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Help--Feedback on Seizures


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Seven had a series of seizures this afternoon and evening. She's now at the emergency vet clinic and I'm looking for some quick feedback from the people here as I believe you all to be dog knowledgeable and grounded. Seven is 12 years old Hound and GSP (we think) mix, and up until this point has been in fab health. Over the past year, we've noted things like less strength in her hindquarters, clouding eyes. We put her on Etodolac several months ago for the arthritis. Leading up to today, there have been no significant events I can recall. She did spend a week at a kennel over Christmas (now 3 weeks ago).

 

This past week, somebody had urinated in our bedroom. We couldn't pin it, but of course suspected Star as Seven is so proven to not have accidents---ever. Last night, she started a foamy drooling and seemed like she was "sucking" while she was in her bed. I checked her out, wiped her mouth, she was alert, responsive, relaxed and it stopped after just a minute. She was fine this morning. Spent the whole day in the house while I was at work. When my daughter came home from school, she called me and said she thought Seven was acting strange---drool all over the floors and she just seemed not right. I said to keep an eye on her. She called back around 30 minutes later in a complete panic. Said Seven had pooped on the floor and was shaking, drooling. It then stopped. I told her to just wait 10 minutes and her sis would be home and we'd decide then what to do. Sis gets home and they both call me screaming, "Seven's having a seizure or something." She'd fallen down and was twitching. One ran for the neighbor and by then it was done, though Seven seemed disoriented was having a hard time using her hind end. Shortly after, DH got home and I met him at the ER vet. While there, she had another drooling, teeth chattering, "sucking" episode.

 

The ER vet said she believes it's most likely a brain tumor. Of course, we left upset. They were preparing to give her phenobarbital and were going to draw blood. When I got home, my natural curiosity took over--what made her say that? Why did she rule other things out (and what are those other things)? I called two friends who rescue older dogs and both of them thought that seemed a rash diagnosis and that older dogs can have seizures for no apparent reason. My googling reveals maybe Lyme as well? Any thoughts you all can share? I'm looking for pointed answers to ask the vet. Seven is the best dog in the world and I want to make the best possible decision for her.

 

Thanks for any feedback--I'm off to go sit with her awhile.

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Well, Seven has made it through the night without any more seizures, so this is good news. Her blood work is normal. The vet spent an hour with me last night answering some questions while I visited Seven. We discussed toxicity, Lyme, thyroid, etc. and she explained why she thinks it's likely a brain tumor. She also allowed that there's a possibility for Lyme and thyroid though she thinks not likely. I'll go get Seven in a bit and then take her to our regular vet for the day. We'll see what he says, too. If anyone has any thoughts, I'd appreciate them so much; I want to make sure I'm asking about everything I should.

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I'm sorry you are going through this, but I was really glad to hear Seven had an uneventful night and that you had an opportunity to talk further with the ER vet and learn what was behind her guess of a brain tumor as a cause. I hope you are able to learn even more from talking with your own vet today.

 

I have a senior dog (Ody) who has had occasional seizures for the last couple of years, but his condition seems quite different from Seven's, so I don't think I can offer any insight. I did, though, want to let you know I understand how upsetting it can be to the humans involved--and say I am thinking of you and your family and Seven.

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I'm sorry you are going through this, but I was really glad to hear Seven had an uneventful night and that you had an opportunity to talk further with the ER vet and learn what was behind her guess of a brain tumor as a cause. I hope you are able to learn even more from talking with your own vet today.

 

I have a senior dog (Ody) who has had occasional seizures for the last couple of years, but his condition seems quite different from Seven's, so I don't think I can offer any insight. I did, though, want to let you know I understand how upsetting it can be to the humans involved--and say I am thinking of you and your family and Seven.

Angie--thank you for the warm thoughts. Seven's resting at our vet for the day so they can monitor her and address any seizures. Our hope is she'll be seizure free and be able to come home this afternoon. They will xray her abdomen to rule out a tumor there, and will do a test for Lyme (along with a few other diseases). Our vet concurs it's most likely a brain tumor. It sounds like we are in wait and see mode. We'll try oral phenyl and see if that controls things or not. Is there anything I haven't thought of?

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Thanks for the update, Cindy. It sounds like you are covering all the bases I know to cover at this point--I hope other folks with more experience will chime in, too, since I know my experience is not a good parallel to yours. I hope Seven continues to be seizure-free through her day at the clinic and today's tests.

 

One thing you might talk to your vet about is continuing in wait-and-see mode a little longer--that is, not starting the meds right away. When Ody first began seizing (albeit his seizures are less dramatic than Seven's were), my vet suggested waiting, observing, and keeping close track of him for awhile before deciding on next steps. She said she wouldn't typically recommend medication unless/until the seizures became more frequent or more severe (she mentioned more than 1/month as a common point at which meds were used).

 

Again, Ody's episodes are milder, so this course of action may not be appropriate for Seven. And initially I was very freaked out and just wanted something to make the seizures stop. But I came to appreciate this more conservative plan, which has worked well for us.

 

Best wishes for an uneventful day!

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I guess the main thing I would want to know is if seizure meds really help if the seizures are the result of a tumor (as opposed to idiopathic epilepsy). I'd probably take a wait and see approach too. I have an epileptic dog, so I know seizures can be very scary, but if she continues to do well, then maybe it's something you could manage without meds.

 

J.

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I hadn't thought of not starting meds. I'll discuss that with the vet. Also, someone on facebook mentioned their dog had a heart condition and had seizures as a result? I'll be asking about that, too.

 

Apparently, even if it's a brain tumor, depending on location and how quickly it's growing, the phenyl can work over a period of a few years. And the dog can have good quality of life in the meantime. If the tumor is very large and/or aggressive, we'll find that the meds don't work and she'll seize through them. Then, we'll know it's not controllable and have a decision to make. Our vet thinks it's possibly a benign meningioma which is not all that uncommon in older dogs and is typically slow growing (though it's also quite possible it's cancerous). If this is the case, we should be able to manage the seizures and inflammation and it's quite possible something else will get her before the tumor does. Abodomen xrays clear, lyme test negative. So I think we've ruled out any other possibilities. Let me know if you think of anything else to ask. Though I'm starting to think I'm reaching.....

 

Thanks for the feedback! I'll keep you posted.

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I appreciate you sharing the information/your vet's thinking about the possibilities of different kinds of tumors and treatments as related to seizures. I hope that, whatever is happening with Seven, she continues to have a good quality of life for a long time yet.

 

The main lesson I have learned, through Ody's experiences, is that the potential causes of seizures are plentiful--and it seems that most of the process of determining the most probable cause is a process of eliminating other possible causes. So, while we have developed a couple of likely causes for Ody's seizures, we have never had a definite cause. (The likely causes = liver disease for one period, kidney infection for another episode.) It took me awhile to get out of the mindset of "must know what causes this so we can fix it" and, instead, just take things one day at a time.

 

I'm glad you've been able to rule out other possibilities, at least, so you can cross them off your list.

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I have gone through a similar series of events the last 6 months with a 10 year old dog and this is what I have learned:

 

There are numerous other diagnostic tests you could do, MRI, spinal tap, CT Scan, ultrasound. The MRI and spinal tap are most geared toward identifying a brain tumor. But, you have to weigh the following: the tests are expensive, you probably would have to go to A&M or other university hospital and see a neurologist, they may or may not be able to identify a tumor, you likely could not treat the tumor.

 

There are other drugs besides phenobarbital that you may want to consider. Many dogs handle it well, but it can make many dogs lethargic if used in high enough doses to control the seizures. There are other side effects as well. I have been trying zonisamide with my dog.

 

From your description, it sounds like your dog likely had at least 3 seizures, although the first ones may have been mild. The urination, the excessive drooling were likely mild seizures. So, anti-seizure meds are probably warranted.

 

You may want to consider a consult with a neurologist. Even if you do not do any additional tests, they can review the work that you have done and provide additional input. Neurologists see and treat seizures almost daily. Your regular vet may be very knowledgeable, but probably does not treat seizures frequently and may not keep up with the latest research.

 

You may not be able to get Seven to your vet or an emergency vet immediately if she starts seizing again. You, and other members of your family, should know what you are going to do if she seizes again. The quickest way to stop the seizures is to give valium intravenously. If you cannot give intravenously, you should be able to give rectally. Many vets will not want to give you valium, but it would be worth asking your vet for a small dose or two to have at home for emergencies. It will depend on your relationship with your vet. In any case, your vet should be able to tell you what you should do if Seven starts seizing in the middle of the night.

 

Hope this helps. Sorry that you and Seven have to deal with this - very scary. Give her a extra pat from me.

 

Gail

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Thank you, Gail, for sharing your thoughts. They are all great thoughts I think. I brought Seven home yesterday evening. She is wobbly from the pheno they've been giving her (they ramped it up) and I now have lovely cheap, unmatching floor runners all over the house so she doesn't slip on the wood and tile! Really, I'm so glad to have her home. We have decided to start her on phenobarbital immediately and will also give a low dose steriod (for any inflammation). The vet would not take a wait and see approach due ot the frequency of her seizures the other night (and I would have to concur--there was concern at the ER Vet they would not be able to stop the seizures due to their increasing frequency). We are just minutes down the road from the ER vet if something happens in the off hours so we are fortunate in this. Vet told us to give 1/2 tab of pheno and take her in right away if she has a seizure again.

 

We could get a CT or MRI--there's a top notch facility close by (I think Carrollton or Las Colinas). The cost would be near $1500. At that amount, I have to start asking myself what we need to know, and what the result of knowing is. I think we've ruled out most things that are not nuerological. We could chase down some other, obscure possibilities with other expensive tests. Since a tumor is #1 (by a long ways) on two vets' lists, I think we treat as if it is. In which case, the seizure meds either will work or not. If they do, we may have her with us another couple of years, which is her lifespan anyway). If not, then we know it's likely a faster growing and perhaps cancerous tumor. She is 12 and a large dog; we would not put her through chemo or radiation or surgery I think. So, if we can just get her over this hump and controlled, my hope is that we'll have some more time with her--and they'll be good times.

 

I'll ask about the valium (I know that's the first thing they gave her in the ER) and zonisamide. Also, you make a compelling point about the nuerologist. The ER Vet encouraged a consult as well but she wanted to do it yesterday. I decided to wait--there's only so much carting around and stress a sick dog should have to go through I think. Perhaps once Seven's a little more stable and seems more herself, I'll take her in.

 

I'll keep you posted, and thanks again for all of the feedback!

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Glad to hear Seven is home and you feel good about your immediate plans for treating her--and are even able to think about some future possibilities like consulting a neurologist. I am also glad Gail mentioned having some diazepam on hand if your vet is willing to dispense it, and it is certainly fortunate you are so near the ER clinic should you need it again.

 

Best wishes for Seven's wobbliness to be reduced as she adjusts to the pheno, and I can certainly relate to the "patchwork of rugs and runners" approach to home decor. :)

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Our old border collie seizures were a little different from sevens, no drool or other body fluids. The first one happened in the middle of the night followed by a couple more before we got him to the vet in the morning. We do not know how old he was at the time, best guess between 12/13.

Our vets first instinct was a brain tumor and put him on phenobarbital which turned him into a zombie. A couple of days after, we got a panicky phone call from the vet to get there now.. Turns out he had chronic kidney failure, the seizure was our first clue that something was wrong.

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Our old border collie seizures were a little different from sevens, no drool or other body fluids. The first one happened in the middle of the night followed by a couple more before we got him to the vet in the morning. We do not know how old he was at the time, best guess between 12/13.

Our vets first instinct was a brain tumor and put him on phenobarbital which turned him into a zombie. A couple of days after, we got a panicky phone call from the vet to get there now.. Turns out he had chronic kidney failure, the seizure was our first clue that something was wrong.

 

Yes, we ruled out kidney failure and liver disease. Did your old border collie make it?

 

BTW, Seven is still doing well, a little brighter and less loopy yet today. Still no seizures. Just took her in to have the IV removed. Keep praying....

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Yes, we ruled out kidney failure and liver disease. Did your old border collie make it?

 

BTW, Seven is still doing well, a little brighter and less loopy yet today. Still no seizures. Just took her in to have the IV removed. Keep praying....

Glad to here Seven is doing well, with Bandit we got 2 months to say goodbye, we gave him fluids subcutaneously most evenings, if he was willing, took him off seizure medication and spoiled him rotten. He died in his sleep, on his bed beside us, in the place he had chosen to sleep his first night home.

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Hi Cindy - Glad my info was helpful.

 

Are they treating with prednisone also? I think confirmed brain tumors are often treated with pred.

 

One of the benefits of zonisamide is that is often does not have the severe lethargy/dopey issues as phenobarbital. We have had to adjust dosages though as we did have a severe cluster of breakthrough seizures. It is a newer med though so many might not be familiar with it.

 

Maybe the neurologist could just review the records/test results/history and give you an opinion as to treatment. You could bring her in after that review if there was a need.

 

Glad to hear Seven is home and good luck with her.

gail

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post-10937-002305500 1326862759_thumb.jpgGail--yes, we start her on the steroid tomorrow. My vet wanted to wait a few days on that as she had been on an NSAID for arthritis. She's doing so much better--now hauling butt out to the back fence to bark at walkers. I wouldn't say she's terribly dopey at this point. Perhaps she's sleeping a little more, she still gets a bit off balance with fast movements, and her brain is definitely processing things slowly at times. DH thinks she had a stroke and has some brain damage. But she is improving each day so I hope it's still the effects of the IV pheno they gave her. They did say she could be dopey for up to 2 weeks as they had her really ramped up on it.

 

Anyway, still seizure free and now checking her fencelines and the trees for squirrels!

 

Alligande--that is my hope for Seven; that she will die in her sleep a happy dog. Too often, we have to make tough decisions....

 

Thanks for the feedback, everyone! I'll keep giving periodic updates.

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Happy to hear how well Seven is doing! It must have been really heartening the first time you saw her charge off to the fence acting like her usual self. :)

 

I hope she continues to feel good and that the residual dopeyness resolves with time.

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  • 1 month later...

Just thought I'd give a brief update. Seven has not had a seizure since that day. She is on pheno and her last blood test showed the levels are low so we upped the dose. She'd also done a round of prednisone. We'll have another blood test next week. Apparently the goal is to be at the optimum level to control (med amount) while still giving room to increase dose if there are issues in the future. She's hungry and drinks a lot, both side effects of the drug. I have to be careful to let her out a lot and we've had a couple of little accidents (right by the door) but I'm okay with those. She's more than earned her accidents by being dead reliable all her life. She used to have a very unreliable appetite--sometimes she'd eat her food and sometimes not. Now, if I wait a little too long in the morning, she's letting me know! She's put on a few pounds, which is nice as she's always been on the too slim side. However, I don't want her to get any heavier as her arthritis is a concern too. She is shiny and bright eyed. Though she is a LOT more relaxed than she used to be. The dopey-ness and the mental slowness seems to have improved, but she still wobbles a little when moving fast. She still likes her walks (only very short, though) and her car rides, and her ear scratches. She grumps at Star a little more, who probably deserves it anyway ;-) . At 12 years old, and a large dog, it makes me sad to know our remaining time with her will be

not be long, regardless of the seizures or the cause of them. I think she is happy and comfortable, and that's my goal. I don't want to terrify and stress her with vet visits trying to figure out something that won't give us any more time with her anyway. So, for now, we are babying her and watching her closely. I still need to look into the zonisamide; my vet hadn't heard of it so I will ask again. Thanks everyone for the feedback. If you think of anything else, please let me know.

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Just thought I'd give a brief update. Seven has not had a seizure since that day. She is on pheno and her last blood test showed the levels are low so we upped the dose.

When I last tested Phoebe's Pb blood level it was on the low end of the normal therapeutic dose (just above what is considered the lowest therapeutic level in the blood). My vet suggested raising her dose to get her blood levels of Pb closer to the mid range, but I opted not to do so (with the vet's agreement), because so far she is well controlled at the level she's at, and it does give me more room to raise her dose in the future should I need to. Pb is not entirely benign, so I'm more comfortable keeping her at the absolute lowest dose that keeps her seizures under control. Of course my decision was based partly on the fact that Phoebe is young (5) and so has a long life of meds ahead of her. I might make a different decision for an older dog for whom the adverse effects of treatment might not really have time to manifest themselves. Just some food for thought.

 

J.

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When I last tested Phoebe's Pb blood level it was on the low end of the normal therapeutic dose (just above what is considered the lowest therapeutic level in the blood). My vet suggested raising her dose to get her blood levels of Pb closer to the mid range, but I opted not to do so (with the vet's agreement), because so far she is well controlled at the level she's at, and it does give me more room to raise her dose in the future should I need to. Pb is not entirely benign, so I'm more comfortable keeping her at the absolute lowest dose that keeps her seizures under control. Of course my decision was based partly on the fact that Phoebe is young (5) and so has a long life of meds ahead of her. I might make a different decision for an older dog for whom the adverse effects of treatment might not really have time to manifest themselves. Just some food for thought.

 

J.

I really hesitated to raise the dose, too, Julie, for the same reasons; Seven hadn't had a seizure at the lower dose and the pheno does have its side effects. The long term side effects are much less of a concern given her age already, but I was very concerned it would make her even more dopey, thirsty and hungry than ever. I talked with the vet at length about this (my poor vet is earning her money!) and she really doubted that we'd see an increase in those side effects by increasing the dose. The vet also thought that dosing her at a less than optimum level could result in a seizure when she might not otherwise have one. It is very important to keep her from having a seizure as each one creates brain damage. Also, her seizures were frequent and clustered before and there was (and would be again) concern that they wouldn't be able to get the seizures to stop. Also, I'm not home as much as I used to be so there's more opportunity for her to start having a seizure when I'm not around to address it. So, after talking with her and a few other people, I went ahead and increased it. Seven is tolerating it very well-I've noticed no difference in her behavior as a result. Though it was a tough decision....I wish they could talk to us!

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