By Emily Finn, DVM
MSPCA-Angell West, Waltham
Seizures, collapse, and abnormal behavior are frequent problems for which dog and cat patients are brought in to see us in the ER. Sometimes it is obvious what has happened – your dog is normal one second and the next he is on his side, paddling his legs, foaming at the mouth, and perhaps losing control of his bowels. After a minute the seizure stops, but he probably acts a bit stressed out, seems extra hungry, or just out of it for a bit afterwards. By the time you get to the vet he seems right as rain. Other times, seizures may only be evident to you when you find some urine or feces on the floor, though you know your dog is perfectly well house trained – yet she seems blissfully unaware of her accident and isn’t showing you any signs of discomfort when using the bathroom. Finally, you may be sitting next to your cat and notice that she is scrunching up one side of her face in a very odd and rhythmic manner – it stops after a minute, but you notice it happening again a few hours later. In each of these cases, your pet may be showing you that he or she is experiencing a seizure – it is not always obvious to you (or us!) if what you are seeing is, in fact, a seizure, but bringing your pet in for evaluation is the best thing to do if you notice any signs (obvious or not) of a seizure.
Seizures are defined as involuntary behavior (whether subtle or obvious) that is the result of abnormal activity from within the brain. Basically, an abnormal signal begins to happen in the brain and this signal triggers more and more abnormal behavior. The severity and duration of a seizure depend on how far these signals spread throughout the brain and how quickly the brain can stop these signals. Seizures that involve large portions of the brain can result in complete loss of consciousness and loss of body control. When this happens, any muscles in the body can (and frequently do) move in a drastic and involuntary manner. Your pet may chomp their mouth, violently paddle their legs, urine and defecate, and will not respond to you calling their name, yelling, or touching them. These are called generalized or Grand Mal seizures. Partial seizures are abnormal brain signals that stay in a smaller area of the brain – this can lead to the facial twitching, a single paddling leg, or head bobbing. Partial seizures can sometimes progress to generalized seizures. Finally, there is a type of seizure called a psychomotor seizure – this kind of seizure is indicated by involuntary abnormal behavior – snapping at non-existent flies, growling, turning around in circles, pacing, or howling/meowing. These seizures can be difficult to differentiate from behavioral problems and can also progress into generalized seizures.
When you bring your pet to the vet after a possible seizure, we have 4 goals. The first is ensure that your pet is stable and that we are prepared to intervene if your pet has another seizure. The next is to work to figure out if your pet had a true seizure or if your pet’s experience was caused by something else. Abnormal heart rhythms can lead to fainting, which can look a lot like a seizure. Psychomotor seizures can be difficult to differentiate from behavioral problems. Our third goal is to work to determine what has caused your pet’s seizure. Your pet’s age is instrumental to determining what the most likely possible causes of the seizure may be. We will discuss any possibility of trauma as well as any exposure to toxins. We will also discuss running bloodwork (basic organ evaluation) to look for metabolic causes of seizures (abnormal blood sugar levels, abnormal liver function, immune system function, among others). Depending on your pet’s age and severity of signs, we will likely discuss advanced diagnostic options – meeting with a neurologist, MRI or CT scan of the brain, and CSF (cerebrospinal fluid) evaluation. Our fourth and final goal is to determine if it is appropriate to begin treatment of the seizures. This depends on how long the seizure(s) lasted, how frequently they are happening, and what we suspect is the most likely cause of the seizure. There are many safe and effective medications available for seizure management and your veterinarian will help you determine which is best for your pet.
If you suspect your pet is having or has had a seizure, please seek care. Calling your veterinarian to describe the event can help determine how quickly you need to be seen. If it is after your vet’s regular business hours, do not hesitate to call an emergency hospital to see if your pet should be seen right away or can wait for your vet to be open. Generally, if your pet has never had a seizure before and then has 2 or more seizures in a 24 hours period, they should be seen immediately. If your pet has had seizures in the past but has been controlled on medications, care should be sought immediately if more than 3 seizures happen in a 24 hour period. Any seizure that lasts for more than 5 minutes is unlikely to stop without medical intervention and can quickly become life threatening. We advise people to start heading to the car and get their vet on the phone once a seizure has gone on for longer than 3 minutes, so that you are well on your way once the 5 minute mark has been reached. Finally, if your pet has a seizure and isn’t acting completely normally within 30 minutes, please seek care straight away.
One final tip – if your pet is having abnormal behavior (whether obviously a seizure or not), please don’t hesitate to take out your smart phone and take a quick video. Bringing this with you to your vet can be very helpful in putting together the pieces of the puzzle.
For more information about Angell’s Emergency/Critical Care service, please visit www.angell.org/emergency or call MSPCA-Angell West in Waltham at 781-902-8400.