My pet just had a seizure, what should I do?
Seizures are frightening to witness. Stay calm. Try to time how long the seizure lasts. The first thing to do is to stay clear. Seizing animals may bite (without knowing it) and trying to hold them down may cause injury. They will not 'swallow their tongue' as you may have heard. Keep fingers away from the pet's mouth. Remove any objects in the area that can injure the animal.
Call your vet. With the first seizure, the patient receives a full physical exam, blood work up, and is monitored -- seizure control medications usually wait at this point. UNLESS the first seizure is a severe cluster seizure (several happening at once) or a continual seizure called Status Epilepticus, this is a medical emergency. If anything is found on physical or blood work that may cause seizures, the underlying conditions will be addressed and treated.
My pet just had a seizure, do I need to start medication?
When to medicate for seizures is usually a decision between the vet and pet owner, but here are some general guidelines and background information on seizures. More on medication for seizure control in a bit.
What causes seizures?
Seizures can be caused by numerous things - poisons, skull injury, brain tumor, viral and bacterial infections, congenital malformations, heat stroke, parasites, fungal infections, low blood sugar (diabetics), and so on. By doing a physical exam and blood work, most causes can be eliminated.
Idiopathic epilepsy (seizure of unknown origin) is most commonly seen in otherwise healthy animals, between the ages of 1 and 5 years, and may be inherited in certain breeds. Beagles, Keeshonden, Irish Setters, Belgian Tervurens, Siberian Huskies, Springer Spaniels, Golden Retrievers, and German Shepherds may be genetically predisposed to idiopathic epilepsy.*
Idiopathic epilepsy is diagnosed when other causes of seizures have been ruled out by a physical exam, blood work, and any other necessary work up procedures. Cats do not experience grand mal seizures as often as dogs.
Another type of seizure, where the cat's skin ripples or the cat appears to frantically groom itself and run off frightened, is called hyperesthesia syndrome. This seen more commonly than the grand mal seizure seen in dogs.
What should I do if my pet experiences seizures?
While observing, the owner should keep a diary of when/where the seizures occur, how long they last, was the animal acting strangely/doing any activity in particular before the seizure, and how long after the seizure did it take for the animal to be 'normal'. This may provide clues if a pattern is noticed.
There are definite seizure triggers for some animals, and if they can be identified, the number of seizures can be reduced if the trigger (activity, excitement, etc.) can be avoided. One dog I knew had a 'going-to-the-vet' seizure trigger. Hard to avoid that one sometimes, but with pre-visit medication, special speedy appointments, the problem was reduced.
Learn more about medications to control seizures.
Seizures have 3 phases:
Pre-ictal, ictal, post-ictal. "Ictal" means seizure.
- Pre-ictal. The "pre" phase often goes unnoticed, but you may notice an altered state of consciousness or restlessness, lasting for a few seconds or minutes.
- Ictus is the seizure itself, and it may last a few seconds or minutes.As mentioned above, a continual seizure, Status Epilepticus, is a medical emergency, and the pet should be rushed to the vet for medication to break the seizure and prevent brain and organ damage from hyperthermia (increased body temperature), acidosis (metabolic imbalance), hypoperfusion (reduced blood flow), and hypoxia (reduced oxygen to tissues). All of the above possibilities occur on a much reduced scale for small seizures, too, so control is important.
- Post-ictal phase is the time after the seizure where the animal appears dazed, confused, depressed. The animal may even appear blind - running into walls, etc. Some animals sleep a lot. This typically lasts several minutes but can last hours, depending on the seizure duration and frequency.
When does a pet need medication to control seizures?
The general rule of thumb is more than one seizure every one or two months. The duration and severity of each seizure need to be evaluated, too.
What are common seizure control medications?
The most common medication used for maintenance seizure control is Phenobarbital. Emergency situations usually call for the quick-acting Diazepam (Valium) to get immediate control of the seizure. Potassium Bromide (KBr) is an old anticonvulsant medication, used since the 1800's, that is used in veterinary medicine, often with positive results. It can be used in conjunction with Phenobarbital (lessening the amount of Phenobarbital that is needed) or it can be used alone. Potassium bromide does take several weeks to reach therapeutic levels in the blood. Phenobarbital takes several days-weeks, too.
During the initial period of Phenobarbital, the animal may appear groggy, this usually goes away with time. If not, your vet should be notified, and the dosage adjusted to maintain a 'normal' animal and not have seizures.
For more information on what medication is right for your pet, speak to your veterinarian.
*Source: Merck Veterinary Manual, 8th, edition.