Abstract
BackgroundSeizures are common in dogs and can be caused by non-epileptic conditions or epilepsy. The clinical course of newly diagnosed epilepsy is sparsely documented.The objective of this study was to prospectively investigate causes for seizures (epileptic and non-epileptic) in a cohort of dogs with new-onset untreated seizures, and for those dogs with newly diagnosed epilepsy to investigate epilepsy type, seizure type and the course of disease over time, including the risk of seizure recurrence. Untreated client-owned dogs experiencing new-onset seizures were prospectively enrolled in a longitudinal observational study including clinical investigations and long-term monitoring at the Copenhagen University Hospital for Companion Animals. A baseline clinical assessment was followed by investigator/owner contact every eight weeks from inclusion to death or end of study. Inclusion of dogs was conducted from November 2010 to September 2012, and the study terminated in June 2014.ResultsOne hundred and six dogs were included in the study. Seventy-nine dogs (74.5%) were diagnosed with epilepsy: 61 dogs (77.2%) with idiopathic epilepsy, 13 dogs (16.5%) with structural epilepsy and five dogs (6.3%) with suspected structural epilepsy. A non-epileptic cause for seizures was identified in 13 dogs and suspected in 10 dogs. Four dogs in which no cause for seizures was identified experienced only one seizure during the study. In dogs with idiopathic epilepsy 60% had their second epileptic seizure within three months of seizure onset. Twenty-six dogs with idiopathic epilepsy (43%) completed the study without receiving antiepileptic treatment. The natural course of idiopathic epilepsy (uninfluenced by drugs) was illustrated by highly individual and fluctuating seizure patterns, including long periods of remission. Cluster seizures motivated early treatment. In a few dogs with a high seizure frequency owners declined treatment against the investigators advice.ConclusionsEpilepsy is the most likely diagnosis in dogs presenting with new-onset seizures. The course of idiopathic epilepsy is highly individual and might not necessarily require long-term treatment. This must be considered when advising owners about what to expect with regard to treatment and prognosis.
Highlights
Seizures are common in dogs and can be caused by non-epileptic conditions or epilepsy
Out of the 115 dogs, four dogs were excluded because the owners were unable to fully describe or document seizure events and five dogs were lost for longitudinal monitoring shortly after inclusion, leaving a final study population of 106 dogs which completed the study from inclusion to death or end of study
The distribution of focal onset seizures and generalized seizures was similar between dogs with idiopathic epilepsy and dogs with structural epilepsy, and we did not find any indication that the seizure type can be a helpful clinical marker of specific epilepsy etiology
Summary
Seizures are common in dogs and can be caused by non-epileptic conditions or epilepsy. The objective of this study was to prospectively investigate causes for seizures (epileptic and non-epileptic) in a cohort of dogs with new-onset untreated seizures, and for those dogs with newly diagnosed epilepsy to investigate epilepsy type, seizure type and the course of disease over time, including the risk of seizure recurrence. For owners of dogs with newly diagnosed epilepsy, most common concerns relate to the possible source of seizures, the risk of seizure recurrence, and prognosis. Few studies have investigated the distribution of seizures caused by epilepsy versus other conditions [1,2,3], For humans with untreated epilepsy, a 2-year recurrence risk of 40% has been estimated after a first unprovoked seizure [4,5,6]. A higher risk of seizure recurrence has been documented in people with epilepsy caused by a structural abnormality [4, 12, 13]
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