E750
Seizures

Seizures usually warrant a true emergency for two reasons: First, prolonged seizure activity can result in breathing difficulty, high body temperature, brain damage, and death. Second, a seizure may indicate another life-threatening situation which requires immediate attention, such as a dangerously low blood sugar level or ingestion of a poisonous substance.

Generally speaking, one of a veterinarian’s most challenging situations is to treat a cat that has suffered a seizure and is being presented for emergency care. Some of the conditions which lead to seizures are extremely difficult to diagnose and require the use of expensive medical equipment which is not often available. Also, a seizure is usually completely over by the time the animal arrives at the clinic, and the veterinarian may be unsure of exactly what happened or how serious the seizure really was.

A good history is often the most important part of the initial assessment of the patient. Questions owners may be asked when arriving at a veterinary clinic following a pet’s seizure include the following:

1. Are there any possible toxic substances your pet may have been exposed to? Substances which can cause seizures to occur include antifreeze, lead, mercury, strychnine, pesticides, organophosphates (many different insecticides), metaldehyde (slug or snail bait), and some household cleaning products.
   
2. How long did the seizure last? Seizures ALWAYS seem longer than they really are. Glancing at a clock or watch and obtaining an approximate time interval is extremely helpful.
   
3. What abnormal behavior patterns did you notice before and after the seizure? Some animals can sense when a seizure is coming and may act differently. Also, any abnormalities noticed afterwards such as confusion, apparent blindness, or hyperactivity should be reported.
   
4. Can you describe the seizure? Though it may be unpleasant to recall, details such as which part of the body became affected first, symmetry of body involvement, and level of consciousness are very helpful. Even though it is usually the last thing on a pet owner’s mind at the time, a videotape recording of the seizure may provide invaluable information to the doctor.
   
5. Have there been any changes in your pet’s personality, appetite, movement, vision, hearing, or health in general prior to this event? Any additional information, even though it may seem insignificant, may be useful to a veterinarian when determining the cause of a seizure.
   
6. Have there been similar problems noted in anyone else at home or in any other animal associated with your pet in the past? Some environmental causes, including toxic gases or chemicals, may cause both human and animal occupants of a house to become sick. This information, if applicable, will be very helpful to the veterinarian.

Being prepared with this and other information at the time of the visit to the veterinary clinic will help the veterinarian arrive at a possible conclusion and formulate a treatment plan. It is important to remain calm, think clearly, and act quickly when a pet suffers a seizure.

Clinical Signs: Seizures are classified into partial or generalized, and mild or severe, depending on the nature of the seizure.

Partial seizures are localized to only one area of the brain and may appear as confusion, muscle tremors, or spasms of the face or limbs. Partial seizures can progress to generalized seizures.

Generalized seizures involve larger and more areas of the brain and are usually associated with unconsciousness, rigidity, paddling/jerking of the limbs, chewing with the jaws, salivation, and loss of bladder and/or bowel control. In more mild cases where consciousness is not lost, the animal may run, pace, turn around in circles, lick at itself or objects, chase its tail, or paw at its face.

Diagnosis: Whether or not diagnostic tests are run depends on the nature of the seizure, whether there has been more than one seizure, and on the general health of the animal as assessed through a physical examination performed by a veterinarian. Blood tests (CBC, blood chemistry profile) and urine analysis are among the first tests that should be run. Other diagnostic tests or procedures which also may be performed include radiographs, CT scan, and other blood tests which are more detailed in their scope of certain systems or organs.

Some of the more common diagnoses made regarding seizures in cats include epilepsy, infectious diseases of the nervous system, low blood sugar (hypoglycemia), trauma, shock, liver dysfunction, congenital birth defects, exposure to toxins and/or poisons, and brain tumors.

Treatment: Immediate treatment for a pet suffering a seizure in the home revolves around keeping the pet from injuring itself or others. Here are some key points:

1. Move the seizuring pet away from sharp or hard objects.
2. Keep all fingers out of the pet’s mouth.
3. Remain calm, act quickly, and take note of answers to the questions addressed above.

Additional treatment depends on the diagnosis. Specific treatment of the underlying problem may involve the use of antibiotic therapy, anti-inflammatory agents, fluid therapy (with or without dextrose or electrolytes), special diets, surgery, radiation, and chemotherapy.

In order to control seizures, anti-convulsant therapy is often used. Anti-convulsants may be prescribed in addition to any of the above specific treatments, or they may be used alone, especially in cases of epilepsy. The basic guidelines in using these drugs are very complex and should ALWAYS be interpreted under the close supervision of a veterinarian for each individual case. Phenobarbital is a standard anti-convulsant drug used in a large number of seizure-suffering cats. Other drugs which may be used are diazepam (Valium) and KBr (potassium bromide).

Some professionals recommend the use of acupuncture as an alternative therapy in the initial management of seizures. Several protocols are used, and patients should be referred to specialists for this type of therapy.