What is Idiopathic Epilepsy?
Also known as primary epilepsy, idiopathic (or spontaneous) epilepsy (IE) is diagnosed in about five percent of dogs. IE is defined as reoccurring seizures with no identifiable structural cause. IE seizures typically occur between six months and six years of age; however, dogs outside this age range are more likely to have an underlying cause for their seizures, which is referred to as secondary epilepsy. In cats, the occurrence of IE is low (less than half a percent), and the onset of seizures typically happens between one and eight years of age.
How to Identify the Signs
Some events, such as twitching or movement while dreaming, are falsely thought to be seizures. It’s important to identify certain behavioral changes such as nausea, attention-seeking, difficulty seeing, or hiding, which may occur just before or after a seizure. It is not uncommon for animals to become unconscious and unresponsive to sounds or visual cues during a seizure. They may also make a paddling motion with their legs, urinate, and/or defecate during the seizure. Of note, a dog or cat with IE may be completely normal in between episodes. If multiple seizures occur in one day, or a seizure lasts longer than five minutes, it should be considered a medical emergency and a trained veterinary specialist should be contacted.
If you are unsure if your pet had a seizure, video investigation by a veterinarian is sometimes helpful in identifying and treating your animal. A more definitive test is an electroencephalogram (EEG). Performed by a veterinary neurologist, an EEG involves placing electrodes on the head of the animal to monitor for abnormal brain activity.
During a diagnosis of IE, a veterinary specialist will consider the animal’s age, and conduct normal physical and neurological examinations along with standard blood work. A complete blood count (CBC), full chemistry panel with electrolytes, bile acid profile, and urine test (urinalysis) are recommended.
If results are inconclusive, more definitive testing such as an MRI of the brain or a collection of spinal fluid may be necessary. Abnormalities in either test suggest there is an underlying disorder affecting the nervous system, which may be causing the seizure.
How to Treat IE
While there is no cure to rid IE completely, there are anticonvulsant medications to help decrease the frequency and severity of your pet’s seizures. It may take several trials to find a medication that works for your pet, but once found, it may significantly reduce the frequency of seizures. If your dog or cat has had two or more seizures within an eight-week period or seizures lasting longer than five minutes, medication is probably required.
A wide variety of medications are used to control seizures; the most common being phenobarbital, potassium bromide (KBr), zonisamide, and levetiracetam. Please note, with each medication, there are side effects, and these should be discussed with the veterinarian overseeing your animal’s treatment.
More than eighty percent of dogs will require at least one of these medications in order to have a significant reduction in their seizure activity, while others may require several. Of note, even with the appropriate medication, some may still experience seizures.
Proper monitoring of anticonvulsant medication is very important when managing an animal with epilepsy. This allows the veterinarian to make changes to dosing in order to help maximize seizure control and minimize side effects. A lack of adequate monitoring is the most common reason for treatment failure in epileptic dogs.
How to Care for a Cat or Dog with IE
The severity and frequency of a seizure can greatly impact the quality of life for an animal. If seizures continue to occur regularly despite appropriate medications, brain damage or death from ongoing seizure activity may occur.
If you have concerns about your dog or cat and need to locate a board-certified internal medicine veterinarian such as a neurologist, use the VetSpecialists.com search tool on the website’s homepage. The tool allows you to search for a veterinary specialist, select the type of animal based on your location by zip code or city name. Contact the hospital of your choice to discuss your pet’s symptoms, and to review whether there is a need for a referral from your primary care veterinarian.