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Canine Health Foundation: Evidence for Cluster Seizure Management

Canine Health Foundation: Evidence for Cluster Seizure Management

By Sharon Albright, DVM, CCRT
Manager of Communications & Veterinary Outreach, AKC Canine Health Foundation

Epilepsy, especially the phenomenon known as cluster seizures, is a challenging disease for affected dogs and their families. Since approximately 30% of dogs with idiopathic epilepsy (seizures of unknown cause) continue to have seizures despite appropriate therapy with anti-seizure medications, the need for effective treatment strategies is a priority. Unfortunately, there is little scientific evidence to guide caregivers on the best treatment strategy for cluster seizures that happen at home. To address this knowledge gap, the AKC Canine Health Foundation (CHF) and its donors are funding a pilot study at North Carolina State University in which Dr. Karen Munana and her team will compare two in-home treatment protocols to assess their effectiveness in controlling cluster seizures in dogs (CHF Grant 03243-A: Comparison of Clorazepate and Levetiracetam as Pulse Therapy for the In- Home Management of Cluster Seizures in Dogs with Idiopathic Epilepsy: A Pilot Study).

When a dog has a seizure that lasts more than five minutes, it’s considered a medical emergency. If a dog has more than two distinct seizures over a 24-hour period, it’s known as a cluster seizure. This increased seizure activity quickly becomes self-sustaining and resistant to standard anti-seizure medications. Cluster seizures can lead to serious problems like irreversible damage to the nervous system, high body temperature, low blood sugar, and low oxygen levels. They also increase the risk that a dog will experience status epilepticus, or prolonged seizure activity that usually needs rescue medication to stop.

In their Consensus Statement on the management of status epilepticus and cluster seizures in dogs and cats, the American College of Veterinary Internal Medicine recommends a multi-tiered approach to managing cluster seizures in dogs. A successful treatment plan should involve short-term and long-term medications, and address any underlying conditions or complications associated with the seizures. Short-acting medications are used to stop seizures and prevent more from happening in the short term. After that, pulse therapy (intermittent dosing) with longer-acting anti-seizure medications is used to prevent seizure recurrence while minimizing the risk of developing drug tolerance.

Dr. Munana’s study is positioned to make a significant impact on the treatment of canine cluster seizures. By comparing two oral, in-home treatment protocols in a randomized clinical trial, this study aims to provide evidence for which medications work best to treat cluster seizures. Thirty client-owned dogs with a history of cluster seizures will participate, with their owners recording the dog’s seizure frequency, medications given, and adverse effects. Dogs will receive pulse therapy with either oral clorazepate or oral levetiracetam (known by the brand name Keppra) with the goal of having no additional seizures for 24 hours after administration.

“There is a critical need for research in veterinary neurology,” emphasizes Dr. Munana. “I am inspired by the wide network of extremely committed pet owners who are focused on advancing our understanding of epilepsy to help both their dog and others suffering from the disorder.”

The results of Dr. Munana’s latest CHF-funded study will provide evidence-based recommendations for the treatment of cluster seizures in dogs. “Idiopathic epilepsy is a chronic medical condition, with seizures tending to occur at a relatively young age and typically requiring lifelong management,” she says. “The AKC Canine Health Foundation has provided me the opportunity to educate pet owners and veterinary care providers about epilepsy and the research being performed in this field, with our shared goal of improving the quality of life for dogs affected by epilepsy as well as their caregivers.”

Stay tuned for the results of Dr. Munana’s pilot study and catch up on all the latest CHF-funded canine epilepsy research at akcchf.org/epilepsy.


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