Epilepsy by Frank Utchen, DVM 2008

Dr. Utchen, we think our dog had a seizure. He stumbled and lay down, and his whole body seemed to spasm for about 10 seconds. After that, he lay quietly for about 5 minutes and then got up but seemed disoriented. Can dogs have epilepsy? 

Answer: Yes, epilepsy occurs in dogs just like it does in people. For most dogs that are epileptic the first seizure of their life occurs before they are 3 years old. Seizures are manifest on a whole continuum of behaviors. They can be brief, lasting only a few seconds, and mild, involving no more than a little twitching, sometimes limited to one part of the body (e.g., only the head, or only the hind legs). Conversely, they can be prolonged and violent, involving a full-body convulsion for several minutes. Some dogs even have what are called “clusters” of seizures, where a group of several seizures occurs over a period of a few days, or within one day. 

Is an epileptic seizure harmful by itself? The answer depends on the severity and duration of the seizure. A prolonged seizure (several minutes or more) can result in a rise in body temperature up to a level that is dangerous to the brain. Even without a high body temperature, seizures can cause the excess release of a neurotransmitter in the brain called Glutamate, which allows excess calcium to enter the neurons in the brain and can damage them. However, brief seizures are unlikely to cause any measurable physical damage to the brain. 

Although there are various medical conditions that can cause seizures, a physical examination and blood tests can help a veterinarian determine if the cause is true epilepsy. 

I describe epilepsy to my clients as a condition where the brain periodically begins mis-firing and results in a seizure from time to time. Generally this begins with a single small group of neurons—sort of like a “spark plug”—and spreads to the rest of the brain, resulting in the seizure. Admittedly, while that is a vast oversimplification, that explanation does emphasize the point that with epilepsy, nothing else is wrong with the body, and during the interval of time between seizures (often many months) there is nothing else abnormal with an epileptic dog.  

Usually, a dog with epilepsy who does not take medications to help prevent seizures from occurring will have seizures at a somewhat regular interval—it may be as infrequently as once a year, or as frequently as weekly (although that is not common).

I do not usually recommend a client treat their dog to help prevent seizures if the frequency of seizures is only every 4 to 6 months, unless the seizures are extremely prolonged or occur in clusters.  The fact is that there is no agreed-upon frequency of seizures, above which a dog must be medicated. Even veterinary neurologists differ in their opinions on which epileptic dogs should be medicated. Strange as it may seem, there are dogs that live long, happy lives while having many seizures a year.

The important thing to know is that epilepsy in dogs is more common than most people realize, and generally can be well managed with either of a few different medications. Dogs that are epileptic can lead a full, normal life. 

There are various medications used to control epilepsy in dogs, with the emphasis being on “controlling” the seizures but not necessarily eliminating them. The goal of therapy in treating an epileptic dog is to reduce the frequency, duration, and severity of the seizures. In most cases this can be accomplished with either of two medications.  

Most commonly, Potassium Bromide is the drug that is used. This is a liquid that dogs take once a day, usually by having it squirted on their food.  

Other dogs respond better to Phenobarbital, which is given in tablet form twice a day. Uncommonly, liver damage may happen from taking Phenobarbital, so if your dog is epileptic and takes Phenobarbital, blood tests should be done periodically (usually every 6 to 12 months) to be sure everything is well with the liver. 

Sometimes both drugs are used together, and less commonly used medications, such as Keppra, Gabapentin, Klonopin, Felbatol, and others are occasionally employed. These are all the same medications their human epileptic counterparts take.   

One interesting therapy that is very helpful is acupuncture (yes, acupuncture for dogs!).  I have the good fortune of working with two veterinarians who practice acupuncture and other alternative therapies (alternative, that is, compared to Western medicine), and have seen remarkable results in reducing the frequency of seizures through acupuncture. Perhaps even more surprising is that dogs apparently to enjoy acupuncture, often falling asleep while being treated! 

Lastly, there are reports that seizures can even be one unusual manifestation of a food allergy, so special hypoallergenic diets—ask your veterinarian for their recommendation—may be worth a try. This is controversial. 

Even as this article goes to press, research continues on other potential therapies. For example, in humans it is possible in some instances to identify the particular small part of the brain where the epileptic seizure actually begins—the “spark plug” mentioned earlier. In humans this small spot can sometimes be destroyed, thereby eliminating the cause for seizures in that individual. Although this has not been successfully done in dogs yet, research into this and other therapies is ongoing. 

If your dog has a seizure it is important to react properly. First, do not put your hands near a dog’s mouth when he or she is seizuring. There is no truth to the myth that they can swallow their tongue during a seizure. Second, do your best to move your dog to an area on the floor away from furniture and other objects that he or she could injured by. Third, call your veterinarian and take your dog in at once.  

It is important that your dog’s veterinarian examine your dog because there are various other reasons that a dog could have a seizure (for example, poisoning by ingestion of snail bait or too much chocolate, or low blood sugar, just to mention a few causes). In most cases blood tests are done to help determine the underlying cause for the seizure so that therapy, if indicated, can be instituted immediately. As with many urgent medical conditions, epilepsy requires that you know ahead of time what to do and where to take your pet in an emergency.