Seizures in Pets | Part II: Diagnostics & Treatment

If your pet is experiencing active seizures, cluster seizures, or status epilepticus, these are considered “RED” – or true emergencies – on our Fast Track Triage system. We advise you to seek immediate veterinary care. Please call ahead of your arrival so the veterinary team knows to expect you!

Note that a single seizure that lasts less than five minutes with full recovery is considered a “GREEN” case on our Fast Track Triage system. This means emergency care isn’t needed, but your pet should be evaluated by your family veterinarian within the next few days.

• If your pet is currently experiencing seizures, keep them safe. This may include blocking off stairs or sides of furniture.
• A seizing pet is not aware of his/her surroundings. They can continue to seem “out of it” for minutes to hours afterwards and behavior can be unpredictable.
• To avoid being bitten, do not place hands near your pet’s mouth.
• To transport your pet to the car, roll the pet onto a blanket, and then lift the blanket.

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If you missed Seizures in Pets: Part I, please read that first to learn about the two main types of seizures in pets and common causes. Here in Part II, we will be reviewing the diagnostics performed to diagnose the cause of seizures, as well as treatment options. Read the summary below or watch our Facebook Live replay video featuring Dr. Smith, board-certified veterinary neurologist and neurosurgeon, for more in-depth information.

Just because your pet has one seizure doesn’t mean they’ll ever have another. Regardless, it’s important to have your pet checked out to determine the cause of the seizure(s).

Diagnostics

Your pet’s veterinary team or a board-certified neurologist will perform the following diagnostics: 

• Bloodwork 

  • Bloodwork will reveal if something systemic is happening in your pet’s body, such as liver or kidney dysfunction, blood sugar problems, or electrolytes being off. Systemic issues like these can cause reactive seizures – meaning that the seizure is a reaction to something else going on. If bloodwork is normal, whatever is causing the seizure may lie within your pet’s brain. 

• Imaging 

  • Your pet may require an ultrasound or sonogram to check your pet’s heart and lungs.
  • If nothing suspicious is happening with the heart or lungs, then your veterinary team may utilize MRI to look at the brain. Your pet will have to undergo anesthesia for an MRI.
    • During an MRI, your pet’s veterinary team is looking for: 
      • Evidence of inflammation from an autoimmune disease or infection 
      • A structural defect (which your pet may have had since they were young)
      • Evidence of something growing in the brain like a tumor

• Spinal Fluid 

  • Spinal fluid is often collected post-MRI while your pet is still under anesthesia. If there’s no inflammation visible on the MRI, spinal fluid will reveal inflammation within the nervous system. 

When Diagnostics Come Back Normal 

In dogs, if the blood work, spinal fluid, and MRI are all normal, this typically indicates your dog has genetic epilepsy, also known as idiopathic epilepsy. A disease is considered idiopathic if it arises spontaneously and the cause is unknown. It can be unnerving not to know why your pet is having seizures, but if other diseases and systemic issues are ruled out, then the upside is that your pet does not require treatment other than seizure medications.  

Treatment for Seizures 

Once your veterinary team finds the cause of your pet’s seizures or diagnoses your pet with idiopathic epilepsy, they will create a treatment plan. Treatment depends on the diagnosis. 

If a dog has epilepsy, it typically begins having seizures between 6 months to 6 years of age. Bloodwork, spinal fluid, and MRI will all come back normal, and your dog will be diagnosed with idiopathic seizures. Treatment focuses on seizure control via medications. There are many different medications for dogs and cats, so there are several options for managing your pet’s idiopathic seizures. 

If something is discovered via MRI or spinal fluid, then your veterinary team will discuss with you how the underlying cause may be addressed. Often, medications will work; however, there are some medications that may be unsafe for one breed or species versus another. For dogs with epilepsy, about 25-30% will require multiple medications to control the seizures. It can take some time to discover the winning combination of medications. 

Young puppies may display juvenile epilepsy at less than one year old – commonly at about 6 months old. These puppies have seizures and eventually grow out of them. We don’t fully understand why juvenile epilepsy happens and then goes away, but your veterinarian will help control the frequency and duration of the seizures as best they can. 

If you have any questions about your pet’s seizures or if your dog is more likely to have genetic epilepsy, contact your family veterinarian to discuss your concerns. In some cases, your family veterinarian may choose to refer your pet to our Neurology Service for diagnostics and treatment plans. 

More Reading: 

• The Eight Things You Need to Know if Your Dog Has Seizures: Part 1 
• The Eight Things You Need to Know if Your Dog Has Seizures: Part 2  
• The 4 Most Common Reasons Pets Visit Our Neurology Service  
• My Dog Can’t Walk: Sudden Paralysis in Dogs
• 5 Most Common Non-Toxin Pet Emergencies  

 Content provided by Dr. Smith, DACVIM (Neurology).