Volume 23 | Issue 5 (2009 Sep-Oct)
Status epilepticus and epileptic seizures in dogs.J Vet Intern Med. 2009 Sep-Oct;23(5):970-6.1 Section of Neurology, Clinic of Small Animal Medicine, Ludwig-Maximilians-University Munich, 80539, Germany.
AbstractBACKGROUND: A special form of epileptic seizures (ES) is the life-threatening condition of status epilepticus (SE), which requires immediate and specific treatment based on a correct diagnosis of the underlying disease condition. HYPOTHESIS/OBJECTIVES: The objectives of this retrospective study were to determine prevalence of ES and SE in dogs presenting at a veterinary teaching hospital, to identify the etiology and relative risk (RR) for SE in general and at the onset of seizures. Furthermore the outcome for dogs suffering from SE was to be evaluated. ANIMALS: Three hundred and ninety-four dogs that were admitted to a veterinary teaching hospital (January 1, 2002 to March 31, 2008) with ES. METHODS: All medical records of dogs with ES were identified by screening the clinical documentation system and evaluated for inclusion in this retrospective study. RESULTS: Dogs with reactive seizures caused by poisoning had a significantly higher risk of developing SE (P < .001; RR = 2.74), particularly as 1st manifestation of a seizure disorder (P = .001; RR = 1.97). After SE, dogs with symptomatic epilepsy had a significantly lower probability of survival than dogs with idiopathic epilepsy (P < .001) and reactive ESs (P= .005). CONCLUSION AND CLINICAL IMPORTANCE: In dogs showing SE as the 1st manifestation of a seizure disorder, intoxication should always be considered and appropriate investigations undertaken. Dogs with SE owing to toxicosis have more favorable outcomes than dogs with symptomatic epilepsy (P < .001).
Companion NotesRetrospective report on status epilepticus and epileptic seizures (ES) in dogs:
Study design - introduction on epilepsy - in human medicine it is the most common neurological disorder - 50 million people affected worldwide (especially in developing countries) - in canine medicine it is the most common neurological disorder - epileptic seizures (ES) commonly divided into 3 groups - idiopathic - symptomatic epilepsy - reactive ES (CNS reacting to temporary systemic disease) - endogenous metabolic diseases - exogenous poisonings - status epilepticus - historically defined as seizure activity lasting over 20-30 minutes - today defined as continuous seizure activity for more than 5 minutes - or ≥ 2 discrete seizures with altered consciousness between - consciousness does not fully return between seizures - cluster seizures have normal consciousness between seizures - study population: - 394 dogs admitted to the Munich teaching hospital from 02-08 - 114 had status epilepticus (SE) (51 presented with SE as 1st seizure) - 280 did not have status epilepticus but had seizures - procedure: records retrospectively reviewed
Results - dogs with reactive seizures caused by poisoning - significantly higher risk of developing status epilepticus (relative risk = 2.74) - especially as the 1st manifestation of a seizure disorder - relative risk = 1.97 - dogs with symptomatic epilepsy after status epilepticus - significantly lower chance of survival than dogs of 2 groups - dogs with idiopathic epilepsy - dogs with reactive ESs - history & signalment - prevalence of seizures: 2.6% - prevalence of status epilepticus: 0.7% - neutered females had a significantly higher risk of developing ES and SE - as compared to the hospital population - ES Relative risk: 1.37 - SE Relative risk: 2.00 - as compared to sexually intact sex:Fs - ES Relative risk: 1.75 - SE Relative risk: 3.24 - breeds with a significantly higher risk of ES - golden retriever, 6.9% of the dogs - relative risk (RR) compared to hospital population: 2.04 - beagle with a RR = 2.35 - breeds with a significantly higher risk of SE - German shepherd dog with a RR = 2.17 - age at 1st onset of seizure activity - median age at seizure onset in SE dogs: 5.7 years of age - age at seizure onset in no SE dogs: 4.5 years of age - idiopathic epilepsy dogs significantly younger at the onset of seizures (compared to dogs with symptomatic epilepsy or reactive ES) - reactive ES dogs significantly younger than symptomatic epilepsy dogs - age at 1st onset of seizure activity varied significantly with underlying etiology - < 1 and 1-5-year old group: idiopathic epilepsy most common cause - > 5-year group: symptomatic epilepsy most common cause - underlying etiology - idiopathic epilepsy, 48.1% of dogs with ES - symptomatic epilepsy 38.3% of dogs with ES - symptomatic epilepsy (also called secondary epilepsy) categorized as: - cerebral tumors, 43 cases in this study - inflammatory brain diseases, 33 cases - other causes including vascular disease and trauma-related, 14 - reactive ES seen in 32 dogs - metabolic disorders, 18 dogs - poisonings, 14 cases - carbofurane and metaldehyde in 3 cases each - paraoxone and crimidine in 2 cases each
“In particular, dogs that were poisoned had a 2.7 times higher risk of developing SE (P < .001, RR = 2.74 [95% CI 2.16; 3.64]) compared with all other dogs, and a risk that was more than 3 times higher than dogs with idiopathic epilepsy (P < .001, RR = 3.18 [95% CI 2.30; 4.39]).”
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