic Drugs, they're on them for life.
Your Veterinarian will spend most of this visit talking with you about the seizure. This is why its so important to make sure you have everything you need before seeing your Vet. This is where your seizure log and video (or detailed description) will come in handy. Your Vet needs to make sure what your pet experienced was truly a seizure, and If so, they need to first rule out Poisoning and Medical Causes. Your Vet should run a diagnostic blood test to verify blood levels of Calcium, Blood Sugar, Thyroid Hormone. They will also check for signs of infection, and Electrolyte imbalance. Depending on the technology available, results from this test may take several days. Your Vet will hold off on prescribing Anti-Epileptic Drugs until your pet experiences more seizures, and blood tests return normal. Once a pet starts Anti-Epileptic Drugs, they're on them for life.
Anti-Epileptic Drugs (AED)
If your pet begins to experience more seizures, your Vet may decide to start on a regiment of Anti-Epileptic Drugs after receiving normal lab results.
|
Phenobarbital
Phenobarbital should only be given under the direct advisement of a licensed Veterinarian. Phenobarbital is the most common Anti-Epileptic Drug (AED) used to treat seizures in cats and dogs. Its popularity is due in part to it's low cost and high seizure control success rate. It is easily combined with KBr without heavily taxing the patient's body.
After starting Phenobarbital, Phenobarbital Blood levels should be checked by your vet at regular intervals. The normal therapeutic range is around 15 to 30 mcg/mL. If your pet's blood level is too high your vet may lower the dose. If too low, your vet may slowly increase the dose. Levels should be checked routinely, especially if your pet is still growing, or has gained weight since starting Phenobarbital. Common Side Effects
1mg - 1.8mg/lb every 12 Hours |
|
|
Potassium Bromide (KBr)
Potassium Bromide should only be given under the direct advisement of a licensed Veterinarian. KBr is a traditional Anti-Epileptic Drug (AED) used in cats and dogs. It is frequently used together with Phenobarbital to control seizures.
Typically, KBr is started with a "loading dose" that is significantly higher than the maintenance dose. This "loading phase" is given over a 1 - 5 day period. After loading, a daily maintenance dose is all that's needed. After starting KBr, Blood Bromide levels should be monitored by your vet at regular intervals. It is also recommended to test Potassium levels and liver enzymes while on KBr as well. Common Side Effects
Recommended Dosing - Loading Phase 52mg - 57mg/lb Daily Recommended Dosing - Maintenance Phase 12.5mg - 16mg/lb Daily Dosing Chart |
|
|
Diazepam (Valium)
Diazepam should only be given under the direct advisement of a licensed Veterinarian. Diazepam, commonly referred to as Valium is a benxodiazepine drug that provides a sedative effect on the brain and central nervous system. Diazepam is often used as a rescue drug, used to control Status Epilepticus or to stop a Cluster Seizure episode.
Diazepam can be administered in several ways, from quickest absorbing to slowest; Intravenously as a liquid, intrarectally as a liquid, intrarectally as a suppository, or orally as a pill. To be effective as a rescue drug, it should be administered intravenously or intrarectally. Common Side Effects
0.23mg - 0.9mg/lb rectally when in Status Epilepticus or after the second seizure in a cluster. |
|
At-Home Rescue Therapy For Cluster Seizures (Dogs)
Veterinary Use Only
The following information is provided as education resources only.
Medications should only be administered under the direction of your Veterinarian. You may use this information to discuss at-home rescue therapy options with your Vet, but never take it upon yourself to administer medication to your pet in any way other than how it was prescribed.
Medications should only be administered under the direction of your Veterinarian. You may use this information to discuss at-home rescue therapy options with your Vet, but never take it upon yourself to administer medication to your pet in any way other than how it was prescribed.
Oral Rescue AED selection & dose recommendation for home treatment of Cluster Seizures in dogs.
Non-intravenous benzodiazepine treatment for at home cluster seizures in dogs.
References:
MedVet: Home Rescue Therapy for Cluster Seizures in Dogs
Accessed: 03/06/2020
Journal of Veterinary Internal Medicine, Vol 9, No 2: The Use of Diazepam Per Rectum at Home for the Acute Management of Cluster Seizures in Dogs
Accessed: 05/11/2020
MedVet: Home Rescue Therapy for Cluster Seizures in Dogs
Accessed: 03/06/2020
Journal of Veterinary Internal Medicine, Vol 9, No 2: The Use of Diazepam Per Rectum at Home for the Acute Management of Cluster Seizures in Dogs
Accessed: 05/11/2020
Life Expectancy
For many pet owners, one of the first questions that come to mind is "how will these seizures affect my pet's life expectancy".
Idiopathic Epilepsy
The diagnosis of epilepsy implies an increased risk of premature death. The prognosis for dogs with epilepsy is dependent on a combination of veterinary expertise, therapeutic success, and the owner's motivation.
Other Causes
Idiopathic Epilepsy
- In general, seizures that are caused by Idiopathic Epilepsy, and are successfully controlled, have little to no affect on life expectancy.
- Pets suffering from Idiopathic Epilepsy with episodes of Status Epilepticus or Cluster Seizures (40%-60% of cases), typically experience a 30% reduction in lifespan. The median age at death is approx. 7.0 years.
- Seizures that are caused by Idiopathic Epilepsy, and are not successfully controlled, can have a devastating affect on life expectancy, with elective humane euthanasia driving down the mean lifespan.
The diagnosis of epilepsy implies an increased risk of premature death. The prognosis for dogs with epilepsy is dependent on a combination of veterinary expertise, therapeutic success, and the owner's motivation.
Other Causes
- Seizures that are caused by toxin exposure generally have no affect on lifespan should the pet avoid repeat exposure to the toxin.
- Seizures caused by other Neurological Disorders have varying affect on lifespan. Efficacy of treatment should influence prognosis.
References:
Journal of Veterinary Internal Medicine: Premature death, risk factors, and life patterns in dogs with epilepsy.
Accessed: 05/12/2020
University of Missouri, Veterinary Health Center: Canine Idiopathic Epilepsy
Accessed: 05/11/2020
Journal of Veterinary Internal Medicine: Premature death, risk factors, and life patterns in dogs with epilepsy.
Accessed: 05/12/2020
University of Missouri, Veterinary Health Center: Canine Idiopathic Epilepsy
Accessed: 05/11/2020
CBD (Cannabidiol)
Colorado State University - Veterinary Teaching School is leading the way with extensive research on CBD and its potential as a treatment for Seizure Control in dogs. Having made substantial findings in previous clinical trials, they are moving forward with a larger Clinical Trial. Enrollment information can be found here: Efficacy of Cannabidiol for the Treatment of Epilepsy in Dogs
"Cannabidiol has recently been making headway for its potential medicinal use. At the present time, there is limited scientific evidence on its efficacy and safety along with its toxicological parameters. In human medicine, it has been documented that the use of CBD oil has increased serum levels of commonly used AEDs. In the dog, we know that cannabis (THC) can have toxic effects. For this reason, there are ongoing studies in dogs with epilepsy at Colorado State University that hope to shed light on future use, efficacy and safety of cannabidiol in the veterinary patient." - MedVet
"Cannabidiol has recently been making headway for its potential medicinal use. At the present time, there is limited scientific evidence on its efficacy and safety along with its toxicological parameters. In human medicine, it has been documented that the use of CBD oil has increased serum levels of commonly used AEDs. In the dog, we know that cannabis (THC) can have toxic effects. For this reason, there are ongoing studies in dogs with epilepsy at Colorado State University that hope to shed light on future use, efficacy and safety of cannabidiol in the veterinary patient." - MedVet
Clinical Trial Results
Randomized blinded controlled clinical trial to assess the effect of oral cannabidiol administration in addition to conventional antiepileptic treatment on seizure frequency in dogs with intractable idiopathic epilepsy.
Randomized blinded controlled clinical trial to assess the effect of oral cannabidiol administration in addition to conventional antiepileptic treatment on seizure frequency in dogs with intractable idiopathic epilepsy.
- Plasma CBD concentrations were correlated with reduction in seizure frequency. Dogs in the CBD group had a significant increase in serum alkaline phosphatase activity. No adverse behavioral effects were reported by owners.
- Given the correlation between plasma CBD concentration and seizure frequency, additional research is warranted to determine whether a higher dosage of CBD would be effective in reducing seizure activity by ≥ 50%.
Seizure Tech
Wearable tech for your pet is a rapidly growing industry, and the spotlight is now on managing epilepsy with collar mounted trackers. The Whistle Activity Monitor is one of these wearable activity trackers with the potential to identify movement patterns associated with seizures.
A newly published study (04/15/2020) indicates the Whistle Activity Monitor can correctly detect seizures. Work is being done to turn that detection into a prediction. Seizure detection / prediction is not currently a feature available on the Whistle. This technology coming from a company as reputable as Whistle is a promising thought for anxious pet owners.
There is currently a wearable monitor on the market that claims to accurately predict seizures in pets, the PetPace Health Monitor. Unfortunately, PetPace has received poor reviews and negative feedback on nearly all it's social media channels. Additionally, the company does not appear to be responding to support tickets, so we can not recommend the PetPace at this time.
Seizure prediction could offer true relief to anxious pet owners, but we recommend waiting for a reliable and highly researched product to be released before making such a large investment.
A newly published study (04/15/2020) indicates the Whistle Activity Monitor can correctly detect seizures. Work is being done to turn that detection into a prediction. Seizure detection / prediction is not currently a feature available on the Whistle. This technology coming from a company as reputable as Whistle is a promising thought for anxious pet owners.
There is currently a wearable monitor on the market that claims to accurately predict seizures in pets, the PetPace Health Monitor. Unfortunately, PetPace has received poor reviews and negative feedback on nearly all it's social media channels. Additionally, the company does not appear to be responding to support tickets, so we can not recommend the PetPace at this time.
Seizure prediction could offer true relief to anxious pet owners, but we recommend waiting for a reliable and highly researched product to be released before making such a large investment.
References:
Journal of Veterinary Internal Medicine: Evaluation of a collar-mounted accelerometer for detecting seizure activity in dogs.
Accessed: 05/12/2020
Journal of Veterinary Internal Medicine: Evaluation of a collar-mounted accelerometer for detecting seizure activity in dogs.
Accessed: 05/12/2020
Quality-of-Life Scale
Score patients using a scale of: 0 to 10 (10 being ideal).
Score |
Criterion |
0-10 |
HURT – Adequate pain control & breathing ability is of top concern. Trouble breathing outweighs all concerns. Is the pet’s pain well managed? Can the pet breathe properly? Is oxygen supplementation necessary? |
0-10 |
HUNGER – Is the pet eating enough? Does hand feeding help? Does the pet need a feeding tube? |
0-10 |
HYDRATION – Is the pet dehydrated? For patients not drinking enough water, use subcutaneous fluids daily or twice daily to supplement fluid intake. |
0-10 |
HYGIENE – The pet should be brushed and cleaned, particularly after eliminations. Avoid pressure sores with soft bedding and keep all wounds clean. |
0-10 |
HAPPINESS – Does the pet express joy and interest? Is the pet responsive to family, toys, etc.? Is the pet depressed, lonely, anxious, bored or afraid? Can the pet’s bed be moved to be close to family activities? |
0-10 |
MOBILITY – Can the pet get up without assistance? Does the pet need human or mechanical help (e.g., a cart)? Does the pet feel like going for a walk? Is the pet having seizures or stumbling? (Some caregivers feel euthanasia is preferable to amputation, but an animal with limited mobility yet still alert, happy and responsive can have a good quality of life as long as caregivers are committed to helping their pet.) |
0-10 |
MORE GOOD DAYS THAN BAD – When bad days outnumber good days, quality of life might be too compromised. When a healthy human-animal bond is no longer possible, the caregiver must be made aware that the end is near. The decision for euthanasia needs to be made if the pet is suffering. If death comes peacefully and painlessly at home, that is okay. |
Total |
A total over 35 points represents acceptable life quality to continue with treatment or pet hospice. |
Source;
Original concept, Oncology Outlook, by Dr. Alice Villalobos, Quality of Life Scale Helps Make Final Call, VPN, 09/2004; scale format created for author’s book, Canine and Feline Geriatric Oncology: Honoring the Human-Animal Bond, Blackwell Publishing, 2007. Revised for the International Veterinary Association of Pain Management (IVAPM) 2011 Palliative Care and Hospice Guidelines. Reprinted with permission from Dr. Alice Villalobos & Wiley-Blackwell.
Original concept, Oncology Outlook, by Dr. Alice Villalobos, Quality of Life Scale Helps Make Final Call, VPN, 09/2004; scale format created for author’s book, Canine and Feline Geriatric Oncology: Honoring the Human-Animal Bond, Blackwell Publishing, 2007. Revised for the International Veterinary Association of Pain Management (IVAPM) 2011 Palliative Care and Hospice Guidelines. Reprinted with permission from Dr. Alice Villalobos & Wiley-Blackwell.