Epilepsy – Knowledge is Power When Dealing with this Disease
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“There are not many things more distressing than watching your dog have a seizure. The feeling of hopelessness and helplessness can be overwhelming.”
By Peri Norman
My sister is terrified of earthquakes. Upon witnessing her first epileptic seizure in a canine friend, she described it by saying it seemed like the dog was having its own private earthquake. There are not many things more distressing than watching your dog have a seizure. The feeling of hopelessness and helplessness can be overwhelming.
Defining epilepsy is not a simple task. Like so many other diseases, seizure disorders have come to be recognized as a spectrum of symptoms varying from potentially fatal cluster seizures to tiny focal seizures that probably go completely unnoticed in our canine friends. It is generally accepted that what is commonly known as idiopathic epilepsy is defined as more than one seizure of unknown/undetermined cause. Often, a genetic origin is a presumed “source” of the disease process. However, epilepsy and other diseases are proving to be a much more complex interplay of heritability and environmental influences than we had imagined. A “provoking” incident may play a crucial role in whether or not a genetically predisposed individual develops symptoms. The presumptive diagnosis of epilepsy is always one of elimination; first to be sure that the event witnessed is a true seizure and not a vestibular attack, idiopathic head tremors, exercise-induced collapse or other seizure-like condition, and additionally, to confirm that the seizures are not secondary to other factors including, but not limited to, structural brain issues (scarring or tumors) or ingestion of some toxic substance (secondary epilepsy). Even when blood work and a complete physical examination have been done, a diagnosis of epilepsy is still subject to change based on the discovery of additional disease processes or external causes.
My first litter of Belgian Tervuren had five puppies. Four of them had at least one seizure. They ranged in severity from one pup who was a bona fide epileptic; seizing regularly from her second birthday to about age 11. Two additional pups had more than one generalized (grand mal) seizure. A fourth pup had a series of focal (petit mal) seizures unrelated to any recognized triggers. It was at that point (circa 1987) that I began looking for and collecting both scientific literature and anecdotal reports of epilepsy in dogs. The first real study I found was published in 1968 in the Journal of Small Animal Practice entitled Fits in Tervuren Shepherd Dogs by NA van der Velden. It was a lucky find back in the day before personal computers and the World Wide Web. One of the best things about our modern internet is that excellent quality information is available to everyone. The recently published series of articles by the International Veterinary Epilepsy Task Force (IVETF) is widely and easily available. There are seven distinct papers, one of which focuses on idiopathic epilepsy in purebred dogs. The International Veterinary Epilepsy Task Force’s Current Understanding of Idiopathic Epilepsy of Genetic or Suspected Genetic Origin in Purebred Dogs discusses studies done on twenty different breeds of dogs and has a list of references that is a gold mine of information.
Scientific literature can be challenging to read. To say that it is dry and can be slow reading is an understatement. To people who do not have a background in medicine, it can be like trying to read a foreign language. Not only that, but even in today’s internet age, some original documents can be difficult to find and access. Nonetheless, there is much to be gained from reading scientific documents and studies. Your efforts will be rewarded because the more knowledge you have, the better position that puts you in to take care of your dog and communicate clearly with the veterinary team working to help you. The International Task Force on Veterinary Epilepsy recently discussed the importance of a common terminology and its positive influence on continuity of care for the patients in the first paper of the series entitled IVETF Consensus Report on Epilepsy Definition, Classification and Terminology in Companion Animals.
One of the most important tasks you have after a pet is diagnosed with epilepsy is assembling a good veterinary team. If your dog has occasional seizures and recovers without much difficulty, you and your general veterinarian may decide not to medicate. That does not mean that adjustments will not be needed to assure that your dog is as healthy as possible and that environmental and provoking factors are minimized to mitigate the risk of seizure triggers. Individual cases will vary substantially, but some dogs can be helped by a change in diet. Others may be seizing due to low thyroid levels. In those dogs, appropriate thyroid medication often eliminates the seizures. Many people feel that seizure risk can be reduced by spacing out vaccinations and avoiding vaccinations with mercury. Epilepsy is not rare in canine populations, either mixed or purebred. Most veterinarians have some experience treating dogs that seize. However, a dog with severe or frequent seizures may need medication on a daily basis. Depending on the severity of the seizures and the individual dog’s response to therapy, this may be something your general veterinarian is comfortable treating. Difficult cases may require assistance from a veterinary internist or neurologist. In these cases, the money you spend on a specialist is a tremendous investment in the quality of life for your dog. Good general veterinarians are thrilled to work with a boarded specialist on difficult cases. They learn along with you. Be sure that the veterinarian(s) you are working with are patient and caring. They should be willing to answer all your questions and make an active investment in the success of the treatment plan(s) developed for your dog.
Just a word about herbal and homeopathic remedies; be sure that your veterinary team is informed about any and all alternative therapies you are considering. Just because something is “natural” does not mean that it will not have an effect. You need to be sure that alternative therapies are designed to give your dog additional support in safe, high quality formulations and that the potential for negative interactions with more traditional therapies is minimized. Alternative therapies like massage, chiropractic adjustments, acupuncture and other body work may help (or not) with controlling seizures, but they certainly can contribute to a better quality of life.
Somewhere in the late 1980s, I had a co-worker who was having seizures. This opened up a whole new realm of information for me to better understand what was happening to my dogs. As my friend and I shared our lunch hours, she would tell me about her seizures; how and when they occurred and how she felt afterwards (usually sore and exhausted). Her situation also confirmed for me that hormones can play a role in the onset of some seizures, as she had never seized until she became pregnant in her late twenties. In her case, the seizures were actually caused by a physical injury which caused scarring in her brain when she was a young child. She was eventually treated by a MD researcher at a teaching university who did surgery and removed the scar tissue from her brain. While brain surgery is the last treatment option in a long list, in her case it worked and the seizures were eliminated. This experience carried several lessons. Humans can speak and tell you about their painful experiences in a way that our pets cannot. This can help us to understand more completely the physical impact of seizing on the body. On a grander scale, our lives and health are intertwined. What we learn from studying animals helps people and what we learn from people can help our animals. Reading medical studies of (human) participant-reported experiences became an additional source of information for me.
The goal of reducing the incidence of devastating and debilitating disease in our purebred dog populations is a vital one. Breeders and fanciers can help in a number of ways. Perhaps the most important thing we can do is to approach canine epilepsy, or any deleterious genetic condition with openness and honesty. No one breeds perfect dogs. In many breeds, genetic bottlenecks have existed at various points (like many breeds that found themselves on the brink of extinction after one or both of the World Wars). With so few dogs available for the re-establishment of an endangered breed, everyone has the same genetic foundations in their pedigrees. Claims of “I don’t have that problem in my line” may indicate either lack of education, lack of follow-through on tracking puppies, or outright falsehood. There is nothing to be gained by ignoring or trying to suppress information about dogs that have epilepsy, but there is a tremendous amount of merit in the sharing of information.
Another important step that breeders and fanciers alike can take to help increase our knowledge of epilepsy and other diseases is to encourage, support and participate in available studies. Although epilepsy is not usually fatal, it can be quite variable in age of onset. It is useful to contribute to studies that require both affected and unaffected dogs, but updates are important in the case of dogs with later onset. Contributing genetic material to studies from both affected and unaffected dogs is one of the hallmarks of a fancier who cares deeply about the future of the breed. Additionally, concerned and caring breeders make health information available on their website in an easily useable format. Participation in open registries and databases can be accomplished by both breeders and owners. They are often the starting point for others searching for information on a particular line. While newbies or a few other naïve parties may be impressed when no negative health information is available on dogs from a particular kennel, many people (including those of us who have bred long enough to have “produced one of everything”) see the lack of information as a red flag, not an attribute. It is not about blaming. It is about sharing information so that all fanciers and breeders can make better educated decisions.
Recently, a young dog I co-bred began seizing at about 18 months of age. The owner was devastated, but determined to do everything in her power for her young dog. The outpouring of information and support from her breeders, the owner of the stud dog, and fanciers who had never met her was a far cry from the stony silence (with one notable exception) that greeted me when I began talking about that first litter of epileptic pups born in 1985. As breeders and fanciers, we have made some remarkable progress, but the stigma of epilepsy lives on. My puppy buyer did significant research and came to a follow-up vet appointment with questions. Her original veterinarian discounted her concerns and told her that her questions were ridiculous, thus necessitating the search for a new veterinarian. One of the trainers she was working with “fired” her and the dog, telling her that training would be detrimental to the dog. More than one person told her that the dog would never live a normal life and would probably have a shortened life span. Thankfully, we were able to share our successes with multiple epileptic dogs that lived long and happy lives and became quite accomplished dogs. I am so proud of this young lady and her willingness to be an advocate for her dog and his health. And I am thrilled at the number of people who have stepped up to share their stories with her, without hesitation and without blame. Together, we can accomplish so much on behalf our epileptic dogs and their owners in terms of knowledge and support.
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Posted by ralbee
on Jan 7 2016. Filed under Current Articles, Editorial, Featured.
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