Seizures in dogs are traumatic and scary for both dogs and their guardians. Recurring seizures can be emotionally draining and economically difficult for the dog guardian. I will cover causes and treatment options, and offer some insight that will help give your epileptic dog the best chance at a high-quality life.
Causes
There are multiple causes of seizures such as:
- Structural abnormalities in the brain (brain tumors, trauma, infection, inflammation).
- Toxin ingestion such as rat poison, Bromethalin, antifreeze (ethylene glycol), xylitol, flea and tick products, etc.
- Metabolic abnormalities such as liver disease, hepatic shunt, kidney failure, hypoglycemia, etc).
- Inherited or genetic abnormalities, collectively called idiopathic epilepsy, are the most common causes of recurring seizures in dogs. It occurs in approximately 5% of the worldwide dog population, most commonly in dogs from 1-5 years of age. Idiopathic epilepsy is the assumed diagnosis when the patient has a normal neurological exam or MRI, metabolic abnormalities have been ruled out, and the dog is under 6 years old.
Treatment
Treatment differs based on the cause of the seizure. I’ll be focussing on treating idiopathic epilepsy specifically.
The basis for deciding when to treat seizures may vary amongst veterinarians. I generally recommend starting anticonvulsants when a dog experiences:
- Multiple seizures in a row (also known as a cluster).
- More than two seizures in a one month period.
- Status epilepticus which is a single seizure lasting more than five minutes or multiple seizures within a five minutes period without recovery in between.
- A severe postictal period (the period following the seizure) that is severe and prolonged.
- The frequency, duration and severity of the seizures are increasing.
Standard Anticonvulsant Medications
Seizures can sometimes be managed with one medication or may require multiple medications. Finding the most effective cocktail is the goal for the individual patient and a neurologist is the best chance at reaching this goal.
- Phenobarbitol is one of the more effective and commonly used medications however it does have potential long term side effects. It is administered twice daily. A patient on phenobarbital must have blood levels monitored periodically to check if the levels are in therapeutic range.
- Keppra (Levitiracetam) is one of the more popular choices right now. It has less side effects than phenobarbital however it is sometimes not as effective as a sole medication in severe cases. It comes in an extended release tablet which may be given every 12 hours. Keppra must be given very slowly and diluted when given intravenously. There have been rare cases of sudden death when this drug was given too quickly IV to hospitalized patients.
- Zonisamide is a safe drug that has few side effects and is given twice daily. It is less likely to control seizures as a sole medication than the other medications. This medication is most often used as an add-on anticonvulsant or as an option when side effects of other medications are a concern for a particular patient.
- Potassium Bromide is another frequently used anticonvulsant medication. It is administered by itself or in conjunction with phenobarbital. It is usually administered twice daily and has minimal side effects. Bromide levels must also be monitored regularly to check therapeutic levels. There are several factors that can affect the blood level of bromide such as changes in salt intake, diuretics, increased water intake, steroid administration and diet changes. It is a good option for dogs with liver disease yet a poor one for dogs with kidney disease. Food and Drug Administration officials announced Jan. 14 that the agency granted conditional approval of a chewable tablet, KBroVet-CA1, for control of seizures associated with idiopathic canine epilepsy.
Despite treatment with appropriate anti-seizure medication, approximately one-third of dogs continue to experience frequent seizures.
Natural Treatment Options
1. Cannabidiol (CBD) is a chemical found in the cannabis plant that people often take to manage chronic pain or to reduce their anxiety symptoms. Unlike tetrahydrocannabinol (THC), CBD is not euphoric or impairing. You and your dog’s body contains a system of neurotransmitters and receptors called the endocannabinoid system. This system is thought to help regulate functions in the body such as appetite, sleep, and pain, as well as immune system response. It’s thought that CBD can modify these functions by interacting with receptors in the endocannabinoid system.
Exactly how CBD contributes to a reduction in seizures and affects the ECS is still unknown. One theory is that CBD has the ability to affect the receptors that calm the neurons firing during a seizure. Here is an article that discusses the promise of CBD helping control seizures in dogs.
In general, science supporting CBD use in veterinary medicine is still lacking. There is an abundance of anecdotal evidence that it works but few well executed research studies. I believe we will see this change in the near future.
If you decide to try CBD for your dog please be aware that there are many CBD products on the market that are untested and unregulated. Make sure that the products you purchase are third party tested.
CBD can interfere with the doses of conventional medications, especially Zonisamide and Keppra. Be sure to check with your primary veterinarian regarding dosing if your dog is already taking these medications.
CBD product resources:
2. Diet plays a huge role in managing seizure patients. I do not recommend that seizure patients receive any processed foods especially dry kibble.
A dehydrated diet such as Honest Kitchen is another option, but I recommend a commercial raw or gently cooked, balanced whole food diet. You can find complete diet recipes at balanceit.com.
Give your dog only natural treats with less than three ingredients. Do not give any treated bones such as rawhide.
Eating a high fat, low carbohydrate diet, known as a ‘ketogenic diet,’ has been shown to decrease seizure frequency and severity in children. There is hope the same positive results can be seen in dogs.
One study found an improvement in seizure control and associated behavioral conditions in dogs fed a ketogenic kibble compared to those eating a placebo kibble. The only concern I have regarding this study is that they fed the MCT oil along with a dry kibble, which should not be fed to seizure patients. My hunch is that these results would have been better if the dogs were fed a raw or whole food cooked diet—two case studies.
3. MCT (medium-chain triglycerides). MCT oil is a popular supplement humans are using to support brain health and provide energy. It contains medium-length chains of fats called triglycerides, and is most commonly extracted from coconut oil. More than 50% of the fat in coconut oil comes from MCTs. Here is a study in human medicine that demonstrated improvement in control of refractory epilepsy with use of specific MCTs.
Research conducted by the Royal Veterinary College (RVC) showed that dogs had significantly fewer seizures during the MCT phase compared the placebo phase, and an improved owner-reported quality of life. According to the co-author of the study DR. Rowena Packer: “Our novel findings indicate that a relatively small change to the diet of dogs’ with hard-to-treat epilepsy can potentially reduce the number of seizures they have, while also improving their medication side effects and overall quality of life. MCT oil offers a promising addition to the wider epilepsy management tool-kit.
4. Other natural treatments options:
- acupuncture
- chiropractic care
- homeopathic remedies
- nutraceutical remedies
Main Points
- Diet is essential.
- Avoid toxic chemicals and stress.
- Seek the knowledge and experience of a veterinary neurologist.
- Involve a homeopathic veterinarian in your dog’s care to help with natural treatment options.
- Don’t give up too soon. I know it is stressful and expensive, but it often takes time to find what will work for your particular dog.
Other Key Points
- Do not give vaccinations to a dog with epilepsy.
- Do not use conventional flea and tick products- natural products only. Here is my article on flea and tick prevention.
- Avoid stressful situations such as non-essential vet visits (consider a house call vet for these) and elective surgery, dog parks, boarding facilities, groomers (grooming him yourself or getting mobile groomer may a better option), etc
- Keep a log of your dog’s seizures including length, severity, time of day, and date in order to look for patterns and assess effectiveness of medications.