Treatment Of Dogs That Have Seizures
To decide on the best treatment for your dog, the vet needs to try to establish the cause of a seizure. Give your vet as much information as possible.
Examples of things to note include the following:
- Is there anything that you can think of that might explain the seizure?
- Has your dog had any head trauma?
- Could the dog have eaten anything that would poison them?
- Severe stress?
- Any other health problems such as diabetes?
- What symptoms did the dog have before the seizure?
- Any drooling or twitching muscles?
- Restless or anxious?
- What exactly happened when your dog had the seizure?
- Was only one side of the body affected, or was one side more affected than the other?
- How long was the seizure?
- What symptoms did your dog have during the seizure?
- Did they fall over?
- Did they remain standing and seem to stare?
- If your dog has had more than one seizure, is there are pattern as to when they have occurred?
If the seizure was a consequence of poisoning, heat stroke, too low blood sugar (hypoglycemia) in a diabetic dog, or other discrete cause, then the treatment will obviously be for whatever the primary cause of the seizure was.
If the seizure is due to head injury, or brain tumor, abscess or scar tissue, your vet will assess what can be done for your dogs particular head problem.
If the seizure is due to encephalitis (swollen brain), the source of the encephalitis will determine the course of treatment. Infections will be treated appropriate antibiotics. Steroids are usually given to reduce the swelling. Generally, a vet will also give a dog seizure medication, while the swelling is present.
Seizure medications do not cure seizures; they will just help control them.
Most vets will generally have guidelines, about the frequency and severity of the seizures, to help them determine whether to give a dog seizure medication.
Since seizure medications have side effects, if the seizures are idiopathic (cause unknown) and infrequent, most vets will not give any medication.
The level of control of seizures will depend on the medication and the dog. The aim is to reduce the severity of seizures and increase the period of time between seizures.
Since dogs can be variable in their response to both dosage and the different drugs, it may be necessary to try different regimes to see what works best for your dog. Depending on your dogs response your vet may increase or decrease dosages, combine drugs, or change drugs.
For some medications, such as phenobarbital, after starting medication and at intervals thereafter, blood tests will be done to determine the level of the drug in your dog’s serum.
It is important that medication be given according to the schedule determined by the vet.
Missing a dose can cause seizures.
NEVER change the dose or stop seizure medication without consulting your vet.
Your vet will test serum levels after several days and adjust the dose as necessary. Serum levels will then be tested periodically thereafter. Like all drugs phenobarbital have a “therapeutic window”. Too low levels will not be effective, and too high levels will result in toxicity. Testing will make sure that your dog is within the therapeutic window.
Initially, when a dog is first given phenobarbital they can be quite sleepy, and may even act as if they are drunk. Usually after a week or two the dog starts to build up a tolerance to the sedative effects of phenobarbital and is not so sleepy. Particularly in senior dogs that have arthritis, hip dysplasia or other joint problems, along with sedation there may be increased balance and mobility problems.
Phenobarbital will often increase both thirst and appetite. It is important to make sure that your dog does not gain weight. Unlike the sleepy/drunk symptoms the increased appetite generally does not go away with time.
Liver function should be monitored periodically by your vet.
If phenobarbital does not control seizures very well, another drug may be added. Recently, the choice of second drug is often potassium bromide. A number of drugs, listed below, can also be given with phenobarbital.
This treatment is becoming more popular; both as a single treatment, or in addition to phenobarbital, when phenobarbital is not giving sufficient seizure control. Also if a dog is taking high levels of phenobarbital, adding potassium bromide will allow a reduction in the phenobarbital dose.
Potassium bromide is usually given once per day. It takes longer to build up to therapeutic levels than phenobarbital.
The side effects can be similar to phenobarbital. Lethargy and sometimes balance problems, and acting as if drunk are common when first starting potassium bromide. Like phenobarbital there is usually an increased appetite.
The serum levels should be tested
The amount of salt (sodium) in the diet should not vary greatly. Avoid giving your dog high salt table scraps.
Other drugs that may be used for seizures in dogs include valium, clorazepate, zonisamide, gabapentin, levetiracetam, felbamate and primadone.
Valium is usually only used in emergency situations (IV or suppository) such as Status Epilepticus, when a seizure event lasts longer than 5 minutes.
Clorazepate is usually given to supplement phenobarbital. It can cause drowsiness and make the dog unstable when standing. Blood levels should be checked periodically, since there is variability in dogs as to how much they absorb. Clorazepate has a similar structure to valium and can be given used in seizure emergencies (not by mouth).
Though often used as a supplement to phenobarbital, it can be used alone. There are few reported side effects for this drug.
Can be used in addition to phenobarbital or potassium bromide. Few side effects. Not clear how effective it is in dogs.
Can be used to supplement phenobarbital or potassium bromide. Most dogs do have any major side effects, but some may vomit, salivate or have a wobbly gait.
Usually given to allow lowering the dose of phenobarbital. Since it does not cause drowsiness, may be given if a dog is permanently drowsy from phenobarbital. Blood should be drawn periodically to check for toxicity.
Another drug is primadone, which is mostly converted to phenobarbital by the liver, and therefore acts and has the same side effects as phenobarbital.
Valproic acid is less effective in dogs than in humans, since it is metabolized very rapidly in dogs. It is sometimes given when other drugs are not being very effective, to supplement them. It can cause hair loss, drowsiness and vomiting. Liver function should be checked periodically.
In dogs phenytoin is rarely used. It needs to be administered every eight hours making it unfeasible for most dogs.
Again, this drug is metabolized quickly by dogs, making its use generally impractical.
If your dog has a seizure, and has not had a seizure before, get your dog to a vet to make sure that the seizure is not a symptom of another problem such as poisoning or brain tumor. Treatment will be then be primarily concerned with treating the main problem.
If your dog has idiopathic (cause unknown) seizures infrequently, usually they will not be given seizure medication.
If a dog has seizures frequently, then your vet will start medication and periodically monitor your dog. Currently the two most common seizure medications are phenobarbital and potassium bromide.