Molly is a 3-year-old Yorkshire terrier who lives with Fran and her husband, Bill, in Modesto. Molly spends most of her time indoors never far from Fran or Bill and has had no health problems until about four months ago.
Fran and Bill were on the couch watching television with Molly sitting next to them. Rather suddenly, Molly began to tremble and rolled to her side. After a few seconds she was shaking violently and urinated and defecated on the couch. Bill and Fran recognized the episode as a seizure and kept Molly from falling off the couch until the episode ended. Fran remarked that it seemed to last forever but in reality it was probably, in all, about a two- to three-minute event.
Fran brought Molly to her veterinarian the day the seizure occurred. A blood sample was drawn to check for any abnormalities that might lead to a seizure and Molly was sent home. The results of her blood test were unremarkable and Fran was instructed to wait to see if Molly had another seizure.
About two weeks later, Molly had two more seizures and again she was taken to her veterinarian. A diagnosis of epilepsy was given and Molly was placed on a medication called Phenobarbital. This medication is used to control seizures in several species of animals, as well as humans. Molly initially was very sleepy on her new medication but, after about five or six days, became used to the drug in her system.
Unfortunately, Molly was still having seizures and her dosage of Phenobarbital had to be increased. In the past three weeks, Molly has had five more seizures and Fran was again instructed to increase Molly’s dosage. Fran has done so but is worried about the possible problems that Molly might have because of taking the Phenobarbital.
It is likely that Molly does have epilepsy. This disease results in what is called a seizure focus in the brain that allows an uncontrolled discharge of electrical impulses through the brain resulting in a seizure.
It is very important to understand that epilepsy is a diagnosis we arrive at after ruling out other causes of seizures. That was a likely reason why Molly’s veterinarian performed a blood test. There are many other potential causes for seizures and some can be quite difficult to diagnose.
Epilepsy usually starts manifesting itself in younger dogs but can show up later in life as well. There are cases of a dog having a single seizure at some point in its life and never again. This is a good reason to wait after one seizure to see if the dog does indeed seizure again. If other causes of seizures have been ruled out, treatment for epilepsy, specifically seizure prevention should be started. It is important to realize that once a seizure happens, it becomes easier for another to occur and so on. It’s as if a neurological pathway becomes more and more burned into the brain with each seizure. This is why with multiple seizure occurrences it becomes imperative that the seizures be prevented.
Seizures are not inherently painful but if left unchecked, they can be damaging to the brain. Also during a seizure, the animal could fall or otherwise cause trauma to their bodies.
In her letter, Fran did not share the dose of Phenobarbital that’s being given to Molly so I cannot comment on whether or not it might be excessive. Patients taking this drug, a drug that works quite well in preventing seizures, should have their blood levels of the drug monitored on a regular basis. This will allow the dose to be properly tailored to the individual patient to achieve the ultimate goal of seizure prevention with minimum medication.
There are cases of epilepsy where seizures are not able to be prevented with Phenobarbital alone, even at the highest allowable dose. These cases likely need the addition of or replacement with another anticonvulsant medication. Usually with combination drug therapy, seizures that have not been controlled by Phenobarbital alone are indeed suppressed bringing about control of the condition.
Jeff Kahler is a veterinarian in Modesto. Questions can be submitted to Your Pet in care of LifeStyles, The Modesto Bee, P.O. Box 5256, Modesto 95352.