EPILEPSY IN DOGS
Epilepsy /fits / seizures in dogs is the most troublesome experience
a dog owner and his pet can have.
EPILEPSY is defined as a neurological disorder characterized by sudden,
recurring attacks of muscular, sensory, or psychic malfunction with
or without loss of consciousness or convulsive seizures.
Epilepsy refers to repeated seizure. Seizure may occur as a one time
event in a lifetime but if it repeats over a period for number of times
,it is termed as epilepsy.
Seizure is involuntary contraction of muscles, which can result from
abnormal electrical activity in brain,brought on by tumors, clots, scar
tissue or chemical imbalances such as low blood sugar or nerve stimulating
drugs
Grandmal seizurs refers to severe, widespread cramping of the body's
skeletal muscles. Skeletal muscles in general are those that attach
to bones and allow for body movement; there are special smooth muscles
that don't attach to bone that usually are unaffected during a seizure.
These smooth muscles reside mainly in the intestinal tract, blood vessels
and specialized organ tissues. The heart muscle is actually different
from either skeletal muscle or smooth muscle. Grand mal seizures are
rather shocking to see.
Petitmal seizure is a less severe form of seizure where the patient
still has some voluntary control of movement and coordination but where
certain muscle groups are "doing their own thing" and brain
electrical activity is mildly disrupted. Staggering, momentary "staring
into space" and other forms of incoordination may be visible to
an observer.
Convulsion refers to a grand mal seizure. Sometimes these terms are
loosely applied to an epileptic episode. We might say a patient is having
an "epileptic attack", or "is having a seizure"
or maybe even a "fit". However we describe it, the occasion
will be uncomfortable for the observer and the victim.
Status epilepticus refers to a very dangerous situation where a rapid
successions of grand mal seizures occur without periods of rest or muscle
relaxation between epileptic episodes. Status epilepticus requires prompt
medical intervention.
Seizure are the sign of brain disease in same way the cough is of lungs.
Damage to the brain can be due to many causes like stroke or tumor but
if the cause is not identified it is called idiopathic. Many of the
idiopathic epilepsy is inherited one due mutated gene. Epilepsy is probably
is the most common neurological disease in dogs but it is difficult
to say how common it is. It is believed that around 4% of the dogs suffer
from epilepsy and in some breed it is more common to the extend of 14%.
If your dog is having seizure contacting veterinarian is the only thing
the owner can do as treatment and management is prolonged and is executed
in regular vigilant manner. Your veterinarian is the best source of
advice as he is having the knowledge based on the scientific studies
and his personnel experience (based on past experiences for the management
of the cases). Be an intelligent owner ,ask questions and educate yourself
as nursing and management is to be done by the owner itself by the advice
of vet. Remember internet is not the valid source of advice as anyone
can post anything over it. Share what you learn with your veterinarian.
Diagnosis
During diagnosis the vet will pay close attention to the heart and neurological
signs .The vet will also take blood and urine sample to check the metabolic
imbalances.
Blood sample - It is an important tool to determine the chemical imbalances
if they are the root cause of the epilepsy. Among the recommended test
are CBC, urinalysis, BUN, ALT, ALP, calcium, fasting blood glucose level,
serum glucose level, serum lead level, fecal parasite or ova examination,
and others if indicated. When the results of the examinations and tests
have been analyzed, one of three conclusions will be drawn: a definitive
diagnosis, a potential cause of seizures requiring further tests to
confirm, or no suggestion of a cause. Liver has many important task
to complete and if there is some problem with it ,it may have indirect
impact on the nervous system and the seizure may result .Blood sugar
concentration has to be regulated with in limits otherwise there may
be neurological difficulties. Sodium ,potassium ,phosphorus ,calcium
are to be examined as there presence in blood is interrelated to each
other for the normal functioning of the nervous system.
Urine sample - diabetic dogs may present neurological seizures so urine
sugar is important. Ketones in urine may reveals excessive utilization
of proteins rather than carbohydrates. Any abnormality in urine may
suggestive of the need to go for further diagnosis to establish the
cause of the seizures.
Xrays ,CT scan ,MRI can also be done to establish the root cause.
Treatment
Epileptic fits can be controlled but rarely cured in most of the instances.
Underlying triggering mechanism if identified can be rectified and cured.
In many cases the drug is to be given regularly to control the fit and
for the long term .When many a times when the fits stops for a long
term the Medicines can be withdrawn slowly. Eventually the dog never
experience any fit in further life span ( it is to be remembered
not to stop medicine at once or to be changed all of sudden ,otherwise
there follows a more severe fits )
Phenobarbital - It is the most common drug
your vet want to prescribe at the dose rate of 1-2 mg/kg of body wt.
for 2-3 times a day orally (initial dose may be increased).
Phenytoin - Initially @ 8-22 mg/kg B wt followed
by 6.5- 11mg daily orally .
Primidone - 8-50 mg/kg B wt daily in divided doses orally.
Diazepam - 5-35 mg total dose slow iv only.
The mentioned drugs are the commonest one used in canine
patient . In human there are more drugs available but there use in canine
is limited due to species difference and toxicity level. The drugs are
also not without side effects so continues monitoring by your vet is
necessary.
Your vet may also want to correct anemia (if present )and may also prescribe
vitamin B complex ,E and C.
Dietry modifications are also done sometime to eliminate the seizures
due to some ( if present ) allergens in food.
TREATMENT AT HOME
Rectal administration of diazepam inject able solution available with
chemists as calmpose injection, is a very good treatment a dog owner
can do by himself at home. The treatment is recommended for the dogs
who were experiencing multiple seizures with in 24 hrs while they were
on the antiepileptic drugs. The treatment is not recommended for the
dog who are experiencing occasional single isolated seizures.Absorbtion
of the diazepam via rectal route is very good and safe . Giving the
drug via oral or intramuscular route may give variable or no results
and there is always difficulty and danger via these route to the patient
experiencing seizures. Diazepam can be given at the dose rate of 1-2mg/kg
via a syringe attached with a teat canula or similar device gently inserted
in the rectum around 2cm or one inch of the patient via anus and released
by pushing the syringe plunger .The same dose can be given thrice a
day.Diazepam suppositories are also available now for the humans (Diastat)but
are costly and not available every where.
.
Some important points
A pet with epilepsy is started with medicines to control the seizures
is not to be discontinued all of sudden and not to be changed as lot
of the medicines for the management of epilepsy are there and no medicine
is better then other .
If you pet is having seizures for more than 5-10 min and
3 seizures a day seek veterinarian advice immediately
Visit your veterinarian for further management at least
thrice a year.
Be skeptical of exorbitant claims of treatment.
Remember to live with epilepsy not for epilepsy. Enjoy
your life and your pets good days as he is having more good days than
bad days when living with epilepsy.
BY -Dr S.P.Singh