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Saturday, October 12, 2013

The First Seizure, Honey's Story


This is Honey.

She was brought in to see me last week after her parents had witnessed what they believed to be four seizures. The first seizure was at 7 am, then again at 8 am, 9:30 am, and 10:45 am. 

Honey presented to me as almost all of the dogs with seizures do. Looking perfectly normal. They walk into the exam room with their parents, wagging their tails, playful, inquisitive, and oblivious to any abnormal event as to ever happening.

They are so adept at hiding a problem that their parents are often left to debate between themselves that anything abnormal happened to begin with? At the time of the event they were "pretty sure" that it was a seizure, but now that their dog seems so normal, "maybe it wasn't?"

Here is how I approach a pet with a suspected seizure.

As soon as a client calls we ask if the pet is still having a seizure? If your pet is having a seizure you should follow these instructions.

If the pet is not having a seizure they should be seen as soon as possible at your veterinarians office.


On the first visit to the vet after a seizure we talk A LOT!

I want to know everything about your pet. Here is what I ask my clients;
  1. Describe what happened in as much detail as possible. 
  2. Time of day, 
  3. Description of your pets behavior/episode, 
  4. Length of time it occurred for, 
  5. Does there seem to be any sort of pattern, 
  6. Or association. For example does it occur around sleeping, eating, after long periods of not eating, stress, over exertion, or even play?
  7. Actions/behavior before, during, and after episode
  8. Last meal time and amount eaten
  9. What kind of food do you feed your pet?
  10. How would you describe your pets personality?
  11. Last time of any preventatives given. Flea/tick/heartworm, etc.
  12. Is your pet receiving any medications?
  13. Does your pet have any history of illness?
  14. Or disease?
  15. Any history, or possibility of trauma? Falling?
  16. When was the last time your pet was vaccinated?
  17. Do you know anything about your pets siblings? Parents?
  18. Is anyone in close proximity to your pet on any medications, topical, gel, or otherwise
  19. Possible exposure to any toxins?
  20. Is anything disturbed in any part of the home, or your pets environment?
  21. Are there other pets in the house?
  22. Are any of them displaying any abnormal behaviors?
I ask so many questions because the hope is to be able to identify a cause, eradicate it, and therefore cure the seizures.

There are about a million things that can cause, or predispose your pet to having a seizure. We call it :lowering the seizure threshold" and making a seizure a more likely to occur event. For people we know that certain medications, fluctuations in body systems and internal components, and even types of visual cues, like a strobe light.

At the first veterinary exam after the seizure I recommend a full blood work. This includes a CBC, chemistry, and urinalysis. If we find any other abnormalities we may recommend additional tests like an x-ray, ultrasound, fecal, etc. There are many things that can predispose, or trigger a seizure. The goal is to identify and address them so that your pet does not have any other seizures. I know that many people are afraid of environmental components, diet, and pet products like flea & tick preventatives, heartworm medications, etc. that could be the cause of the seizure. Please before you discontinue, or change your pets diet, talk about the risks of not using, changing, etc. these with your vet. 

If the episode happens again try to capture it on video. A video is the best tool available for us to understand what your pet is doing. It is the easiest most efficient way to insure we are all speaking in the same language and about the same clinical signs.

Here's what I tell my first time seizure clients;

Where there is one, there are likely to be more. I do not know when they might recur. In general, a pet is more likely to have additional seizures around each other, they tend to cluster. They are also more likely when waking up, after strenuous play or excitement, and often there are small subtle clues that they are approaching, like a change in behavior, facial expression, etc.. The more your pet has the more likely they are to have others. A diagnosis is often made by running tests, and your history. You play a vital part in helping to identify a cause and come to a diagnosis. But don't loose hope. Many times they pop-up out of nowhere, and many times they disappear just as mysteriously.

Honey is a perfect example. In the four day period that we first saw a seizure, she had a half dozen others. We prescribed valium to have at home to help stop her from clustering into others. None of the subsequent seizures were as violent as the ones she had when I saw her, and after four days, it has been weeks since she has had any others. Hopefully, that's the end of them. But, just in case, we have a plan to help her get a diagnosis, and a treatment to control them long term.

Honey.
In her finest.
Thank-You to her mom for sharing this picture
.

I always share my own personal seizure story with my clients at the first visit. When I was in vet school I had a cat that had seizures. It was during my third year. At that time I was pretty much living at the vet school. I went off to campus at 7 am, and got back home at around midnight. Over a one week period my cat Squeak-box had four violent seizures. The first time it happened was at about 2 am. I woke up to a loud banging on what I thought was my front door. It turned out to be my cats head on the wood floors. It was awful to watch, and I was petrified that if I saw it four times in one week on a week that I was only home for a small portion of the day that she was likely to be having dozens of seizures. each seizure knocked the wind out of her for many hours. All of our detective work, diagnostics, and worry amounted to not one single answer. After that one week she never had another (that I witnessed). She went on to live another 15 years perfectly healthy.

Squeak Box

If you have any pet related questions you can find me at Pawbly.com, or on Twitter. I am happy to help if I can.

Please Always Be Kind.



5 comments:

  1. Hi Y'all,

    My Humans' niece and nephew had a dog who they adopted that had constant seizures his entire life with them. They had medication for him. Finally when he was estimated to be about 13 his seizures became almost continuous and the vet recommended putting him to sleep. After much fretting they decided it was the kindest thing. By this point he would come out of his seizure and remain totally disoriented for long periods of time, walking into doors and walls and unable to find his food or water dish.

    They've since adopted another dog. Fortunately this dog has had no health problems.

    Y'all come by now,
    Hawk aka BrownDog

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    1. I wish that every pets story had a happy ending. Some dogs with seizures are severe and become life altering, or unmanageable, these poor souls are sad, heart breaking cases that most often end in feeling as if there is no longer anything we can offer to keep any quality of life present. I have had to say goodbye and assist with humanely ending a dogs suffering from intractable seizures. The act of ending suffering is never more true than a dog who cannot stop seizing.

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  2. Fabulous article. Great at telling owners what to think about and tell their vet and assuring them that most pets do very well.

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    Replies
    1. Thank you for reading and for taking the time to write. I know that for most people seizures are a big can of frightening worms that seems overwhelming and insurmountable. The element of unknown is unsettling ground for all of us. But in general many of these guys can be managed and even a few resolve, as mysteriously as they arrived.

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  3. Thank you so much for this. I really enjoyed reading all of you posts. I know exactly where you're coming from. I worked as a veterinarian in Toronto for 14 years and it's hard not to develop a relationship with each animal.

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