Oh, the nostalgia of COVID springs past. The smell of fresh crocus buds mixed with a new pandemic mask is one that evokes awakening. The freshness of April baseball overlapping with the anxiety of crowded super-spreader events, weddings, and birthday parties with only limited mortalities makes the body and brain feel young again. Socially distant first dates are in the air and all the Spring kids playing Legos together over Zoom brings back the hope squashed by the constraints of Winter kids playing Legos together over Zoom just weeks ago. The dogs and cats can feel the weather changing and with it, ramp up their dog and cat A-game. And with that, I end my introductory ramblings and segue, quite unnaturally, into a discussion regarding … your cats’ and dogs’ general neurologic behavior.
There’s This Weird Thing that Happens…
As always the bearer of angst-inducing theoretical scenarios, I would like to evoke a scene that is relayed to me often that goes like this. A dog is doing generally well. No real issues. She is eating and drinking fine, seems to be getting along with the new dog, loves to take walks, yes, there are no issues. But [hesitates for a moment], there’s this weird thing that happens every so often, I am told, and it’s probably nothing but she seems to just stare off into space every once in a while, acting like she’s not there. Then she stops, licks her leg for a few minutes, and then seems to come to and then there’s nothing wrong.
The cat version is usually something similar but often involves chasing a fly (or dust) and then twitching for a bit. I ask how long it’s been going on and often the answer is vague, like she has always done odd things like that but we thought it was just a thing, like when she goes to sleep and twitches and chases bunnies in her dreams, and sometimes whimpers… So it’s been going on for years, but it seems to be getting worse.
The Movie Version of Seizures
I think when people think of dogs and cats having seizures, they usually evoke the classic grand mal seizure like one you’d see a person have in a movie, or if you know humans with epilepsy, in real life. This big seizure in dogs and cats usually presents with them seeming off for a bit, maybe scared and hiding under the bed or in the closet for a few minutes with dilated eyes and hearts beating fast. Then the seizure will hit causing their front legs to go stiff and stick out. Their back legs paddle, their eyes can start twitching back and forth, and often they vomit, defecate, or urinate. Then comes the post-seizure time frame where they slowly come out of it and seem exhausted and not themselves for a few hours.
This would be the seizure most likely to be portrayed in the Lifetime Movie Network’s scandalous romantic thriller about a single mom/widower with a heart of gold who adopts a dog from the local church auction and then gets more than she bargained for when the dog’s neurologic activity comes between her and her rebellious daughter’s new boyfriend [screenplay pending].
Abnormal neurologic behavior is very far-ranging and sometimes we see cats and dogs act like both of the above examples and sometimes it’s even vaguer or weirder. With hopes that I am not inciting a mob of people calling with thoughts that their animals are having seizures, I will say that seizures often are retroactively understood to be seizures after they progress.
What Is a Seizure?
I’m sure you’ve heard the term “seizure,” but it’s important to know what this means. Here’s a simplified explanation: The brain is constantly activating and suppressing parts of the body through, essentially, electrical and chemical conduction. A seizure is an abnormal event where the brain is essentially not able to control its firing. It loses control of all the carefully metered out activity of the body.
Seizures can be caused by many things, and it’s important to remember that often the cause does not have to be as scary as one first assumes, especially if an animal is otherwise doing well.
If a dog or cat is not particularly young or old, let’s just say 2 to 9 years old, the first thought is idiopathic epilepsy. This is just a way of saying, to be simpler than I like or actually have ever been, that there is no real reason or cause for the seizure.
We usually get to this diagnosis by two means. The first option is that we examine the animal and perform complete blood work to rule out metabolic and endocrine causes of seizures (like anemia, abnormal electrolytes, etc.). I usually will also focus on the heart to make sure that abnormal cardiovascular or blood pressure activity is not causing events that look like seizures. If all is normal, we monitor and see if the seizures continue while not really affecting a dog’s or cat’s life in a significant way. Sometimes we add anti-seizure medications (which are generally cheap and safe) if things are progressing. If enough time goes by and things seem controlled (with or without medications), it’s most likely epilepsy. Sometimes we have no options other than to go this direction due to limited finances or temperament of the animal.
The second option is more expensive and thorough. This would require an animal to see a boarded neurologist at a specialty hospital and most often have advanced imaging and diagnostics performed, such as an MRI and cerebral spinal fluid tap under anesthesia. I usually would have an echocardiogram of the heart performed for the reasons explained above. If there is no other cause of seizures found, we call it epilepsy, and the management is similar to option 1: monitor and start anti-seizure medications if things are getting worse.
I want to be clear, though, that seizures are serious, regardless of whether they are vague and mild or serious and dramatic. Every seizure has the potential to cause brain damage, and every seizure can be one that is life altering and even fatal. That is why doing a work-up for animals suffering from seizures is important and why we always want to rule out the other things before presuming that this is “just” epilepsy. It may not always be an emergency, but we should always see animals who are having abnormal neurologic events.
Other Causes of Seizures
And then what is it if it isn’t epilepsy? Besides being a repulsive sentence to say aloud, it also is answered by a conversation that everyone wants to avoid.
The first thing that everyone is fearful of, especially if an animal is older, is that seizures are being caused by a brain tumor. Though this is possible, there are other things about which to worry such as liver or kidney dysfunction, low blood sugar, anemia, high or low calcium, magnesium, potassium, chloride, congenital malformations of the brain, trauma, toxins, infections (viral, fungal, bacterial), diseases caused by tick bites, parasites that go to the brain, immune-mediated causes, and in some dogs we see degenerative causes that sometimes can cause our pets to act “senile.”
Unfortunately, in many cases, dogs and cats that are having seizures can be thought to have epilepsy or, at least all of the above are presumed to not be occurring. Later we discover one of these causes, like cancer, had been hiding without detection. If a cat or dog is presumed to not be suffering from all of the above and is diagnosed with epilepsy, the proper course of treatment is often, again, just to monitor or start anti-seizure medications, but if it is not working, sometimes rescue drugs like steroids are tried.
Serious But Often Very Treatable
With fear of ending on a bad note, I want to emphasize that seizures are serious, definitely scary to see, vague and can manifest in a wide-array of abnormal behavior, but often very treatable and controllable. Some dogs, though, just do weird things for no reason. My dog loses his mind whenever he sees a black bag, either on the ground or blowing in the wind, and his behavior is probably insane enough to be viewed as abnormal by most people, but he’s just crazy.
Some dogs and cats just do weird things, and this is not reason to treat your dog for a neurologic event. So let us know if you have questions and enjoy the remainder of your pandemic.
Wear your masks, read your books: https://www.bookcellarinc.com/book/9781501160349
Brett Grossman, DVM
Medical District Veterinary Clinic