Canine Epilepsy

Understanding Canine Epilepsy

How Seizures Are Classified

In dogs, seizures can be caused by a number of things, including ingesting poison or other toxic substances, low or high blood sugar, electrolyte imbalances, or other metabolic reasons. The most common treatment for canine epilepsy is medication. These medications often help, but will not eliminate the possibility of your dog having a seizure. In this article, you’ll learn about seizures in dogs, what to do when one is occurring, and things you can do to help your pet.

How Seizures Are Classified The most common cause of seizures in dogs is idiopathic or primary epilepsy. This is a disorder whose cause is unknown but may be a genetic condition. In other words, there is no underlying identifiable disease, nothing “provoking” the seizures, and the dog is otherwise healthy. There are several “types” of seizures. The major groups are generalized, focal, and unknown seizures.

Generalized onset seizures affect both sides of the brain simultaneously. This type could produce one of the following seizures:

• Tonic-clonic: Formally referred to as a “grand mal,” dogs having this seizure lose consciousness and have stiffened muscles and jerking movements. The seizures last one to three minutes, and it takes longer to recover. A tonic-clonic that lasts more than five minutes is considered an emergency.

• Absence: This seizure used to be called a petite mal and start/end quickly and can last only a few seconds. They are often mistaken for staring and can go undetected.

• Atonic: These are often called “drop attacks” because the sufferer suddenly loses muscle tone, so their head or body goes limp.

“Focal onset seizure” is the more accurate term for what was once referred to as a partial onset seizure. Focal seizures start in one area or cell group on one side of the brain and could produce one of the following:

• Aware: In this seizure, the sufferer is awake and aware. 
• Impaired awareness: In this seizure, the sufferer is confused or their awareness is affected.

Both types of the above seizures can be known as “cluster” seizures. This is when your dog has two or more seizures within a 24-hour period. Some research indicates that this type of seizure can cause damage to your dog’s brain. 

With unknown onset seizures, the beginning of the seizure is unknown. It is not witnessed by anyone but can leave evidence of structural changes in the brain.

Seizures go through three phases. They start with the aura phase. Although sometimes this phase is not noticed, owners of epileptic dogs often start to recognize the changes in their dog’s behavior as the aura phase. This can include drooling or excessive salivation, restlessness, nervousness, and clingy or skittishness behaviors. Next is the ictus phase. Often lasting between one and three minutes, this phase is what people think of as the seizure stage and can have any of the above indications. Finally, the post-ictal phase occurs after the main part of the seizure is over, when pets may be exhausted, disoriented, confused, temporarily blinded, or restless from a few hours to a few days.

What Causes Epilepsy in Dogs?

Genetics can play a large role as a risk factor in idiopathic epilepsy. Studies of dogs with idiopathic epilepsy have found that intact female dogs have the most frequent episodes of seizures. Three possible types of inheritance come into play with idiopathic epilepsy. These are simple recessive inheritance, polygenic inheritance, and recessive combined with additive genetic inheritance. In simple recessive inheritance, your dog has received genes for epilepsy from both parents. Neither parent shows the actual trait, but since the trait is recessive they are “carriers” for it and have passed it to your dog. Since your dog has two copies of the same recessive gene, the trait (epilepsy) is expressed. With this type of inheritance, the trait can often be found in previous generations of both dogs, such as their grandparents or great-grandparents. 

In polygenic inheritance, the characteristic, in this case epilepsy, is controlled by more than one gene. This is almost like the luck of the draw: You can have two very healthy parents without the genetic markers who end up having a puppy with the condition. The interplay of multiple genes causes the condition. In dog breeds that are overbred, recessive genes in combination with “additive” genes are thought to cause idiopathic epilepsy. These overbred dogs cause more recessive gene combinations to occur with each successive generation. Although problems may not develop for a few generations, eventually problems arise. These dogs may be genetically predisposed to epilepsy, but because they are also overbred, they have fewer genes that act as protection from the onset, which causes the epilepsy to come out earlier and more severely in their lifetime. 

Some breeds are more genetically predisposed to having seizures and epilepsy. Some publications swear that the smaller breeds are more predisposed, but as you can see from the following list, it is more about genetics and breeding.

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What to Do if Your Dog Is Having a Seizure

Few things are worse than seeing your best friend in the throes of a seizure, especially when you are not prepared. Although most seizures last only one to three minutes, it may feel a lot longer. The following is a list of things to do when you find your dog in the grips of a seizure.

• Remain Calm: One thing to remember that may help calm you is that seizures do not cause pain for your dog. They are also counting on you to keep their fear contained, so it is best to try to be calm for them. Especially after the seizure, they may be disoriented, confused, and even blind for a time. 
• Move Any Items That Could Hurt Your Dog: Clear some space and make sure that your dog is in a safe environment, such as not on the stairs or in a pool. If your dog has epilepsy, you may want to consider limiting his pool time to keep him safe from accidentally drowning during a seizure. 
• Stay Away from His Mouth: This is for your own safety because he may accidentally bite you. Since your dog is not capable of swallowing his tongue, you do not need to be near his head. 
• Keep from Overheating: Excess heat sources while in the grips of a seizure because put extra stress on your dog’s body. If he is outside in the sun, provide him some shade. 
• Call Vet After the Seizure: If this was your dog’s first seizure, call your vet to get your dog an appointment. Any information you have about your dog’s activities or exposures may help your vet come up with a treatment plan. There are only two types of seizures that require emergency treatment: one that lasts over five minutes, and cluster seizures, those that occur multiple times in a 24-hour period. 

How Your Vet Diagnoses Epilepsy in Dogs

Dogs with epilepsy will have had two or more seizures or have a tendency for them to recur. Your vet will diagnose epilepsy using your dog’s medical history, blood or urine tests, and a neurological exam. They will start with a physical exam looking for anything that is obviously abnormal. Your dog’s medical history will help your vet determine if they need to look for certain diseases. Your dog’s breed and age will give your vet further clues about possible diseases that are causing or are concurrent to your dog’s seizures. 

The blood test will tell your vet about your dog’s red blood cell (RBC) and white blood cell (WBC) counts. RBC counts indicate whether your dog is anemic, which is a decrease in red blood cells. Anemia causes your dog’s heart to pump more blood to make up for the lack of blood oxygen. Over time, and if severe enough, anemia can cause an enlarged heart or heart failure. Dehydration is another condition that a blood test can diagnose because the body tries to falsely compensate for a low fluid volume by making more RBC’s, leading to a high RBC count. Blood tests can also reveal lead poisoning and toxins, and can also determine whether your dog’s WBC count is elevated, signaling infection or other bone marrow diseases, such as cancer. 

The blood chemistry profile will include kidney and liver tests. The kidney tests will include the blood urea nitrogen (BUN) and creatinine. The BUN tests measure the amount of nitrogen in the blood, revealing if there is kidney injury or disease present. If kidney function is impaired, urea can build up in the blood. Too much urea in the blood can be toxic to your dog’s organs. The liver tests look at liver enzyme and bilirubin levels. High levels of these can reveal an inflamed or injured liver. 

A urinalysis can also determine whether your dog is dehydrated, and can help determine whether your dog’s kidneys are working properly to make urine. The test also looks for other substances in the urine, such as blood, crystals, excess protein, and bilirubin. Crystals in the urine can be a precursor to kidney stones or a urinary tract infection. Bilirubin is made during the normal process of the liver breaking down old red blood cells. Elevated levels of bilirubin in the blood tell your vet that the liver is not clearing it properly and can signal liver damage. 

If your vet does suspect liver disease, they may run additional blood testing, such as a bile acid test, a thyroid test, and specific infectious disease tests. A bile acid test looks for whether the liver is healthy enough to do its job, whether it has an adequate blood supply, and whether bile is moving freely inside of and out of the liver. A thyroid test is a basic inexpensive test that looks for whether the thyroid is producing enough hormone. Vets are not sure of the mechanism that causes seizures in cases of hypothyroidism, but they do note that a relationship exists. 

Specific diseases that vets test for in seizures and epilepsy include canine distemper virus and toxoplasmosis. Seizures are a later-stage development in the case of distemper. They signal a neurological issue that, even in cases of recovery from the disease, may persist. Toxoplasmosis is a disease caused by the parasite T. gondii. This parasitic disease is very common, and it is known to affect nearly all warm-blooded animals and humans. Unwashed fruits and vegetables can host T. gondii. There are acute and chronic forms of toxoplasmosis, but it is mainly the acute symptoms that crop up in dogs, especially puppies whose immunity is vulnerable. Seizures are a symptom of this acute version of toxoplasmosis.

Finally, your vet will run a cerebrospinal fluid (CSF) analysis to check for encephalitis. This may be done after other diagnostic tools such as magnetic resonance imaging (MRI) and computed tomography (CT) scans have been performed. 

Your Epileptic Dog 

Once your dog has a diagnosis of epilepsy, you can learn how to live with the diagnosis and make his environment lower-stress and supportive. Part of this is learning to recognize the warning signs that a seizure is impending. These are important because if your dog is in a stressed state, you may be able to remove the stressor and keep the seizure from happening. Signs that a seizure is imminent include:

• Acts Stressed: You know your dog, and you can tell when he is stressed. Some dogs pace, some dogs howl or whine. Whatever way your dog shows his stress, he may have a seizure pending.
• Scared: Hiding, whining, or acting skittish may be signs of a seizure’s aura phase. 
• Dazed: Having a “zoned-out” appearance is a warning sign, especially in dogs who are normally ready at a moment’s notice.
• Worries: Pacing and pawing at you may indicate that a seizure is starting to overtake them. 
• Muscle and Limb Contractions: Some dogs show ictus-type contractions before a full-blown seizure comes on. 
• Visual Disturbances: Some dogs appear to be watching something that is not there, or bark at non-existent objects as a part of their seizure aura. 
• Loss of Bowel and Bladder Control: This can happen even in the aura phase of a seizure and can signal fear or inability to control their body.
• Altered Mental Status: Some seizures in dogs are mild and exhibit as just staring off into space. For some, this is their aura before a much more violent seizure takes hold.
• Seeks Companionship: You are your dog’s comfort, and they may seek you out when they are distressed. Alternately, some dogs may turn from you as a comfort and become aloof when they are in the seizure aura.

Concurrent Conditions

Helping your epileptic dog comes with some sacrifices. These dogs need special care and a safe, stable environment. Sometimes they have other concurrent conditions that crop up because they are epileptic or because of the medication they are on to control the seizures. The following are some concurrent conditions that go with epileptic dogs:

• Hotspots: Hotspots are a very common condition associated with epilepsy and seizures in dogs. Hot spots are a good indicator of something systemic going on with your dog, and they are predominantly associated with nutrition and possible food allergies. If your dog had hot spots prior to being medicated for seizures, take a long hard look at his diet, as something in it may be causing both his hotspots and his seizures.
• Overweight or Underweight: The normal metabolism of dogs is altered when they are on epilepsy medication. This is a tricky thing because the medications are prescribed based on your dog’s weight, and when that weight fluctuates, the medication has decreased efficacy or the potential for overdose. Maintenance of a steady body weight is challenging for the medicated epileptic dog, especially because one of the main side effects of some epilepsy medications is increased appetite. 
• Diet and Urine pH: Another thing that affects the rate of medication elimination and therefore efficacy, is your dog’s urine pH. Some diets make your dog’s urine more acidic, and some make it more alkaline. Diets that are meant to prevent kidney stones significantly alter the pH of your dog’s urine, and combining this diet with anti-seizure medication can cause either loss of seizure control or drug 

How to Manage Your Dog’s Epilepsy 

Conventional seizure treatment puts your dog on anticonvulsant medications, such as Phenobarbital (PB), Potassium Bromide (KBr), Zonisamide, and Mysoline, among others. Diazepam is not used in seizure-prone dogs because its effects only last a few minutes. Phenobarbitol and Potassium Bromide are the most commonly prescribed drugs for anticonvulsant therapy. Some of these medications are prescribed concurrently. However, both have side effects and must have blood analysis performed regularly. Too much medication can become toxic, while insufficient levels will not adequately control your dog’s seizures. Drug metabolism varies widely and is strongly affected by your dog’s diet and nutritional composition. Therefore, it is important to have your dog monitored to ensure he is on the right dosage.  

Another treatment that is being evaluated for epileptic dogs is Vagus Nerve Stimulation (VNS). VNS has been used successfully in humans since 1997, and in dogs since around 2002 with some measure of effectiveness. It is still considered cutting edge technology in 2018 but is performed by a handful of veterinarians in the United States through an implant similar to a pacemaker. A newer, less invasive method is also being performed through ocular compression. The vagus nerve is in your dog’s neck, near their carotid artery and jugular vein. Stimulating this nerve can slow or reduce seizures. 

Whether you choose a traditional therapy, something less conventional, or a combination of the two, your main objective is to tip the balance away from physical and mental excitement and toward mental and physical calm. You are looking to control your dog’s epilepsy, not necessarily cure it. Especially in idiopathic epilepsy, you must understand that the lifestyle and environment you are giving your dog can keep him seizure-free and living a long life. The following is a list of possible courses of intervention you may consider for your dog:

• Reduce stress and triggers: If you haven’t figured it out already, having an epileptic dog means that you may have to make some lifestyle changes. Your dog needs to be on a consistent schedule, to have his behavior monitored for changes, his playtime monitored so he doesn’t overexert himself, his weight maintained regardless of his medications, and above all a stress-free environment. Finally, you may want to consider keeping a seizure journal to determine what his triggers are and how to avoid them. 
• Prevention: Work with your vet to determine which vaccines are necessary, and on what schedule. Getting education about the immunity offered by specific vaccines and the veterinary community’s research-based recommendations is important in case you have a vet whose opinion is biased by anecdotal information. Give vaccinations responsibly, especially in your diagnosed epileptic dog. 
• Mind the toxins: Everyday, people and pets are exposed to toxins. In our food, in our environment, and even in our homes. Consider taking on a study of your environment for possible toxins. Review the foods you feed your dog, and what exactly is in them. Are all the ingredients good for him? What does research say about any of the fillers in his food? You may be surprised to learn that you and your dog are eating things that could cause health problems. 
• Supplements: Many people swearthat supplementing your dog’s diet with specific natural ingredients will help them in epilepsy. As always, do your own research before you commit to anything medicinal, and understand that you are introducing something not normally present in your dog’s diet when you give him a supplement. Further, you may be able to wean your dog off his normal medication with supplementation, but abrupt changes may cause him physical distress. Work with your vet to determine what is right for your dog. Some of the supplements recommended for epileptic dogs include:

• DHA: DHA is docosahexaenoic acid. It has anti-inflammatory properties and plays a vital role in brain development. DHA may have a protective effect on a dog’s brain when given as a supplement. 
• Omega-3 Fatty Acid (Fish Oil):  This supplement combines three polyunsaturated fatty acids, ALA (alpha-linolenic acid), EPA (eicosapentaenoic acid), and DHA (docosahexaenoic acid). According to researchers, although testing on mammals is limited, what is available is promising, indicating that Omega-3 Fatty Acids taken in supplement form can reduce seizures. 
• Taurine: Taurine is an amino acid that your dog cannot naturally synthesize. It is considered safe to give your dog as a supplement, but the evidence for efficacy in epilepsy and seizures is mixed. Some studies have found that it is moderately effective, and some have found that it is not at all effective in reducing seizures. 
• DMG: Dimethylglycine is a chemical naturally produced in the body in small amounts. It is an intermediary metabolite from the amino acid glycine. Little scientific evidence supports its use in decreasing seizures. However, there is anecdotal information supporting its use. At this time, the pathway from DMG to decreasing seizures is unknown. 
• Vitamin E: A fat-soluble vitamin found naturally in foods, Vitamin E acts as an antioxidant in the body. Researchers have found that one of the causes of seizures is the destruction of neurons from oxidative stress. Since Vitamin E can absorb free radicals of oxygen, it is often used as therapy in medication-resistant epilepsy.  
• Vitamin B Complex: Vitamin B complex refers to all the water-soluble vitamins, except Vitamin C. This includes B1, B2, B3, B5, B6, biotin, folic acid, and B12. Studies are still being conducted not only of the efficacy of B complex in decreasing seizures, but of the individual components on decreasing seizures. Researchers recommend combining B complex with other traditional epilepsy medications. 
• Calcium: Low levels of calcium (hypocalcemia) and elevated levels of calcium (hypercalcemia) can cause seizures. Some anti-epilepsy drugs can seep calcium from the bones, requiring an additional supplement of calcium. 
• Vitamin D3: Some anti-epilepsy medications interfere with the way thatyour dog’s body processes Vitamin D, so supplementation may become necessary. Aside from a known deficiency however, there is no evidence that supplementing with Vitamin D helps decrease seizures. 
• Choline: An important chemical in the nervous system, choline is known to help decrease swelling and inflammation. It is also known to help absorb nutrients from the digestive tract to help supply energy to the brain. Vets that use choline supplementation to treat dogs and cats with cognitive disorders report that about 75 percent show improvement.
• Lecithin: Also used in treating cognitive disorders, lecithin contains a substance that is part of the membranes that surround cells. Thirty percent of the brain is made of lecithin, as it enables the brain’s nerve cells to send and receive messages properly. Many natural-therapy proponents recommend lecithin supplementation, but there is not much research that supports this helping your dog with epilepsy or seizures. 
• Vitamin C: Well-known to help decrease inflammation and boost the immune system, Vitamin C is an antioxidant that is critical in the brain. Researchers suggest Vitamin C to help decrease damage to the brain during seizures in humans, although this mechanism is not yet well-studied in dogs. 
• Zinc: Zinc is another nutrient whose deficiency can cause seizures, especially in dogs such as Huskies and Malamutes. 
• Western herbs: Herbs such as chamomile, milk thistle, skullcap, valerian, oat straw, and ginkgo biloba are considered alternate therapies to conventional medications. As they can interfere with the traditional medications and interact with them, make sure your vet is aware if you are considering supplementing your dog with these. Some of these, such as milk thistle, can cause major intestinal upset when taken for extended periods of time. 

Holistic Treatment: Holistic treatments treat the whole person or body, not just the disease parts or symptoms. Aside from the treatments listed above, there are holistic treatments to consider for epilepsy that are not traditionally used in western medicine. Further, there may not be much research on these treatments. However, some of them have been used for many years, and some are safely used concurrently with traditional medical interventions. Further, many do not have deleterious side effects, so are worth trying. For example, you could try:

• Gold Bead Implant Therapy: A part of acupuncture, gold bead therapy is the permanent implantation of tens, hundreds, or thousands of metallic fragments, or beads. In theory, the beads emit a positive electrical charge to neutralize the joint’s electric charge. The implantation is done with large bore needles. The information that exists on this practice is limited, with few recent studies performed. Proponents of the treatment say that is it 99 percent effective in the treatments of joint, bone, and seizure disorders. However, the practice in humans is considered medical malpractice, and the “evidence” supporting its efficacy is muddied by CT scans and MRIs that are inconclusive. Further, it is considered downright dangerous when the implants migrate to organs and traumatizing when the implants are removed. 
• Chiropractic Care: In certain types of epilepsy, especially those that result from injuries of the spinal cord and with concurrent ear infections, regular chiropractic adjustments make sense. However, ensure that your vet is certified in chiropractic care and has experience with epileptic dogs. 
• Nutraceuticals: In the U.S., the Food and Drug Administration (FDA) regulates nutraceuticals as dietary supplements, food additives, and foods rather than medicines. In other words, the quantities and efficacy of these products are not evaluated as a part of regulation. Nutraceuticals are marked as such so that manufacturers can differentiate them from other products. They are intended to be pharmaceutical-grade, standardized ingredients and medicinal in nature. They are food or food additives as medicine, and can be in pill, powder, or supplement form. Review the ingredients in these supplements and determine if they are appropriate for your dog with epilepsy. 

Herbal Remedies: There are plants or plant parts that have been used and recommended for controlling seizures. Many of these are poisonous or contain poisonous chemicals, and they must be used under the care of a naturopath and given in correct doses. Herbalists note that these remedies are given based on the dog’s constitution (personality during seizures), not based on the specific diagnosis of epilepsy. Further, there is little clinical evidence that these remedies are effective in treating epilepsy or reducing seizures.

 Canine Epilepsy Diet: How Raw Dog Food Can Help

Many dog owners also use dietary changes to help manage epilepsy and reduce the food triggers that may contribute to seizures.

My dog no longer has petit mal seizures on the raw diet – Kevin Q., Nevada 

Darwin’s customer Sandra DeMers shared with us the experience she had treating her epileptic dog, Cory, with raw food instead of medication:

There is no question that changing our dog Cory over to a raw, all-natural diet was the reason that his seizures stopped. I know that not all dogs will be completely cured of canine epilepsy simply by a changing to a home-cooked or a natural raw diet, and many dogs’ lives will be saved by anti-epileptic drugs. These are decisions that must be made on a case-by-case basis by a loving dog owner and a trusted veterinarian. But the only commercial pet food I would choose is one that is based on the raw meaty bone diet, which is free-range and organic, such as Darwin’s Natural Selections™ with free-range meat and organic vegetables.

It took five years from the time I started feeding Cory the raw meaty bone diet until his last seizure, so be aware it doesn’t happen overnight. But his seizures did become less and less frequent over that five-year span until they stopped completely, and that was now over five years ago.

I wish all of you who are struggling with the pain of dealing with canine epilepsy comfort and support in your own journey to find answers that will work for you. Cory and I hope our experience can help you fit together some of the pieces to the overall puzzle of reducing or even curing your dog’s seizures.

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