We adopted Max at the beginning of the year, and although we were told "he has seizures, but they're controlled with medication" that was not the case.
Max has idiopathic canine epilepsy with grand mal seizures. Idiopathic: no known cause, grand mal: AKA Tonic Clonic seizures, are the seizures you see in movies; the full on crazy foaming at the mouth seizures. Max's start only during sleep. He will wake suddenly with his eyes open as wide as they go and it looks like he's looking at a bug flying around his head, he may also sniff uncontrollably. Shortly after he will go into the Tonic phase starting with his mouth which will rhythmically open and shut until his whole body goes rigid. He then starts the clonic phase and his limbs join into the rhythmic movements. He foams at the mouth and looses bowel and bladder control. This lasts about 20 seconds, then he lays rigidly with his eyes open, usually for another 20 seconds. Although his eyes are open, he is unconscious during the entire seizure. Upon regaining consciousness, he starts the post seizure or "post-ictal" phase. He "wakes" from the seizure confused and disoriented. He cannot see for a few minutes and walks around aimlessly while running into everything. This is the hardest thing to see. He can however, smell immediately and this is when we give him his valium in a pill pocket (more on that later). He's also ravenously hungry which is a result of the intensity of the seizures which are akin to running a marathon.
He was on the first line canine epilepsy drug phenobarbital or "pheno" when we adopted him. However the dose was "subtherapeutic" or ineffective for his size. When the foster said he hadn't had a seizure the entire time he's had him, he lied. I felt angry that we were taken advantage of, and had many a pity party that we adopted a dog with epilepsy. I'm not proud of it, but I thought about giving him back to the rescue. Fortunately, after many discussions with Mike we decided that Max was worth it, that he was such a sweet loving boy, that just needed someone to love him and who better than us. He's surprisingly well trained, he comes when he's called and can be off leash, without fear of him taking off. I believe the only reason he was let go from his family were the seizures, which had probably just started. When he brought him home, he seizured 4 times over 3 days before we could bring him to the vet and get his dosage corrected. This incorrect dose coupled with the stress of a new home was enough to cause those 4 seizures. Once we got the dose corrected the seizures started to decrease in frequency.
Until.
He started to cluster.
A cluster seizure is when a dog has multiple seizures over a short period of time, in Max's case it was 6 in a hour. It tore us up to see him like this, and the ER vet was horrible to us. (I still have an indent in my steering wheel from where Mike punched it). But the next day we contacted our regular vet and things started to turn around.
Max was put on another medication that's given to dogs who cluster called Potassium Bromide or KBr. KBr takes 2-3 months to build up in their system but should allow for a decrease in the dosage of pheno. Although the vet wanted to attempt to decrease his pheno dose shortly after starting the KBr, I didn't do it. I knew he wasn't ready. He also gave us good ol valium to give to Max after a seizure to prevent him from clustering, which has helped tremendously.
He takes medications twice a day. The pheno is given twice a day and it works for 12 hours and needs to be given again. It needs to be given exactly on time. The KBr is given once a day and the timing is much more relaxed since it builds up to a steady blood level in their system over the course of those 2-3 months. The only problem with these medications is that they can be extremely hard on the liver. So we are required to get blood levels checked to make sure they stay in a therapeutic range. We are currently getting them checked about every two months, but once we are certain his dose is correct, we'll only have to do this once a year. Actually, while writing this, I received a call from our vet stating that his levels are looking great. That they are actually both on the low end of the therapeutic range. This means that the KBr has not reached it's full effect yet and that it would be safe to increase his dose of pheno if we need to. Which we might have to because although the frequency has decreased dramatically (3 weeks, then a month), he is still clustering. The clusters are so problematic because they have the potential to cause extreme increases in blood pressure which can cause a stroke, as well as extremely high temperatures. Although it's been stressful, Max has brought so much love into our lives. We got him for Olive. We thought she would love a buddy to play with and to provide her with the companionship she could only get from another dog. When I see them laying together, I know it was the right choice.
If you're dog has been diagnosed with epilepsy, here are a few things to remember:
- There are treatments - It is important to find a good doctor who has worked with dogs with epilepsy is is will to work with you and your dog. However, just as a person on medication for epilepsy, your dog may still have seizures occasionally.
- It doesn't hurt them. The seizures may look scary, but they are unconscious. They need you to be there for them.
- Be patient. It may take some time to get the seizures under control and the correct treatment. It may sound silly, but remember that your dog has NO control over their seizures
- It gets better.
