Witnessing your dog having a seizure is certainly very concerning for any pet parent. One of the most common causes of seizures in dogs is idiopathic epilepsy. Idiopathic epilepsy is a neurological seizure disorder that can affect dogs at any age but most dogs will be 2-6 years of age when they have their first seizure. The underlying cause of idiopathic epilepsy in dogs is unknown although there are some theories about a possible genetic link with a heritable trait. Unfortunately, there is no cure for epilepsy in dogs and treatment goals are directed at reducing the frequency and severity of the seizures. While a diagnosis of epilepsy is serious, there are many treatment options to help manage the frequency and severity of seizures. The information provided in this article can be used as a guide to help you understand idiopathic epilepsy in dogs.

The anatomy of a seizure in dogs

A seizure is a result of abnormal neuronal activity in the brain. During a seizure, neurons fire excessively and send signals to other parts of the brain faster than they should – these misfires can cause all types of movements and behaviors that we often associate with seizures. Typical manifestations of seizures caused by idiopathic epilepsy include:

  • Loss of consciousness
  • Convulsions
  • Dilated pupils
  • Involuntary loss of bowel/bladder control
  • Vocalizations

Although it may feel like an eternity when watching your dog go through a seizure, most seizures as a result of epilepsy are short-lived and last from 30-90 seconds.

General goals of therapy for dogs with idiopathic epilepsy

The treatment of idiopathic epilepsy requires the use of anticonvulsants. After the second or third confirmed single seizure, or after any series or cluster of seizures, anticonvulsants are generally started. If seizures are mild, brief, and occur less than twice per year, anticonvulsants aren't generally required. It's critical to understand the advantages, dangers, and drug monitoring requirements before starting anticonvulsants. Unfortunately, there is no cure for epilepsy in dogs and treatment goals are directed at reducing the frequency of seizures. The goal of therapy is to reduce the frequency of seizures. It can be unrealistic to expect complete, 100% control of all seizure activity but with the proper treatment plan, the frequency of seizures can be greatly reduced. In most cases, once treatment has started, lifelong therapy is often required.

Treatment options for idiopathic epilepsy in dogs

There are many anticonvulsants available for the treatment of epilepsy. The most important aspect of anticonvulsant therapy for idiopathic epilepsy is proper seizure control and minimization of side effects as a result of treatment. In some cases, it may be difficult to know what drug would work best, however, phenobarbital is usually the first-line therapy for dogs with idiopathic epilepsy.

Phenobarbital -- Phenobarbital is frequently used to treat idiopathic epilepsy in dogs due to its high success rate and affordability. Common side effects include increased appetite, increased thirst and urination, and sedation. It is very important to perform regular drug monitoring for phenobarbital and should first be performed 3 weeks after starting therapy. As phenobarbital is metabolized by the liver, it should be avoided in dogs with liver disease. In addition, in some dogs, phenobarbital can cause liver disease so frequent monitoring of your dog's liver enzymes is very important.

Potassium Bromide (KBr) -- Potassium bromide is commonly used as an alternative to phenobarbital. It has the benefit of having minimal sedation compared to other antiepileptic drugs. As potassium bromide takes months to reach a steady state in the blood, more veterinarians will not use it when seizures are first noticed. Potassium bromide is better used together with phenobarbital. If seizures are improperly controlled with phenobarbital alone, your veterinarian will likely recommend adding potassium bromide to the treatment plan.

Side effects of potassium bromide are similar to those of phenobarbital and include increased appetite, increased thirst and urination, and sedation. Potassium bromide should not be used in dogs with kidney disease and regular blood monitoring is required for this drug.

Levetiracetam (Keppra®) -- Levetiracetam is slowly becoming a common first-line anticonvulsant medication amount veterinarians. Levetiracetam has few side effects compared to phenobarbital and potassium bromide. It can be used together with phenobarbital if your veterinarian feels it is necessary. Levetiracetam is not metabolized by the liver and has minimal drug interactions (making it very safe for dogs with other medical conditions). There are no significant side effects and regular drug monitoring is not required. The downside of levetiracetam is its cost and it can be cost-prohibitive, especially in larger dogs that require a higher dose.

Diazepam (Valium®) -- Diazepam is not given on a regular basis to treat idiopathic epilepsy in dogs. Diazepam is commonly used in emergency situations when a dog has had a seizure. It's usually administered intravenously or rectally and can be given during an active seizure.

Tips to help manage seizures in dogs

One of the most important aspects of managing idiopathic epilepsy in dogs is to make sure your dog lives in a safe and low-stress environment. Idiopathic epilepsy in dogs isn't curable, but seizures can be managed and minimized with anticonvulsant therapy. You can gently lower your dog to the floor if it's having a seizure so that it doesn't fall off a bed or sofa and sustain more injury. Alternatively, if your dog is having a seizure on a bed or couch, for example, using a pillow as a guard can be helpful. Make sure to avoid handling the mouth during a seizure to prevent accidental bites.

Commonly asked questions about idiopathic epilepsy in dogs

Can a dog live a good life with epilepsy?

With proper diagnosis and treatment, most dogs with epilepsy can lead happy, healthy lives.

What can trigger a seizure in a dog?

This varies greatly from dog to dog. Typical triggers for seizures in dogs can be a stressful event or even light.

What are the early signs of epilepsy in dogs?

In some dogs, sudden behavioral changes are often the first signs of idiopathic epilepsy in dogs. If your dog becomes aggressive or submissive out of nowhere, this could be a sign that something is physically wrong with them.
When a seizure first starts, you may see your dog begin to look around as if seeing something no one else does. They will become unsteady on their feet and even fall over. This is followed by paddling or convulsions of the legs. The eyes, tongue, and head may be affected as well. Your dog's breathing may increase, slow down, or even change to where it appears they are gasping for air.

What age does idiopathic epilepsy affect dogs?

Affected dogs are usually between the ages of 2-6 years when the first seizure is noticed.

What are the symptoms of idiopathic epilepsy in dogs?

The symptoms of idiopathic epilepsy can include changes in personality, unusual behavior, and seizures.

If you notice that your dog has had a seizure, try to write down the time that it occurred and report this to your veterinarian. This can help your veterinarian determine if a change in treatment is necessary. If your dog was on any medication at the time of the seizure, be sure to tell your veterinarian. It may or may not be related to treatment. If you are administering an anticonvulsant medication, specify which one and how much is given. Also, inform your veterinarian if your dog is improving or not, as this can help determine what changes (if any) should be made.