Often there is no apparent reason why your dog should have developed epilepsy. In some breeds of dog, most notably the German Shepherd, epilepsy is inherited and is most often seen in males. Sometimes epilepsy is the result of minor damage to the brain caused by a blow to the head or as a result of oxygen starvation during a difficult birth. Usually the seizures start many years after the damage had occurred, so it is not easy to make a connection between the two events.
It is usually not possible to remove the cause of the seizures so your vet will use medication to control the seizures. It is important to realise that this treatment will not cure the disease but merely manage the signs – even a well-controlled epileptic will have occasional seizures. Treatment for epilepsy is decided on an individual basis and it may take some time to find the best combination and dose of drugs for your pet. You must have patience when managing an epileptic pet.
If your dog has only had one seizure your vet may advise that you monitor it at home before starting any treatment. The drugs used to treat epilepsy often do not stop the seizures altogether, but will make them less frequent. Therefore, it is important to know how often the seizures occur without treatment to be sure that the treatment is having a positive effect. Once your dog starts on treatment it is likely that this will have to be continued for the rest of his life. Treatment must be given regularly and at roughly the same time every day. If you stop the drugs suddenly it may cause your dog to seizure. It often takes a few months to get the dose of drug just right for your dog. During this time, your vet will keep in regular contact with you and may need to take a number of blood samples from your dog to check that the blood levels of the drug are not too high or too low.
It is rare for epileptic dogs to stop having seizures altogether. Drugs may control the seizures so that they do not affect your dog’s lifestyle but, in most cases, if you stopped treatment the seizures would come back. However, provided your dog is checked regularly by your vet to make sure that the drugs are not causing any side-effects, there is a good chance that your dog will live a full and happy life.
Most dogs with epilepsy can be controlled by drugs which are given every day by mouth. When your dog starts on treatment your vet will probably check them regularly over the first few weeks to monitor the frequency of their seizures and any side-effects of treatment. Once things have settled down check-ups will probably be scheduled around twice a year. Your vet may want to take blood tests at this appointment so don’t feed your dog before the appointment. Check with your vet whether they would like to see your dog before or after they have received their medication for the day.
Your vet may ask you to record a diary detailing all the seizures your pet has had. Keep this record up-to-date and take it with you every time you visit your vet.
There are many drugs used in the control of epilepsy in people but very few of these are suitable for long-term use in the dog. Many epileptic dogs require a combination of one or more types of drug to achieve most effective control of their seizures.
Phenobarbital is sold under the name Epiphen. Another anticonvulsant, primidone, is broken down in the body to make phenobarbital.
Phenobarbital is the most commonly used drug for prevention of seizures. It is effective in most dogs when given twice daily – but it is important to remember to give the drug regularly because blood levels of the drug can drop quite quickly if a dose is missed and this may trigger seizures.
Phenobarbital is usually given as tablets but a liquid form is also available. The tablets come in a range of sizes, making it easy to give the correct dose to a tiny dog as well as a giant one! The drug is broken down in the liver and so with long-term use it may have some effects on the liver. If your dog is prescribed phenobarbital your vet will want to take regular blood tests to check that there is no damage to your dog’s liver.
It is very important when using phenobarbital that the blood levels of the drug are kept at an appropriate level. If levels get too high the drug can have more severe toxic effects, and if they are too low there may be no beneficial effect from the drug. There is a blood test to measure levels of phenobarbital in the blood and if your vet has prescribed phenobarbital for your dog he will want to monitor blood samples. These tests may be done several times in the early weeks of treatment to help determine the correct dose of drug for your dog, and then on a less frequent basis to monitor long-term effects.
All drugs have side-effects and phenobarbital is no exception. Usually these are relatively mild and may wear off once your dog gets used to the drug. Drowsiness, increased appetite and thirst are common. Most vets will use phenobarbital in all dogs with epilepsy unless there is a reason not to do so. Dogs with liver disease may have problems with the drug and so alternative treatment may be better in these cases. For some dogs phenobarbital alone is not enough to control seizures sufficiently and a second drug may need to be added to their regime.
Bromide is one of the oldest anticonvulsants in human medicine (although it is not commonly used in people anymore). Bromide remains in the body for a long time and only needs to be given once daily. It is removed from the body through the kidneys and so is suitable for use in dogs with liver disease, but must be used with care in animals with kidney disease.
Bromide is usually given as a liquid with food. Giving it with food helps the dog to absorb the drug and if given on an empty stomach bromide can cause nausea. If your dog is receiving bromide keep their food constant as fluctuations in the salt levels of the diet can affect the levels of the drug. Side effects of bromide are rare although occasionally drowsiness and increased appetite may occur. Skin reactions are seen in some people and have been occasionally reported in dogs.
Bromide is often used at the same time as phenobarbital particularly in dogs who tend to have groups of seizures (cluster seizures).
Diazepam is very effective at stopping seizures but unfortunately it is quickly removed from the body and dogs become tolerant of its effects if it is given regularly. It is mainly used to stop a seizure while it is occurring. Diazepam can be given by injection but is also effective if given per rectum (as a suppository). Your vet may give you a supply of diazepam to use as a suppository if your dog has a prolonged seizure.
New treatments are being developed for epilepsy but it takes a long time for these to come through the development process and be licensed for use. Other drugs used in humans are sometimes prescribed for dogs whose epilepsy cannot be controlled by the standard medications. These drugs are generally used as a ‘last resort’ and you may need to be referred to a neurology specialist to get them.
Once your dog has started on medication for his epilepsy there are a number of very important golden rules:
1. Give medication regularly
It is important that medication is given at the same time each day. Once your dog has been on treatment for a while he will become dependent on the levels of drug in his blood at all times to control seizures. If you miss a dose of treatment, blood levels can drop and this may be enough to trigger a seizure. Once a dog has started on treatment it is usually continued for the rest of their life. However, if for any reason your vet asks you to reduce the dose of medication this must be done gradually.
2. Never change anything without contacting your vet
Never adjust the dose of medication or stop treatment without asking your vet. Increasing the dose of medication without careful monitoring can cause severe side-effects and reducing the dose may trigger seizures. Some other drugs can affect the way that the anticonvulsants work (and the anticonvulsants in your dog’s system may affect the action of other drugs) so always check with your vet before giving any additional medication to your pet.
3. Keep records
Each epileptic is an individual and a treatment plan will be designed specifically for them – this will be based on the severity and frequency of their seizures and how they respond to different medications. Keep a record of events in your dog’s life, note down dates and times of seizures and record when you have given medication. Each time you visit your vet take this diary along with you so your vet can see how your pet has been since their last check-up. If seizures are becoming more frequent it may be necessary to change their medication.
It is unlikely that an epileptic dog will ever be ‘cured’ and most will continue to have some seizures. However by careful use of medication the frequency of seizures can usually be reduced so that your dog is able to lead a happy and healthy life. Your dog will not be worrying about when their next seizure is going to strike he will be enjoying one day at a time, and as long as the good times outweigh the bad you can feel happy to do the same.
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