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Idiopathic Epilepsy in Cats

By: Dr. John McDonnell

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Idiopathic epilepsy is a specific term referring to a seizure disorder in cats that has no identifiable cause. It is also referred to as genetic or congenital epilepsy. The terms epilepsy, seizure, fit or convulsion all mean the same thing, the physical manifestation of a sudden, excessive electrical discharge of neurons in the brain that results in a series of involuntary contractions of the voluntary muscles, abnormal sensations, abnormal behaviors, or some combination of these events.

In your pet, the physical manifestation can vary between a far-away look or twitching in one part of the face to your pet falling on his side, barking, gnashing his teeth, urinating, defecating and paddling his limbs.

Seizures usually appear suddenly and end spontaneously, and can last from seconds to minutes. Idiopathic epilepsy can occur in all pedigree breeds as well as mixed-breed cats.

Because idiopathic epilepsy or a predisposition to epilepsy might be inherited, neither epileptic animals nor their first-degree relative should be used for breeding.

Components of a Seizure

There are three components of a seizure:

  • Aura. Certain signs of an impending seizure may be evident, such as restlessness, whining, shaking, salivation, affection, wandering or hiding. These signs may persist from seconds to days in duration and may or may not be apparent to you.

  • Ictus. During ictus, the seizure occurs. The attack may last seconds or minutes. Your cat may fall on his side and may look like he is kicking or paddling. He will salivate, lose control of his bladder, and be unaware of his surroundings.

  • Postictial stage. This stage occurs immediately after the seizure. Your cat will appear confused and disoriented and may wander or pace. This period may be short or it may last for days.

    What to Do If You Pet Has a Seizure

  • Do not panic. If your pet is having a seizure, he is unconscious and he is not suffering. Your pet may seem like he is not breathing, but he is.

  • Time the seizure. Actually look at a clock or watch and note the time; although it may seem like forever, it may only be 30 seconds.

  • Keep your pet from hurting himself by moving furniture away from the immediate area. Also protect him from water, stairs, and other sharp objects. If possible, place a pillow under his head to prevent head trauma.

  • Note what type of muscular activity or abnormal behavior does your pet exhibits during the seizures? Your veterinarian may want you to keep a record of the date and length of time of each seizure.

  • If the seizure lasts more than 5 minutes, call your veterinarian or veterinary emergency clinic immediately.

  • Pets do not swallow their tongues. Do not put your hand in your cat's mouth – you may get bit. Do not put spoons or any other object into your pet's mouth.

  • Keep children and other pets away from your seizing animal.

  • Remain by your pet's side; stroke and comfort your animal so when he comes out of the seizure you are there to calm him.

    After the seizure

  • Observe your pet's post-seizure behavior. Do not allow your pet access to the stairs until he is fully recovered. Offer water if he wishes to drink.

  • Be prepared for vocalization and stumbling after the seizure ends. You need to be strong and offer support and comfort to your pet. He will be confused and may feel as though he did something wrong. Speak softly and with a soothing voice.

  • If your pet has not fully recovered within 30 minutes, contact your veterinarian or local emergency facility.

    Signs That Require Emergency Veterinary Attention

  • Seizures that last longer than 10 minutes
  • Seizures that occur more than 2 times in a 24 hour time period
  • Seizures that begin before your pet has completely recovered from the previous seizure

    Diagnosis

    By definition, idiopathic epilepsy is a seizure disorder with no known cause, however it is important for your veterinarian to determine your pet's general health and make sure there is no underlying disease that may be causing the seizures. Your veterinarian will take a detailed history and perform a complete physical and neurological examination. Recommended blood tests may include a CBC, serum biochemistry panel, toxin screen, feline infectious disease panel, urinalysis and fecal examination.

    Treatment

    The goal of treatment is to reduce the severity and frequency of the seizures while avoiding unacceptable side-effects. It is rare to completely eliminate all seizures in cats with idiopathic epilepsy. Your veterinarian may chose to treat the disorder with anticonvulsant medications.

    Drug Therapy

  • Phenobarbital is usually the drug of first choice for idiopathic epilepsy. It is given two to three times a day by mouth. During the initial treatment period of 10 to 14 days, side effects are usually seen with this drug consisting of excessive drinking, urinating and eating. Some cats may act very lethargic as well. These side-effects are temporary and diminish two weeks after initiating treatment.

  • The other common anti-convulsant used in cats is oral diazepam or valium. It must be given three times a day. On a much more serious note, oral diazepam has been linked to a very rare but fatal idiosyncratic hepatic failure. Diazepam (Valium) is used for the treatment of status epilepticus. Your veterinarian usually gives it in emergency situation by the intravenous (IV) route.

  • Bromide is the active ingredient in potassium bromide and sodium bromide and is another anticonvulsant that can be used in addition to phenobarbital or as an initial drug. Many cats that do not initially respond to phenobarbital alone will have a dramatic decrease in seizure frequency and severity with the addition of bromide. Bromide is the drug of choice for animals with liver disease.

    Side-effects from the bromide include increased eating, drinking, urinating and incoordination. These side-effects are usually temporary but if they are problematic, a dose reduction in either one of the drugs may be recommended.

    Home Care

    At home, follow your veterinarian's recommendations regarding drug administration and monitoring, and maintain a complete seizure log with information regarding the seizures, any medication change, veterinary visits and illnesses.

    Haphazard drug administration or abrupt changes in medication may be worse than no treatment at all and may cause status epilepticus, a condition characterized by persistent seizure activity for a period of more than 30 minutes or repeated episodes of seizure activity without recovery in between.

    Blood tests will be required to monitor your cat's response to therapy and guard against toxic effects from the seizures as well as the anti-convulsant medications.

    The diagnosis of idiopathic epilepsy is not a death-warrant; epilepsy is a chronic disease that can be managed in the vast majority of cases. There is help for you and your cat. Work with a veterinarian with whom you feel a good rapport. Educate yourself on seizures and their treatment.

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