I love science. Most of all I like learning about the brain. I am interested in both the psychological and neurologic aspects of the brain. Because dogs learn so quickly and adapt to us I am very interested in applying my human neuroscience knowledge to my dogs. I relish seeing their minds work when I ask them to complete a task.
I became very involved in canine neurology, not by my choosing, a few years ago when Darla was diagnosed with a seizure disorder also known as epilepsy.
Epilepsy is a chronic condition and affects 2.2 million people in the U.S.(4) Working in a neurology practice I encountered patients with epilepsy. I understood the basics but epilepsy is not my passion.
I felt very frustrated when Darla had her first seizure—I knew that we were headed down a long and twisting road, not quite sure what could trigger her next event.
Seizures are caused by deregulation of neuronal activity—Just like our heart; the brain has an electrical circuit. When this circuit is disrupted it can become hyperactive causing deregulation of cellular signals and produce a seizure. This deregulation can be secondary in nature meaning that there is something in the brain causing these changes such as a lesion in the brain, irritation from blood (hemorrhage), increased pressure in the head, infectious, toxic, and metabolic causes. Most often we have no idea why a patient is having seizures and they are diagnosed with idiopathic epilepsy or primary epilepsy. The pathophysiologies of canine and human epilepsy are very similar. (2)
I remember the first night Darla had a seizure. She was in the living room lying on the sofa—her normal spot. About 2 AM I was awoken to a loud crash followed by repetitive banging. I jumped out of bed and ran to the noise. I found Darla in-between the sofa and the coffee table having a tonic-clonic or grand-mal seizure.
I am not sure what I felt at that time. I am sure that many other medical providers would agree with the following statement: you don’t feel, you do. I immediately moved the coffee table to keep her head from hitting it and I began to time the event. Her first seizure lasted about 70 seconds. She lost control of her bladder function and created a large amount of foamy saliva. Like most epileptics, Darla was out of it after her seizure. She had no memory of her name and she was very confused—she could barely put one foot in front of the other without falling.
I called the vet and they stated that she did not need to come in immediately as the seizure stopped and as long as her seizure did not last over 2 minutes and her temp remained normal her episode was not an emergency.
In the following days Darla continued to have more seizures—I was terrified that her food, treats, and certain activities were triggering her seizures. I was obsessed with figuring out triggers so I never had to see her suffer from these seizures again.
After Darla continued to have events I knew that she needed an intervention and my vet agreed. I knew that the antiepileptic drugs (AEDs) available to dogs at her time of diagnosis were not nearly as advanced as human drugs and these agents have terrible side effects. I hated to put Darla on one of those agents but I did not have a choice. You see, epilepsy is not just a chronic condition without a cure but it comes with risk of death. (1) Darla had to receive treatment.
We tried phenobarbital and Darla did not do well with it. She was very lethargic and had some ataxia. I was talking with a training friend when she mentioned a herbal supplement that had been very helpful for other dogs. Fortunately the supplement worked well for Darla. She was able to gradually stop phenobarbital and was very well controlled for about two years on herbs with little to no adverse effects. I was so happy for her.
After having such a good run with herbals Darla deteriorated a few weeks ago. I had been out and came home to a flipped over crate and a post-ictal dog that was acting fruity. She had 4 more seizures over the next 24 hours, some at the vet’s office. While she was at the vet’s office she had one of her worst seizures. They were unable to stop it with Valium and she had to have phenobarbital. The phenobarbital worked to stop her seizures. When Clint picked her up she was so drugged and still post-ictal—she could barely walk.
My vet is really great. She knew that I was not interested in phenobarbital again as a daily treatment and was happy to prescribe us a newer AED. We landed on Keppra. Keppra is more expensive than phenobarbital. We were able to find a coupon that makes it very affordable. It also has to be dosed three times per day, which is hard, but we have a very good dog walker that can come in and give the afternoon dose if we are not home. Even though the dosing is hard to remember and it is an expensive drug we are so happy with how she is doing!
After about one month on Keppra, Darla is back to her fun-loving Sashi-biting self. At first she was a little ataxic but I am not sure it was due to the Keppra. The ataxia could have been from the large dose of Valium and phenobarbital she was given for seizure abortion, this cleared up about three days after she started the Keppra. She did have some loss of appetite at first but after about 2-3 weeks she was back on her food. Otherwise she has not had any issues. She does have to go back to the vet for blood work but so far so good!
I am so thankful that there are more drug options for Epileptic dogs and that because of these great medicines Epileptic dogs can live an exceptionally close to normal lives!
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Devinsky O, Hesdorffer DC, Thurman DJ, Lhatoo S, Richerson G. Sudden unexpected death in epilepsy: epidemiology, mechanisms, and prevention. Lancet Neurol 2016;15:1075–1088.
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Pitkänen A, Lukasiuk K. Molecular and cellular basis of epileptogenesis in symptomatic epilepsy. Epilepsy Behav 2009; 14 Suppl 1:16.
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Koestner, A. (1988). Neuropathology of canine epilepsy. Problems in veterinary medicine, 1(4), 516-534.
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Epilepsy Statistics. (n.d.). Retrieved May 17, 2017, from http://www.epilepsy.com/learn/epilepsy-statistics