Seizures occur when a part of the brain begins to release uncontrolled electrical discharges. These discharges spread throughout the brain and cause the nerves that control the muscles of the body to fire. This results in the violent muscle movements that are common to seizures.
Seizures can be caused by any of the following:
- Infections with virus or bacteria
- Head trauma
- High fevers
- Blood sugar abnormalities
- High blood pressure
- Liver and kidney disorders
- Inherited predisposition
Seizures tend to come with a certain pattern with each pet. Some pets have distinct triggers that bring on seizures (fireworks, full moon, trips to the vet etc) while others seem to seizure randomly. Most pets can live relatively normal lives in spite of their seizure disorder, providing the seizures are well controlled.
How and when do we try to control seizures?
Our goal of anti-convulsant therapy is to reduce the number of seizures your pet is experiencing and to reduce the severity of those seizures that continue to occur. In order to do this; we must know how many seizures your pet typically has in a month before we begin the therapy. We typically allow your pet to have 4-6 seizures and then average the amount of time between the seizures to determine how often we expect to see the seizures occur on their own. If the seizures are coming less than once a month, we may decide not to begin therapy. If they are more frequent than that, we will probably begin drug therapy. Exceptions to this rule are if your pet is having “clusters” of seizures over a day or two, or if your pet gets stuck in a seizure and can’t stop it (Status Epilepticus), in which case we might start anti-convulsant therapy right away.
Knowing how many seizures your pet will have without drugs, we can tell if our therapy is working if the number of seizures reduces after beginning the drugs. For example, if your pet averages one seizure every 2 weeks before drugs and after taking the drugs for 2 months we find that the seizures are coming an average of every 4 weeks, we know we have made an improvement.
Seizures can frequently be controlled using anti-convulsant drugs. These drugs make the brain less likely to have a seizure, but they rarely completely stop all seizure activity. Anti-convulsant drugs must be given every day to maintain adequate blood levels to prevent seizures. They will not stop a seizure in progress unless they are administered by intravenous injection. Therefore, if your pet is having a prolonged seizure (greater than 4 minutes by a clock) a veterinarian must administer an injectable anti-convulsant to stop the seizure.
What is involved in anti-convulsant therapy?
There are a number of drugs used to control seizures. Most commonly we start your pet on Phenobarbital. This drug is very effective and generally safe in most pets. It is given twice daily by mouth and must be given regularly. In order to be effective, the amount of Phenobarbital must reach a certain level in the bloodstream. If the level is too low, it will probably not be doing the pet any good and if it is too high, it may cause untoward side effects including sedation, disorientation, weakness and liver disease.
The blood level can not always be predicted by giving a specific amount of the drug per pound of body weight because each pet handles the drug differently. Therefore, we must monitor the blood levels by doing blood tests at regular intervals.
As an owner you must be prepared to have Phenobarbital levels checked every 6 months and have a general chemistry profile performed before beginning the drugs and once yearly while taking the drugs to monitor the effect of the Phenobarbital on the liver and other organ systems.
Sometimes, other agents such as levicetram (Keppra) or Zonisamide may be chosen as a first line anti-convulsant. They must be given daily as well and monitoring protocols will be explained if they are used.
What are the costs anticonvulsant therapy?
- The cost of Phenobarbital is rather reasonable and should run about $30.00-$50.00 per month for the drug itself.
- Blood chemistry profiles cost about $180.00 and are performed before treatment is started and once yearly thereafter.
- Phenobarbital blood levels are run 10 days after beginning therapy. If the dosage is correct, the next test will be run 6 months later. If the dose is too high or too low, the dose is adjusted and the test must be run again in 10 days to ensure that we are at the right amount.
- Phenobarbital levels are taken before the evening or morning dose to determine what the lowest concentration of Phenobarbital is during the day. The cost of Phenobarbital blood levels runs around $75.00.
- All pets taking Phenobarbital must have a physical exam performed at our hospital at least once yearly.
Once your pet’s Phenobarbital dose has been determined, we generally dispense 1-2 months worth of the drug to you at a time. Phenobarbital is a controlled substance and dispensing it requires quite a bit of paperwork and must be done by a doctor at our facility. Therefore, we ask that you give us at least 24 hours notice to refill the drug.
If an alternative drug, such as Zonisamide or Levicetram are chosen for your pet, the doctor will give you an idea of the annual cost of therapy.
What to do when your pet seizures:
- Seizuring pets are not in their normal mind, as such they may not recognize you and could accidentally harm you if you get near their faces.
- If you pet is banging his/her head, place a blanket or pillow under the head to protect it.
- Pets will not swallow their tongues so do not put your fingers in the pets’ mouth.
- When a seizure starts, look at your watch to check the time. If the seizure lasts for more than 4 minutes and shows no sign of lessening, transport your pet to the veterinary hospital (after hours go to the emergency pet hospital on Benson Avenue in Montclare).
- Pets may be disoriented for a few minutes to a few days after a seizure. Use caution when dealing with them and protect them from potentially harmful circumstances (such as pools, hot tubs etc).
- Keep a digital rectal thermometer in your pet first aid kit. Seizing animals can develop high body temperatures (in excess of 105 degrees) especially if they have a seizure outdoors during the heat of the day. These pets require immediate cooling with cold water until their body temperature reaches 103 degrees. Then towel dry them and the evaporation will continue to cool them to more normal temperatures (100-102).
- Keep track of your pet’s seizures using a calendar or a written log.
- Keep track of who in the family has given the drug to your pet.
Pets with seizures can live full, productive lives. Anti-convulsant therapy can keep the seizure activity from interfering with their lives. If your pet has a seizure disorder, it is well worth trying to treat it with anti-convulsants.