Epilepsy in dogs

What happens during an epileptic seizure?

An epileptic seizure occurs when a large number of nerve cells in the brain suddenly discharge electrical energy in an excessive and uncontrolled manner. Normally, nerve cells work together in an orderly fashion, exchanging electrical signals in a precisely coordinated rhythm. During a seizure, however, these signals become "out of sync." This results in convulsions, muscle twitching, disorientation, and even loss of consciousness.

Status epilepticus occurs when a seizure lasts longer than five minutes or when several seizures occur in quick succession, preventing the dog from fully recovering between them. This is a life-threatening emergency.
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If several seizures occur within 24 hours, this is referred to as cluster seizures (serial seizures), which also require urgent treatment.

Causes

There are many causes of epileptic seizures. Seizures can be caused by structural changes in the brain, such as tumors, inflammation, bleeding, infarcts, or the effects of trauma. Poisoning or metabolic disorders—such as liver disease, hypoglycemia, or kidney failure—can also disrupt the delicate balance of nerve cells and trigger seizures.

If all these possible causes are ruled out by means of examinations, imaging, and laboratory tests, the condition is referred to as idiopathic epilepsy. In this case, no physical illness or external influence can be identified as the cause. Instead, it is assumed that there is a genetic or congenital predisposition that makes the nerve cells more susceptible to overexcitation.
Certain dog breeds show an increased familial incidence of idiopathic epilepsy, including Golden Retrievers, Labrador Retrievers, Collies, and Beagles. However, mixed breeds can also be affected.
Idiopathic epilepsy is the most common form of epilepsy in dogs and usually occurs for the first time between the ages of 1 and 5.

Recognize signs

Epileptic seizures can vary greatly in appearance. Some dogs experience an aura phase beforehand, during which they become restless, particularly affectionate, or unusually anxious. Owners often report that their dog "seems different" or seeks their company more than usual.

The subsequent generalized seizure usually begins abruptly: the dog falls over, lies on its side, shows severe convulsions, and flails its legs. It often salivates heavily, loses urine or feces, and its eyes may be rolled back. During the seizure, the dog is usually unresponsive.
However, there are also focal seizures, which are much more subtle. In these cases, only a specific area of the body may twitch—such as the facial muscles—or the dog may stare into space or snap at invisible flies. These forms are sometimes more difficult to recognize, but can also be a sign of epilepsy.

The seizure is followed by the postictal phase: the dog is confused, restless, or disoriented. It may appear unsteady on its feet or seem fearful. This phase can last from minutes to several hours.

How urgently do I need to see the vet?

A single brief seizure is usually not life-threatening. However, there are situations that are considered absolute emergencies.

• In status epilepticus: a condition in which a seizure lasts longer than five minutes or multiple seizures occur in such quick succession that the dog does not fully recover between them.
• In the case of cluster seizures, i.e., multiple seizures within 24 hours. These also require rapid veterinary care because they can quickly progress to status epilepticus and place a heavy strain on the body.

Both situations place a massive strain on the brain and can be life-threatening if left untreated.

Our tip: Are you unsure whether your dog has had an epileptic seizure and need veterinary assistance? As a Calingo customer, you can talk to a veterinary professional at any time—24/7, all year round—from the comfort of your own home. Simply use the chat, phone, or video function, without an appointment, via the telemedicine icon at the bottom right.

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diagnosis

The diagnosis always begins with a detailed medical history. Videos of the seizures are particularly valuable for veterinarians, as they help to classify the types of seizures. Since many dogs appear completely normal between seizures, detailed observations by the owner are often crucial. This is followed by blood and urine tests to rule out metabolic disorders or other diseases.

Changes in the brain—such as tumors, inflammation, bleeding, or malformations—can be most reliably detected using MRI (magnetic resonance imaging). If an inflammatory disease of the central nervous system is suspected, an examination of the cerebrospinal fluid (CSF) can provide valuable information.

Depending on the individual case, it may also be useful to perform X-rays, ultrasound examinations, or a CT scan to find evidence of diseases that could trigger seizures—such as tumors in other parts of the body that have spread to the brain, or comorbidities that lead to metabolic disorders. These examinations complement the neurological diagnosis and help to rule out other causes.

An EEG (electroencephalogram) can help detect epileptic activity or distinguish epileptic seizures from movement disorders and circulatory problems (only performed in specialized centers).

therapy

The treatment of epilepsy depends on the frequency, severity, and cause of the seizures. Drug therapy is usually initiated if a dog suffers more than one seizure within 6–8 weeks or if cluster seizures or status epilepticus occur. The goal of therapy is not always to achieve complete freedom from seizures—although this is of course desirable. In many cases, a significant reduction in the frequency, duration, and intensity of seizures is considered a great success, as it noticeably improves the dog's quality of life.

Common antiepileptic drugs are phenobarbital, levetiracetam, potassium bromide, and imepitoin. Medications often need to be combined to achieve good seizure control.

In cases of status epilepticus, medication is administered directly into the vein. The dogs are closely monitored, and if there is a specific cause, it is treated accordingly. In rare cases, the animals must be anesthetized to control the seizures.

What happens after diagnosis and initial treatment?

Regular check-ups and, depending on the medication, monitoring of drug levels in the blood are important to ensure the correct dosage and detect side effects at an early stage.

Side effects such as drowsiness, unsteadiness, or increased appetite often occur at the beginning of treatment with certain medications, but usually improve over time.

An attack diary is very helpful, in which each event is recorded with the date, duration, possible trigger, and behavior before and after the attack. This allows patterns to be identified and the therapy to be optimally adjusted.

In an emergency—what should I do if my dog has a seizure?

• Keep calm
• Do not touch the dog (risk of being bitten), never reach into its mouth
• Remove dangerous or hard objects from the immediate vicinity.
• Only use emergency medication (e.g., diazepam as a rectal solution or suppository) if it has been prescribed by a veterinarian.
• If the seizure lasts longer than five minutes or the condition does not improve quickly: contact your veterinarian immediately.

Insurance coverage for epilepsy

Epilepsy can quickly become expensive—from the initial assessment and diagnosis to ongoing treatment. With Calingo, your dog is reliably covered: the veterinary costs incurred are covered within the scope of your chosen coverage and in accordance with the insurance terms and conditions. Secure the dog insurance that really suits your faithful companion now.

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