Yesterday, I explained the basic causes and symptoms of idiopathic seizures in pets, otherwise known as epilepsy. Today I am going to talk more about how your vet diagnoses the disorder, and some options for treating it.
It is important to get your pet to the vet as soon as possible following a seizure. Your vet will take a full history and perform blood work to rule out metabolic reasons for the seizures. In young to middle aged pets, a diagnosis of epilepsy is made by excluding other underlying conditions, so further testing is at the discretion of the attending veterinarian.
Treating epilepsy doesn’t mean curing it; the best we can do for patients with epilepsy is to suppress seizures that are occurring too frequently. This means that treatment will probably not be started right away. Typically, we would want to limit seizures to not more than once every three or four months. If seizures occur more frequently than that, medications will likely be started to suppress them. Patients with cluster seizures (or seizures that occur one on top of another) should also be started on medications, as should patients with seizures lasting longer than five minutes.
Phenobarbital is a long-acting barbiturate that has been used to suppress seizures for many, many years. It is an inexpensive medication, but requires blood tests to monitor its effects on the liver and drug levels in the blood, which can quickly add to the cost (something to be aware of if you do not have pet insurance). Common side effects are sedation (which is generally temporary), increased water intake, and increased hunger. Most pets respond well to phenobarbital, though some also benefit from the addition of potassium bromide.
While there are many anti-seizure drugs for humans, they don’t always translate well to the veterinary world, either because of their cost or their inconvenient dosing schedule (or both!). However, if your pet is not responding well to phenobarbital, other medications can be tried. Communicate regularly with your vet and note any behavior changes or adverse reactions to help him or her determine whether alternative medications need to be considered.
If your middle aged pet is having seizures, epilepsy is very likely to blame. It will help to keep a diary of seizure activities to get a bigger picture of how your pet is affected by epilepsy. You and your veterinarian can develop a treatment plan that is appropriate for your individual family.