Witnessing a seizure in your pet can be a very scary thing. Just a moment ago your dog was nosing around the back yard, and then suddenly he is lying on his side, jerking and twitching for what seems like an eternity. What do you do? Sometimes people worry about their pet injuring itself or swallowing its tongue. Fortunately is not physically possible to swallow a tongue, and I have never actually seen an animal that has injured itself during a seizure. Keep in mind that during a seizure the muscle contractions in your pet’s jaw are powerful enough to amputate any fingers you might decide to poke in his mouth in order to protect his tongue. If your dog bites his tongue it will heal just fine. If he bites off your fingers they will probably never work quite the same even if they can be reattached. Resist the urge to hold or comfort your pet and just wait for the seizure to end.
As horrible as it looks it may be small consolation that a seizuring animal is unconscious during the event, so he will have no memory of it. Afterwards there is a period of time called the post-ictal phase where the animal is conscious and almost back to normal, but the brain is rebooting and some systems may be a little out of whack for a while. This phase may last five minutes or five hours, but is a normal part of the process. Isolated seizures of a few minutes duration do not cause measurable brain damage, but a prolonged series of closely spaced seizures, or a seizure that is lasting more than 10 minutes (as measured by the clock, not just by how long it seems) starts becoming a risk for permanent problems. Those pets need immediate medical intervention at a veterinary hospital.
The reasons for seizures in dogs and cats fall into two general categories. The first is known as extracranial, or outside of the brain. Examples would be metabolic problems like a buildup of toxins from a liver or kidneys that are not working very well, low blood calcium in a nursing mother, or very low blood sugar in a diabetic being treated with insulin or a ferret with a blood sugar lowering tumor. When presented with a patient that has had a seizure for the first time your veterinarian will usually run some bloodwork to rule out systemic problems that could lead to seizures.
Often the labwork will come back normal, which is suggestive of seizures caused by the other big category of reasons: intracranial problems, or problems originating inside the brain itself. Animals that have their first seizures when they are over the age of ten are more likely to have something like a brain tumor triggering the problem. Animals that present with repeated seizures at younger ages are more likely to have epilepsy, a condition in which there is an abnormal area of the brain that generates seizures for reasons that are difficult to explain. Finding out exactly what is causing intracranial seizures usually requires advanced diagnostics, like a CT scan of the brain. Although that multimillion dollar piece of equipment is not generally available to the average veterinarian we can refer to specialists who have access to those types of tests. When the expense of a CT scan makes that procedure impractical we must use our best judgment to choose a treatment plan.
Epilepsy can usually be controlled with anti-seizure medications like phenobarbitol and potassium bromide. Once we start an animal on seizure control medications it is a lifetime commitment. For that reason veterinarians will often have an owner simply note when seizures occur until they reach a frequency that requires treatment. Sometimes an animal will have an isolated seizure and will never have another one, and in those situations it would be unfortunate to start them on medication for the rest of their life without a real need for it. Occasionally owners are reluctant to control their pet’s seizures with medication because they fear the medication is “toxic”. All seizure medications can have side effects, but they tend to be minor and easily dealt with. If I had the choice of having my pet live a normal, happy, seizure free life but would have to put up with him gaining some weight and drinking and urinating more I would cheerfully choose that over watching him eventually seizure to death because I was afraid of the medication that would solve the problem.