Canis ISSN: 2398-2942

Seizure: management

Contributor(s): Rodney Bagley, Kyle Braund, Laurent Garosi, Mark Lowrie

Introduction

  • Guidelines have been established to aid the clinician as to when antiepileptic medication should be initiated.
  • In general antiepileptic drugs may either raise the seizure threshold or prevent the spread of the electrical activity.
  • The aim of any antiepileptic treatment is to “control” the seizures by reducing their frequency, intensity and severity with minimum side effects while maximizing the owner’s and dog's quality of life.
  • Owners should be appropriately advised to ensure that their expectations are realistic from the outset.
  • Unless idiopathic epilepsy is considered to be the primary differential diagnosis for the seizure activity, specific treatment of the underlying cause is essential and the success of this will determine the need for symptomatic seizure therapy.
  • The decision of when to start antiepileptic treatment is still a subject of controversy:
    • Dogs with a single seizure or isolated seizures separated by long periods of time (more than one month) do not require treatment.
    • Treatment is indicated when:
      • The animal has a very severe seizure or clusters of seizures, irrespective of the frequency of the seizures or seizure clusters
      • Seizures occur more than once a month and/or the owner objects to their frequency.
      • Seizures are becoming more frequent or more severe.
      • An underlying progressive intracranial disorder has been identified as the cause of the seizures.
      • Post-ictal signs are objectionable (eg aggression).

Standard treatment

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Newer antiepileptic medication

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Summary

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Management of Status Epilepticus

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Further Reading

Publications

Refereed papers

  • Recent references from VetMed Resource and PubMed.
  • Rundfeldt C, Tipold A, Löscher W (2015) Efficacy, safety, and tolerability of imepitoin in dogs with newly diagnosed epilepsy in a randomized controlled clinical study with long-term follow up. BMC Vet Res 11 , 228 PubMed.
  • Lowrie M, Thomson S, Bessant C et al (2015) Levetiracetam in the management of feline audiogenic reflex seizures: a randomised, controlled, open-label study. J Feline Med Surg , pii: 1098612X15622806 PubMed.
  • Tipold A, Keefe TJ, Löscher W et al (2015) Clinical efficacy and safety of imepitoin in comparison with phenobarbital for the control of idiopathic epilepsy in dogs. J Vet Pharmacol Ther 38, 160-168 PubMed.
  • Kiviranta AM, Laitinen-Vapaavuori O, Hielm-Björkman A et al (2013) Topiramate as an add-on antiepileptic drug in treating refractory canine idiopathic epilepsy. J Small Anim Pract 54 ,  5125-20 PubMed.
  • Muñana KR, Thomas WB, Inzana K D et al (2012) Evaluation of levetiracetam as adjunctive treatment for refractory canine epilepsy: a randomized, placebo-controlled, crossover trial. JVIM 26, 341-348 PubMed.
  • Monteiro R, Anderson TJ, Innocent G et al (2009) Variations in serum concentration of phenobarbitone in dogs receiving regular twice daily doses in relation to the times of administration. Vet Rec 165, 556-558 PubMed.
  • Dewey C W, Guilliano R, Boothe D M et al (2004) Zonisamide therapy for refractory idiopathic epilepsy in dogs. JAAHA 40 , 285-291.
  • Ruehlman D, Podell M & March P (2001) Treatment of partial seizures and seizure-like activity with felbamate in six dogs. JSAP 42 , 403-408.
  • Levitski R E, Trepanier L A (2000) Effect of timing of blood collection on serum phenobarbital concentrations in dogs with epilepsy. JAVMA 217 , 200-204.
  • Platt S, Randell S C, Scott K C et al (2000) Comparison of plasma benzodiazepine concentrations following intranasal and intravenous administration of diazepam in dogs. AJVR 61 , 651-654.
  • Patent J M (1998) Clinical management of seizures. VCNA 18 , 947-964.
  • Nichols E S, Trepanier L A, Linn K (1996) Bromide toxicosis secondary to renal insufficiency in an epileptic dog. JAVMA 208 , 231-233.
  • Dyer K R, Shell L G (1993) Anticonvulsant therapy: a practical guide to medical management of epilepsy in pets. Vet Med 88 , 647-653.
  • Speciale J, Dayrell-Hart B, Steinberg S A (1991) Clinical evaluation of gamma-vinyl-gamma-aminobutyric acid for control of seizures in dogs. JAVMA 198 , 995-1000.

Other sources of information

  • Platt S R, Adams V, Garosi L S et al(2003) Gabapentin as adjunctive therapy for refractory idiopathic epilepsy in dogs. Proc ECVN Annual Symposium.
  • Podell M (1997) In: Proceedings of 15th ACVIM. Lake Buena Vista, Florida, USA.


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