Abstract
BackgroundBehavioural changes associated with idiopathic epilepsy (IE) have been identified in dogs, with fear and anxiety-related problems seen in both drug-naïve dogs and dogs treated with anti-epileptic drugs (AEDs). Treating anxiety-related behaviour in dogs with IE may be challenging, as seizures are a contraindication for many conventional anxiolytic drugs. In addition, many dogs with IE are already treated with AEDs to reduce their seizure frequency, which may have negative effects if used in polytherapy. Imepitoin is low-affinity partial agonist at the benzodiazepine (BDZ) site of the GABAA receptor, and has been demonstrated to have both anticonvulsant and anxiolytic effects in laboratory rodents. Imepitoin has been developed for the treatment of IE in dogs, with demonstrated anticonvulsant effects and high tolerability and safety. To date, imepitoin’s potential to reduce anxiety in dogs with IE has not been investigated. An online survey was conducted to investigate the effect of imepitoin on fear and anxiety-related behaviours in dogs with IE. Eighty-five valid responses were received from owners of dogs with IE currently treated with imepitoin. Anxiety-related behaviour was quantified before and during imepitoin treatment using a validated questionnaire tool (C-BARQ).ResultsNo differences were observed in the five fear/anxiety-related measures between the two time periods (before vs. during treatment) for dog directed fear, stranger directed fear, non-social fear, pain sensitivity and separation related behaviour. A median 45% reduction in seizure frequency/month was observed following imepitoin treatment; however, imepitoin did not appear effective in reducing seizure frequency in a minority of cases. Polyphagia was the most common chronic side effect, and more side effects were reported in polytherapy cases.ConclusionsImepitoin does not appear to improve anxiety-related behaviour in dogs with IE treated with this medication for its anti-epileptic effects. Investigating the effects of imepitoin upon the behaviour of dogs with recognised behavioural anxiety-related problems (e.g. specific fears and phobias, separation related behaviours), in both healthy dogs and dogs with epilepsy is required to further explore any potential anxiolytic effects of this medication.
Highlights
Behavioural changes associated with idiopathic epilepsy (IE) have been identified in dogs, with fear and anxiety-related problems seen in both drug-naïve dogs and dogs treated with anti-epileptic drugs (AEDs)
Co-morbid anxiety has recently been recognised in dogs with idiopathic epilepsy (IE) [11], with behavioural changes including increases in fear and anxiety associated with the development of IE [11]
Responses were deemed invalid (n = 91) for the following reasons: n = 74 were incomplete and could not be analysed, n = 9 dogs were deceased at the time of response, n = 4 dogs were not receiving imepitoin at the time of response, n = 2 dogs were over the limit of age at first seizure, and n = 2 had been diagnosed with structural epilepsy [26]
Summary
Behavioural changes associated with idiopathic epilepsy (IE) have been identified in dogs, with fear and anxiety-related problems seen in both drug-naïve dogs and dogs treated with anti-epileptic drugs (AEDs). The impact of co-morbid psychiatric disorders upon patient quality of life (QoL) may be severe, with interictal anxiety and depression found to have greater adverse effects on QoL than those of seizure frequency, severity and chronicity [10]. Co-morbid anxiety has recently been recognised in dogs with idiopathic epilepsy (IE) [11], with behavioural changes including increases in fear and anxiety associated with the development of IE [11]. Increased fear and anxiety were observed in drug-naïve dogs as well as those treated with AEDs, indicating these behavioural changes were not merely a treatment side effect [11]. Due to the potentially severe impact of anxiety upon QoL, addressing this behavioural change alongside managing seizures is desirable
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