Thyme Is Seizing! At Emergency Now...

[MaryJane]

I just watched the video and that seizure was not too bad but, it was seizure activity. She seemed to be aware through most of it and she calmed down when someone was holding her and petting her. I might suggest that if she has another one, do that same thing as it might shorten the duration of the seizure. She did seem scared and aware, so some reassurance might help if she has another one.

[Guest DeniseL]

I just watched the video and that seizure was not too bad but, it was seizure activity. She seemed to be aware through most of it and she calmed down when someone was holding her and petting her. I might suggest that if she has another one, do that same thing as it might shorten the duration of the seizure. She did seem scared and aware, so some reassurance might help if she has another one.

 

I was running around like a nut trying to get dressed to take her to emergency, otherwise I have we have held her through all of them. So far the seizures have happened in the morning when I am not even dressed lol of course. Someone suggested we give her space when she is seizing, but with her, I think she feels safer when we are close and holding her, and yes, I think that she stayed pretty coherent through it. Afterwards, I called her name and she looked at me, she recognized me and her name. The first seizure a few weeks back as the most severe, but still not as bad as some videos I have seen since then...

How do I tell if her temperature is getting high?

[MaryJane]

She doesn't seem aggressive so, you don't need to give her much space. You don't want to bundle her up and squeeze her but, just get her on the ground, hold her head, pet her, and keep her legs from jerking around. One thing I keep around the house (in a few locations) is small mats that I can use to cover Lucy's legs (and mine) and to wipe the drool from her mouth. Lucy has GM seizures and they are very violent for the short time she has them. I still manage to hold her and keep her on the ground so she doesn't hurt herself but, she can fling herself across the room - that's how bad the spasms are. Once she starts to become aware, I get her up but, only after she can walk - I don't like her stumbling around.

 

The following is a video (from youtube) of a GM seizure. That is the type of seizure that will cause over-heating if it goes on for too long. If you have to take a temperature, get a rectal one. You can also feel the dog heating up. That's another reason that I give Lucy ice cream after a seizure - it's frozen so it can cool her down a bit.

 

http://www.youtube.com/watch?v=3rzIXhju_2c

 

I agree, seizures seem to happen at "not so great times".

[tbhounds]

You might want to consider bringing her to the clinic on an emergency basis-have her admitted today-she will be watched closely through out today and tonight-this way she will be monitored and will be seen as soon as the neuro arrives in the a.m. We call that getting through the back door ;-)

Edited November 17, 2013 by tbhounds

[a_daerr]

I agree, the seizure wasn't *that* bad. She was standing for most of it, which indicates a focal (partial) seizure that's only affecting one section of the brain. But the part that is concerning for me is that the seizure activity continued on for a pretty long time. Over two minutes. At this point, I wouldn't take her to the e-vet unless she starts clustering. But she's had a lot of these in a short amount of time, so I'd medicate ASAP. Definitely get some rectal Valium on hand for situations like this.

[Guest DeniseL]

I will probably get some answers tomorrow, but re medication: I hear most are really bad for the liver, etc. If her seizures continue mild like this maybe every couple of weeks, would it be better to just let her have them and not risk giving her the medications?

[MaryJane]

All the medicines have pros and cons and the neurologist will be able to cover that well. Let me add a bit of what I found out when I was researching.

 

- Pheno can give you great seizure control but, can cause liver issues and as a result, tests every 6 months or so. If you go to regular vet, this is the one they usually know about and will prescribe.

- Kbr - can give great seizure control but can cause issues like pancreatitis (must watch fat content of food and also salt)

- Zonisamide - is one that is gaining in popularity with neurologists as a 1st medicine. Very few side effects but, in some cases has "grace period, works for about 1 years and then stops. This is what happened to Lucy.

- Keppra - another one that is gaining in popularity but, seems to be used as an add-in to an existing drug. Very few side effects. Also in some cases, seems to have a grace period and then stops working or not as effective. Downside is expensive.

 

These are the most common - there are others.

 

Lucy started with Zonisamide and we got 1+ year with seizures controlled (less than 1 seizure per month). Keppra was added once she went into 2nd set of clusters. Keppra with Zoni worked for about 7 months and just recently in August of this year we had to add Kbr because she was having seizures about once a week.

 

Note, once you put a dog on medicines, they usually don't come off the medicine. And, it is not easy switching from one type to another -- can be done but, the risk is seizure activity. Most times it seems that neurologists will add on drugs, rarely do you go the other route which is taking drugs away and moving to another.

 

The rule of thumb that neurologists seem to use (IMHO) is if there is less than 1 seizure a month and if a dog is not clustering, then the dog may not need seizure drugs, at least not yet. Clustering means more than 1 seizure within 24 hours. Thyme already seems to be having more than 1 seizure a month -- seems like it might be about 4 at this time. But, the seizures are not GM and maybe the neurologist will wait a bit to see what happens with the next seizure. Whether you get seizure medicines and whether you get a cluster-buster are two different topics. Seizure medicines depend on how often and the type of seizures and also whether clustering. The cluster-buster is an "emergency measure" so that if you have a dog that has a second seizure within 24 hours, you can try to make sure that they stay far enough away (time-wise) from the next seizure so that the dog does not go into "status epilectus" which pretty much becomes a death sentence. The long seizures can cause brain damage if they are allowed to continue as well as the damage from the over-heating.

 

It's all about controlling the seizures. Make sure that you don't come home tomorrow without a "cluster-buster". You want a fast acting one - rectal valium is very quick. You may never need the rectal valium but, it is such a good feeling to know that you have it.

 

Something to remember is that most people will have a seizure free period and then decide to discontinue the seizure medicine and the seizures come back faster and more furious than before and sometimes ... not controllable anymore. It was the medicine that was keeping the seizures AT BAY. The seizures don't get "cured".

 

Let us know how the neurology appointment goes tomorrow.

[tbhounds]

I'll add my limited experience with anticonvulsants. My Shannon is on phenobarbital -1gr twice daily. She was diagnosed with a brain tumor. We are seeing a board certified neurologist and speaking with her she claims her go to drug is still pheno. It's tried and true and known to control seizure activity well. She said that she also favors it because it's easy to titrate the dosage if needed. Yes, you do need to watch those liver values. She placed my girl on Denamarin to support the liver. I'm not happy about using any anticonvulsants but, it was a must. In our case hopefully, once the tumor starts to dissipate (she had SRS radiation) we will be able to wean down the dosage.

[a_daerr]

There is a little bit of damage done to the brain every time the dog has a seizure. Also, because those neuro pathways are being used on a semi-frequently basis, it's likely that the number of seizures will continue to increase (think of walking through a forest- the first time is a lot of work, but each time after gets easier once you've made a path). Hopefully the neurologist will give you some insight on meds, but it sounds like your girl should be medicated now. With Henry, it was a little different. He would have a seizure, then go months upon months without having any. By the time the next one came on, I'd almost forget he was an epi-dog.

 

If your neurologist recommends Pb, I strongly suggest a liver support supplement like Denamarin. It's expensive, but worth it. If you go with Keppra or Zoni, do yourself a favor and get your scripts filled at a price club like Sam's Club or Costco. It really is significantly cheaper. The others are Potassium and Sodium Bromide, which I know have a lot of side effects dealing with peeing, appetite, and ataxia, but those are also other options.

[Guest DeniseL]

Thanks everyone!! Me and DH going out for dinner. When I come home, I'm going to start getting everything together for tomorrow, questions, seizure log, etc. Sure hope I like the neurologist...

[Saffron]

She doesn't seem aggressive so, you don't need to give her much space. You don't want to bundle her up and squeeze her but, just get her on the ground, hold her head, pet her, and keep her legs from jerking around. One thing I keep around the house (in a few locations) is small mats that I can use to cover Lucy's legs (and mine) and to wipe the drool from her mouth. Lucy has GM seizures and they are very violent for the short time she has them. I still manage to hold her and keep her on the ground so she doesn't hurt herself but, she can fling herself across the room - that's how bad the spasms are. Once she starts to become aware, I get her up but, only after she can walk - I don't like her stumbling around.

 

The following is a video (from youtube) of a GM seizure. That is the type of seizure that will cause over-heating if it goes on for too long. If you have to take a temperature, get a rectal one. You can also feel the dog heating up. That's another reason that I give Lucy ice cream after a seizure - it's frozen so it can cool her down a bit.

 

http://www.youtube.com/watch?v=3rzIXhju_2c

 

I agree, seizures seem to happen at "not so great times".

What Mary Jane said.

 

I was the "someone else" that suggested giving her space when having seizures. I thought I'd made it clear that I was dealing with a grey whose Grand Mal seizures are so violent that he could clamp his jaws down on my hands and hurt me when he is totally out of it. And a grey that is so scared by seizures that he gets aggressive in the post-ictal phase. These reactions are not that common, but people should be aware of the risks. Perhaps my writing skills didn't make it clear that those were extreme precautions. Sorry.

 

In lay-terms, a grand mal (tonic-clonic) seizure basically send the whole body into massive spasms with huge muscular activity that causes the body to over-heat. Continuous seizures so violent can be fatal and constitute a medical emergency.

 

In the video you posted, Denise, I'd call that "focal" or petit mal, not Grand Mal But focal seizures can turn into Grand Mal. That is why Mary Jane is cautioning you.

 

These seizures are coming so closely together that I'm fairly sure that your neurologist will recommend meds immediately. Please talk to the neuro about pros and cons of each med.

 

FYI: A couple of questions Caesar's neurologist asked to be prepared for, and that I wasn't expecting, were: how old is your house? and have you done any renovations recently?

 

Please keep us posted on what is happening with Thyme.

[MaryJane]

 

FYI: A couple of questions Caesar's neurologist asked to be prepared for, and that I wasn't expecting, were: how old is your house? and have you done any renovations recently?

 

 

 

 

Good Point, in Lucy's case I had been adding an addition and a small part of my existing 100 year old home was also being renovated. The neurologists concern was lead. Lucy was tested and was negative. We were also concerned about the floors being sanded and finish added but no test available to see if that was the cause.

 

Also think whether there are different smells (candles) in the house. Lucy can trigger from smells (lily flowers) so I have stopped using all cleaners that have the pine smell (the "sols" like pinesol, lysol).

[WalterWallerson]

Thanks everyone!! Me and DH going out for dinner. When I come home, I'm going to start getting everything together for tomorrow, questions, seizure log, etc. Sure hope I like the neurologist...

hugs for you, Vinny, Thyme, Miami & Izzy <3 I'm so sorry.

[Guest DeniseL]

What Mary Jane said.

 

I was the "someone else" that suggested giving her space when having seizures. I thought I'd made it clear that I was dealing with a grey whose Grand Mal seizures are so violent that he could clamp his jaws down on my hands and hurt me when he is totally out of it. And a grey that is so scared by seizures that he gets aggressive in the post-ictal phase. These reactions are not that common, but people should be aware of the risks. Perhaps my writing skills didn't make it clear that those were extreme precautions. Sorry.

 

In lay-terms, a grand mal (tonic-clonic) seizure basically send the whole body into massive spasms with huge muscular activity that causes the body to over-heat. Continuous seizures so violent can be fatal and constitute a medical emergency.

 

In the video you posted, Denise, I'd call that "focal" or petit mal, not Grand Mal But focal seizures can turn into Grand Mal. That is why Mary Jane is cautioning you.

 

These seizures are coming so closely together that I'm fairly sure that your neurologist will recommend meds immediately. Please talk to the neuro about pros and cons of each med.

 

FYI: A couple of questions Caesar's neurologist asked to be prepared for, and that I wasn't expecting, were: how old is your house? and have you done any renovations recently?

 

Please keep us posted on what is happening with Thyme.

 

No need to apologize!! Actually, the emergency vet we saw a few weeks ago suggested that, too, probably for the same reasons. She said to make sure she didn't harm herself, but otherwise to leave her alone. I, however, probably won't be capable of that. Thyme loves attention and cuddles and will actually cry from across the room for you to come and sit next to her and cuddle her. She doesn't have an aggressive bone in her body. But, i'm sure if her jaw was clamping down spastically, she could bite me...so I will stay close and touch her and comfort her, but if her seizures get more severe I will be cautious.

 

Thank you, you have all been so helpful.

 

No work being done in the house, and the cleaning lady who comes every few weeks uses mostly alcohol and vinegar to clean the house, and some chemical based cleaners, but nothing we haven't been using for the last couple years. I did burn a candle a few times, but again, its a candle that I have been using the last few holiday seasons. No change in food, no change in medications. The only thing was the Frontline I used the night before the first seizure, but I haven't used it since.

hugs for you, Vinny, Thyme, Miami & Izzy <3 I'm so sorry.

 

THANK YOU!!! we were all set for the Trenton walk this morning...until....

[Guest DeniseL]

Ok we are back!! Pretty much what everyone has been saying here. He wants to medicate immediately because of the frequency, if not the severity. We went thru all the medications and settled on Zonisamide, 200mgs twice a day, and see what happens. We will do blood work in 7 -10 days to make sure her body is tolerating it well, he did say that it is a very safe drug overall, but that he knows of two dogs that had significant liver problems very soon after starting it, one reversible, one not. yikes. He said it is expensive and they just told him hat the price is being raised significantly, we could be looking at $100 a month in the near future, but I called Trupanion and they cover the medications, yay!

 

I also have the cluster-buster, rectal valium. 3mls if needed.

 

He asked about her eyes during the episodes, if they darted from side to side. I never noticed that, and if you look in the video she is focused and looks straight ahead.

 

He said we are most likely looking at an epi-dog here. Although, he did give me the option of MRI and spinal tap, to rule of tumor/encephalitis, which would be over $2500, but that my insurance would cover 90%.

 

So here are my questions:

1. Zonisamide, side effects? experiences?

2. Should I get the MRI/ Spinal tap?

3. Do your dogs eyes dart from side to side during the seizures?

[MP_the4pack]

My Pearl had a petite seisure once, it was caused by a clot, which was caused by her hypertension. So, very little relationship to Thymes seisures. However, her eyes darted side to side. (I was in the middle of taking her for a walk when she suddenly started to walk funny and in a circle). I called her cardiologist and she was pleased I noticed. Apparently if they go up and down that's a very bad sign.

 

So......eye darts side to side were caused by a clot. So it was probably more of a stroke than seisure.

 

Give that little girl a hug and kiss for me.

 

And truthfully, if insurance paid for the MRI/Spinal tap, I'd do it to at least rule out encephalitis. This did seem to come on quickly. But then again. I take my girls to the vets if they lick their bum one too many times!

[Saffron]

Glad you are back and have the meds and cluster-buster.

 

1. We've not used Zonisamide so I'll leave others to answer that.

2. MRI/Spinal tap? I'm going to say -- probably not really necessary yet and up to you. I'd see if the meds work first. Note: We did do both with Caesar, but that was because we really needed to rule out a brain tumor due to behavioral changes when we put him on Potassium Bromide. Again, Caesar is a special snowflake who has rare side-effects with many drugs.

3. No. Eyes are fixed and staring. The neuro is probably asking about nystagmus (eyes darting) to consider causes other than idiopathic epilepsy -- vestibular disease, head trauma, cancer (inner ear) or brain tumors, encephalitis, hypothyroidism and other things.

[a_daerr]

1. Zonisamide, side effects? experiences?

2. Should I get the MRI/ Spinal tap?

3. Do your dogs eyes dart from side to side during the seizures?

 

1. Zonisamide is exactly what Henry takes. 200mg twice a day. I would venture to guess our experience is rare (or maybe we got lucky and are just having a really long honeymoon period), but he has been seizure-free for a year. He does very well on it. Every six months we go for follow-up bloodwork, and there have been no adverse effects. I can't say he had any side effects, except that his personality changed a lot after starting the meds. He started becoming less nervous and more energetic. We get it from Sam's Club, and it's about $50 for a 90-day supply (that comes out to about $17 a month). If you go through a regular pharmacy, you're looking at about $100 a month. If you're still responsible for 10% of cost after Trupanion pays their share, definitely go through Sam's or Costco.

 

2. We never did an MRI or spinal tap because it was very expensive and did not seem necessary. His first seizure happened on his third birthday, which is right around the age where large breed epi-dogs start showing symptoms. There was nothing abnormal in his bloodwork or behavior. For us, all signs strongly pointed to epilepsy. My vet at the time also explained to me if there was a brain tumor or encephalitis, there would most likely be other symptoms (i.e. a tumor pressing against part of the brain would likely cause other neurological problems and gait issues). All in all, it wasn't really worth it, medically or financially.

 

3. Henry's eyes don't dart around. When he's having a partial (and during the tonic phase), his eyes get wide as saucers and the pupils are fixed and dilated. If the seizure progresses into a grand mal, he has rapid eye movement where they open and shut a lot. I could be wrong, but I think eyes darting from side to side is more indicative of a vestibular disease than a seizure. Probably not the case with your dog, as she goes back to normal once the seizure is over.

 

 

As for giving the dog space during seizures, I would just make sure your hands are nowhere near her mouth. Lots of owners get bitten because they stick their hands in the dog's mouth during the seizure. It seems like a common sense thing NOT to do. However, a million years ago, it was recommended that epileptic humans be given a bite block to keep them from "swallowing their tongue." People assume the same applies with dogs. It doesn't (and actually it doesn't even apply to people anymore, as science has proven it's impossible for someone to swallow their own tongue). When Henry is seizing, I usually help him onto his side, speak softly to him, and just let him go. If I'm extra prepared, I'll give him a few drops of Bach's Rescue Remedy after it's over. Some people on this board have had success putting an ice pack on the dog's back, applying occular pressure, and/or giving ice cream afterwards.

[MaryJane]

Ok we are back!! Pretty much what everyone has been saying here. He wants to medicate immediately because of the frequency, if not the severity. We went thru all the medications and settled on Zonisamide, 200mgs twice a day, and see what happens. We will do blood work in 7 -10 days to make sure her body is tolerating it well, he did say that it is a very safe drug overall, but that he knows of two dogs that had significant liver problems very soon after starting it, one reversible, one not. yikes. He said it is expensive and they just told him hat the price is being raised significantly, we could be looking at $100 a month in the near future, but I called Trupanion and they cover the medications, yay!

 

I also have the cluster-buster, rectal valium. 3mls if needed.

 

He asked about her eyes during the episodes, if they darted from side to side. I never noticed that, and if you look in the video she is focused and looks straight ahead.

 

He said we are most likely looking at an epi-dog here. Although, he did give me the option of MRI and spinal tap, to rule of tumor/encephalitis, which would be over $2500, but that my insurance would cover 90%.

 

So here are my questions:

1. Zonisamide, side effects? experiences?

2. Should I get the MRI/ Spinal tap?

3. Do your dogs eyes dart from side to side during the seizures?

 

 

The 3ml rectal valium is not enough - it should be about 14 to 16 ml and with that, 3 ml will do nothing, that sounds like an oral dose and not rectal. Lucy weighs 68 pounds and she gets 16 ml after each seizure (up to about 3 times). Please check the strength of the vials and post again.

 

Lucy started on Zonsiamide and she didn't have any side effects but, she was one of the few that it stopped working to control the seizures after about a year.

 

I never noticed Lucy's eyes, I'm usually too busy trying to keep her on my lap with her legs controlled and her head is facing away from me.

 

MRI and spinal will rule out a tumor. If you would plan to operate if they found a tumor, then have the tests done but, if you would just treat the symptoms (seizures) then, not much sense to have the MRI. In any case and from what I have been told, brain tumors usually progress to the point that it would be obvious in about 18 months anyway.

 

I was going to have an MRI and spinal for a baseline but decided after thinking about it that if I was going to have the money for it to be done only once (well .. maybe twice), I would rather save it for a time when the information might be more critical to have. So far, I have been happy with my decision.

[Saffron]

Another quick thought on the MRI and Spinal Tap -- they have to be done under general anesthesia.

 

Just another thing to consider when you are weighing risks versus benefits.

[Guest RMarie]

Oh my, that was really sad to watch. I'm sorry you guys are going through this.

[Guest DeniseL]

ok, I just read the valium prescription. It says, "If Thyme has a seizure that lasts longer than 5 minutes or if she has two seizures in 24 hrs, please give 3ml rectally. Flush the catheter with 3mls of water after delivering." I checked the syringe and it is 3ml. Do you think maybe it is a stronger concentration? Or I guess I should call the Dr. and ask...

[MaryJane]

ok, I just read the valium prescription. It says, "If Thyme has a seizure that lasts longer than 5 minutes or if she has two seizures in 24 hrs, please give 3ml rectally. Flush the catheter with 3mls of water after delivering." I checked the syringe and it is 3ml. Do you think maybe it is a stronger concentration? Or I guess I should call the Dr. and ask...

 

 

You only have one syringe?

[MaryJane]

This is one page on the rectal valium

 

http://www.canine-epilepsy-guardian-angels.com/OralandRectalProtocol.htm#How%20is%20the%20proper%20dose%20determined

 

This page talks about the dosage

 

http://www.canine-epilepsy-guardian-angels.com/rectal_valium.htm

 

Also, Valium should not be stored in a syringe, they should have given you the brown vials and you would have to draw it up yourself at the time of the incident. Valium pretty much breaks down with exposure to light (that's why the brown vials) and it will react with the plastic.

 

Regular vets do this all the time with the oral dosage (rather than rectal) and putting it in syringes already .. not sure why???

[Guest DeniseL]

No I have a bunch, but they are all 3ml.