The Poodle Papers / Summer Edition

Page 33

Seizures in Poodles: Important but Less Fre- quently Asked Questions

Barbara Licht, Ph.D., Linda Hyson, B.A., KathleenHarper, DVM, Ph.D.,Mark Licht, Ph.D.

This article has three goals. First, we want to let readers knowthat some educational handouts are now available to address some of the most frequently asked questions concerning seizures. Second, we want to address some questions that areless frequently asked, but that are very important. Many of these questions concern very severe seizures, which fortu-nately, are not the norm with poodles. Finally, we want tobrag again about our most recent accomplishments. We re-viewed our accomplishments in a previous Newsletter and ina letter that we mailed to our research participants. How-ever, we have gotten some requests to mention these again,and we are always happy to brag.

☺

Educational Handouts

The educational handouts listed below are now available byrequest for individual use or for dissemination at breed clubevents. They address the questions that are most frequentlyasked by owners and breeders of dogs with seizures. We have been disseminating the first three handouts for some time,and the last two handouts are new. Please feel free to requestany of these that may be of interest.Overview of Epilepsy (provides overview of causes, treat-ment, and prognosis)Diagnostic Work-Up for Dogs with SeizuresTreatment of Seizures: Phenobarbital (PB) versus PotassiumBromide (KBr)Types of Seizures Seen in PoodlesLiver Monitoring for Dogs Taking Phenobarbital

Important, but Less Frequently Asked Questions

Can seizures be life threatening? If so, what should be done?

The vast majority of seizures are not life threatening and donot require emergency treatment. However, seizures can be life threatening under certain conditions. The firs

is whenthe seizure is particularly long—for example, a 30-minuteseizure involving the entire body and loss of conscious-ness. Similarly, it can be life threatening if the dog cyclesin and out of a severe seizure for a 30-minute period. Thesesituations are called

status epilepticus

, which often is short-ened to just

status

. Because it generally takes at least 20minutes to transport the dog to a veterinary hospital, a gen-eral rule of thumb is to time the seizure and consider it anemergency if the seizure continues without any responsive-ness to the owner for more than 5 minutes. (Most seizureslast between 1 and 3 minutes, although they seem like aneternity, and the recovery period can last many hours.) Asecond condition that requires emergency treatment is whenmultiple seizures occur over a short period of time. This isreferred to as a

cluster

episode. We recommend emergencytreatment for clusters involving three or more seizures in a24-hour period, regardless of how long the seizures last, or if the dog has more than one seizure in the same hour.Some dogs have seizures during which they do not loseconsciousness at all. For example, the dog may stagger around in a confused fashion with mild shaking of his/her body. While these milder seizures also tend to last an aver-age of 1 to 3 minutes, they sometimes can continue for verylong periods. These seizures are less likely to be life threat-ening than those involving strong movements or rigidity of the dog’s entire body and complete loss of consciousness.However, we recommend taking the dog to an emergencyclinic if one of these mild seizures continues for 30 min-utes or more.Other emergency conditions are defined more by who hasthe seizure than by the severity of the seizure. For example,we recommend seeing a veterinarian immediately if a sei-zure occurs in a pregnant or lactating bitch, as well as if aseizure occurs for the first time in a very young puppy. Sei-zures in a diabetic also require emergency care.For dogs that are prone to have very long seizures or clus-ter seizures, we have two recommendations. First, and mostimportantly, we recommend early treatment with anti-sei-zure medication to prevent seizures from occurring. For dogs that are prone to potentially life-threatening seizures,one does not have the luxury of waiting to see if the sei-zures increase in frequency. While all medications can haveside effects, these side effects are outweighed by the risksof having status or cluster seizures. We do not want to scareanyone; your poodle needs you to stay calm! However, for

cont. on page 34

The Poodle Papers / Summer Edition

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those dogs with severe seizures, we encourage owners totalk to their veterinarians about taking an early and aggres-sive approach to treatment.Our second recommendation for owners of dogs with se-vere seizures is that they speak with their veterinarians abouthaving liquid Valium (Diazepam) on hand for when their dog does have a seizure. The Valium is administered throughthe rectum (via a needle-free syringe) as soon as the dog’s body is still enough to do so. This should stop or reduce theseizure quickly and prevent it from progressing into a life-threatening situation. Rectally administered Valium gets tothe brain almost as quickly as when Valium is administeredintravenously by the veterinarian. Thus, administeringValium rectally can reduce or even eliminate the need for emergency clinic visits. This can save a lot of stress (for both dog and owner), time, and money. In contrast, whenowners administer extra medication by mouth, it takes muchtoo long to get to the brain to prevent or treat an emergencysituation. We can provide more information on rectal Valiumif needed. However, this information does not replace con-sultation with the dog’s veterinarian. Owners must discussthis procedure thoroughly with their veterinarian before re-lying upon it, and they should be prepared to take appropri-ate action if it is not sufficient. Note that Valium is recom-mended for use in emergency situations because it acts morequickly than most other anti-seizure medications. However,Valium generally is not effective for long-term preventa-tive use. (Owners whose dogs have never had unusuallylong seizures or cluster episodes do not need to keep liquidValium on hand.)

Can Seizures Cause Brain Damage?

The answer depends on two things: 1) how frequent andsevere the seizures are, and 2) what “test” is used to evalu-ate brain damage. Although it is never possible to predictwith certainty if permanent brain damage will occur, thekinds of seizures that have the greatest potential to result in brain damage are

status

and long

cluster episodes

. Despitethe clear risk of brain damage, a number of dogs and peoplethat undergo these very severe seizures are fortunate enoughto maintain their intellectual abilities.The tougher question to answer is whether or not brain dam-age can occur from the more typical run-of-the-mill seizures.For example, if a dog has one seizure (1-3 minutes long)every 3-4 months, could that result in brain damage over the years? I would like to say “no.” But in light of recentresearch on human seizures, a more accurate answer is that itdepends on your criterion of brain damage. For the most part,owners whose dogs have had one seizure every 3-4

monthsdo not report clear signs of brain damage over the years. Af-ter several years of seizures, a number of owners do say thattheir dog doesn’t seem to learn new things or remember oldcommands as well as he or she did previously. However, itoften is not possible to separate out the effects of having sei-zures from the effects of the dogs getting older and not beingtrained as often or as carefully as was done during their youth.The newest research on human epilepsy shows that when verysensitive measures are used to evaluate a child’s ability to process very complex information, there may indeed be dam-aging effects on the brain of having repeated seizures. Al-though there are differences between the brains of dogs and people, we suspect that this is true for dogs as well. However,even poodles that engage in complex performance activitiesdo not need to think at the level of a brain surgeon. For thatmatter, most people don’t either. So if our poodles are experi-encing subtle brain damage from having average intensityseizures, we may never see any change in their ability to learnor perform. Perhaps, the “take-home” message is that if your dog has a small number of not-too-severe seizures (say acouple seizures per year), we wouldn’t worry at all about thedog losing any intelligence. However, with many repeatedseizures over many years, we couldn’t say for sure. That isone of the arguments in favor of using medication to preventseizures.Our final comment on this issue concerns the possible intel-lectual side effects of anti-seizure medication. It is widelyknown that anti-seizure medication, particularly at high doses,can make some dogs seem mentally and physically slow. Asmany readers know, we favor early treatment, even for dogswhose seizures are not that severe. Our reason is because wethink the side effects of medication are less severe than theside effects of having repeated seizures. It also is because of research suggesting that with early treatment, you are morelikely to be able to get the seizures controlled with a low doseof medication, and you are more likely to be successful later on at cutting back the dosage. As indicated in our handout onTreatment of Seizures, many dogs that initially need medica-tion to prevent seizures can be weaned off their medication(or at least have their dose reduced) after being seizure freefor two full years.

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Can seizures be prevented with behavioral strat-egies?

A number of human epilepsy patients and owners of dogs withseizures report that if they notice the early warning signs thata seizure is going to occur, then they often can take some behavioral (or cognitive) action to prevent the seizure. For the most part, these reports do not come from controlled sci-entific studies. Rather, they are based on individual accounts.Thus, if the seizure does not occur in an individual when pre-ventive action is taken, how do we know for sure that theseizure would have occurred had they not taken preventiveaction? Nonetheless, there are a couple scientific studies thatgive credence to these reports. It seems that for

some

indi-viduals and

some

kinds of seizures, being involved in an ac-tivity that really focuses your attention can lessen the likeli-hood of seizures, although it does not prevent seizures en-tirely. To illustrate, I know of one owner who takes her dogwalking in very quick paces as soon as she sees the first signsof a seizure, which involve the dog coming to her and seem-ing agitated or scared. While walking the dog quickly doesnot always work to prevent the seizure, she reports that it worksfrequently. The theory that a very focused brain may be lessvulnerable to seizures is consistent with some reports of epi-leptic dogs that really enjoy engaging in competitive perfor-mance activities. While there are exceptions, most of thesedogs do not have seizures

during

the activity—perhaps be-cause their brains are so focused at the time of the activity.While we see no harm in trying to avert seizures by focusingyour dog’s attention at the first sign of an impending seizure,we do not recommend relying solely on this strategy. The samecan be said for “holistic” or “natural” approaches to prevent-ing seizures. At the present time, the only treatments scien-tifically proven to prevent seizures are anti-seizure medica-tions (see Handout on Treatment of Seizures).

Review of our Primary Accomplishments

We would like to end this article with a brief review of our two main research accomplishments. Our first major researchaccomplishment is that we were able to demonstrate with pedi-grees of affected litters (and confirm with statistical analyses)that, at least in some Standard Poodle families, idiopathic epi-lepsy is inherited as a

recessive

trait. Recessive means that inorder to have epilepsy, a dog must inherit two defective cop-ies of the epilepsy gene—one from each parent. Parents that possess only one defective copy of the epilepsy gene (“carri-ers”) will not have epilepsy, but they can pass down their onedefective copy to an offspring. Thus, neither parent needs toever have epilepsy or seizures. Our second main accomplish-

cont. from page 34

ment is that the geneticists with whom we are collaborating(the laboratory of Stefan Pulst, M.D. at UCLA) have begunthe DNA analyses on the blood samples that many of youhave provided. It is not possible to predict how long it willtake to find the genes for epilepsy in Poodles. It could besoon

or it could take years. However, regardless of howlong it takes, we are eager to receive blood samples fromadditional poodles (of all varieties) with epilepsy and their close relatives.More details on our research are provided in an earlier News-letter and the research update that we recently mailed to our research participants. This was mailed to everyone that hasever provided data for our research, including data on non-seizing poodles. Unfortunately, approximately 60 (out of almost 1000) were returned to us due to an incorrect or out-dated address. Thus, please send us your full mailing ad-dress if you have ever provided us with any kind of infor-mation, but have not received this update, or if you havenot provided us with information, but would like to be onour mailing list.To receive handouts, or to provide blood or seizure infor-mation from your poodle, please contact Dr. Barbara Licht.Mailing address: Department of Psychology, Florida StateUniversity, Tallahassee, FL 32306-1270. Phone: (850) 644-6272. Fax: (850) 644-7739. Email: blicht@psy.fsu.ed

I would like to thank I would like to thank I would like to thank I would like to thank I would like to thank the many people whothe many people whothe many people whothe many people whothe many people whoextended their many extended their many extended their many extended their many extended their many words of kindness,words of kindness,words of kindness,words of kindness,words of kindness,calledand or sent notescalledand or sent notescalledand or sent notescalledand or sent notescalledand or sent notesand helped me during and helped me during and helped me during and helped me during and helped me during the loss of my mother.the loss of my mother.the loss of my mother.the loss of my mother.the loss of my mother.It was all greatly ap-It was all greatly ap-It was all greatly ap-It was all greatly ap-It was all greatly ap- preciated. preciated. preciated. preciated. preciated.Tom Carneal Tom Carneal Tom Carneal Tom Carneal Tom Carneal