other names: genetic-based epilepsy, primary epilepsy
Overview
A seizure happens when abnormal, excessive brain activity causes the brain’s “wiring” to misfire for a short period of time. Idiopathic epilepsy is a brain disorder where recurring seizures occur without an identifiable underlying cause, such as a tumor, infection, or toxin.
This condition is most often diagnosed in young to middle-aged dogs and cats, typically between 1 and 6 years old, and can affect any breed, although certain breeds have a higher risk. However, it can occasionally occur in animals younger or older than this age range.
Cause
Idiopathic epilepsy is generally thought to be a genetic or inherited condition, but as the name suggests, the exact cause is unknown. In some individual dogs, there may be non-genetic factors involved that we simply have not yet identified.
Clinical Signs
The classic generalized seizure involves a loss of consciousness, rhythmic convulsions with stiffening and paddling of the legs and jaw chomping, and may also include involuntary urination, defecation, or foaming at the mouth. Although this is the “classic” seizure, seizures can appear in many other ways. Some may only affect specific areas of the body, such as a single limb or the muscles of the face, while others may occur without loss of consciousness or present as episodes of excessive tremoring.
A seizure generally has three stages:
- Pre-ictal phase – This is the warning period before the seizure, lasting seconds to hours. Pets may hide, seem anxious, seek extra attention, pace, shake, or drool.
- Ictal phase – This is the seizure itself. Many pets fall to their side, and their muscles contract strongly. This stage usually lasts a few seconds to a few minutes. Sometimes, dogs may experience cluster seizures, which means having two or more seizures within a short period, usually 24 hours.
- Post-ictal phase – After the seizure, pets may be disoriented, confused, restless, drool excessively, pace, or appear temporarily blind. This can last minutes to hours.
Dogs with idiopathic epilepsy are generally normal between seizures, with normal physical and neurological exams. If your pet shows other abnormal neurological signs between seizures, idiopathic epilepsy is less likely, and other causes of seizures should be considered.
Diagnosis
A thorough history of recent events, especially recent exposure to any toxins or medications as well as comprehensive blood tests are typically the initial steps to rule out systemic disease (e.g. low blood sugar, liver disease) that could be causing the seizures. Blood pressure is often recommended to rule out hypertension
If the systemic work-up is normal, the next step is typically an MRI scan and cerebrospinal fluid (CSF) analysis to further investigate the cause of seizures. In some cases, infectious disease testing may also be necessary. If all these results are normal, your pet is diagnosed with idiopathic epilepsy.
Treatment
The goal of therapy is to reduce the frequency and severity of seizures while minimizing side effects from medication. Completely eliminating seizures is an unrealistic expectation.
Anti-seizure medications are the mainstay of therapy for idiopathic epilepsy. Although they don’t cure epilepsy, but they help us manage it. Our goal is to achieve good seizure control, which varies greatly between patients but generally means having one seizure every 4 to 6 weeks or less. Even more importantly, we focus on preventing multiple seizures occurring within a single day, or clustering.
There are many different types of anti-seizure medications, and the best choice depends on several factors: your pet’s seizure type and severity, their overall health, lifestyle, and your ability to administer and monitor the medication. We’ll help choose the right one based on what fits best for both you and your pet.
Patience is key when treating epilepsy. Anti-seizure drugs aren’t one-size-fits-all. It often takes a bit of trial and error and many months to find the medication and dosage that works best. When we start or adjust a medication, it may take several days to weeks to reach its full effect. Our goal is always to strike the right balance between controlling seizures and avoiding unwanted side effects.
Additionally, there are also alternative approaches that may help reduce seizure frequency, such as dietary changes, supplements, and stress reduction, among others. Your neurologist will discuss whether these options are an appropriate option for your pet.
Prognosis
Most dogs and cats with proper treatment and monitoring enjoy an adequate quality of life. Idiopathic epilepsy cannot be cured, but anti-seizure medications can greatly reduce the frequency and severity of seizures in many pets. Even with medication, your pet will likely still have seizures, but if we are successful at reducing their frequency and severity, most pets can have a good to excellent quality of life.
Unfortunately, in some cases, seizures can be severe or difficult to control, which may affect a pet’s lifespan or quality of life. A small percentage of pets with idiopathic epilepsy do not respond to medication, and seizures continue frequently despite treatment with multiple anti-seizure drugs or alternative therapies.
With the right treatment plan, lifelong medication, and regular bloodwork monitoring with your neurologist, the majority of pets with epilepsy can enjoy a long, happy, and fulfilling life.
Home Care
It is VERY important to keep a seizure log or diary of your pet’s seizures. Write down the date, time, how long the seizure lasted, and what it looked like. This helps us to monitor the seizure frequency, severity, and duration, and track patterns over time to make informed decisions about treatment adjustments. Although you don’t need to notify Neuro Vet after every seizure, we typically request a seizure log every 4 to 6 months—or sooner if seizure control is poor—to ensure your pet’s condition is well managed.
Never stop or change your pet’s seizure medication without our guidance. Anti-seizure medications should never be discontinued abruptly, as this can lead to significant worsening in seizure activity.
Emergency Situations
If your pet has idiopathic epilepsy, it’s not necessary to visit the veterinary hospital after every seizure. However, you should seek emergency veterinary care if:
- Your pet has more than three seizures within 24 hours, or
- A seizure lasts longer than five minutes.
These are just general guidelines, and your neurologist will advise you if your pet needs to be seen sooner or if different criteria apply. If you ever have questions about whether to bring your pet in or not, please don’t hesitate to call us at 925-298-3855. We’re available 24/7 to help provide guidance and support.