I received a question from a reader named Karen.
Our 4-year-old Chi/Terrier mix has developed epilepsy. The vet said there isn’t much we can do except for monitor him and give him comfort when it happens. It’s not severe, but he has about one or two seizures a month. What is the life expectancy of a dog with epilepsy?
There are few things as terrifying as watching a loved one, including a pet, have a seizure for the first time. I know this from personal experience. When I was in my early teens, my cat had a seizure in the kitchen. I had assumed she was going to die before my eyes. Imagine my surprise when 30 minutes later, she was acting like nothing happened.
In pets, seizures tend to come in three phases. The first phase is called the pre-ictal stage. Dogs may pant, vocalize, pace, or become agitated. In dogs, a majority of seizures occur at night, and often dogs begin to seize when they are sleeping. Therefore, this phase does not occur universally.
Next comes the seizure itself. Dogs’ bodies may go rigid, and then they convulse. They may may lose bowel and bladder control. They generally are not conscious during this phase, which usually lasts 30 to 120 seconds.
After the seizure comes the post-ictal stage, which may last anywhere from a few seconds to several hours. Dogs may pant, vocalize, be disoriented, appear to be blind, or be agitated.
And then, most of the time, everything goes back to normal. In my work, I have seen many dogs in the middle night who suffered seizures but were completely asymptomatic by the time their owners could get them to me.
There are many causes of seizures, including brain deformities, trauma, exposure to toxins like snail bait or cheap flea products, liver failure, kidney failure, encephalitis, meningitis, and brain tumors. However, the vast majority of dogs who develop seizures between 2 and 6 years of age do so because of epilepsy.
The brain is made of cells that communicate through electrical impulses. Epilepsy is a condition in which an area of the brain fires excessive impulses. Those impulses then travel to and cause more electrical firing in other areas. A chain reaction occurs, and soon the entire brain may be overtaken by the electrical firestorm. The result is a seizure.
Can anything be done for dogs with epilepsy? On that matter, my opinion differs significantly from that of Karen’s vet. It is true that during and after a seizure owners can and should help to comfort their dogs, but there is much that can be done to prevent the seizures as well.
Many medications are available for the treatment of seizure disorders, including epilepsy, in dogs. There is some degree of controversy about when and how they should be used, but I believe that Karen’s dog is a good candidate for medication.
The argument against medications boils down to side effects. Seizure medications work by decreasing brain activity. Decreased brain activity has a clinical manifestation: sedation. Therefore, almost all anti-seizure medications can cause sedation. Furthermore, some of the more commonly used medications may cause other side effects in the long run. Phenobarbital, undoubtedly the most commonly prescribed anti-seizure medication, may cause weight gain and liver problems, and it may have some potential to cause problems with the pancreas. Potassium bromide, another commonly prescribed treatment, also may cause weight gain and pancreas problems.
The risk of medication side effects must be balanced against the potential benefits. Namely, the medications reduce the frequency and severity of seizures. Seizures can cause brain damage and have been linked to memory problems and cognitive decline in humans. Such issues don’t generally cause serious issues for dogs, but another complication of seizures might: Seizures beget more seizures.
Each time that an electrical firestorm sweeps through the brain, additional hot spots may be created. In other words, every time a dog has a seizure, his risk of more seizures in the future increases. Preventing this progression of the condition is the key argument in favor of medicating dogs with regular seizures.
Karen, there are veterinarians who believe that dogs who suffer even a single seizure should go on medications. However, they are in the minority. A majority of vets that I know do not recommend medication for dogs who have a single seizure, or only a seizure every few years.
Your dog, however, is different. He is having seizures more than every month. He is, in my opinion, well beyond the threshold at which I recommend anti-seizure medications.
Some newer anti-seizure medications seem to have fewer side effects despite being very effective. In particular, a medication called levetiracetam (more commonly known by the brand name of Keppra) may have significant promise for your pet.
I’d recommend that you talk to your vet about this drug. With treatment, your dog’s epilepsy hopefully will not progress and his life expectancy should be near normal. Without treatment, I worry that things could get worse, leading to more frequent seizures, clusters of seizures, and ultimately perhaps intractable seizures, which might be fatal.
Read more from our Ask a Vet series:
- Will My Dog Catch a Disease or Fleas at the Vet’s Office?
- A New Vaccine May Help Treat Lymphoma in Dogs
- How Do You Feel About Ear Cropping and Other Unnecessary Surgeries?
Got a question for Dr. Barchas? Ask our vet in the comments below and you might be featured in an upcoming column. (Note that if you have an emergency situation, please see your own vet immediately!)