Expert: nicole damphouse - 6/4/2004

Question
My dog looks like he is having a seizure shaking and stagering around what must I do?

Answer
Hi Gordon!It is very possible he may be having seizures and will need immediate veterinarian care.

Seizures are the result of muscle responses to an abnormal nerve-signal burst from the brain. They are a symptom of an underlying neurological dysfunction. Toxic substances, metabolic or electrolyte abnormalities and/or imbalances cause an uncoordinated firing of neurons in the cerebrum of the brain, creating seizures from mild "petit mal" to severe "grand mal."

Stages of seizures:
There are four basic stages to a seizure:
~ The Prodome: may precede the seizure by hours or days. It is characterized by changes in mood or behavior.
~ The Aura: signals the start of a seizure. Nervousness, whining, trembling, salivation, affection, wandering, restlessness, hiding and apprehension are all signals.
~ The Ictus: the actual seizure. A period of intense physical activity usually lasting 45 seconds to 3 minutes. The dog may lose consciousness and fall to the ground. There may be teeth gnashing, frantic thrashing of limbs, excessive drooling, vocalizing, paddling of feet, uncontrollable urination and defecation.
~ The Post Ictus: after the seizure the dog may pace endlessly, appear blind and deaf and eat or drink excessively.

Causes:
The cause can be anything that disrupts normal brain circuitry:
~ Idiopathic Epilepsy, meaning "no known cause" and possibly inherited. This is also referred to as Primary Epilepsy. Check history or pedigree and make sure your veterinarian has looked for possible underlying factors. Seizures caused by underlying factors are referred to as Secondary Epilepsy.

~ Congenital hypoglycemia (low blood sugar)
~ Hypothyroidism (low thyroid function)
~ Infections causing brain damage (such as canine distemper, cryptococcosis)
~ Ingestion of toxins (such as lead paint chips, insecticides)
~ Brain tumors
~ Portosystemic shunts (improperly routed intestinal blood vessels bypass the liver - one of the body's important waste-product detoxifiers)
~ Vaccinations

Types of Seizures:
~ Mild (Petit Mal) can be a simple as momentarily staring into space or upward eye movement.

~ Moderate (Grand Mal) occurs when the dog falls down, loses consciousness and extends its limbs rigidly. Paddling of limbs, salivation followed by possible loss of control of bladder and bowels and vocalization (blood curdling scream) may follow. This may occur for 1-3 minutes and is most often followed by a period of restlessness, pacing, bumping into objects and loss of balance. Post Ictal period:  The dog is conscious but may appear deaf, blind and disoriented. Great care must be taken to prevent the dog from injuring itself at this time.

~ Status Epilepticus can occur as one continuous seizure lasting 10 minutes or more or as a series of multiple seizures in a short time with no period of normal consciousness intervening. This may be life threatening.

~ Cluster Seizures are multiple seizures within a 24 hour period time. This may also be life threatening. It is often difficult to distinguish between the two types and veterinarian assistance is imperative. Rectal Valium is extremely useful in breaking cluster seizures. Please see information regarding this on our website at these links:  Home Treatment with Rectal Diazepam and Home Treatment with Rectal and Oral Valium/Diazepam.

Post Seizure Treatments:
~ To Reduce Post Ictus Pacing:  As soon as your dog has regained consciousness and can safely eat, feeding a small amount of Breyers All Natural vanilla ice cream (a teaspoon for small dogs; a tablespoon for medium dogs; two tablespoons for large dogs) can restore normal blood sugar levels. A seizure may drop blood sugar levels and low blood sugar levels can cause more seizures. A seizure to your dog is equal to your running the Boston Marathon so you will need to replace lost energy by feeding a full meal after the ice cream and then giving a couple of handfuls of kibble or pasta or rice with a little butter every hour. Feeding a small amount of carbohydrates every hour will keep blood sugar levels stable. It is important to remember that your dog will be ravenously hungry so you will need to feed very small amounts at a time either with your fingers or in a bowl so they do not inhale the food and cause aspiration pneumonia. Watch your fingers as you feed them - when dogs are this hungry and recovering from seizures, they can bite you without ever realizing it.

The use of Bachs Flower Essence Rescue RemedyŽ (found in many health food stores) has been found to be extremely useful in some cases when given at this time. Simply put four drops of the Essence into the dog's mouth after the seizure has finished.

Using these suggestions, the post ictal time and severity will be reduced considerably in many dogs.

Medications (listed by trade and generic name):
~ Phenobarbital (abbreviated pb or phb)
~ Potassium Bromide (abbreviated KBr)
~ Phenobarbital & Potassium Bromide
~ Valium (diazepam)
~ Dilantin (phenytoin)
~ Neurontin (gabapentin)

Most dogs can be controlled by using Phenobarbital or Phenobarbital and potassium bromide. Potassium bromide is used alone if the dog's liver has become damaged by Phenobarbital. (IMPORTANT: Dogs on Phenobarbital need to have their liver enzymes tested every three to four months using the following tests:  ALT (SGPT); AST (SGOT); GGT; and Alkaline Phosphatase. They also need pre- and post-meal bile acid testing at the same time to make sure the Phenobarbital has not caused liver damage. If caught very early, liver damage can be reversible.) Both Phenobarbital and potassium bromide are available by prescription in pill, capsule, and liquid form. Primadone, once commonly used, metabolizes to Phenobarbital in the liver; with prolonged treatment it can also cause liver damage. Valium, injectable administered rectally and oral tablets, are a good choice to halt a cluster seizure or interrupt status epilepticus. Dilantin is currently not recommended for use. Gabapentin is a newer drug being used for humans. It does offer exciting possibilities for dogs as it is only partially metabolized by the liver. At present it is very costly to use at around $250.00 a month; however, with the few dogs that have used it, the results have been very positive.

Diet:
Diet plays an important role in the management of Canine Epilepsy. It is very important to feed a kibble that is preservative-free. Preservatives such as ethoxyquin, BHT, and BHA should be avoided as they can cause seizures. Many "supermarket" foods are loaded with chemical dyes and preservatives. Buy a high quality kibble made from "human grade" ingredients or better yet, cook for your dog. Many recipes can be found in Dr. Pitcairn's Complete Guide to Natural Health for Dogs and Cats. PLEASE NOTE:  If your dog is taking potassium bromide, be very careful when you switch dog foods. Try to make sure the sodium content is the same as the previous food. Change over very slowly, whether it is the same sodium content or different, so that the absorption rate of the potassium bromide remains constant.

SUSAN WYNN, DVM, on the canine diet:  "Dogs evolved from Canis lupis - the wolf. Wolves eat caribou or the like, but if they are forced, they will eat smaller game (rarely). They have been observed to graze on grass, eat berries, etc, but only when they need to. This is our lesson in canine nutrition - they are omnivores who do well with fresh meat, the vegetation they get in a caribou stomach (which is mostly green, unless the beast is eating from baited fields), and a smattering of other stuff if they are hungry.

"Food companies have, in the main, revolutionized pet nutrition by eliminating major nutritional deficiencies and providing optimal nutrition for the average pet. Our concern, however, is not for the average pet. It is for the sick pet. If epileptic animals have a disease with even a small nutritional component, wouldn't we want to deal with it? Is your epileptic animal showing other signs of allergies? If s/he is chewing feet, scratching ears, having anal gland problems, vomiting bile seasonally, etc., one may want to consider dietary changes, including hypoallergenic diets, if appropriate.

"I think that the main benefit of feeding real food - meat (raw or cooked) raw or steamed veggies, cooked grains - is to provide stuff that is killed in the kibble extrusion process. If you or I were to eat a diet of Wheaties, yogurt, VegAll, and Spam day after day for 20 years, would this be enough? I don't know, but it makes me uncomfortable. I think our pets need a more varied diet and a fresher one than we can give them with commercial kibble. So I do recommend supplementing pet food with lean meat and vegetables."

Environment:
It is important to keep your epileptic dog as free from chemical pollution as possible. Think about the environment your dog is living in. Do you use chemical sprays on your lawn? Dogs will sometimes seize only when the lawn is sprayed for weeds. How about the cleaner you use for the floor? Some dogs have been known to seize after the floor has been washed with a pine-scented cleaner. There are many things that can lower a dog's seizure threshold. Keep a diary of your dog's seizures. Note anything you have done or anything that the dog could have recently come in contact with which could have contributed to seizure. It is also a noted phenomenon that some dogs have seizures around the full moon.

Vaccinations:
Vaccinations can lower a dog's seizure threshold and trigger a seizure. If you feel that this is the case for your dog, ask the vet to split the shots and give them separately. Also ask for the rabies vaccine to be given 2 weeks later. Ask your vet if he/she knows about the new three-year protocol being used now by many vets.

I hope this has been helpful and I wish you the best of luck!Please keep me posted and give that doggie tons of get well kisses for me!Sending wagging tails your way!
Nicole.D.