Diagnostic tests are performed to identify underlying diseases that may be causing the seizures. Diagnostic tests may include:
Complete medical history and physical examination including neurological examination and ophthalmologic (eye) examination. Routine laboratory tests to evaluate the general health of your pet and to identify potential underlying causes of seizures, including the following: A complete blood count (CBC or hemogram)
A serum biochemical profile to evaluate for low blood sugar, low blood calcium and abnormalities of liver function
Bile acid determinations to evaluate liver function
The need for additional diagnostic tests is determined based on the results of the medical history, physical examination and initial laboratory tests. These tests may include:
X-rays of the abdomen to evaluate liver size
Ultrasound examination of the abdomen to evaluate liver size, assess other internal organs and identify tumors that may be present
Electroencephalography (EEG) to record electrical activity of the brain
X-rays of the skull
Blood lead determination if lead poisoning is suspected
Cerebrospinal fluid analysis
Brain imaging consisting of either computerized tomography (CT) or magnetic resonance imaging (MRI). MRI is more sensitive than CT for examining the brain but cost and availability may limit its use.
Your veterinarian may recommend additional diagnostic tests based on the results of initial examinations. These tests may help diagnose other concurrent medical problems or allow your veterinarian to better understand the impact of the underlying disease on your pet. Such tests ensure optimal medical care and are selected on a case-by-case basis.
Optimal therapy of any serious or persistent medical condition depends on establishing the correct diagnosis. Seizures have many potential underlying causes, and the underlying cause should be identified before specific treatment can be recommended. Medication with anti-convulsant drugs will be recommended for patients with idiopathic epilepsy. Your veterinarian will determine if treatment is warranted, and if so, which specific medication is indicated.
Seizure medication usually controls the seizure disorder but does not eliminate seizures entirely. Identification and specific therapy for seizure disorder in your cat is the best treatment.
Drugs commonly used to treat pets with seizures include:
Phenobarbital is used most commonly. More than 60 percent of cats with idiopathic epilepsy can have their symptoms controlled using phenobarbital at therapeutic dosages.
Primidone is considered more toxic and less effective than phenobarbital.
Phenytoin is of limited effectiveness and generally is not recommended.
Potassium bromide often is used in conjunction with phenobarbital when seizures cannot be controlled by phenobarbital alone or when evidence of phenobarbital toxicity is present.
Diazepam (Valium®) is not effective for long-term management of seizure disorders in cats. Your veterinarian may however use diazepam administered intravenously to terminate a seizure in an emergency situation.
Pets that experience a number of seizures over a relatively short period of time may require hospitalization while tests are performed and the animal is monitored for the occurrence of additional seizures. Pets that have cluster seizures, that is more than two seizures in 24 hours, are often hospitalized until they have had no seizures for a 24 hour period. Intravenous administration of drugs such as diazepam, pentobarbital or propofol may be necessary to control seizures initially. Supportive care may include fluid therapy, soft bedding, temperature monitoring and repositioning a recumbent animal every two to four hours.
Administer all prescribed medications as directed by your veterinarian.
Keep a "seizure log" that describes all of your pet's seizure activity including date, length of seizure, activity or behavior during the seizure and length of time until your pet is normal.
Maintain a complete record of drug dosages and dates of blood drug tests.
See your veterinarian to monitor drug blood concentrations as recommended. Blood phenobarbital concentrations usually are evaluated approximately 14 days after beginning phenobarbital therapy.
Blood potassium bromide concentrations usually are evaluated approximately six weeks after beginning potassium bromide therapy.
Blood drug tests usually are recommended every six to nine months and whenever seizures occur.