About The Webinar
The learning outcomes of this webinar include:
• Develop a systematic diagnostic approach to canine epilepsy
• Optimise treatment and QoL in dogs with epilepsy
• Optimise client support and satisfaction
The fundamental steps in the management of a dog presenting with a history of seizures is to:
1. Establish if the dog is truly having epileptic seizures (by a detailed description of the episode and video footage whenever possible)
a. Findings supporting a clinical diagnosis of epileptic seizures include: Recognition of a pre- and/ or post-ictal phase, occurrence of autonomic signs (hypersalivation, urination, defecation), rhythmic muscle contractions, oro-alimentary and/or pedal automatisms, impairment of consciousness, epileptic seizure tend to occur at rest or upon waking from sleep and have a stereotypic phenomenology
2. Establish the cause of the epileptic seizures (by a detailed medical history, clinical examination and diagnostic investigations)
3. Identify the most appropriate treatment, outcome measures and monitoring overtime
The aim of idiopathic epilepsy treatment is to optimize quality of life, by minimizing epileptic seizure occurrence and ASD’s adverse effects (AEs).
Epilepsy has been defined as a disease of the brain characterized by an enduring predisposition to generate epileptic seizures. This definition is practically applied as the occurrence of two or more epileptic seizures at least 24 h apart, that are not caused by toxin exposure or a metabolic disorder.
IE is the most common chronic brain disease in dogs, affecting 0.6-0.75% dogs in primary care and up to 5.6% in referrals IE onset is often at a young age (between 6 months to 6 years) and the disorder is often lifelong, with remission rarely achieved IE threatens both the lifespan and wellbeing of affected dogs.
The aims of idiopathic epilepsy treatment are to:
• Maximise the dog’s quality of life
• Decrease epileptic seizures frequency and severity
• Minimise/ avoid adverse effects of ASD
• Abolish or mitigate neuro-behavioural abnormalities
• Decrease IE-related mortality and morbidity
Antiseizure treatment should be initiated when the dog with IE has:
• Two or more epileptic seizures within a 6-month period
• History of cluster seizures or status epilepticus
• Postictal signs that are considered severe or prolonged (> 24 hours)
• A worsening of the epileptic condition based on an increase in seizure frequency, duration, or severity noted over a timespan equal to 3 interictal periods
Client education regarding the goals and expectations of treatment is an extremely important component of successful ASD therapy and should be provided before any medication is prescribed.
Primary therapeutic success is defined as seizure freedom for a time span exceeding 3 times the longest interseizure interval (in days) in the year preceding the treatment and for a minimum of 3 months.
Secondary therapeutic success is defined as prevention of cluster seizures or status epilepticus a relevant reduction of seizure frequency based on the pre-treatment seizure frequency a reduction in seizure severity.
Serum ASD concentrations should be routinely measured for ASDs like Phenobarbital and KBr:
• Once steady state has been achieved after initiation of treatment or dosage adjustment
• When seizures persist despite an apparently adequate dosage
• When there are concerns about ASD related toxicity or pharmacokinetic interactions with other drugs
• Every 6-12 months to screen for any changes in drug disposition over time
Dosage adjustments are made incrementally, based on response to therapy assessed by:
• the seizure frequency once steady state serum levels are achieved
• the presence and severity of adverse effects
• serum drug concentrations (when applicable)
Animals should be evaluated at minimum of every 6-12 months, for examination and laboratory evaluation, and more frequently if seizures are not adequately controlled or intolerable AEs are present
