Pet epilepsy
Pet epilepsy is a neurological disorder similar to human epilepsy . Dogs are most frequently affected, cats are less likely to get sick , and rabbits very rarely . An accumulation in Arabs has been described for horses . Due to the other nerve circuits in the animal brain, however, the term “epileptiform seizure” is often used. As in humans, a distinction is made between idiopathic (about 80 percent) and symptomatic epilepsy as well as focal and generalized seizures.
Focal epilepsy
In focal epilepsy, a distinction is made between simple and complex partial seizures and seizures with secondary generalization. The simple focal seizures often only present themselves as uncontrolled movement of individual limbs or muscle groups, jaw clapping or head shaking. In the case of purely sensory or vegetative focal epilepsy, no seizures are usually noticeable. As a result of the associated disturbance of consciousness, complex seizures present themselves as behavioral problems: In addition to unmotivated barking, chewing, licking, aggressiveness and twitching of certain parts of the body (e.g. ears, face), the symptom of "snapping flies" or the urge to wander (compulsive walking in circles) is often the symptom ) observed. It is often difficult to distinguish it from special individual behavioral patterns in healthy dogs.
Generalized epilepsy
Generalized seizures are divided into different groups: absences (extremely rare), myoclonus, tonic seizures, clonic seizures, tonic-clonic seizures (see above). The most common type of seizure is the tonic-clonic grand mal seizure. In the dog it is divided into different phases:
- Prodromal stage: Characterized by subtle changes in personality, staring into space, sniffing. This stage can last several hours to days, is often absent or is overlooked before an attack.
- Aura: It is often difficult to distinguish it from the other phases and is characterized by pronounced fearful behavior such as restlessness, nervousness , attachment or barking. They last from a few seconds to a few minutes.
- Iktus: The actual seizure. It often begins with local twitching, which later turns into generalized spasms with tonic-clonic twitching, jaw striking, saliva, uncontrolled urination and feces and unconsciousness. This phase usually lasts a few seconds to minutes. An ictus that lasts longer than 30 minutes or two or more seizures in a row without regaining consciousness is called status epilepticus .
- Postictus: This stage lasts for a few minutes up to days, in which the animal shows symptoms of exhaustion. Occasional disorientation, cravings, and unmotivated aggressiveness are also possible.
Breed disposition
In the case of idiopathic epilepsy in dogs, a racial or familial disposition has been partially proven.
Epilepsy is more common in the following breeds: Golden Retriever , Cocker Spaniel , Poodle , St. Bernard , Irish Setter , Miniature Schnauzer , Wire-haired Fox Terrier , Dachshund , Border Collie and Great Swiss Mountain Dog .
Lafora-type seizures in the beagle and basset hound are caused by an accumulation of glycoproteins in the central nervous system. In Keeshonden and Irish Wolfhounds an autosomal recessive mode of inheritance is described. In other breeds such as German and Belgian Shepherd , Golden Retriever , Labrador Retriever , Bernese Mountain Dog , Boxer and Vizsla a complex pattern of inheritance has been demonstrated.
Differential diagnosis
Various diseases must be excluded from the differential diagnosis. In dogs, these are mainly cardiac syncope , liver disease ( hepatoencephalic syndrome ) and infectious diseases (dog: distemper , cat: feline infectious peritonitis (FIP)). The list of other differential diagnoses, after the acronym VETAMIN D are processed.
therapy
As a result of limited financial or diagnostic possibilities, a "diagnostic therapy" is often carried out after the most important differential diagnoses have been clarified.
In veterinary medicine, phenobarbital is still frequently used, as the newer human anti-epileptic drugs in dogs have short plasma half- lives and therefore have to be taken frequently or there are no studies on these active ingredients. A new alternative is imepitoin , which was specially developed for dogs and has a better side effect profile. Potassium bromide is usually used in dogs as an additive to therapy with phenobarbital, if an increase in the phenobarbital dose is no longer an option due to the narrow therapeutic range. If treatment fails , the administration of gabapentin , felbamate , levetiracetam or zonisamide should be considered. In cats, phenobarbital is the drug of choice, diazepam and potassium bromide are not suitable for long-term therapy. In most cases, anti-epileptic therapy has to be lifelong and, if properly adjusted, has a relatively good prognosis.
In the case of status epilepticus, diazepam is the first choice. It should be noted that the status epilepticus is a life-threatening emergency that requires immediate treatment. The pet owner can provide "first aid" at home with rectal use of diazepam-containing suppositories or enema or the careful oral administration of diazepam drops in order to then visit the vet as soon as possible.
Individual evidence
- ↑ A. Fischer, H. Potschka, V. Stein, A. Tipold: Chapter 4: Therapy. In: Andrea Fischer u. a .: The idiopathic epilepsy of the dog. 1st edition. Stuttgart 2013, ISBN 978-3-8304-1265-6 , pp. 66ff.
- ↑ a b Thilo von Klopmann: Treatment of epilepsy - use of anticonvulsants in veterinary medicine. In: Small Animal Medicine. 5 (2011), pp. 240-246.