Idiopathic epilepsy in dogs

Content by Dr Siân Burwood MA VetMB MRCVS

Epilepsy is a long-term neurological condition where a dog has seizures (or fits) while being entirely normal in-between.

A seizure is disorganised electrical activity in the front part of the brain that causes loss of consciousness and uncontrolled muscle spasms. Seizures have many causes, but the word epilepsy is usually used in relation to ‘idiopathic epilepsy’ – where we don’t know what the underlying cause is, but recognise the disease.

• Idiopathic epilepsy is a long-term condition where a dog has seizures or fits
• Seizures can be caused by organ failure, toxicity or issues within the brain itself, as well as epilepsy
• Idiopathic epilepsy is when there’s no obvious medical cause for the seizures, but is perhaps the most common and treatable form in dogs
• Dogs with idiopathic epilepsy can live long and happy lives when on the correct treatment, as they are their normal selves when not fitting
• Treatment for idiopathic epilepsy usually requires medication in the form of tablets

A seizure (or fit) happens when the forebrain of the dog experiences disorganised electrical impulses and everything is firing at once.  Seizures can have many causes:

• Structural problems inside the brain itself (such as developmental problems in young puppies, or tumours in older dogs)
• Developmental issues with the liver which causes a build up of ammonia in the blood that then affects the brain
• Organ failure of the liver or kidneys, which causes a build-up of ammonia and other breakdown products in the blood, that then affects the brain
• Toxins that affect liver, kidney or brain function

If none of the above are found to be the cause, a dog is said to have ‘idiopathic epilepsy’. ‘Idiopathic’ is a fancy scientific term for ‘we don’t know the cause’… But what is well known is how the disease of epilepsy presents and how it can be treated. We also know that it can be inherited in certain breeds.

Seizures related to idiopathic epilepsy are most commonly seen in young adult dogs, with typical diagnosis somewhere between 6 months and 6 years old.

We know around 1 in 200 dogs in the UK are epileptic. It can affect any breed, but it is seen more commonly in:

• Border Collies
• Beagles
• German Shepherds
• Dachshunds
• Labrador and Golden Retrievers
• Siberian Huskies
• Basset Hounds
• Hungarian Vizslas
• English Springer and Cocker Spaniels

The main symptom of idiopathic epilepsy is seizures, which have 3 distinct phases. You may not see all of these, as dogs often fit in the middle of the night when they’re asleep. Sometimes you only realise a fit has happened after the event.

• Before the seizure – aura

When your dog is about to have a seizure, they may appear not quite right beforehand: distracted, restless, clingy, unsettled, off their food. This can last anywhere from a few minutes to a few hours before the seizure actually happens.

• Seizure

During a full ‘grand mal’ or ‘tonic clonic’ seizure, your dog will lose consciousness and fall to their side. All their legs will be stiff and moving in a jerky way. They may drool or foam at the mouth, and may lose control of their bladder and bowels. This phase should last 1-2 minutes before spontaneously stopping.

• After the seizure – post-ictal phase

After a fit, your dog is likely to be exhausted and feel very hot. They may well want a big drink and may act a bit drunk for a while, seeming a bit wobbly and clingy. This can last for a few minutes to a few hours.

It can be very distressing to watch your dog have a seizure, especially for the first time. The most important thing to do is to stand back. It’s very natural to want to comfort them, but when they’re unconscious and cannot control their muscles (including their jaws!), it’s very easy to get bitten.

Start a timer. Turn the lights off, turn the TV or radio off and open a window to keep the room quiet, cool and dark. You can move any hazards around your dog if it doesn’t put you in danger of getting bitten.

When your dog comes out of the seizure, stop the timer and make a note of how long it lasted. Keep them quiet and calm until you’re certain they’re fully back to normal.

If your dog doesn’t come out of the seizure on their own after 2 minutes, call your vet for advice. If you’re a Petgevity customer, you could also video call FirstVet for free.

Over time you may find you recognise certain triggers for your dog having a seizure: loud noises, bright lights etc. You can then make sure you avoid these as much as possible.

Diagnosis

It’s very rare for a vet to actually see a fit happen, as they should be over long before you get to the practice. In most cases, it’s best to wait until your dog is fully recovered so they don’t have another fit while travelling.

Your vet will take a history, and it’s really useful if you’ve taken any videos of what happened. Blood tests will likely be suggested to check for any liver or kidney issues. If the presentation seems odd or to make sure there’s nothing wrong in the brain, your vet will refer you to a neurologist for an MRI scan and assessment. In many cases, a diagnosis is made on the basis of history and normal blood tests alone.

You don’t always have to treat idiopathic epilepsy. Some dogs have fits so infrequently that they cause neither owner nor dog any problems, and so monitoring is considered enough. Your vet will ask you to keep a seizure diary so any patterns or changes in the fits can be recognised.

• If your dog has frequent seizures (or the frequency is increasing)
• If they’re lasting longer and longer, or
• If they seem to struggle to recover from them

…your vet will likely advise starting medications. While they may not stop the seizures altogether, they can reduce the frequency and severity to manageable levels for both dog and caregiver.  

There are several types, and they work by reducing the excessive brain activity that causes the seizure. The most common drugs will require blood tests to be taken every few months to make sure that they are at a safe and effective level in the blood, and that the liver is coping OK with these medications.

Some dogs stay on the same dose forever. Others will need more drugs added in as the disease progresses with time, or special drugs to use around the time of seizures to bring them under control quicker.

Some prescription diets containing medium-chain triglycerides have been shown to help reduce seizure frequency.

Prognosis

The prognosis for true idiopathic epilepsy is very good, and many dogs lead full and normal lives with the disease. Even if your dog needs medication to control the frequency and severity of the seizures, their prognosis is good if you maintain regular check-ups with your vet.

At these check-ups, as well as a physical examination and blood tests, your vet will mostly be checking that both you and your dog are coping with the level of symptoms. They’ll also check that the diagnosis of idiopathic epilepsy still makes sense.

• Cluster seizures

Cluster seizures are when a dog has barely finished having one fit before they go straight back into another one. This is dangerous as the body temperature rises uncontrollably and oxygen getting to vital organs is affected. 

• Status epilepticus

Any seizure lasting more than 5 minutes is called ‘status epilepticus’, and this is why any fit lasting more than 2 minutes needs a phone call to the vets. As with clusters, the continual muscle activity causes dangerous overheating and damage to vital organs.

Diagnosis

Diagnosis involves history and blood tests, but more advanced imaging like MRI scans are more likely to be offered to see why the seizures are more severe.

A dog having cluster seizures is always a reason to medicate. Additional medication might be needed for a dog already on treatment to be given on the days when they do have seizures.

Status epilepticus is an emergency and should be seen by your vet, or their out-of-hours cover. Special drugs will be given directly into the bloodstream to try to stop the seizure, and sometimes your dog will need to be put under anaesthetic. This will all involve a period of time in hospital on fluids with constant monitoring.

If seizures cannot be brought under control in this way, euthanasia may sadly be the only option.

Prognosis

Cluster seizures can still carry a good prognosis if they’re controlled well with medication and regular check-ups.

Status epilepticus carries a poor prognosis as it often results in damage to the whole body, and euthanasia may be advised.

“Epilepsy is the commonest neurological disease I see in practice. While it can seem scary at first, I’d really urge all owners to treat it! These dogs can lead completely normal lives, both those on or off medication. And while we need to monitor the drugs they’re on, I have no concerns about prescribing them.

“The main thing I need to know as a vet is how much you and your individual dog can cope with. Some caregivers are fine with their dog having a seizure once a week, for others that’s too much… Then together we can form the best treatment plan.

“Remember not to try to ‘help’ a dog who’s fitting, as there’s a high risk you’ll get bitten!”

Dr Siân Burwood, MA VetMB MRCVS

When getting a quote for Petgevity Lifetime Plus dog insurance, tell us about your dog’s epilepsy, plus any other conditions they’ve had in the past two years*.

It’s really important to list your dog’s conditions when taking out pet insurance. This increases your chances of making a successful claim.  

Find out more about our dog insurance for pre-existing medical conditions.