Epilepsy in dogs: essential advice for owners
The International Veterinary Task Force (1) consensus was intended to improve the clinical diagnosis of and research into epilepsy. The diagnostic approach to patients with suspected epilepsy involves two steps: firstly, ensure that the episodes are actually epileptic seizures, and secondly, identify the cause of the seizures.
Even experts can find it very hard to differentiate between epileptic seizures and nonepileptic paroxysmal events. The consensus presents criteria to help with this differentiation. It also contains criteria that guide in the diagnosis of idiopathic generalised epilepsies.
Are they epileptic seizures? And if not, what is the dog doing?
Sometimes it is difficult to be sure that the dog is suffering epileptic seizures. Which is why the medical history is so important. The owner can complete a questionnaire and record a home video, using a mobile phone, so that we can later have a look at the suspected seizures.
A complete physical examination, including a neurological exam, can help distinguish between syncope and a seizure if there are cardiovascular abnormalities, or between a neuromuscular disease and vestibular dysfunction.
There are certain characteristics that can help differentiate between an epileptic seizure and a nonepileptic paroxysmal event.
Paroxysmal dyskinesias are hard to discern from motor seizures, as in both cases the animal is normal between episodes.
Absolute certainty about the epileptic origin of a paroxysmal event can only be based on a video EEG capturing an event. This is very difficult to obtain in clinical practice. In addition, any muscle or ECG artefacts that occur during recording can affect the correct interpretation of the EEG. Given the scarcity of literature available in the area of veterinary medicine, there are no current recommendations for EEG recordings.
Aetiological diagnosis of epilepsy in dogs
In dogs under 6 months or over 6 years old with interictal neurological abnormalities, status epilepticus or clusters of seizures at the onset of epilepsy, or suspected drug-resistant idiopathic generalised epilepsy, once acute symptomatic seizures have been ruled out (reactive seizures), we recommend a brain MRI and basic cerebrospinal fluid (CSF) analysis to establish the aetiology of the seizures.
In addition to this recommended article, there are websites dedicated to the topic. We recommend this one.
