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The following article was submitted to Labforums by Emma Milne, the T.V Vet. See http://www.emmathevet.co.uk/
Emma writes...
Recently I had an emergency call out to a client whose dog appeared to be having a ‘fit’. ‘Chunk’, as he is affectionately called, is a 1 year old Black Labrador and had never as far as we knew had any kind of episode like this before. Understandably, Chunk’s owner was very upset. Anyone who has witnessed any kind of seizure, whether it be in an animal or a human, will be aware of how frightening and stressful it can be for everyone concerned.
Chunk had had a normal day and had eaten his dinner as ravenously as normal and had been resting quite peacefully. He got up and started to walk around and then collapsed on the floor and started convulsing. This went on for about 2 minutes and he lost control of his bladder. By the time I arrived at the house he was relatively normal again, if a little disorientated. In fact, he was a lot less upset than his owner.
I gave Chunk a thorough check over and found nothing abnormal. We agreed to have him in for the day to do some tests to make sure there was no obvious reason for the attack.
The next day we took some blood and did a full work- up. There was no abnormality. I also did a neurological examination. This is where we check things like the dog’s reflexes and sight and balance. This is a fairly standard set of events after one seizure.
There are many things that can cause seizures. By far the most common thing is ‘idiopathic’ epilepsy. Idiopathic just means that no- one fully understands why it happens and there is no apparent cause. Even though epilepsy is the most likely cause we have to be sure that there is nothing else going on. Other causes can be anything from poisoning to a tumour in the brain. Epilepsy can also be ‘acquired’ and can be triggered by things such as a blow to the head and in this case the seizures can start months or even years after the initial trauma.
Having ruled out any other obvious causes of Chunk’s seizure we made the presumptive diagnosis of epilepsy. This disease is characterized by episodic abnormalities of the electrical impulses in the brain. The brain is basically a massively complex set of electrical connections. The electric signals fire along the neurons at very specific times and through very specific pathways. When this goes wrong you get a focus of electrical activity that builds up in one place and then spreads out in a wave from the focus. This wave of electricity causes the seizure and uncontrollable muscle contractions and often the loss of consciousness seen in an epileptic fit. Another defining characteristic of the disease is that the animal is, to all extents and purposes, completely normal between episodes.
Epilepsy of this kind almost always starts between the ages of 6 months and 3 years and in general, the later it starts, the better the prognosis for controlling it with medication or, in some cases, not needing medication. Besides being a suspected inherited condition in Labradors, it is also inherited in breeds such as the German Shepherd Dog, Beagle and Dachshund, but is also quite commonly seen in breeds such as the Golden Retriever, Border Collie, Saint Bernard, Sheltie and the Springer Spaniel, to name a few.
So what was the next step for Chunk? It may surprise you to hear that the next step was to do absolutely nothing except wait. Most epileptic animals do require medication to control their fits at some stage. However, this can have long- term side- effects such as liver damage and often the dose needs to be increased with time. Therefore if we can avoid the use as long as possible we do. Some animals go months without a seizure and when they do have one it may be very short- lived. In these cases if the dog and the owner can cope with the fits then no medication is necessary. In most cases the seizures do become more violent and prolonged with age and the frequency usually increases. In these cases and in those where the fits are severe from the outset we start anticonvulsant medication. The other aspect that we have to try and balance is that each fit may increase the likelihood of another or cause the severity to worsen. It is a disease that must be truly judged for each individual.
The drug that is most effective in most cases and is most widely- used is phenobarbitone. The drug acts on the brain to prevent the abnormal electrical impulses and is effective in about 80% of cases. The dose needed varies a great deal between dogs and it can be very toxic at high doses so when treatment starts it has to be monitored carefully. It also takes about seven to ten days to reach the right concentration in the blood. For this reason all dogs are started at the same dose and this should not be altered for at least two weeks, even if seizures are still seen. After two weeks a blood test is taken to check the level of the drug in the blood stream. It is then that the dose is altered if this is too high or low. When the level is deemed to be correct the waiting game starts again. We wait and see what happens to the seizure pattern. Ideally they should stop altogether but in some cases it is adequate to reduce the frequency and severity of the attacks.
So what is the future for Chunk? To be honest it is uncertain at the moment. He is at the young end of the range and may be more likely to be a severe sufferer or harder to control because of it but who knows? These are only general guidelines and, as in all things, there are exceptions to every rule. All we can do is wait and see what the future brings.
With Many Thanks To Emma Milne For Writing This Story On Epilepsy
Emma writes...
Recently I had an emergency call out to a client whose dog appeared to be having a ‘fit’. ‘Chunk’, as he is affectionately called, is a 1 year old Black Labrador and had never as far as we knew had any kind of episode like this before. Understandably, Chunk’s owner was very upset. Anyone who has witnessed any kind of seizure, whether it be in an animal or a human, will be aware of how frightening and stressful it can be for everyone concerned.
Chunk had had a normal day and had eaten his dinner as ravenously as normal and had been resting quite peacefully. He got up and started to walk around and then collapsed on the floor and started convulsing. This went on for about 2 minutes and he lost control of his bladder. By the time I arrived at the house he was relatively normal again, if a little disorientated. In fact, he was a lot less upset than his owner.
I gave Chunk a thorough check over and found nothing abnormal. We agreed to have him in for the day to do some tests to make sure there was no obvious reason for the attack.
The next day we took some blood and did a full work- up. There was no abnormality. I also did a neurological examination. This is where we check things like the dog’s reflexes and sight and balance. This is a fairly standard set of events after one seizure.
There are many things that can cause seizures. By far the most common thing is ‘idiopathic’ epilepsy. Idiopathic just means that no- one fully understands why it happens and there is no apparent cause. Even though epilepsy is the most likely cause we have to be sure that there is nothing else going on. Other causes can be anything from poisoning to a tumour in the brain. Epilepsy can also be ‘acquired’ and can be triggered by things such as a blow to the head and in this case the seizures can start months or even years after the initial trauma.
Having ruled out any other obvious causes of Chunk’s seizure we made the presumptive diagnosis of epilepsy. This disease is characterized by episodic abnormalities of the electrical impulses in the brain. The brain is basically a massively complex set of electrical connections. The electric signals fire along the neurons at very specific times and through very specific pathways. When this goes wrong you get a focus of electrical activity that builds up in one place and then spreads out in a wave from the focus. This wave of electricity causes the seizure and uncontrollable muscle contractions and often the loss of consciousness seen in an epileptic fit. Another defining characteristic of the disease is that the animal is, to all extents and purposes, completely normal between episodes.
Epilepsy of this kind almost always starts between the ages of 6 months and 3 years and in general, the later it starts, the better the prognosis for controlling it with medication or, in some cases, not needing medication. Besides being a suspected inherited condition in Labradors, it is also inherited in breeds such as the German Shepherd Dog, Beagle and Dachshund, but is also quite commonly seen in breeds such as the Golden Retriever, Border Collie, Saint Bernard, Sheltie and the Springer Spaniel, to name a few.
So what was the next step for Chunk? It may surprise you to hear that the next step was to do absolutely nothing except wait. Most epileptic animals do require medication to control their fits at some stage. However, this can have long- term side- effects such as liver damage and often the dose needs to be increased with time. Therefore if we can avoid the use as long as possible we do. Some animals go months without a seizure and when they do have one it may be very short- lived. In these cases if the dog and the owner can cope with the fits then no medication is necessary. In most cases the seizures do become more violent and prolonged with age and the frequency usually increases. In these cases and in those where the fits are severe from the outset we start anticonvulsant medication. The other aspect that we have to try and balance is that each fit may increase the likelihood of another or cause the severity to worsen. It is a disease that must be truly judged for each individual.
The drug that is most effective in most cases and is most widely- used is phenobarbitone. The drug acts on the brain to prevent the abnormal electrical impulses and is effective in about 80% of cases. The dose needed varies a great deal between dogs and it can be very toxic at high doses so when treatment starts it has to be monitored carefully. It also takes about seven to ten days to reach the right concentration in the blood. For this reason all dogs are started at the same dose and this should not be altered for at least two weeks, even if seizures are still seen. After two weeks a blood test is taken to check the level of the drug in the blood stream. It is then that the dose is altered if this is too high or low. When the level is deemed to be correct the waiting game starts again. We wait and see what happens to the seizure pattern. Ideally they should stop altogether but in some cases it is adequate to reduce the frequency and severity of the attacks.
So what is the future for Chunk? To be honest it is uncertain at the moment. He is at the young end of the range and may be more likely to be a severe sufferer or harder to control because of it but who knows? These are only general guidelines and, as in all things, there are exceptions to every rule. All we can do is wait and see what the future brings.
With Many Thanks To Emma Milne For Writing This Story On Epilepsy