Epilepsy

Epilepsy in dogs describes recurring seizures arising from abnormal electrical activity in the brain. Idiopathic (primary) epilepsy has no identifiable underlying cause and is believed to be genetic - it's the most common form. Structural epilepsy arises from brain abnormalities (tumours, injury, inflammation). Reactive seizures occur due to metabolic causes (hypoglycaemia, toxins) and resolve when the underlying problem is treated.

For dogs with idiopathic epilepsy, the condition is lifelong. The aim of treatment is not to eliminate seizures entirely but to reduce their frequency and severity to a level that preserves quality of life, while minimising medication side effects.

A seizure diary is not optional for epileptic dogs - it is the central tool of management.

What to monitor and log

Every seizure requires a detailed entry. Log:

• Date and time the seizure started
• Duration from first signs to when the dog is fully recovered
• Type of seizure: generalised (whole body, loss of consciousness, paddling, convulsing) or focal (one body part affected, unusual behaviour, facial twitching)
• Phase details:
  • Pre-ictal (aura): unusual behaviour before the seizure - staring, anxiety, seeking attention, hiding
  • Ictal (seizure): what the body was doing
  • Post-ictal (recovery): confusion, blindness, excessive drinking/eating, exhaustion - note how long this phase lasted
• Triggers: exercise, excitement, stress, sleep, eating, nothing apparent
• Cluster or single: multiple seizures within 24 hours is a cluster event

Also log daily: medication given (time and dose), any missed doses, and your dog's general behaviour and demeanour even on non-seizure days.

Understanding seizure thresholds

Epileptic dogs have a seizure threshold - a level below which electrical activity doesn't trigger a seizure. Many things temporarily lower this threshold: stress, illness, sleep disruption, and missed medication. Consistently noting what preceded a seizure often reveals patterns that can be managed (for example, reducing intense exercise in the days after a seizure, maintaining strict medication timing).

Medication

Common antiepileptic drugs used in dogs include:

• Phenobarbital - most widely used; requires regular blood level and liver function monitoring
• Potassium bromide - often used alongside phenobarbital for dogs with poor seizure control
• Imepitoin (Pexion) - licensed specifically for canine epilepsy; milder side effect profile
• Levetiracetam - increasingly used, particularly for cluster seizures and as an add-on therapy

Consistency is critical. Dose timing matters - irregular administration causes fluctuating blood levels that increase seizure risk. Missed doses should be handled according to your vet's specific guidance for the drug your dog is on.

Emergency management

You should know in advance:

• Cluster seizures (two or more seizures within 24 hours) require emergency vet assessment
• Status epilepticus - a seizure lasting more than five minutes, or failure to regain consciousness between seizures - is a life-threatening emergency requiring immediate veterinary care
• Many vets prescribe rectal diazepam or buccal midazolam for home use during prolonged or cluster seizures - ask about this when your dog is first diagnosed

When to contact your vet

Go to the emergency vet immediately if:

• A seizure lasts more than five minutes
• Your dog has two or more seizures within 24 hours
• Your dog does not recover consciousness between seizures

Contact your vet the same day if:

• A single seizure occurred in a dog previously seizure-free (first ever seizure)
• Seizure frequency has significantly increased compared to the established pattern
• The character of seizures has changed noticeably

Schedule a routine appointment if:

• Seizure frequency is steady but you want a medication review
• Medication side effects are affecting quality of life
• It's time for routine blood monitoring (typically every 6 months on phenobarbital)

Frequently Asked Questions

Should I put something in my dog's mouth during a seizure? No. Dogs cannot swallow their tongue. Putting anything in a seizing dog's mouth risks a serious bite injury. Keep your hands away from the mouth.

Is it safe to be near my dog during a seizure? Keep the area clear of hazards. Don't try to restrain your dog - this can cause injury. Speak calmly, dim lights if possible, and reduce noise. Time the seizure. Your presence and voice can be calming in the post-ictal phase.

My epileptic dog seems to seize more at night - is this normal? Seizures during sleep or the transition into or out of sleep are very common in dogs with idiopathic epilepsy. This is thought to relate to changes in brain activity during sleep states. It doesn't necessarily change management but is worth logging.

Can my dog live a normal life with epilepsy? Many epileptic dogs live full, happy lives. Well-controlled epilepsy - meaning seizures are infrequent and brief - has limited impact on daily life. The keys are medication consistency, avoidance of known triggers, and regular monitoring. Dogs with poorly controlled epilepsy may face more restrictions.

How often does my epileptic dog need blood tests? For dogs on phenobarbital, blood levels and liver function tests are typically checked 2–4 weeks after starting or changing the dose, then every 6 months once stable. Regular monitoring is essential - phenobarbital can affect liver function over time.