What is Epilepsy?
Epilepsy is a chronic medical condition produced by temporary changes in the electrical function of the brain, causing recurrent seizures which affect awareness, movement, or sensation. “Recurrent” is a key word because a dog who has an isolated seizure does not have epilepsy. Also note that epilepsy is not a disease but rather a neurological disorder that affects the brain and shows itself in the form of seizures.
Will my dog die from it?
Dogs rarely die from a single seizure or even a couple of seizures of normal duration of one to five minutes. However, when a dog has one long seizure or several seizures in rapid succession, it is a life threatening situation that needs immediate medical attention.
In a study on the effects of status epilepticus and a dog’s life span, researchers found that dogs with epilepsy who had never had an episode of status epilepticus, lived to their normal life expectancy. Dogs who had been in status had only a slight reduction in expected life span.
How is it treated?
There are two medications that are most often prescribed to treat epilepsy, Phenobarbital and potassium bromide. These two drugs used either alone or in combination with each other control seizures in 80 to 95% of all dogs. For dogs who are not controlled with these two drugs, there are other medications that aren’t as consistently helpful but may be the perfect medication for an individual dog.
What are the side effects of medications?
Phenobarbital and potassium bromide both have the same potential side effects of excessive hunger, excessive thirst, excessive urination, sedation and ataxia (hind end weakness). Not all dogs will have all of these side effects and most of the side effects will subside or disappear as a dog becomes adjusted to the medication. Phenobarbital and potassium bromide also have more serious potential side effects that are seen in a very small percentage of dogs. Phenobarbital may cause some changes in liver function and these may be serious. The small risk of liver failure can be reduced by frequent monitoring of liver function through chemistry panels and bile acid tests. Potassium bromide may cause a condition called megaesophagus when blood serum is maintained at high levels. This condition is reversible and will resolve when bromide levels are reduced. There is also growing evidence that potassium bromide may contribute to pancreatitis. For this reason, if your dog is on bromide and begins vomiting aggressive diagnostics and treatment for pancreatitis should be considered.
Will medication keep my dog from ever having another seizure?
The goal of medicating is to reduce the frequency and severity of seizures. Some dogs never have another seizure, however, most dogs with epilepsy will have occasional seizures despite medication. An occasional seizure will not affect your dog’s quality of life. As a general rule, if seizures are more than 30 days apart, it’s considered good control.
My dog is on medication and still has frequent seizures. What can I do?
If your dog has just started on medication, be patient. It frequently takes several adjustments in medications before the right dose and combination of medications are found. If your vet has tried both Phenobarbital and bromide and your dog still doesn’t have good control, you should consider asking your vet for a referral to a veterinary neurologist who may try other second and third line medications.
Do seizures get worse over time?
Left untreated seizures may get worse over time. Studies have shown that early treatment of seizures results in better long term control of seizures. With early treatment, seizures should become less frequent and less severe.
Will seizures cause permanent brain damage?
In general, seizures do not cause permanent brain damage. The brain has an amazing amount of unused capacity and even if cells are damaged during a seizure, your dog should have the ability to relearn. If your dog has had a cluster of severe seizures you may notice some changes in their behavior, but these should be temporary. Most dogs fully recover from seizures in a few days but for some it may take a few weeks.