Epilepsy in dogs

March 16th, 2008

Epilepsy in dogs can be dangerous and debilitating. Katie Cincotta learns that although there is no cure, treatment is available to manage the condition.

Some describe it as an electrical storm in the brain when millions of nerve cells fire off all at once, causing a body meltdown known as a seizure. Those sudden fits can vary from mild periods of unresponsiveness, known as petit mal seizures, to the most severe tonic clonic or gran mal seizures that produce loss of consciousness, body stiffness and rhythmic jerking of the muscles.

Dr Georgina Child, a specialist neurology vet from the Veterinary Specialists Centre in Ryde, NSW, said up to 5 per cent of dogs suffer with epilepsy, with breed predisposition for Beagles, German Shepherds, Cocker Spaniels, Irish Wolfhounds, Labradors, Boxers, Border Collies and Alaskan Malamutes. She said very few dog breeds have avoided epilepsy, including mixed breeds.

The most common form of epilepsy has been variously called primary, idiopathic, genetic or inherited epilepsy, and it is, in most cases, a genetic abnormality. Most of those dogs will have their first seizure before three years of age, Child told Dogs Life.

Child explained that apart from genetic causes, animals could also develop epilepsy through head injury. Human boxers and football players are a good example of that; its called acquired epilepsy. There’s nothing you can do to prevent that form of the disease, but for genetic epilepsy, responsible breeding is the key. All epileptic dogs should be spayed, she said.

Epilepsy can be dangerous

In both humans and dogs, epilepsy is the same neurological brain condition, which can be debilitating and dangerous without proper diagnosis and management.

Child warned that dogs suffering seizures face the danger of misadventure, such as falling into a pool and drowning, or getting wedged under furniture and suffocating.

Lisa Todd, Epilepsy Actions policy and advocacy manager, said that knowing first aid for epilepsy is vital, and that the same rules apply for humans and dogs.

With first aid, you need to protect the dog, especially its head, from injury. If its on cement and its head is jerking, put cloth under it, or even a handbag or jumper. If its under a table near chairs, move the furniture away. Do not ever put anything in its mouth or try to hold it down, Todd said. Once the fit is over, the dog will be groggy and unsteady on its feet. Just watch the dog and make sure its okay. Seizures use up a lot of energy, like having a massive workout at the gym, so the muscles can be very sore.

Vets say recurrent seizures or prolonged seizures that last more than a few minutes pose the risk of death, caused by the overheating of the internal organs or the inability to breathe.

If the animal doesn’t stop its seizure within a few minutes, or has repeated seizures in a short period of time, that becomes a medical emergency. That’s the time to put the dog in the car and take it to the vet, Child warns.

Treating epilepsy

While there’s no known cure for epilepsy, drugs can help control the frequency and severity of seizures. For dogs, the two most commonly used drugs are phenobarbitone or potassium bromide, Child said.

The problem is, those barbiturates can cause sedation, increased appetite and potential liver damage. The difficult decision facing many owners is whether to continue with a high dosage of medication and its side effects to have fewer seizures, or to reduce a dogs medication but suffer more attacks.

Specialist veterinary surgeon Dr Charles Kuntz of Melbourne’s Southern Animal Referral Centre has paved the way for a surgical solution to the most severe forms of canine epilepsy.

American-trained Kuntz has performed eight brain-splitting operations known as the corpus callosotomy, a surgery that severs the connection between the left and right brain. The radical procedure is designed to localise the abnormal electrical activity in the brain in order to stop or lessen seizures.

Because the technique is still new, patients are being charged half the normal $5,000-$6,000 bill, with surgery and peri-operative care totalling around $2,500.

For dogs enduring up to 10 seizures a day, even on medication, Kuntz said the chance for a better quality of life led owners to consider the last-resort surgery, despite its risks. All the owners were right on the verge of euthanasia. Most of the dogs were having up to nine seizures a day, and a lot came in on such a high level of medication they were in a stupor, Kuntz said.

Brain-splitting surgery

While previous brain-splitting surgery performed on normal dogs more than a decade ago held risks of brain damage due to the need for retraction, Kuntz’s new, less-invasive technique uses a small camera inserted through the top of the skull.

I started doing it on cadaver dogs, then perfected the procedure and began performing the surgery on live dogs about 18 months ago. We’ve done eight dogs since. The last six have been neurologically back to normal within 24 to 72 hours, he said.

Of the eight epileptic dogs that have received Kuntz’s brain-splitting surgery, one was euthanased due to neurological deficits resulting from the surgery, four experienced a reduction in seizures but their owners ultimately decided on euthanasia due to continued poor quality of life, and another three dogs have had dramatic success stories.

Kuntz’s furry patients, Poppy the Fox Terrier, PJ the Labrador and Furgus the Staffy, have had their medication reduced by at least half and have gone from suffering nine seizures a day to a total of between four and five in the last year.

A new life for Poppy

Poppy’s owner, Gail Taylor, told Dogs Life that Kuntz’s surgery was life changing. Poppy’s medication was increased to the point where she was a zombie. She had no personality or energy. She was sleeping all day. She had no quality of life, Taylor said.

On the four-hour drive to Melbourne for her surgery, Poppy suffered four seizures in the car. They would last for minutes. They were very violent and frightening, with lots of frothing at the mouth, she said.

Although the Taylors were warned that the post-op would be unpredictable, they said nothing fully prepared them for the challenge of Poppy’s recovery. She was like a village idiot; she didn’t even know how to eat properly. We had to put mattresses in the dining room because she was walking around and trying to walk through walls, Taylor said.

But after several weeks of tending to Poppy like a newborn, things improved. All of a sudden, she remembered her toilet training and the swelling on the brain went down, Taylor said. And since the surgery in May 2006, she has only had six seizures. Even with the gran mal seizures, she has come out of them better. It used to take her 24 hours to come back to normal.

The Taylors said the brain surgery has made a massive difference to Poppy’s life. Her medication has halved. Shes doing so well. If we hadn’t gone through with it, she would’ve been dead by now, Taylor said.

To his knowledge, Kuntz is the only vet in the world performing brain surgery for dog epilepsy using the keyhole camera. I often challenge myself to think of new solutions, so its very rewarding when things go well like that, he told Dogs Life.

Dogs that detect seizures

Another fascinating facet of the epilepsy story is that some dogs can detect the onset of seizures in humans. Epilepsy Actions Todd said its still a mystery how they do it. Scent, body language and human/animal bonding are all possible explanations.

Researchers really don’t know how dogs can detect the onset of a seizure. They think dogs are picking up on changes in behaviour. The last research paper I read said there had to be good bonding between the dog and the owner, Todd said.

She said some pets naturally alert for seizures, even up to 20 minutes before an episode, with dogs now being trained for this work through Assistance Dogs Australia. Some dogs will lick the hand or tap with the paw. And some will not only alert, but guard the owner as well, Todd said.

Alison Brennan, who has suffered epilepsy since she was 15, has a trained seizure-alert dog, a golden Labrador called Adonis. He usually gives her 15 minutes warning before she has a seizure, which gives her time to go to the toilet and find a safe place to lie down. Adonis has a strike rate of almost 100 per cent.

Hes only ever missed one, and that was the day he got back from being desexed and was still getting over the anaesthetic, Brennan told Dogs Life.

But, like scientists, even Brennan is baffled by how Adonis can predict a seizure. I have no idea how he does it. I don’t think its body language, because sometimes hes outside in the backyard playing with another dog and hell come running in, she said.

With her husband often posted overseas for the army, Adonis has given Brennan the independence she needs to live on her own.

When Adonis was seven months old, Brennan suffered a clot on the brain that could have proved fatal with another seizure. While on the waiting list for surgery, and with her husband serving in Iraq, Adonis proved he had brains as well as brawn.

I went out the front door to get something to eat and Adonis started pulling at the keys, recalled Brennan. I thought he was playing, so I ignored that. But then he went to the bottom of the stairs and growled at me, which hed never done before. I went back upstairs and lay on the couch. He kept alerting me, so I called an ambulance. By the time they turned up I was already unconscious. While they were checking my vital signs, Adonis brought over his Assistance Dogs jacket, the house keys and a backpack to go to the hospital. When the paramedics opened the bag, they saw it was full of dog toys and dog food it was his bag, not mine!

Adonis saved his owners life. Brennan said the other amazing aspect of having Adonis is that she is less stressed in his presence, which gives her fewer seizures. Since I got Adonis, my seizures have reduced dramatically because the stress is reduced. Now I don’t take my medication any more and I can go a week or two without a seizure, she said.

Doctors warned her against stopping medication, but Brennan had a simple retort. Ive got the best medication I can get, and that’s Adonis.

For more information

For more information on dogs that detect epilepsy and first aid, contact Epilepsy Action on 1300 EPILEPSY (37 45 37) or visit www.epilepsy.org.au

For more about assistance dogs, contact Assistance Dogs Australia on 1800 688 364 or visit www.assistancedogs.org.au

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