Seizure Management and care of the epileptic greyhound.
In 1993 Rufus joined our pack of greyhounds, he was then eight weeks old. For the next eight months we were on our toes rescuing furniture and other household items from this rambunctious puppy. One day when he was roughly nine months old, he lost his balance fell to the floor and started to thrash about. I assumed that he was choking and tried to find something that was obstructing his airway. About a minute later he was back on his feet, still a bit off balance but he seemed none the worse. Several months went by, this incident was forgotten and then it happened again. So off to the vet we went. There was the usual blood sample, complete checkup and then the vet gave us the news that Rufus may be having seizures. The CBC came back normal, so now we started other tests to find out what was causing the seizures. There were, tick titers, thyroid tests, Glucose tests even a MRI. Everything came back normal that is when Rufus was diagnosed as having idiopathic epilepsy. What follows in this article is the knowledge that my wife and I have gained living with an epileptic hound.
Every once in a while I get an E-mail from someone asking “My hound just had his/her first seizure, what is the treatment for epilepsy?” The first thing that I would like to do in this article is to say that just because a dog has seizures does not mean that the dog is epileptic. There are far too many reasons for seizures and epilepsy is just one of the causes, some of the other causes are tick borne disease, thyroid disease, Diabetes, head injury and so on. It is because there are so many causes of seizures that diagnosis can be expensive. There is no test for epilepsy; the only thing that can be done is to rule out other causes, when all other tests come back normal then the diagnosis of epilepsy is made. Once a hound has been diagnosed with epilepsy, the next question an owner asks is “What medication should I be giving the dog?” In most cases there is no need to start any medication (there are exceptions which I will cover later) Medication is indicated only if the frequency of seizures is less than thirty days. That is to say the time between two seizures is less than thirty days. Before we dwell into what should be done for a seizure prone dog lets take a look at the different kinds of seizures.
· Petite Mal Seizure
During a Petite Mal seizure the dog will appear to be disoriented, unresponsive, possibly a bit unsure of their footing.
· Grand Mal
During a Grand Mal seizure the dog will loose their balance and will fall to the ground, they will thrash around violently and may urinate or loose bowel control. Typically they will not throw up unless they have just had a meal prior to the seizure.
· Cluster Seizure
This is by far the worst kind of seizure. This is not really a different kind of seizure but rather it’s a sequence of seizures. The dog starts off with a Grand Mal seizure and just as they are recovering from the seizure they go into another one. Cluster seizures are dangerous to the health of the dog because there is a rise in the body temperature of the dog and a rise in the heart rate for a sustained period of time. If a dog has cluster seizures it is very likely that the vet will start medications immediately, even if this is the first seizure that the dog has ever had.
What are the medications used to control seizures? The primary medications used in seizure management are Phenobarbital and Potassium Bromide (KBr). While neither of these medications can cure epilepsy, the drugs will increase the time between seizures. Both these drugs have side effects that you should be aware of since they directly affect the health of the dog. Phenobarbital is metabolized in the liver/kidney of the dog and hence you must test the liver and kidney functions to ensure that the drugs are not causing damage. Typically this should be done once every six months or so. The side effect of Potassium Bromide is manifest as a weakness in the rear legs. Occasionally you will notice that the dog is dragging the rear legs or that the rear legs seem to buckle under the dog. This however will go away once the dosage is adjusted. If you notice this however, talk to your vet so that they can adjust the dosage. Phenobarbital can take about two weeks to reach an effective level in the dog’s blood, so don’t panic if the dog has a seizure right after you have started medication. Initially the dog will be lethargic, but will quickly adjust to the Phenobarbital. If you and your vet decide to reduce the dosage of Phenobarbital remember to do it gradually. A sudden stop in medication is almost sure to trigger a seizure. While there are no documented drug interactions between Phenobarbital and antibiotics we have noticed that when Rufus gets antibiotics his Phenobarbital level in his blood drops and he has seizures. So talk to your vet before you start any other medications.
As mentioned above, even with medications the dog is likely to have seizures, here are some things you can do to ensure that the dog does not hurt itself during a seizure or just after a seizure (post ictal stage). In the case of a Petite Mal seizure make sure that you guide the dog away from places where they can hurt themselves. Stairs are particularly dangerous during this time. Essentially you have to act as the eyes of the dog and prevent them from possible harm. In the case of a Grand Mal seizure there are several things you need to do. The most important of these is to remain calm. Remove any item around the dog that is likely to hurt the dog during the seizure. If the dog is outside try and move the dog to a grassy surface rather than on hard dirt or pavement. The trashing around can cause serious wounds if they are on a hard surface or pavement. If it appears that the dog is choking DO NOT try and put your hand in the dog’s mouth to check for obstructions. During a seizure the jaw moves involuntarily and can inflict a very serious bite. If the dog throws up during a seizure use a stick or other object to move the vomit away from the dogs mouth. Talk to the dog in a soothing quite voice. This may or may not help the dog but it helps you to stay focused on the task at hand. Do not force the dog to get up as soon as the seizure is over. Let it lie down for a while. When the pet struggles to its feet, assist it and then make sure that you stay with it during the post ictal stage. The pet will still be disoriented, so make sure that the dog is safe. If your dog was diagnosed as having seizures caused due to hypoglycemia now is the time to give them something sweet. For those of us that have multiple dogs it is very important to ensure that the rest of the dogs are kept away from the dog that is having seizures. This is because pack behavior can lead to the other dogs attacking the dog having the seizures.
Of all the seizures that can affect a dog, the most serious are Cluster Seizures. A cluster seizure is a series of Grand Mal seizures. Just as the pet appears to be coming out of one seizure the second seizure starts. The second seizure can also happen during the post ictal stage of the first seizure. These seizures are dangerous because of a couple of reasons. Firstly, the body temperature of the pet rises. To counteract this try placing a towel that is soaked in cold water on the dog. Secondly, the heart rate during a seizure increases and a sustained high heart rate, especially in an older dog can cause serious damage to the health of the dog. To break the cycle of these seizures you have to administer Valium rectally to the dog. The amount of Valium will be something that the vet will decide. As an example however, Rufus weighs seventy-two pounds, his initial dosage of Valium is fifteen CC. If the clusters continue you must administer a second or sometimes even a third dose. During a particularly bad cluster seizure (Twelve seizures in half an hour) Rufus required Sixty CC of Valium to break the seizure cycle. Vets differ in opinion about the administration of the other drugs (Phenobarbital and Potassium Bromide) after a cluster seizure. A neurologist at one of the leading vet hospitals in the country told us to double the Phenobarbital and Potassium bromide dosage after a cluster, then drop back to the normal dosage the next day.
Unfortunately, most of us cannot be with our pets at all times. During those times that the pet must be alone there are several things that you can do to help in case the pet has a seizure. Make sure that the pet is not wearing a muzzle or a collar. If you have multiple dogs make sure that the pet prone to seizures is protected from the other dogs. We keep Rufus in an X-pen. The base of the X-pen is lined with baby bumpers and pillows to prevent his paws from getting caught in the wires of the pen. His bed is lined on the inside with a plastic sheet. This makes it easier to clean up in case he looses bladder/bowel control. Make sure that there is nothing that might get caught in the dog’s paws that might cause more damage or even risk a fire. Things like electric appliances, radios; lamps should be put well away from the X-pen or surroundings of a pet prone to seizures. The water bowl is attached to the X-pen at a height were it wont hurt the pet.
What else can you do for this pet? Keep a diary, record the duration or each seizure, record the time of the seizure, any activity that the pet was involved in prior to the seizure, was there thunder? Was it a very hot day, a very cold day, anything in the pet’s environment even though at first glance these things seem completely irrelevant to the seizure? As you record more seizures you may find that there is a pattern to these seizures and help you avoid them later. Here is a checklist of things we have found helpful.
1) Diary to record seizure and other information
2) Medication if any should be easily accessible
3) Vet Records should you need to rush the pet to the ER Take the diary with you
4) Make sure your pet normally wears a collar with tags. Make sure that the tags have your phone number, your vets phone number, the dog’s name and a simple warning “Needs Medication”. This is a lifesaver should your pet accidentally get loose.
During a seizure
1) Remain calm
2) Make sure that the immediate surroundings of the pet are clear of hazards
3) Damp towel in case of cluster seizures to keep the pet cool.
4) Protect the pet from other dogs
After the seizure
1) Remain calm
2) Stay with the pet, you are the pets eyes during the post ictal phase of the seizure
3) Do not attempt to give the pet commands during this stage, it will frustrate you and the pet has no control over its actions
4) Do not correct the pet if he/she looses bowel or bladder control.
By now you must be wondering, Why should I adopt a dog that is prone to seizures? Too many things to keep track of, too much that can go wrong and the pain of seeing your pet thrashing around as we watch helplessly. The answer to this question is simple, Ninety Nine percent of the time this is a perfectly normal pet, if any of you saw Rufus you would not be able to tell that there was anything wrong with him. So love them, enjoy them and take care of them.