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A follow‐up investigation was conducted in January and February 2012. Owners of included dogs were contacted by telephone and interviewed using a structured questionnaire. The questionnaire consisted of three sections:
Life span investigated time from date of birth and until time of death/time of follow‐up and survival time investigated time from date of index seizure and until time of death/time of follow‐up.
The study was designed as a retrospective hospital based study with follow‐up. The study population consisted of dogs diagnosed with idiopathic epilepsy or epilepsy associated with a known intracranial cause between 2002 and 2008 at the Small Animal Veterinary Teaching Hospital, University of Copenhagen. To be included in the study, the dogs should have a diagnosis of idiopathic epilepsy or epilepsy associated with a known intracranial cause from the hospital neurology clinic.
A significant association was found between cause of death, life span (P = .00021), and survival time (P = .0030) (Figs , ). Dogs that died/were euthanized because of causes directly related to the epileptic condition had a significant shorter median life span and median survival time compared to dogs that died or were euthanized because of other causes. An association was also demonstrated between cause of death, the occurrence of cluster seizures, or both status epilepticus. The frequency of cluster seizures (P < .001) and status epilepticus (P = .003) were significantly increased in dogs in which epilepsy was the direct cause of euthanasia compared to dogs in which death was motivated by other causes.
The group of dogs with epilepsy associated with a known intracranial cause consisted of 22 purebreds (distributed among 19 breeds) and 2 crossbreeds. Of these, 4 were females (3 intact, 1 neutered) and 20 were males (15 intact, 5 neutered). Eleven dogs (46%) were diagnosed with intracranial neoplasia, nine dogs (38%) with intracranial inflammatory disease, three dogs (12%) with malformation (hydrocephalus) and one dog (4%) with hemorrhagic stroke. Upon presentation 6/24 dogs had a normal interictal neurological examination including a normal interictal behavior reported by the owner. Median age at index seizure was 47.5 months (Q1–Q3: 14.75–75.25 months, range: 1–138 months), 4 years. The median number of months the dogs had epilepsy (from index seizure to time of either death or follow‐up) was 8 months (range: 1–73 months).
In pets, seizures tend to come in three phases. The first phase is called the pre-ictal stage. Dogs may pant, vocalize, pace, or become agitated. In dogs, a majority of seizures occur at night, and often dogs begin to seize when they are sleeping. Therefore, this phase does not occur universally.
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There are many causes of seizures, including brain deformities, trauma, exposure to toxins like snail bait or cheap flea products, liver failure, kidney failure, encephalitis, meningitis, and brain tumors. However, the vast majority of dogs who develop seizures between 2 and 6 years of age do so because of epilepsy.
After the seizure comes the post-ictal stage, which may last anywhere from a few seconds to several hours. Dogs may pant, vocalize, be disoriented, appear to be blind, or be agitated.
The brain is made of cells that communicate through electrical impulses. Epilepsy is a condition in which an area of the brain fires excessive impulses. Those impulses then travel to and cause more electrical firing in other areas. A chain reaction occurs, and soon the entire brain may be overtaken by the electrical firestorm. The result is a seizure.
Epilepsy In Dogs: 9 facts you NEED to know
Epilepsy is the most common neurological disease in veterinary practice. However, contrary to human medicine, epilepsy classification in veterinary medicine had not been clearly defined until recently. A number of reports on canine epilepsy have been published, reflecting in part updated proposals from the human epilepsy organization, the International League Against Epilepsy. In 2015, the International Veterinary Epilepsy Task Force (IVETF) published a consensus report on the classification and definition of canine epilepsy. The purpose of this retrospective study was to investigate the etiological distribution, survival time of dogs with idiopathic epilepsy (IdE) and structural epilepsy (StE), and risk factors for survival time, according to the recently published IVETF classification. We investigated canine cases with epilepsy that were referred to our teaching hospital in Japan during the past 10 years, and which encompassed a different breed population from Western countries.
A total of 358 dogs with epilepsy satisfied our etiological study criteria. Of these, 172 dogs (48 %) were classified as IdE and 76 dogs (21 %) as StE. Of these dogs, 100 dogs (consisting of 65 with IdE and 35 with StE) were included in our survival study. Median survival time from the initial epileptic seizure in dogs with IdE and StE was 10.4 and 4.5 years, respectively. Median lifespan of dogs with IdE and StE was 13.5 and 10.9 years, respectively. Multivariable analysis demonstrated that risk factors for survival time in IdE were high seizure frequency (≥0.3 seizures/month) and focal epileptic seizures.
Focal epileptic seizures were identified as a risk factor for survival time in IdE. Clinicians should carefully differentiate seizure type as it is difficult to identify focal epileptic seizures. With good seizure control, dogs with IdE can survive for nearly the same lifespan as the general dog population. Our results using the IVETF classification are similar to previous studies, although some features were noted in our Japanese canine population (which was composed of mainly small-breed dogs), including a longer lifespan in dogs with epilepsy and a larger percentage of meningoencephalomyelitis of unknown origin in dogs with StE.
Epilepsy is a common chronic and functional brain disorder in dogs and humans that is characterized by recurrent epileptic seizures. In the veterinary field, classification and terminology of epilepsy in part reflects current proposals from the human epilepsy organization, the International League Against Epilepsy [1–4]. However, a consensus on classification and terminology in veterinary medicine had not until recently been agreed; diagnostic procedures of epilepsy are slightly different between humans and animals, therefore routine examinations in human medicine (e.g., electroencephalogram (EEG) or functional imaging) have limitations in veterinary medicine. In order to address this problem, the International Veterinary Epilepsy Task Force (IVETF) was recently organized from specialists of veterinary neurology and other neuroscientists. Accordingly, new consensus reports on canine epilepsy were published in 2015 [5–11].
According to the IVETF consensus, “epilepsy is defined as a brain disease characterized by an enduring predisposition to generate epileptic seizures” [5]. Consequently, IVETF etiologically classified canine epilepsy into idiopathic epilepsy (IdE), structural epilepsy (StE), and unknown cause [5]. Additionally, IdE is further divided into genetic epilepsy, suspected genetic epilepsy, and epilepsy of unknown cause. Classification of dogs into genetic or suspected genetic epilepsy requires genetic and/or family analysis.
The IVETF criteria for IdE diagnosis is described by a three-tier system [6]. The tier I confidence level describes a history of two or more unprovoked epileptic seizures occurring at least 24 h apart, with an age at epileptic seizure onset of between 6 months and 6 years, an unremarkable interictal physical and neurological examination, and no significant abnormalities on minimum data base (MDB) blood tests and urinalysis. The tier II confidence level describes unremarkable fasting and postprandial bile acids, brain magnetic resonance imaging (MRI), and cerebrospinal fluid (CSF) analysis. The tier III confidence level describes characteristic EEG abnormalities for seizure disorders. In addition, the IVETF consensus recommends performing MRI and CSF analysis in dogs with the following conditions: age of initial epileptic seizure onset <6 months or >6 years, neurological deficits, cluster seizures (CS) or status epilepticus (SE) at initial epileptic seizure onset, and cases previously diagnosed as presumptive IdE but showing single antiepileptic drug (AED) resistance.
Because the IVETF classification has only recently been defined, there have not yet been etiological or survival studies of canine epilepsy based on this classification system. Previous studies of lifespan in dogs with epilepsy have been reported using different (conventional) classifications. A recent study reported median lifespan to be 9.2, 5.8, and 7.6 years for dogs with IdE, StE, and epilepsy from all causes, respectively [12], with premature death due to epilepsy-related causes. Moreover, some studies have focused on CS [13, 14] and/or SE [15], and reported that dogs with frequent CS may be associated with euthanasia [13], while dogs with SE may have a short survival time [15].
Here, we retrospectively investigated the etiological distribution of canine cases with epilepsy, which had been referred to our teaching hospital in Japan (Tokyo) during the past 10 years (2003–2013). In this study, distribution of breeds in the canine population was different from Western countries. The purpose of our study was to classify dogs with epilepsy according to the recent IVETF classification in 2015, and to investigate survival time, lifespan, and risk factors influencing survival time in dogs with IdE and StE.
Because this was a retrospective and survey study, ethics for animal use was not requested. Nevertheless, all owners of the dogs included in this study had agreed to use of their dogs’ data for academic education and studies, and had previously signed a consent form on the first presentation to the teaching hospital.
The present study consisted of two components: 1) a study of the etiological distribution at the time of epilepsy diagnosis; and 2) a survival study performed using a questionnaire survey, which included evaluating risk factors associated with survival.