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Although a condition which implicate a possible risk of premature death, epilepsy is also a potentially self‐limiting disorder and remission might occur either spontaneously or upon treatment.13 Remission of epilepsy has been documented in several studies of dogs ranging between 14 and 24% of the populations investigated.3, 6, 8, 9, 12, 14
This study documented a remission of epilepsy of 13% and thus confirmed that idiopathic epilepsy in dogs is not necessarily a chronic condition. Our result is supported by a previous study in using an identical definition for remission, and which found a remission rate of 15%.3 Three of the dogs that entered remission in this study had a history of one or more episodes of cluster seizures, indicating that remission can be achieved even in such severe cases. This has also been reported for Border collies and Australian shepherds diagnosed with idiopathic epilepsy.8, 9
Our finding is consistent with human epilepsy studies on survival, which have documented that case fatality is highest in individuals with epilepsy associated with a known intracranial cause compared to idiopathic epilepsy.1, 4 A similar result, which found a significantly longer mean survival time in dogs with idiopathic epilepsy compared to dogs with epilepsy associated with a known intracranial cause, has previously been reported.6 However, the study only included dogs with seizure onset before the age of 1 year, and the results are therefore not directly comparable to this study.
Fifteen dogs (19%) experienced focal seizures whereas 49 dogs (63%) experienced focal seizures with secondary generalization and 11 dogs (14%) experienced primary generalized seizures. Seizure type could not be classified in 3 dogs (4%). A history of cluster seizures was reported in 47 dogs (60%) and 14 dogs (18%) experienced status epilepticus (Table ). In four of these dogs, status epilepticus occurred more than once. MRI was performed in 14 dogs, CT was performed in 16 dogs and 9 dogs had a CSF examination (6/9 dogs had also MRI performed and 2/9 had CT performed). No abnormalities were found on any of these specialized diagnostic tests.
At the time of follow‐up one dog (4%) was alive while 23 dogs (96%) were dead. The median life span was 69.5 months (95% CI: 56–83), 5.8 years, whereas the median survival time after index seizure was 8 months (95% CI: 3–21), 0.7 years (Table ). Epilepsy‐related cause of euthanasia was reported in 19/23 dogs (83%). A significant association was found between survival time and the underlying etiology, with dogs diagnosed with inflammatory CNS disease having a significantly longer survival time (P = .0096) than dogs diagnosed with intracranial neoplasia, malformation, or hemorrhagic stroke (Fig ).
Treatment may not prevent all seizures
The treatment that we give our dogs to reduce their seizures is doing just that. Treatment expectation is generally to reduce the frequency and reduce the severity of a dogs seizures. It is unrealistic to expect complete elimination of all fitting.
This is because giving the really high doses that may be needed to eliminate all seizures could result in some very severe side effects. In other cases no matter the amount of drug given, seizures would never stop completely. That said, a small proportion of dogs will actually be seizure free once theyre started on medication.
If your dog continues to have the odd, minor seizure after starting treatment then that is to be expected. It doesnt mean that the medication is not working. If however the seizures are taking place at a really high frequency, or if they are lasting a long time and recovery is prolonged it may be time to reassess the diagnosis, treatment plan or both.