January 4th 2011 2:53 pm
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Idiopathic seizures/Seizure disorders/epilepsy normally presents in dogs around the age of two. Seizure activity prior to this is often associated with endocrine issues (hypoglycemia, liver shunt etc) and seizure activity arising later in life is more commonly associated with endocrine issues (namely diabetes), neurological disorders or cancer (brain/spine). Idiopathic epilepsy is defined as epilepsy with no known cause. What it means is that the seizures are caused by a genetic or congenital issue rather than a endocrine, organ, toxin or disease process. This type of epilepsy can be controlled in most cases.
The following breeds are some that have a known genetic idiopathic epilepsy diagnosis; Beagles, GSD's, Irish Setters, Belgian Tervurens, Poodles, Saints, Keeshonds, Cockers, Labs and Goldens. Any dog developing seizures should be considered unbreedable. As hormone influxes can cause seizures to worsen serious consideration shoud be made in speutering a pet with idiopathic seizures.
In some cases a dog may have one seizure during its entire life and never have another witnessed by the owner. In other cases your dog may have a seizure every couples years, yearly, every few months or closer together. Medication is not recomended until the seizures become longer in duration than 5 minutes, come in clusters (more than 1 seizure within 30-60 minutes) or happen closer than every 6-8 weeks.
Every case is different. If your pet has a seizure there are several steps you can take to help determine their need for medication, additional testing, nursing care etc.
Start a journal where you record the time, date, length, symptoms/actions, what was happening at that time and weather at the time. It is also important to record any medications he recieved that day and what time. This is important because some animals have seizures associated with medication administration - this happens to some animals after heartworm preventative or flea/tick topical meds.
This journal is very important because it will help you keep track of how often they are happening and give you the ability to find a pattern if there is one.
Seizures are scary events for the witness NOT neccesarily the affected. Most humans report that they have no memory of the seizure and they are generally not painful. So keep in mind your anxiety when Charlie comes around may negatively affect him or cause him stress. During the seizure there are several small nursing care things you can do to help make your dog comfortable and also help calm yourself as well.
You can start prior to any more seizures by "seizure proofing" your home. If you know your dog is having seizures you should ensure that he is confined to one floor during the times he is home alone. This will help prevent any possible falling down stairs if he loses conciousness. Also look around the rooms he is most likely to be in for any super sharp corners or places that he may fall onto something and hurt himself. It may be neccessary to have a "safe" room for him when he is alone.
OK - Now for DURING the seizure -
The average seizure (shaking/convulsing) should last no longer than 5 minutes. If it is longer or they are not coming out of it at all your regular vet or emergency vet should be contacted immedietly. If a dog is having a seizure for longer than 8 minutes with no sign of improvement OR has cluster seizure that are more frequent than every 10 minutes or lasts 1/2 hour then you should go to the closest open animal hospital for IV medications like valium or phenobarbitol IMMEDIETLY!
Most times a seizure is pretty safe for the witness but I also would like to note that there are a small percentage of dogs who have agression associated with seizures. This can be very dangerous so please monitor your pets behavior. If they become aggressive leave immedietly, lock them in another room and contact someone(this may include your neighbor, family member, police, animal control, veterinarian etc-all precautions should be taken to keep you and your pet as safe as possible-seizure induced aggression usually lasts less than 30mins but may be longer-if your dog is aggressive DO NOT RISK TRANSPORTING THEM UNRESTRAINED IN A VEHICLE-Crate them OR get police/AC to take them) ASAP. The seizure should not last long so usually they come around and get back to themselves but NEVER lock yourself in a room/car with a seizuring animal. I don't mean this to scare you but have seen this happen and it is not fun!
1-Never put your hand near or in his mouth during the seizure. He may bite even if he has never bitten you before, and during a seizure he may not let go.
2-Never place your face close to his - same reason as above - he may bite and it may be very dangerous.
3-Make sure to remove any dangerous items from around him so that he does not hurt himself. Place him on the floor if he is not already. If this is not possible then position people around him to prevent him from rolling off whatever he is on.
4-Make sure he is laying down and not tangled in any blankets. I would remove all blankets from him. During a seizure body temperatures increase dramatically and can cause overheating or heat stroke.
5-Provide a pillow under his head to prevent him from flopping and banging his head on the floor. In general dogs do better during seizure while laying on their sides on the floor.
6-Place a fan nearby (especially in summer) to help cool him. You may also want to wipe his face with a cold face cloth. In my experience the cooling sensation helps them to recover slightly faster and it also helps the witness by giving them something to focus on to stay calm.
7-Your dog is likely to lose control of bladder and sphyncter resulting in both urination and defecation. It is most likely to get all over them so keeping things like towels or doggie pee pads close by is a good thing.
OK - Now AFTER the seizure.
The convulsing part is followed by the POST-ICTAL period. This is a period of confusion, disorientation and ataxia that last anywhere from 1/2 to 1 hour. Some people report feeling funny for the rest of the day. This is a time when constant supervision is required for your dog. He may have trouble standing, walking, may appear dizzy. Some instances vomiting or diarrhea may occur now. Some owners also report dogs become very thirsty following a seizure. You should limit the amount of water you offer at one time to reduce the chance of him drinking very large amounts then vomiting. Offer 1/2 cup amounts every 15-30 minutes until he is satisfied and discontinue/call your vet if he vomits.
At this point you may need to confine your dog to a small comfortable area and sit with him. Speak calmly and take time to stroke and pet him. Humans have reported that during the post-ictal stage human touch helps them to feel comforted and often helps them feel less stressed. In my experience with dogs they calm down better when you spend time stroking and talking to them after a seizure. This may also be a good time to write in your seizure journal.
1 ) Some people use bells on the collar of the pet to help notify them when they are unable to keep constant visual contact but are within hearing distance. Bells will shake violently when the dog is having a seizure. This is common practice at alot of vet clinics to help notify nursing staff of a seizure.
2) There is a group on Dogster called "the movers and the shakers". This is a group of other dogs and owners who are dealing with the same things as you and may be able to give some good info too.
3) Consider adding a medical alert tag to your dogs collar incase he gets free or is picked up by a citizen or animal control. This will ensure he is treated properly in case a seizure happens in their care. It is just a emergency notification type thing.
4) Make sure EVERYONE in the household understands seizures and what to do if they happen! It may be neccessary to tell guests as well.
5) Make sure to NOTIFY any place your dog goes like groomer, daycare, kennel etc so the staff knows. I would also make sure to mention it at every vet visit and bring along the journal too so that the vet has all the info you do. This will be helpful when considering medication and also to help make sure no medications are given that may negetively affect him. Some clients also call their vet after every seizure so that the receptionist or tech can place a note in his file everytime - this is sort of like a back-up to the journal just in case.
There are anti-seizure medications that can be given. These medications have side effects on the Liver, kidneys and also cause polyphagia (increased appetite) and polydipsia (increased thirst). These side effects cause concern so many vets will only treat an epeleptic dog if they have seizures consistantly lasting longer than 5 minutes or they have seizures more frequently than once monthly. These medication require frequent bloodwork to check that they are providing adequate levels in the blood and also to check the liver and kidney functions.
The two most common preventative medications are phenobarbitol(tablet) and potassium bromide/KBR(capsule or liquid). There also appears to be a link between KBR and pancreatitis. If you notice a decreased appetite or diarrhea while taking this medication contact your vet. Depending on the severity of the seizures when medication is started your vet may reccomend hospitalization for a loading period. A loading period is usually 24 hours of hospitalization where anti-epileptic drugs are given IV at a high dose that usually causes some sedation (which is why we only do this hopitalized) but builds the drug level up quickly in the system so we can get the seizures under control then start a pill regiment at home. Anti-seizure medications are given either once daily or twice daily.
A newer medication being used is Keppra which can be cost prohibative for larger breeds.
Ther e is really only one way to diagnose 100% seizures and that is an MRI (MRI) and CSF (ceribrialspinal fluid tap - CSF tap ) tap - This test can be expensive and requires anesthesia (usually costs about $1500-2000 depending on the area MRI'd and the CSF tests). The MRI will show any issues in the brain and the CSF shows infectious diseases, brain chemical inbalances etc. These tests are not an everyday option in most areas and a referral to a board-certified neurologist may be neccessary (and in my opinion IS VERY necessary). There are many many dogs out there who have seizure disorders and have never seen an neurologist so it definetly is not required but I wanted to make sure you know it was available and that it may be something to condider especially if your dog is younger. Dogs who have seizures disorders at his age often will have them for life.
January 4th 2011 8:42 am
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"Full Bloodwork" for most vets includes a Chemistry Panel and CBC. Often, depending on age, vets will also include a thyroid check and urinalysis. Some labratories (I am only really aware of US labs) have "wellness panels" that lump several different tests together at a discounted rate to offer to clients. IE Antech (a us vet lab) has a Senior Dog Panel which includes Chem, CBC, T4 and UA. There are others that may lump in a HWT, T3 or limited chem. Limited chems are an easy, cheap alternative for younger, healthy dogs to get bloodlevels checked when healthy to track later (or before easy anesthetic procedures).
What do these tests mean?
First you need to understand the parts of our blood. Blood is broken down pretty much into 2 parts, serum and RBC's. Testing of certain things requires different types of blood. We almost never test just the RBC's alone but we do require whole blood for some testing and serum for other testing.
Whole blood is everything. After the sample is taken from a patient it is placed in a tube containing an anti-coagulant (IE something that prevents it from clotting - EDTA is the most common). This helps keep all individual cells seperate so that counts/tabulations can be made about what types of cells are present in a patient.
Chemistry Panels require the serum. Serum is what is left over after the red blood cells are spun down. IE anything that is NOT red. Serum is normally straw colored and clear. However in some cases it can be lipemic (cloudy + pink/redish) which usually means there are extra lipids (fats) in the blood. This is common in older animals, animals suffering from liver disease, overweight patients etc. In some cases it can also be hemolyzed (clear + red/pink) which can be the result of a mechanical degradation of the RBC's (IE damage due to the actual blooddraw or placement of blood into tubes-this is a common occurance especially if patient is not cooperative or too small a needle is used or too much pressure is applied when placed into tubes) OR a chemical degradation (in cases where the body system is attacking the RBC's -IMHA for example- the serum is often hemolyzed). In cases where the serum is icteric (clear + dark yellow) we know that hyperbilirubinemia is present. Increased bilirubin can be indicative of diseases that cause hemolysis or of liver involvement and when it leaks into the serum it causes the dark yellow appearance. It can also cause the mucous membranes of a patient to appear yellow as well (IE gums, whites of eyes, inside ears).
The serum is also responsible for most other endocrine tests including Thyroid, cushings, addisons, diabetes etc.
OK now for the individual tests.
A chemistry panel looks at all the markers that tell us how well the patients organs are functioning. This includes kidney function, liver function, protiens, lipids, some electrolytes etc.
Common levels you may be familiar with that are included in the chemistry are:
BUN/Creatinine - Kidney's
Blood Glucose - Pancrease
ALP/ALT - Liver
For an indepth look into what each number and what they mean check this out. Remember that not all Chemistry Panels include everything listed on this link. There are full and partial chemistries depending on the lab and doctor request. Understanding the Chemistry Panel
COMPLETE BLOOD COUNT
A CBC measures and evaluates the individual cells circulating in the blood. It measures White Blood Cells which can be indicative of infection. Red Blood Cells which can give us information about anemia or regeneration of blood. Platelets which are important for clotting. It can also show signs of parasitic infections as Eosinophils rise when parasites are present in a patient.
This article explains more precisely what each different level in a CBC means --> Understanding the CBC.
Hope this helps clearly explain what we mean when we say "full blood work"
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