King Hill Mastiffs
Epilepsy Cause & Treatment

Epilepsy is a subject that all owners and breeders should educate themselves about especially in our large breeds because it is an emotionally devastating disorder that currently has no cure. My occupation is a developmental therapist and my entire adult life has been spent working in the field of mental & developmental disorders. I have managed epilepsy in humans on a daily basis for countless years. Needless to say, I have extensive experience and first hand knowledge with all aspects of this disease. However, it wasn't until my first show dog that I would open my eyes to canine epilepsy and it's heartbreaking effects. I think it's important to understand that Epilepsy is NOT a seizure. Having a single seizure does not mean a canine has epilepsy.

What is Epilepsy- A Primary medical condition with recurrent unprovoked seizures where no underlying disease process can be identified. Also commonly referred to as Idiopathic Epilepsy,Primary Epilepsy or Genetic Epilepsy. Epilepsy is a brain disorder characterized by an enduring predisposition to generate seizures. This complex disease is believed to affect from 2 to 4 percent of dogs. Individual bloodlines and some breeds have a higher incident rate concluding a genetic basis. A seizure is a symptom of epilepsy and takes place when the brain is experiencing electrical difficulty. This is triggered by certain cells and neurons sending out the incorrect signals. Seizures typically begin between 1 and 3 years of age. While epilepsy cannot be cured, for some canines the seizures can be controlled with medication, diet, devices, and/or surgery. Most seizures do not cause brain damage, but ongoing uncontrolled seizures can lead to brain damage. It is not uncommon for canines with epilepsy to develop behavioral and emotional problems in conjunction with seizures. For many canines, the risk of seizures restricts their independence and recreational activities. In simple terms, Epilepsy it's like faulty wiring in the brain, or a short circuit.

Seizure Disorder-Unlike Primary Epilepsy which is unprovoked in many cases seizures can develop as a result of a problem. Also known as Secondary Epilepsy or Seizure Disorder. This often occurs when something alters the normal workings of the brain. A few known problems that cause seizure disorder are an active disease process, infection, trauma, metabolic disorder, brain tumors, allergies, ticks, thyroid, poison, intolerance to wheat gluten and many others. Seizure disorder can often be cured once the source is successfully treated.

The Difference Between Primary and Secondary Epilepsy-In some cases,canines may have symptoms that look very much like a seizure but in fact are non-epileptic events caused by other disorders. Medical professionals have developed a number of different tests to determine if a dog has Primary or Secondary epilepsy and, if so, what kind of seizures they suffer from. Veterinarian will not be able to differentiate between these two conditions without close observation and intensive testing. These tests include CBC, urinalysis, BUN, ALT, ALP, calcium, fasting blood glucose level, serum glucose level, serum lead level, fecal parasite or ova examination. If the test results conclude in No known cause then further testing will be needed including CSF analysis (cell count, protein levels, pressure), skull radiographs, and an EEG. Finally, after every test has exulted and a large amount of money has been spent with the results as inconclusive Then & only Then, Primary Epilepsy also known as Idiopathic Epilepsy is diagnosed. At that point, it's best to seek a Neurologist.

What Are the Different Types of Seizures?-There are many different types of seizures. Each seizure is unique and defined by the behaviors displayed during the seizure. Typically, there is a change in behavior (eg. confusion, fear, rage), consciousness (the animal may or may not lose consciousness), motor activity (rigid or jerky muscle spasms, or paddling), and autonomic activity (salivation, urination, and defecation). Changes in sensory function may lead to pawing at the face, tail chasing, or biting at part of the body or the air. Seizures may be partial or generalized, and mild or severe (grand mal). A dog experiencing a mild generalized seizure might be confused, show weakness and some muscle tremors, and look to the owner for reassurance. A dog in a grand mal seizure will be unconscious, with rigid or jerking limbs, and involuntary salivation, urination, and defecation. Cluster seizures occur when the brain does not really return to below the seizure threshold. The dog will apparently recover and start to walk around fairly normally but suddenly crash into another seizure. Some canines with epilepsy are at risk for abnormally prolonged seizures or status epilepticus. Status epilepticus is a medical emergency that can lead to brain damage, and even sudden death.

Phases of a Seizure- There are 4 basic phases to a seizure:
1)Premonitory-It is common for a dog to show a change in behavior for hours or even days before a seizure
2)Aura or Preictal-signals the start of a seizure. Signs include restlessness, nervousness, whining, trembling, salivation, affection, wandering, hiding, hysterical running, and apprehension
3)Ictus or Seizure stage-characterized by sudden increase in tone of all muscle groups. The ictus is either tonic or tonic-clonic, generally lasting from 1-3 minutes
4)Postictus- abnormal behavior associated with fatigue, depression, hunger, thirst, or hyperactivity. lasting minutes to days after the seizure the dog may be confused, disoriented, restless, or unresponsive, or may wander or suffer from transient blindness. At this stage the animal is conscious but not functional. Some research suggest that in this stage often seizures are establishing a pattern.

Who has Epilepsy & Why- The answer to this question is a complex interrelationship between genetics and acquired factors. It appears that canines inherit their seizure threshold but whether or not they develop seizures may depend on trigger events. Canines with epilepsy have seizures, but canines with a seizure disorder do not necessarily have epilepsy. In order to acquire epilepsy there must be a genetic predisposition. Conditions that can exacerbate epilepsy or cause seizures are hormones, electrolyte abnormality, poor nutrition, sleep deprivation,hypoglycemia, metabolic failure and stress.

Treatment-You may not recognize that what has occurred in your dog is a seizure (especially if mild) and your dog will likely be back to normal by the time you see your veterinarian (except in the case of status epilepticus). Accurate diagnosis of the type of seizure is crucial for finding an effective treatment. Once idiopathic epilepsy is diagnosed, it is important to begin treatment as soon as possible. Research suggests that medication and other treatments may be less successful in treating epilepsy once seizures and their consequences become established. Appropriate management of epileptic dogs entails obtaining an accurate diagnosis, ensuring proper education, selecting an appropriate antiepileptic medication, and periodic evaluation and therapeutic drug monitoring to determine a dose that controls the seizures and avoids side effects. The effects of a seizure depend on the part of the brain involved and there are a few options when choosing the correct course of treatment.

Anti-epileptic drug treatment-Choosing which anti-epileptic drug to use in efforts to control seizure activity often depends on many different factors including age of onset, type of seizures, severity,frequency and even diet. When selecting an anticonvulsant drug,the veterinarian should consider the following:
1. Has the drug been shown to be beneficial for the treatment of epilepsy in dogs?
2. Do the drug pharmacokinetics suit the patient in question?
3. Is the drug safe and cost-effective?
4. Can serum concentrations be measured if necessary?
Common medication used for treatment are Phenobarbital, Potassium bromide (KBr), Diazepam (Valium), Zonegram, Keppra ect. Correct medications and dosage are individually based and usually discovered through a trial & error process. Dogs metabolize many of these drugs at a very rapid rate, resulting in a very short half-life. Some drugs are more effective for specific types of seizures. A canine with seizures, particularly those that are not easily controlled,will need to be treated aggressively for refractory epilepsy and will often be placed on a multiple combination of drug therapy. Routine blood work is needed to evaluate liver values and drug levels with using any medication. The bloodstream is the pathway to the brain and, therefore, leads medication to the centres of the brain in which seizures begin. If a drug's blood level concentration is too low, seizures may occur and the dosage will have to be increased. Conversely, too high a drug level may cause side effects, such as drowsiness or confusion. This necessitates a reduction in dosage or, possibly, a change to a different medication.

Diet-Special diets may help to control seizures when medications are either not effective or cause serious side effects. The ketogenic diet is sometimes used in humans and can be beneficial to canines as well. This diet is higher in fats and lower in carbohydrates than a typical diet. Also a Raw meat diet has shown some effects in decreasing seizure activity. Epileptics should have No Corn, No Wheat & No preservatives.

Medical- Brain Surgery,Deep Brain Stimulation, Vagus Nerve Stimulation, Gold Bead Implants have all been effective in decreasing seizure activity with some inherent risk involved.

Complementary treatment- There is no scientific evidence to suggest that any type of complementary treatment can reduce or stop seizures However, alternate treatments may be effective as a first line of treatment. Among these are Acupuncture, Herbal treatments,Homeopathy,and Aromatherapy Holistic veterinarian Roger DeHaan,DVM states that some forms of epilepsy respond to supplementation of vitamin B6, magnesium, and manganese

Why Treatment Fails-There are many reasons why medical treatments can fail. The biggest reason is the owner's lack of proper administration of the prescribed drug. The progression of an underlying disease (such as brain tumor) may also resist treatment. Also, gastrointestinal disorders can affect drug absorption, and tranquilizers may stimulate seizures. Drug interactions can occur and adversely affect the level of anticonvulsant drug in the dog's system. And it just might be that a particular drug may not work for that animal. Subsequently, when treatment fails despite every effort often the seizures have established that the brain "needs" them & owners find themselves faced with a tough decision regarding the quality of life.

Prevention-At this time any canines that have experienced seizures or their parents and siblings should NEVERbe used for breeding.

Recent Studies and Info-Recently medical science has discovered a technique called the gene chip, which can quickly screen thousands of genes in an individual. However we can do that in canines with a simple cheek swab or blood test. Abnormalities in the genes that control neuronal migration (a critical step in brain development)can lead to areas of misplaced or abnormally formed neurons, or dysplasia, in the brain that can cause epilepsy. Researchers are studying the underlying causes of the epilepsy as well as seizures that occur following brain trauma, stroke, and brain tumors. Ongoing research is focused on developing new model systems that can be used to more quickly screen for epilepsy. The identification of genes or other genetic information that may influence or cause the epilepsy may allow breeders to prevent this disorders. Scientists also continue to study how neurotransmitters interact with brain cells to control nerve firing and how non-neuronal cells in the brain contribute to seizures.

Further information about Canine Epilepsy, Research and ways you can help are found here:
www.mastiff.org/SEIZUREDISORDERSINMASTIFFS
cgap.ucdavis.edu
www.canine-epilepsy
canine-epilepsy-guardian-angels.com


Thank You Margaret in the UK for all your help in trying to develop a DNA test. I could not think of a better person to have shared the experience.Please bare with me this is a work in progress.