A SEIZURE refers to the involuntary contraction of
muscles. Seizures can result from abnormal electrical
activity in the brain brought on by tumors, blood clots or
scar tissue, or from chemical imbalances such as low blood
sugar or nerve stimulating drugs. Tetanus toxin poisoning
can stimulate muscles to contract resulting in a seizure.
A seizure may involve all the skeletal muscles or be
localized to spasms in a single bundle of muscles. When we
see an athlete fall down, stretch and massage the calf
muscle during a muscle cramp… those calf muscles are in a
state of seizure due to lactic acid buildup from changes in
oxygen availability within the muscle.
A GRAND MAL SEIZURE refers to severe, widespread
cramping of the body’s skeletal muscles. Skeletal muscles
in general are those that attach to bones and allow for body
movement; there are special smooth muscles that don’t attach
to bone that usually are unaffected during a seizure. These
smooth muscles reside mainly in the intestinal tract, blood
vessels and specialized organ tissues. The heart muscle is
actually different from either skeletal muscle or smooth
muscle. Grand mal seizures are rather shocking to see.
A FOCAL SEIZURE (formerly referred to as a petite mal
seizure) is a less severe form of seizure where the
patient still has some voluntary control of movement and
coordination but where certain muscle groups are “doing
their own thing” and brain electrical activity is mildly
disrupted. Staggering, momentary “staring into space” and
other forms of incoordination may be visible to an observer.
usually refers to a grand mal seizure. Sometimes these
terms are loosely applied to an epileptic episode. We might
say a patient is having an “epileptic attack”, or “is having
a seizure” or maybe even a “fit”. However we describe it,
the occasion will be uncomfortable for the observer and the
refers to a very dangerous situation where a rapid
successions of grand mal seizures occur without periods of
rest or muscle relaxation between epileptic episodes.
Status epilepticus requires prompt medical intervention.
True epileptic episodes where the triggering mechanism is
not due to poison, low blood sugar or other chemical
stimulants have their origins within the brain tissue.
Researchers believe that there is a locus (an actual spot or
area in the brain) of abnormal or damaged brain nerve
tissue. This tiny area may be of no consequence 99.9
percent of the time. But for various reasons such as
dietary, chemical, or even psychological, this tiny locus of
abnormal nerve tissue decides to start firing off signals.
The nearby normal nerve cells are affected by these wayward
nerve impulses and respond to them. This response then
triggers other nearby nerve cells to fire and the outcome of
this electrical chain reaction is an upset in the normal
coordinated brain activity. The body receives messages that
make no sense and lack coordination!
The nerves from the brain that stimulate the voluntary
muscles of the body (called motor nerves) are telling the
muscles to get to work but without proper supervision and
control the different muscle groups are contracting without
integrated coordination. Think of this as an orchestra
where all the musicians are playing the same song except
that the conductor isn’t present. Each musician starts and
stops the melody at their own discretion without regard to
what any other musician is doing. Surely not a pleasant
thought… harmony, coordination and melody no longer
integrate the music. And so it is with EPILEPSY. The
harmonious and finely tuned integration of nerve
transmission directing coordinated muscle movement is lost.
The result is a seizure.
If this occurs in your pet, your first reaction is to race
to the phone and call your veterinarian for help.
Fortunately almost all epileptic episodes are of short
duration… one to three minutes is most common. Five to ten
minute episodes are getting into the more serious range of
duration; and any seizure lasting longer than fifteen
minutes generally requires medical attention.
A typical seizure due to epilepsy looks like this: The dog
will seem perfectly normal when, without warning, it may
begin to stagger just a bit when walking. Then it may
appear to be backing up, will sit down on the hind legs and
the facial muscles and eyelids will begin to spasm. (This
is termed “muscle fasciculation”). Often the jaw muscles
will spasm and the dog will appear to be “chattering his
teeth” and will begin to salivate. Breathing will begin to
be forced and if the jaw is set in a closed position the
forced breathing will stimulate the saliva to foam up. Now
the dog appears to be “foaming at the mouth.”
On other occasions the jaw will be held involuntarily in an
open position and appears as if the dog is trying to yawn…
or even as if to scream out and no voice is heard. This
truly can be an unpleasant and scary experience for the dog
and the owner! As the event continues the dog may fall over
on its side, and stretch out with legs and neck extended,
eyes rolled back, mouth foaming and the entire body going
into a rigid state. Now it appears that the dog cannot
breathe because of the intense muscle contractions and stiff
After a few seconds (surely seems like minutes!) the dog
begins to relax, the breathing returns to normal and
voluntary movement becomes more evident. Here’s an
interesting phenomenon: If the breathing is so interrupted
that the dog begins to lose consciousness, the oxygen
deprivation to the brain shuts off the seizure! So just
when you think your dog is dying the seizure stops! Anyone
watching the event returns to more normal breathing, too!
After a few moments the dog will sit up, begin to “shake it
off” and go back to normal activities as if to say “What was
the deal with THAT?”
From start to finish the entire event may last from one to
five minutes… just enough time to get the veterinarian on
the phone to tell the veterinarian you think your dog is
dying. By the time you describe what has transpired, the
dog is often up and aware and looking for that rawhide chew
toy it was working on just before he was interrupted. The
veterinarian will ask you to describe what you saw and will
then give you advice about what to do next.
And that is to have the dog examined… maybe not necessarily
immediately as long as you can stay in touch with the
veterinarian in the event that other seizures follow. But
surely any dog that has experienced a seizure should be
examined and some blood tests should be run to gain some
knowledge of the dog’s physical and biochemical status.
During the complete physical exam the veterinarian will
want to pay close attention to the heart and to neurological
signs. Often the physical exam is normal… you have a
physically healthy dog who happens to scare the biscuits out
of you with unannounced seizures! During the office call
your veterinarian will obtain a blood sample for laboratory
tests to get an insight into the dog’s invisible metabolic
Blood samples are a vital tool in determining whether or not
chemical imbalances are at the root of the epileptic
episodes. For example, the liver has thousands different
tasks to perform and if any are not accomplished properly
the effects may impact the nervous system and a seizure may
result. Blood sugar concentrations have to be regulated
within certain boundaries otherwise neurological and other
difficulties will arise. And electrolytes, such as sodium,
potassium, calcium and phosphorus all need to be present in
the blood in an interrelated and coordinated fashion for
healthy neurological and biochemical reactions to occur. If
the veterinarian discovers an imbalance in any of the blood
chemistry values, detective work follows that may result in
a diagnosis of what is causing the seizures.
A urine sample can reveal infections of the urinary tract
although urinary infections rarely will affect the
neurological system. Relative to seizure activity, the
urinalysis may reveal sugar in the urine that suggests a
diabetic condition might exist. Ketones in the urine may be
revealed which suggests the excessive utilization of
protein, instead of carbohydrates or fat, for energy.
Acid, protein and bile constituents may be seen in higher
amounts than normal. Any abnormal urine factors are hints
that something in the body’s chemistry in not right and
further tests are needed.
But guess what? Over ninety percent of dogs that exhibit
epileptic manifestations will have NORMAL blood and urine
values! In fact, that is what veterinarians hope for when
checking laboratory values in suspected epilepsy patients.
They want to see that everything is functioning properly.
So now you are asking, “If all those tests are normal, what
is causing the epileptic episodes?” Veterinarians have a
diagnosis for these cases… they will remark with profound
confidence that your dog has IDIOPATHIC EPILEPSY. “Oh,” the
owner responds. “What does that mean?” And the
veterinarian replies, “That means we don’t know what the
Intravenous sedatives and
anesthetics may be required to shut down an
Blood tests and
evaluation for internal parasites play a role in
maintenance of good health.
Even otherwise healthy patients
may experience an epileptic seizure.
employ a number of methods to evaluate epileptic
The post ictal quiescent period
after a seizure may last a few minutes to many
A well equipped "crash cart"
contains commonly needed supplies and medications
required in emergency situations.
Some "status epilepticus" patients
require IV medications to inhibit persistent seizure
Veterinary technicians play a
vital role on the pet health care team.
This dog with "drop jaw" is not
having a seizure but is experiencing a cranial nerve
Epilepsy in cats is uncommon and
when it does occur can be difficult to control.
Various medications are used to
control epilepsy in dogs.
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IDIOPATHIC EPILEPSY means the actual cause of the
seizure activity is unknown. Researchers believe that if we
could look all through the brain with a tiny microscope we
would eventually find a small bundle of nerve cells that
aren't quite normal. It would be this locus of nerve sells
that for various reasons begin to fire off impulses on their
own. Those renegade nerve firings trigger other neighboring
nerve cells to respond. This starts a cascade of nerve
firings that spreads out from those renegade cells and
pretty soon the whole electrical harmony of the brain is
upset. A seizure is the result.
What can be done to prevent epileptic episodes? The answer
depends upon a number of variables. If the dog has had only
a single episode and physical exam and lab tests are normal
and the diagnosis is IDIOPATHIC EPILEPSY (we really do not
know the cause), probably no medication is required.
However if the dog begins to show some sort of pattern to
the episodes, let’s say that the seizures are happening
about every three or four weeks, you may wish to consider
starting low doses of medication to try to inhibit the
WHAT CAUSES EPILEPSY?
What creates those little renegade bundles of nerves? One
of the theories is that a head injury resulted in a small
hemorrhage into the brain. As the blood clot resolves and
reabsorbs, scar tissue can remain behind that interrupts
normal nerve cell integrity.
Small tumors can be a source of abnormal nerve activity.
That’s why any case of epilepsy that seems to be
progressively worsening should have brain tumor considered
as a possible inciting cause, especially in epileptic cases
that have an onset in middle or old age.
Genetic predisposition for epileptic activity has been shown
in certain breeds of dogs. The exact mechanism whereby the
genetic determiners impart their influence on nerve cells is
yet to be discovered.
Psychological stimuli can play a role, too. I know of a
case where the pet owner’s little dog got so stressed every
time the owner was preparing for a trip (without the dog)
that the little rascal would work up to an actual seizure
episode! Talk about trying anything to get your own way…
An unusual food allergy may be at the heart of the matter,
too. To establish a food-related trigger for epilepsy will
take a skilled and persistent diagnostician, in cooperation
with very complying owners.
It is very important to develop a close relationship with
your veterinarian on this point of whether or not to
prescribe medication. If the dog is having a two minute
seizure every six months, does that suggest the dog should
be given medication every day to keep these infrequent
episodes from happening? Be sure to keep good notes:
Record the date, time of day, related environmental factors,
length of time the epileptic episode was evident and
severity of the seizure.
If the seizures are of the petit mal variety and last just a
few seconds, even if they occur fairly frequently, should
the dog be medicated daily as a preventative? You see, we
can’t predict when these episodes will occur so giving
preventative medication is an ALL OR NOTHING commitment. If
we knew that every Saturday at five o’clock the dog would
have a seizure, we could start medication twelve hours prior
to that, prevent the seizure, then cease giving the
medication until next week. Unfortunately that scenario
doesn’t happen. The situation calls for an either/or
commitment. Medication is given daily for a period of time
or no medication is given at all.
Fortunately most cases of epilepsy can be controlled.
Cured? Probably not, unless an underlying triggering
mechanism is discovered and rectified. Also, if the seizure
activity is due to a tumor it is unlikely that attempts at
controlling the seizures will be successful. Many cases of
epilepsy in dogs will dictate that treatment be instituted.
Follow-up blood analysis is recommended at selected
intervals to be sure the correct levels of medication are
being given and that no abnormal blood values are starting
to show up. Fortunately, many dogs that have been treated
for epilepsy over a period of time can slowly be weaned off
medication, and eventually not require any further
medication. (Never abruptly eliminate anti-epileptic
medication! Sudden withdrawal of medication often will
trigger a long and difficult episode.)
Phenobarbital is the most commonly used medication to treat
epilepsy in the dog. If given in the lowest dose required
to keep the seizures to a minimum, Phenobarbital can be a
very useful medication with minimal side effects. Many dogs
being given Phenobarbital are living very normal and happy
lives. Some pet owners are adverse to giving their dog a
“drug” for long periods and look at the situation of having
a pet that is “drugged-up all the time” to be unacceptable.
Most veterinarians agree, too, that if the dog requires such
high levels of medication that it acts and feels
“drugged-up” that this scenario is unacceptable.
Fortunately, the majority of cases will be helped by
medication with little, if any, side effects. The “side
are looking for is the elimination for those
A drug called Dilantin (phenytoin) has been used for years
but in general has been a secondary choice after
In some cases Valium may be used when Phenobarbital cannot
be utilized or when a combination of medications are
Potassium bromide (KBr) is being used in some dogs where
response to traditional medication is unsatisfactory.
Potassium Bromide had been used to treat human epileptics
for over 100 years. It may be the anticonvulsant of choice
for dogs with liver disease. Sometimes veterinarians will
prescribe KBr along with Phenobarbital for patients who do
not respond well to Phenobarbital alone. KBr is not easily
obtained and may require a pharmacist to acquire and
formulate the proper dose.
Just as the brain must be in good balance with the rest of
the body, so should we look for a balance in the treatment
of epilepsy. Too much medication is not good because we
don’t want the pet to have dulled senses; reoccurring
seizure episodes are unacceptable so we may need to use a
Any dog receiving anti-epileptic medication should have
periodic blood samples evaluated for blood chemistry
balance. Since many medications are degraded and eliminated
from the body via the liver, an assessment of liver function
is a priority.
WHAT TO DO DURING A SEIZURE
If you happen to witness a seizure, there actually is
not much you can do to get it under control. Try to remove
any objects from the immediate area that the dog may bump in
to and injure himself. Do not try to open the dog’s mouth
to pull the tongue out. Although it can happen, it is
extremely rare for the dog to “swallow the tongue” and
obstruct the airway. Plus the strength of the dog’s jaws
will probably prohibit any attempts you make to open the
mouth to inspect the area.
NOTE: If your dog is actually choking on something
and is consciously gagging, hacking, salivating and in
trouble breathing, you may need to intervene. However this
discussion concerns how to deal with the epileptic patient
displaying seizure activity as described previously.
It may be helpful to gently talk to the dog, and to try to
make the dog comfortable during the seizure activity by
rolling it onto a blanket or padded mat. If you try to pick
the dog up you will need to be very careful because the dog
will be thrashing about and you very likely will lose your
grip and drop the dog. Try to turn off any loud music or
other stimuli such as bright lights and escort any screaming
children away from the area. They can watch but they need
to be silent. “Do something!! Do something!! ” is the high
pitched phrase most often heard during one of these
episodes! However, about all you can do is wait.
The most troubling thing you will see occurs just before a
Grande Mal seizure is over. The dog stiffens up, ceases to
breathe, and just when you think death has visited the dog,
he relaxes and begins to breathe again. In fact what has
happened is that the semi-loss of consciousness depresses
the nerve function and terminates the electrical chaos in
the brain and the seizure is turned off. Another marvel of
survival! It is as if the dog’s survival center says
“Seizure, you want to lock me up in a big muscle spasm and
suffocate me? OK. I’ll show you. When I’m unable to
breathe the brain will be starved for oxygen and that
depresses the oxygen-sensitive brain cells before anything
else. When those nerve cells that triggered the seizure
become deprived of
oxygen they shut down... and the seizure
The fact is that EPILEPSY, though truly a challenging
condition in the dog, in most cases can be dealt with
successfully. Just as each and every pet is a unique
individual, every case of epilepsy should be dealt with on
an individual basis. No two cases will be exactly alike!