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Alternative Dog Medication for Seizures

Alternative Dog Medication for Seizures


Dr. Mark is a veterinarian. He works mostly with dogs and exotic animals.

Although the decision about whether or not to put your dog on seizure medication should be decided between you and your veterinarian, I think that the better-educated dog owner will make a better decision. This article will give you some information about the medications available and give you a few guidelines you might choose to follow.

Watching a dog go through a grand mal seizure is a horrible thing. The neurons in the brain fire all at once, and the dog loses consciousness, falls down, all of the muscles twitch, and the dog may even lose control of his bowels and bladder. A seizure may be a one-time event, though. A dog must have more than one seizure before he is considered an epileptic. If he is suffering from another disease, he may have a single seizure, and after he is cured of the disease, he may never have another problem.

If your dog has an absence seizure, you may not even notice. They are more of a problem in human beings since the epileptic is not able to drive or work around machinery. Is the brain being damaged when he has the seizure? Yes, but it may not be significant.

The treatment for epilepsy will vary. No medication is without side effects, and some of the best medications to control seizures have the most side effects.

What Are the Medications Most Commonly Used to Control Seizures in Dogs?

  • Phenobarbital: This is the most common drug since it is very effective. It also has a lot of side effects. It will make your dog act tired, pee excessively, be constantly hungry and thirsty, wobbly, and restless. Some of these side effects go away after a short time; some of them will come back every time you need to alter the dose. If you have to put your dog on Phenobarbital for a long time, he might have liver damage. Sometimes this can be picked up on blood work, and sometimes it can be treated with milk thistle or other drugs. Some dogs will have liver failure and die.
  • Potassium bromide: This drug is effective in some dogs, either by itself or when used with Phenobarbital. It also may make your dog uncoordinated, drowsy, weak, and sometimes even causes skin problems. If your dog has behavioral changes, sometimes it helps to decrease his dosage. Another side effect of potassium bromide can be GI problems like vomiting or nausea. It may help to give the drug with food, it may help to divide the dose, or you might have to stop giving the drug. If a dog has kidney problems, he may not be able to excrete the drug and can build up toxic levels in his blood.
  • Diazepam: This is an anti-anxiety medication, but it is also effective in controlling seizures in some dogs. It can cause drowsiness, disorientation, and incoordination, so your dog may just lie around except when he wobbles in to eat or drink.

What Are the Newer Medications to control Seizures?

  • Felbamate: This anti-epileptic is used to control seizures when mixed with Phenobarbital or potassium bromide since it will not make your dog drowsier. A dog may be nervous, or more hyperactive, the drug might cause liver problems, and it is expensive and has to be given three times a day.
  • Zonisamide: This drug seems to control seizures in a lot of dogs, but since it has not been used very often, there have not been many reported side effects.

There are other anti-epileptic medications that can be tried but, unfortunately, everything has a side effect, even if it has yet to be discovered.

Every drug has side effects. You can find a drug or a combination of drugs that will keep your dog from having any more seizures. Of course, he might stop climbing the stairs, stop playing with the family, and just sit around when he is not eating.

There are also holistic cures. An article in the Journal of Holistic Veterinary Medicine discussed the use of an ice pack placed on the dog's spine just before or during a seizure. (The area of the back treated is just over the abdomen). Many of the dogs stopped their seizures, and owners that were able to notice a pre-seizure aura actually prevented their dogs from having seizures.

Are you willing to use drugs and sacrifice your dog´s quality of life? Make this decision carefully.

Should you put your epileptic dog on drugs?

Questions & Answers

Question: My six-month-old my puppy had two grand mal seizures 26 days apart. We started him on zonisamide. He's been seizure-free for four months! Do you think we could wean him off the zonisamide in a few months?

Answer: I would definitely start weaning him off the medication. You need to talk to your vet or the person who prescribed him the meds and tell him that you are interested in weaning him off the meds and get his or her suggestions as to how fast you can do so.

Question: My dog is out of phenobarbital. Is it ok to give diazepam instead?

Answer: You should NEVER let your dog run out of phenobarbital. Sometimes a seizure can be provoked just by a low level of phenobarb in the blood.

Diazepam is given in emergency situations to prevent seizures. If you have it on hand, and are not able to get another phenobarb refill, it is your best alternative.

Question: My four-year-old rat terrier recently had a seizure. He has been on phenobarbital medication, which is administered two times a day. What do I do?

Answer: If your dog is not responding to phenobarb, the first thing to do is try him on potassium bromate. Some dogs will do just fine when the medications are combined. Talk to your vet about getting the new prescription.

Question: My female dog is about thirteen years old, and has been on Potassium Bromide for seizures for about ten years now. I am considering taking her off the medication. She hasn’t had a seizure in about seven or so years. The drug is expensive, and so is the blood work that is required to have done once a year. Is this a good idea?

Answer: Yes, it is a good idea, just wean your dog off slowly. Give her 3/4 of the regular dose for a few weeks, then a half dose for a few weeks, then a 1/4 dose for a few weeks. Give her as little as possible until you are sure that she is still not having seizures. All drugs have side effects, so if she can get by without them, you both might have many more years ahead.

Question: My dog is 5 years old and healthy except for the cluster seizures she has once a month. Should she be put on medication?

Answer: Since you are her caretaker that has to be your decision. All seizure medications cause some side effects, and all seizures cause some brain damage. You just have to decide if the severity of her seizures and the change in her personality after justify the side effects.

If this were my dog, what would I do? Without knowing her, it is impossible to say, but I probably would not put her on medications.

You really need to discuss this issue with your regular vet since he or she will be familiar with your dog and any other health conditions that might be going on.

Question: My 1 1/2-year-old Jack Russell is on phenobarbital and has been for around six months; however, seizures are becoming more frequent. Do you have any suggestions?

Answer: You should talk to your regular vet about putting your dog on a Potassium Bromide trial. This drug is sometimes effective alone, but it can also be used in conjunction with phenobarbital.

Question: My adult Chihuahua has been having seizures, and they are increasing in frequency. They last about 3 minutes, but he does not lose bowel or bladder control. What should I do?

Answer: A dog of that age with multiple seizures should be put on medications. You do not indicate if you have tried putting him on phenobarbital, potassium bromide, or any of the other traditional medications. Every time a dog goes through a seizure, brain cells are destroyed, and since he has so many years in front of him, this may become a serious issue. Get him examined by your regular vet.

Question: Why wean off Zonisamide if it is working?

Answer: All drugs have side effects. The most common, according to the manufacturer, are ataxia (kind of wobbly drunk) and sedation. The dog may also start vomiting, have diarrhea, skin problems, etc.

There may also be long term side effects that we are not even aware of because this drug has not been available very long. Keeping a dog on any drug that is not necessary is not a good idea.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on March 20, 2019:

Missy, you cannot say "my dog has not had a seizure in 6 weeks therefore the Nuroplex is working". It just means that the dog has not had a seizure in 6 weeks.

There is nothing wrong in giving it. Nuroplex is a placebo. It is not harmful as it is just water.

Missy Norris on March 20, 2019:

I started giving my 15 year old shitzu on Nuroplex. It seemed to be affective for a month and a half but has had some in the last 3 days. Is this medication a good med for cooper?

Dr Mark (author) from The Atlantic Rain Forest, Brazil on December 15, 2018:

Hi Cindy, Nuroplex is one of those homeopathic remedies that are okay for people with placebos but certainly not for dogs that have a life threatening condition. I do not know why you are not able to get her medical care, but I can tell you that I have seen dogs die from status epilepticus, a condition where one seizure leads to the next, the dog does not cool down, and slowly the dog dies becuase the brain is destroyed from the body heat.

Get Lucy some help now. The medications for seizures (like phenobarbital) are controlled and your vet cannot legally sell them over the counter. During the exam they may even sedate her with something to stop the seizure activity right away.

Cindy Allen from Flowery Branch on December 13, 2018:

I have a 12 yr old small female Boxer weighing around 35-40 lbs. her name is Lucy. She started having seizures 5 days ago.first day she had one and then 2 days later she had 2 and has had 2-3 every day since. They last about 1-3 minutes. I purchased from AllergicPets.com some Nuroplex 500 mg caplets. She started them last night, I gave her 3 with food and again this morning aprox 11 hour after her first dose. 2 hours later she had another seizure lasting 2-3 minutes. She hasn't really recovered form it (it was aprox an hour ago or longer) She is pacing as i am typing this and her balance is not normal. She act and walk like she is disoriented and I'm she is wondering wth is happening. Is there something i can give her that is a quick fix without a prescription something i can buy from maybe the local health food store or local pharmacy??? Help! Help me Help her Please!!

Thanks in advance,

Lucy scared Mom

Dr Mark (author) from The Atlantic Rain Forest, Brazil on January 08, 2018:

Linda, there is no evidence that Nuroplex or any of that class of meds does any good. You are probably just throwing your money away, and each time your dog has a seizure she is losing brain cells. What is worse, the meds or the loss of brain? I am on meds for my seizures, and although all have side effects, they are less than the pain and suffering that a dog goes through each time she has to go through the seizure.

The apoquil was probably a coincidence, but who knows?

Linda Fojtik on January 08, 2018:

Our 12 Yr old Boston Terrier started having seiures after taking Apequil she had never had them before having one a week sometimes 2 in one day, took her off the meds and changed her food for allergies. Maybe thinking that it would help. She has 1 a week and last night she had 3, 3 to 4 hours apart. She is on Nuroplex, was starting out low dose to start. I don't want to put her on Anti seizure meds. Any help you can give is helpful.

LongTimeMother from Australia on January 05, 2015:

Thanks for taking the time to discuss this with me, Doc. I value your opinion.

I think it is time to consider some natural therapies for epilepsy. I'm aware of a few that have been used by people. I will research their potential use with dogs. Thanks again.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on January 04, 2015:

A dozen petit mal seizures in a year does mean your dog is epileptic, but does it justify daily anti-epileptic medications? Not in my opinion. I cannot promise you that he is not going to be effected, and maybe his life span will be shorter than a healthy dog, but it sounds like he has a good quality of life now, and may not if you take him in every six months for evaluation and seizure meds.

LongTimeMother from Australia on January 03, 2015:

Maybe a dozen episodes last year. Months can pass without one, then he might have two within days. It is like there are stages to it though it doesn't take very long. He gets wobbly legs, has a little vomit and crap, then gets foamy mucous in this mouth and his body goes very tense.

The first time we thought he might have been poisoned - but we couldn't figure out how that could have happened. No poisons, rat baits or snail pellets here. He recovers promptly and seems fine again.

We talked about taking him to a vet but he hates going to the vet and it feels a bit pointless taking him when he looks healthy and fit. We just stay with him and talk to him during an episode.

I would hate to be ignoring symptoms of something severe and treatable but it is easy to forget about them because he just bounces back to his usual energetic self. He is about 6 or 7 years old now but still plays fast-running games with his other canine friends, catches rabbits etc.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on January 03, 2015:

Hi LTM, it can be a petit mal seizure but it is definitely not grand mal. How often does it happen? If if is erratic, not a daily problem, I would not bother treating it since most of the meds have serious side effects.

Let me know if you have any other questions about him.

LongTimeMother from Australia on January 03, 2015:

Hello Mark. One of my dogs occasionally gets wobbly legs, vomits a little, eyes glazed, then body tightens and/or shakes. It only lasts a few minutes. Does this sound like epilepsy? He always remains upright. (He also always try to take himself outdoors when it begins.)

Dr Mark (author) from The Atlantic Rain Forest, Brazil on March 06, 2013:

I can understand that, since the first time my dog tried to warn me of an oncoming seizure I just thought she was bothering me and put her outside. She could have saved me some busted ribs and broken glasses if I had paid attention. Humans can be really thick at times!

Kelly from New England on March 06, 2013:

You know, Dr. Mark, Brian will come and find us once Anakin starts seizing, however, I will be honest and say I haven't paid attention to him letting me know prior to the event. Thanks for mentioning that, I'm going to keep an eye on him. The two of them are extremely close and always together - I bet I've been missing the warning signs from Brian!

Dr Mark (author) from The Atlantic Rain Forest, Brazil on March 06, 2013:

Hi Kelly does your Bichon let you know when Anakin is going to have a seizure? Training seizure alert dogs is really simple, a lot more so than the people who sell them claim! Maybe if he lets you know you can have the ice pack ready, or at least you can make sure Anakin lies down and is not injured when falling over.

Keep trying. It is great that you are keeping track of the triggers, and hopefully you will be able to prevent more in the future.

Kelly from New England on March 06, 2013:

A great article, yet again, Dr. Mark. This one is near and dear to my heart as Anakin, our Siberian Husky, was diagnosed with canine epilepsy. He can go for entire summers without a single seizure, but he has a hard time with them in the winter months. I once read an article about sudden severe changes in barometric pressure being a trigger in canine seizures, and I have been able to relate a lot of his episodes with the rise/fall of the pressure here. I had never heard of using an ice pack before, and I'm going to try it out. He paces a lot prior to his seizures, so I might be able to tell when it's coming and try that. We tried him on meds, but we felt like he was worse on them. His seizures are mild in comparison to other dogs we've seen and only last a couple of minutes. Interestingly, we found that the smell of eucalyptus and rosemary seem to trigger seizures for him... we do our best to keep a list of triggers and steer clear. Thanks again, Dr. Mark, for keeping us dog owners/lovers in the know!!

Dr Mark (author) from The Atlantic Rain Forest, Brazil on October 09, 2012:

Sometimes it is helpful, will extend life and improve quality. Unfortuantely that is not always the case. Thanks for commenting!

Jessica Peri from United States on October 09, 2012:

Voted up! My boyfriend's aunt's dog was on seizure medication before she passed away. I don't know what it was, but it was necessary because she had them constantly without it. She had decided against putting her down. It extended her life a little, but the dog just recently passed away. Your hub was very informative.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on September 12, 2012:

Frontline (fipronil) is no better or worse than any of the poisons that people put on their dogs in order to get rid of fleas. Drug companies will tell you that the poisons have no side effects; well, at least none they know about at the moment. As you point out, however, they can always say the problem was caused by something else. "No, Frontline is safe, it only affects fleas and other insects."

Thanks for leaving the comment.

Christy from The Deep South on September 12, 2012:

Hey, I did some reading about seizures in dogs. DId you know that Frontline, the flea medicine, can cause seizures in dogs and actually is more frequently doing so then is made known. Deffinately something to look into if your dog is suffering from seizures!!!

Dr Mark (author) from The Atlantic Rain Forest, Brazil on September 12, 2012:

Thanks for the visit. Cute picture of the IG at Christmas, don't you think? Look at those legs!

Linda Crist from Central Virginia on September 11, 2012:

So glad you covered this topic DrMark1961. It's so important for owners to know they have options. Great work. Voted up.

Dr Mark (author) from The Atlantic Rain Forest, Brazil on September 11, 2012:

Hi wetnosedogs! No, I think that she puts up with me but can´t smile about it all of the time. Have you seen that new "page of shame" that has dogs wearing signs saying things like "I like to eat dog poop"? None of the dogs can read the signs but they all look unhappy.

DoM, it is good to hear from you, even with that story. My friend in Rio Grande has a similar story about the Chihuahua she picked up on the street. When she got old the owner did not want her anymore and dumped her. The dog recently died at 20+, and Maria Luiza had to deal with seizures on occasion. It is really hard to watch.

Melissa Flagg COA OSC from Rural Central Florida on September 11, 2012:

My little yorkie/shitzu had seizures. They were myoclonic seizures but she only had them once or twice a year. She had brain damage from an old lady who beat her over the head with a broom when she was a puppy. When I rescued her (literally stole her), she had them every now and then, as she got older they became more frequent. I decided against medication because they were so infrequent, and she never had any other problems. She died a year ago this November 1 (cancer, a tumor that caused torticollis). I always held her during the seizures.

Anyway, sorry to be so depressing. Great hub!! :D

wetnosedogs from Alabama on September 11, 2012:

Your dog is ever loyal wearing that scarf or whatever it is. I really don't see a happy face, though!


Holistic Treatments for Epilepsy in Dogs

Question: My dog was just diagnosed with canine epilepsy. Are there holistic treatments that will prevent or reduce dog seizures while avoiding the use of harsh medications like Phenobarbital?

Answer: Canine seizure disorder and epilepsy are common ailments, seen in at least 1 percent of all dogs. Dog seizures, also known as convulsions, are precipitated by any process that alters normal brain function and causes inflammation. One of the difficulties in treating epilepsy in dogs is that your veterinarian may not be able to easily determine the cause of the seizures.

Veterinarians usually arrive at the diagnosis of idiopathic epilepsy (cause unknown) only after systematically eliminating all other causes of dog seizures, including low blood sugar (hypoglycemia), severe ear infection, head trauma, allergic reaction and reaction to environmental toxins or certain medications, severe vaccine reaction, and finally, brain tumor and liver disease. If your dog experiences a seizure and your vet suspects epilepsy, he or she will want to do a comprehensive blood panel and perhaps x-rays to rule out other possible causes. Once everything else is excluded and a diagnosis of epilepsy is made, most traditional veterinarians will prescribe anticonvulsant medications such as Phenobarbital and potassium bromide to control the symptoms.

Holistic veterinarians look for ways to treat dog seizures on a deeper, constitutional level instead of temporarily palliating the symptoms, and can offer a variety of natural alternatives to anticonvulsant medication, which can have toxic side effects and cause over-sedation and personality changes when used on prolonged basis. Following is an overview of holistic approaches to treating epilepsy in your dog.

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Integrative Options: Natural Remedies for Dog Seizures

Acupuncture

In my practice, acupuncture—the ancient Chinese art of inserting fine needles into specific points in the body to gently move energy, or “chi”—is the most effective treatment for canine epilepsy. Initially, I give 20 to 30 minutes of acupuncture once a week for four to six weeks, then every six to eight weeks as needed to prevent further seizures. I often prescribe Chinese herbs in addition to regular acupuncture sessions additionally, gold-bead implants can be used once a long-term treatment plan is in place.

Depending on your dog’s specific situation, sometimes diet changes alone can be effective in treating seizures in dogs. Numerous case studies have shown a correlation between food allergies and epilepsy. Switching your dog to a hypoallergenic diet or transitioning from an over-the-counter commercial food to home-prepared meals with organic ingredients can prevent seizures and make a huge difference in your dog’s overall health.

Essential Fatty Acids (Omega-3 and Omega-6 oils)

Many humans with epilepsy have been helped by eating a ketogenic diet (high in fat, low in carbohydrates). High fat seems to decrease the excitability of the neurons in the brain, and the addition of omega-3 and omega-6 fatty acids (both of which are found in wild-caught-salmon oil) can decrease seizure frequency and intensity in dogs.

Chiropractic Care

Regular chiropractic adjustments are especially effective in treating cases of epilepsy that follow head injuries or physical trauma, as well as chronic, recurrent ear infections that seem to trigger seizures. Make sure your pet’s chiropractor is a certified veterinary chiropractor with experience in canine epilepsy.

Nutraceuticals

The exact mechanism of action of each supplement is beyond the scope of this discussion, but a variety of vitamins and nutritional supplements have been highly effective in decreasing seizures in dogs naturally. In my practice, we regularly recommend the following for our epileptic patients: DMG (n, n dimethyl-glycine) Choline taurine L-tryptophan magnesium melatonin phosphatidylserine and antioxidants such as vitamins C, A and B complex.

Western Herbs

Many natural over-the-counter Western herbs, in both capsule and tincture form—including chamomile, milk thistle, skullcap, valerian, oat straw and ginkgo biloba—are used to treat seizures. As with nutraceuticals, always discuss appropriate herbs and dosages with your veterinarian(s) before giving them to your dog.

Homeopathy

Homeopathic remedies work on the premise of “like cures like.” They contain tiny amounts of substances that, if given to a healthy animal, would cause symptoms similar to those you are treating. Choosing the perfect remedy for your pet’s illness is a complicated process and requires an experienced homeopath however, once a proper remedy is given, it can stop a seizure in its tracks. Commonly prescribed remedies include Belladonna, Aconitum and, in cases of vaccine-related seizures, Thuja. It is always best to consult a homeopath before giving a remedy.

Flower Essences

The Bach flower essence Rescue Remedy can be used when you suspect your dog is about to have a seizure, or as an overall stress reducer to prevent future seizures.

An Ounce of Natural Prevention

Avoid vaccinations once your pet has been diagnosed with epilepsy. Over-vaccination can aggravate the condition.

Avoid exposing your dog to toxins. A chemical-free environment helps protect your pet against contaminants—such as car exhaust, cigarette smoke, polluted drinking or swimming water, flea-control products, and food additives and preservatives—that can irritate brain tissue.

Create a happy, stress-free environment for your pet. Many cases of epilepsy follow a stressful event, such as a prolonged stay at a boarding kennel, moving to a new home, long periods of time alone and boredom. Keeping your dog happy, relaxed and well-exercised will help prevent stress.

Epilepsy and dog seizures can be a frightening and frustrating illness to diagnose and treat. Once a diagnosis of canine epilepsy has been made, however, there are many safe, natural, easy holistic options that can be used to both treat and prevent seizures. In some cases of refractory cluster seizures (a more serious condition that can require hospitalization), low doses of medication may still be necessary to control episodes. Overall, however, the holistic approach can help you assist your dog to gently heal.

If you are interested in pursuing a more holistic, integrative approach, including any of the treatment options listed here, please consult your veterinarian, or seek out a holistic veterinarian who can help you make the best treatment choices for your special pet. Contact the AHVMA and IVAS to find veterinarian near you who offers acupuncture and holistic alternatives to preventing seizures in dogs naturally.


Seizures and Anticonvulsant Medications

Seizures are a clinical manifestation of excessive hypersynchronous neuronal activity. The causes of seizures are due to an inadequate amount of neuronal inhibition (i.e., GABA and glycine), excessive neuronal excitation (i.e., glutamate) or both. Seizures originate from the cerebrum and/or thalamus.

The four components of a seizure are the pre ictal (prodrome and aura), ictus, and post ictal period. Prodrome is prior to the onset of seizure and may or may not be seen or reported. It may manifest as increased hiding, pacing, or attention seeking. The aura is the initial manifestation of the seizure. It may last seconds to minutes and may be seen as stereotypical motor, behavioral, and/or autonomic changes. Clinically it may be difficult to differentiate between the prodrome and aura and is typically referred to as the pre ictal period. The ictus is the actual seizure event and typically lasts less than two minutes. The post ictal period can last minutes to days after the seizure. Patients may show behavioral and/or neurologic (forebrain) symptoms in the post ictal period.

Epilepsy is defined as recurrence of seizures and typically designated as two or more seizures occurring at least one month apart. Epilepsy is a symptom it is not a disease. A cluster is defined as two or more seizures within a 24-hour period, with a recovery of consciousness. Status epilepticus is a seizure lasting longer than 5 minutes or two or more seizures without a recovery of consciousness.

Seizures can be classified by the type or etiologic category. The three main types of seizures are focal, generalized, and focal with secondary generalization. The latter is the most common in people and dogs with primary epilepsy. Generalized seizures can be described as tonic, tonic-clonic, clonic, myoclonic, atonic, or absence. Focal seizures are either simple (no loss of consciousness) or complex (loss of consciousness).

The etiologic classification describes the seizures based on two major underlying causes:

1) Idiopathic (otherwise known as genetic or primary) epilepsy
2) Structural epilepsy

Idiopathic epilepsy is a very common neurologic disease, estimated to affect 1 percent to 2 percent of the entire dog population. It can be subclassified into three types (genetic epilepsy, suspected genetic epilepsy, and epilepsy of unknown cause). Seizures are refractory to one medication in about 25 percent of cases. There are many breeds that can be affected with primary epilepsy and a complex mode of inheritance is suspect in most purebred dogs. Genetic epilepsy is a diagnosis of exclusion. Factors that support the diagnosis include first seizure event between 1 and 5 years of age in dogs, normal interictal period and normal diagnostic testing.

Structural epilepsy is characterized as epileptiform seizures due to an underlying intracranial pathology. Possible differentials for structural epilepsy include degenerative, anomalous, neoplastic, inflammatory (infectious or immune-mediated), trauma, or vascular. Extracranial causes of seizures, such as toxins, hypoglycemia, hypoxemia, hepatic disease, renal disease, thiamine deficiency, etc., are considered reactive seizures. In these cases, the epileptiform activity is occurring as a response to a transient disturbance in function of a normal brain.

It is rare to visualize the seizure event. Therefore, we need to rely on the owner’s history of the episode. In many cases, video recording of the event can be helpful. There are many episodes that can mimic seizure (e.g., syncope, vestibular events, head bobbing, sleep disorders, cervical muscle spasm). Therefore, a thorough history and neurologic examination are keys to not missing a diagnosis of a different disease process.

There are three questions we should ask of all cases with the chief complaint of seizures: 1) Is it a seizure? 2) What is the cause? 3) Does it require treatment?

When deciding to start treatment for seizures, we need to consider the disease and treat any underlying issue that may be causing a symptom of seizure, such as detoxification and antibiotics for infectious disease. We also need to consider the kindling phenomenon each seizure can cause a positive feedback loop and stimulate another seizure. Lastly, we need to consider the patient and client compliance (for example, the difference between medicating a fractious cat versus a food-motivated Labrador retriever). Such factors need to be discussed and decided with the owner.

Maintenance anticonvulsant treatment should be considered required in the cases where there is known intracranial disease, the patient is in status epilepticus, and/or there are two or more isolated events or cluster episodes within a 4-week period. The 2016 ACVIM consensus statement on seizures also recommends starting antiepileptic drug treatment if there are two or more seizures in a 6-month period.

Educating Clients

Client communication is key to success and meeting reasonable expectations for their pet’s treatment. The discussion about seizures and anticonvulsant medications is as important as the discussion you would have with clients about diabetes and insulin treatment.

Clients must understand that seizure therapy is considered successful if there is a 50 percent or greater reduction in the frequency, intensity, and/or severity of seizures. It is unrealistic to communicate to the owners that there will be no seizures. The owners also need to realize that the patient will likely require lifelong treatment with frequent reevaluations and monitoring. They should also be aware that there is the potential for emergency visits and possible side effects of the medications. It is also important for them (and us as the clinicians) to not judge the efficacy of the medication for at least 4 weeks.

Clients should be advised to not change the medication dose without consulting their veterinarian. Unless there is toxicity or other side effects with the medications, it is strongly recommended to wait one year for the patient to be seizure free before trying to decrease the medication.

Owners should be informed that they should not stop the medications “cold turkey,” which could cause the patient to have an increase in epileptiform activity (in other words, cluster seizures or status epilepticus).

Owners should also be instructed to keep a calendar to record the date, time, and duration of the pre ictus, ictus and post ictus periods of every seizure.

At-home Seizures

Owners should be taught what constitutes an emergency. If a seizure lasts 5 minutes or longer and/or the pet has three or more seizures within a 24-hour period, the pet requires emergency evaluation by a veterinarian. After a seizure, the owner should be instructed to administer medications.

Many owners are adverse to giving medications rectally. Unless the patient has a history of cluster episodes, we can avoid the rectal route. The owners should be instructed to give an extra oral dose of their maintenance anticonvulsant once the patient is awake and aware enough to swallow. This works with most seizure medications, except bromide (due to its long half-life).

For patients that tend to cluster, consider a pulse dose and additional short-acting anticonvulsant drug to be administered over 48 to 72 hours after the last seizure. Strategies that allow the owner to administer medications at home to avoid additional seizures can mean that the patients stay out of the emergency room and can ultimately avoid euthanasia.

Treating Seizures in the Clinic

Antiepileptic Medications Chart

When a patient presents actively having a seizure, initially assess the ABC’s and vital parameters. Hyperthermia and hypoxia are potential complications of status epilepticus. It is also important to try to obtain intravenous access. If you are unable to get intravenous access, you can give diazepam (1 to 2 mg/kg rectally) or levetiracetam (20 to 30 mg/kg subcutaneously or intramuscularly).

Be sure to collect blood in order to rule in or out hypoglycemia, hepatic, and other metabolic diseases. Be sure to collect blood for possible levels before reloading a patient on medications. For phenobarbital, collect blood in a red top without a serum separator.

Once you obtain IV access, administer levetiracetam (20 to 30 mg/kg IV) or a benzodiazepine, such as midazolam (0.1-0.2 mg/kg IV or IM in multiple species), diazepam (0.5 mg/kg IV in dogs or cats), or lorazepam (0.2 mg/kg IV dogs) to most rapidly stop the seizure. If intravenous access cannot be obtained quickly, both diazepam and midazolam can be administered intranasally (same as the IV dose) and diazepam can be administered rectally (at double the IV dose).

Remember that most of the benzodiazepine therapies have a very short duration of action. This is very important, as they can be helpful and quick to stop the initial seizure. Be sure to start the patient on maintenance drug therapy or start loading medications to prevent additional seizures, as the effects of the benzodiazepines wear off quickly.

Please refer to the chart regarding the available antiepileptic drug therapy.

By Devon Hague, DVM, DACVIM (Neurology)


CBD Oil for Dogs with Seizures

Many people give CBD to their dogs to help control seizures.

Seeing your beloved dog have a seizure can be a frightening experience. Seizures can be subtle, indicated by staring, a dazed appearance, whining, twitching, jerkiness, heavy breathing, or unusually rapid eye movements. They can also be distressingly severe, resulting in uncontrollable fits, tremors, and even loss of consciousness.

Seizures are basically caused by the abnormal firing of neurons in the brain. If your dog has seizures, whether mild or severe, you should visit your veterinarian to determine the cause.

If you want to supplement your dog’s treatment with a natural remedy, CBD oil should be your first option. Cannabidiol (CBD), is a non-psychotropic component of the Cannabis sativa plant, which has been shown to have anticonvulsant properties. Extracted from industrial hemp (not marijuana) and legal in all states, CBD won’t make animals high and there are no known side effects.

How does CBD work to reduce seizures?

All mammals have an endocannabinoid system, a network of numerous receptors that regulates body functions. Endocannabinoids are synthesized on demand by the body to maintain homeostasis – a stable internal environment. When a condition such as epilepsy interferes with homeostasis, these internal mechanisms lag behind the body’s needs. Supplementing with the phytocannabinoids found abundantly in hemp can help restore balance.

Two types of endocannabinoid receptors have been identified: CB1 receptors, found predominantly in the brain, nervous system, glands and organs and CB2 receptors, existing mainly in the regulatory cells of the immune system. While CBD supplements benefit both types, their ability to calm overactive neurons and control seizures comes from the interactions with CB1 receptors. When the nervous system has been impacted by an illness or injury, CBD supplements can restore homeostasis.

How effective is CBD at treating seizures in dogs?

Anecdotal feedback is highly encouraging. There are countless testimonials and endorsements from pet parents sharing how CBD has helped their furry friends overcome dog seizures, including cases where conventional medications haven’t helped. Regular use has shown to decrease both the frequency and severity of seizures.

Preliminary research is so highly promising that the American Kennel Club Canine Health Foundation is currently conducting research on CBD’s effectiveness at treating seizures in dogs https://www.akc.org/expert-advice/health/alternative-medicine/cbd-oil-for-dog-seizures/ through Colorado State University https://cvmbs.source.colostate.edu/preliminary-data-from-cbd-clinical-trials-promising/ Initial research found that 89 percent of dogs who received CBD in the clinical trial had a reduction in the frequency of seizures.

Additionally, the National Institute of Health has published CBD research demonstrating strong reductions in epileptic seizures in rodents and shows CBD to be an effective therapeutic anti-convulsant. https://www.ncbi.nlm.nih.gov/pubmed/22520455

How do you treat dogs’ seizures with CBD?

To reduce the severity and frequency of seizures, give your pet CBD regularly. Typically, relief will be best achieved by dosing twice a day. Dosage amounts can vary quite a bit from one situation to the next, so it may be necessary to experiment to find the right amount, and how often to give. Keep in mind that you cannot overdose and there is no toxicity associated with CBD.

CBD for dogs is available in many convenient forms. Extracts can be given from a dropper bottle directly into the mouth, added to food, dropped on a treat, rubbed into bare skin or inside the ears, or dropped on an animal’s paw so they will lick it off. You can also find hemp CBD biscuits, hemp CBD capsules, honey with CBD, and topical hemp CBD ointments. Make sure the CBD product you choose is lab tested so you can be sure you’re giving your pup the best opportunity for natural relief with hemp CBD.

CBD can provide multiple additional benefits.

We cannot provide veterinary advice

Please note, we cannot provide health recommendations for individual animals and we are not veterinarians. Please contact your dog or cat’s veterinarian with any health concerns you may have.


Phenobarbital

One of the most commonly used medications to manage seizures in dogs is called phenobarbital.   It is a type of drug called a barbiturate and works like other seizure medications by sedating or slowing brain activity. This slowing of the brain activity is helpful since the brain is overactive when a dog is having a seizure. Phenobarbital is commonly used because it is not only effective but it is also usually one of the least expensive options for seizure medication. Medications to manage seizures are typically used life long so the cost of them adds up quickly.

If your pet takes phenobarbital then your veterinarian will routinely check its blood work to ensure there are no detrimental side effects and that the drug levels are appropriate in the body. Phenobarbital is known to cause liver dysfunction since it is primarily metabolized in the liver so some pets may not be able to take it if their livers are already compromised or damaged. It is typically dosed twice daily.


Watch the video: Dog Epilepsy: How to Stop a Dog Seizure