seizures and canine epilepsy with Bel update (Bel's not doing well)
I posted about this on the Shiba side, since it happened to my Shiba girl, Bel, but thought I'd post over here, too, to see if anyone here had more experience with seizures in dogs. Here's the link to that thread: http://www.shibainuforum.org/forum/comments.php?DiscussionID=6825&page=1#Item_18)
Background: Bel is a 5 year old Shiba. She has always been odd. Partially not well bred, partially not socialized, also hypothyroid but she has been on meds (and regularly tested, levels are fine) for 2.5 years. She has what I thought of as behavioral issues that we've been trying to work, but the behavioralist thought we needed a medical intervention before training would help (she is extremely fearful of people, and has developed more fears as she got older--thunder, for example). She has periods of confusion. Sometimes they are very brief--she'll suddenly look at me like who are you? and run. A few minutes later she is fine. Sometimes she goes into what I call "fugue" states where she goes outside, usually at night, and won't come in. She runs and runs barking crazily, and when I try to catch her, she clearly doesn't know who I am--she's totally blank eyed. These last episodes are the worst, because I can't catch her, and I'm afraid to leave her outside where she may, again, be attacked by coyotes. I've tried treating her for her odd behavior. We tried Fluoxetine--she became WAY more fearful and wouldn't eat at all, and since she's never been a good eater, this was a disaster. I had to stop after 2.5 weeks. Before that, we tried valium for the thunderstorm fear, but it made her hyper and very very hungry. I was just about to take her back to the vet who prescribed the fluoxetine to try another med, but on Friday, she had a seizure.
It wasn't typical grand mal, so at first I wasn't sure what it was. (There are links to a shiba having a seizure in the other thread--hers looked somewhat similar). She fell over, and mostly was very scared and couldn't get up, and her front legs were frozen. Took her to the vet, and after eliminating all the other possibilities (no injuries, no soreness in her back,no head trauma), the vet concurred that it must have been a seizure. She was going to take a wait and see approach, but when we talked about Bel's other issues, we began to see that perhaps this was only the first seizure I saw (or understood to be a seizure). While apparently no one knows for sure if animals have petit mal seizures, certainly the absence I see in her from time to time sounds very like petit mal seizures. We suspect that Bel has some sort of seizure disorder.
At this point, my vet has given me a very low dose of phenobarbital for her. (15 mg. twice a day). She's tolerating quite well--she's not slowed down in the least, and other than being more hungry than usual, I don't see any difference so far. Of course, I'm concerned about using it long term, given the possibility of liver damage. I wondered if I even needed to treat her--after all I've only seen the one confirmed seizure. But I suspect she's had others, so I feel like it might be better to go forward assuming she has a seizure disorder.
I can't afford a CT scan, but we may do a basic head xray to make sure there isn't a brain tumor. The EKGs seem expensive and probably not terribly helpful in a dog who is not seizing at the moment. Other than that, I'm not sure what to do.
Anyone have experience with this? Do you think her other odd behavior is related? (That's my basis for treatment--that she's been seizing all along and I just didn't recognize it). I don't want to be giving her phenobarb if she doesn't need it, but I also don't want the seizures to get worse.
I've found forum about canine epilepsy, so I'm going to spend some time there too, but thought I'd see if anyone had thoughts/experiences with this here, too.
Background: Bel is a 5 year old Shiba. She has always been odd. Partially not well bred, partially not socialized, also hypothyroid but she has been on meds (and regularly tested, levels are fine) for 2.5 years. She has what I thought of as behavioral issues that we've been trying to work, but the behavioralist thought we needed a medical intervention before training would help (she is extremely fearful of people, and has developed more fears as she got older--thunder, for example). She has periods of confusion. Sometimes they are very brief--she'll suddenly look at me like who are you? and run. A few minutes later she is fine. Sometimes she goes into what I call "fugue" states where she goes outside, usually at night, and won't come in. She runs and runs barking crazily, and when I try to catch her, she clearly doesn't know who I am--she's totally blank eyed. These last episodes are the worst, because I can't catch her, and I'm afraid to leave her outside where she may, again, be attacked by coyotes. I've tried treating her for her odd behavior. We tried Fluoxetine--she became WAY more fearful and wouldn't eat at all, and since she's never been a good eater, this was a disaster. I had to stop after 2.5 weeks. Before that, we tried valium for the thunderstorm fear, but it made her hyper and very very hungry. I was just about to take her back to the vet who prescribed the fluoxetine to try another med, but on Friday, she had a seizure.
It wasn't typical grand mal, so at first I wasn't sure what it was. (There are links to a shiba having a seizure in the other thread--hers looked somewhat similar). She fell over, and mostly was very scared and couldn't get up, and her front legs were frozen. Took her to the vet, and after eliminating all the other possibilities (no injuries, no soreness in her back,no head trauma), the vet concurred that it must have been a seizure. She was going to take a wait and see approach, but when we talked about Bel's other issues, we began to see that perhaps this was only the first seizure I saw (or understood to be a seizure). While apparently no one knows for sure if animals have petit mal seizures, certainly the absence I see in her from time to time sounds very like petit mal seizures. We suspect that Bel has some sort of seizure disorder.
At this point, my vet has given me a very low dose of phenobarbital for her. (15 mg. twice a day). She's tolerating quite well--she's not slowed down in the least, and other than being more hungry than usual, I don't see any difference so far. Of course, I'm concerned about using it long term, given the possibility of liver damage. I wondered if I even needed to treat her--after all I've only seen the one confirmed seizure. But I suspect she's had others, so I feel like it might be better to go forward assuming she has a seizure disorder.
I can't afford a CT scan, but we may do a basic head xray to make sure there isn't a brain tumor. The EKGs seem expensive and probably not terribly helpful in a dog who is not seizing at the moment. Other than that, I'm not sure what to do.
Anyone have experience with this? Do you think her other odd behavior is related? (That's my basis for treatment--that she's been seizing all along and I just didn't recognize it). I don't want to be giving her phenobarb if she doesn't need it, but I also don't want the seizures to get worse.
I've found forum about canine epilepsy, so I'm going to spend some time there too, but thought I'd see if anyone had thoughts/experiences with this here, too.
Comments
Once on phenobarbital it is my understanding you really have to be careful in weaning off, most often you wouldn't to take the dog off once started give it is usually for higher level seizures and major grand mal events. Maybe things have changed in terms of practitioner common practices and medicating.
I am sure you will talk with your vet about it to make a fully informed decision. Opinions may vary from practice to practice so if anything I would get a second consult from another vet.
At this point I am not sure I would go with a full blown ct scan etc etc. Why stress the dog more if the events are only mild.
Just my 2 cents....
Snf
I'm sorry to hear about Bel. It's no fun to feel like there's something wrong with your dog and not have a good idea about how to treat it. :-(
I'll basically agree with Snf.
If her seizures are very infrequent, I wouldn't be too rushed to treat them. I think seizures are often harder for dog owners to watch than they are for the dogs to experience. I do think you're right to be looking at the big picture. As for running a CT or head x-ray, what good will that provide? If it rules out a tumor, you haven't really gained anything. If it indicates a tumor, there's not a whole lot you can do anyway. So I would just keep an eye on her, keep a journal of your observations, and consult with your vet if things get progressively worse.
I don't have much to add by way of expertise, but I would get a second opinion to be sure.
That could be part of a seizure or something.. I'm not sure actually..
Pearly my first boxer was 13 years old she did stuff kinda like that except for the barking, but when she went outside to go potty or was playing she'd act like she was afraid of me and would run away few times she tried to bite me.
I've never hurt Pearly in her life so it must been the seizures she was having that caused her to be like that..
Not sure what you can do it's hard for me to say. Bella's seizures was caused by something that wasn't fixable so we kept her safe when it happened and talked to her.
Good luck with Bel hope things go better.
A couple of people who have more experience with canine seizures have been telling me they think dogs DO have petit mal seizures, and that Bel's previous odd behavior is in keeping with epileptic dogs....That's just anecdotal evidence, of course, but I have to go with my gut to a degree...and I think something is misfiring in my girl's brain, and has been for awhile. In a lot of ways, this makes a lot of sense. But I need to make sure I'm not too eager to medicate something I don't need to, and I also need to make sure I make informed decisions on how to treat her.
Thanks--you've all given me some things to think about.
Ok, this is really scary. Toby just had a seizure. His was classic grand mal type: he suddenly sunk down into a sit, but with his back legs splayed out. Then he fell on his side and his front and back legs started kicking like crazy. He was conscious, but he couldn't control himself at all. He came out of it really fast--the whole thing was maybe 30 secs. I gave him a bit of ice cream (a tip I got on the canine epilepsy forum) and then gave him one of Bel's pheno-barbitals.
Right now, he's absolutely fine, if a bit agitated. He's shaking himself a lot, not like shivering, but like shaking after getting wet. Other than that, he's fine.
This really freaks me out. Why would they both have siezures? They are not related. They are fed raw, human quality chicken. They get salmon oil on it and either seameal or the Missing Link (the only new thing in their diet). We use almost no chemicals in the house. We use bleach in the laundry or to clean the toilets, but the bathrooms are always closed, so the dogs don't get in there, and neither Shiba has ever shown the slightest interest in drinking out of the toilet even if the bathroom was open.
No pesticides. No harsh cleaning supplies. They don't even plastic dishes, they have stainless steel dishes.
They are both hypothyroid, but both take thyrosin for it, and both have been recently tested (Toby JUST had a full thyroid panel done by Dr. Jean Dodds) and both are at a good level. They get their pills every day, about 12 hours apart, not with food.
This is really freaking me out.
(BTW, before all this happened to Toby I was going to post that Bel is doing well on her very low does of phenobarb, and she's a much more normal dog now, not skittish, not disoriented anymore. So just yesterday my vet was really happy to hear that things were going well with her. And now this!)
However, I am glad to hear that Bel is doing better.
As for suggestions, I am not sure. Possibly a parasite? Maybe something environmental that you might not be aware of?
Either way, I hope Toby is doing better today.
I'll ask Jen her thoughts on this too, she did a LOT of research when the Nori situation came up.
So sorry Lisa.
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Other parasites are a possiblity, though. Need to check into that. Esp. since Oskar did have coccidia when we got him....we treated everyone for it, and everyone seemed ok, but...I'm going to run that by my vet when I talk to her.
I've joined a couple of epilepsy forums, including a pretty active one Epil-K9, and am hoping people may have suggestions (and I'm waiting to hear back from my vet, though I suspect she will be pretty stumped too).
We're not having a easy time of it, and while it does seem like there might be an environmental factor since both Shibas had a seizure, I also think there is something really, really wrong with Bel that is beyond anything going on with Toby.
I don't know what to do. Keeping them separate had been working (occasional slips aside) but she's starting to scare me now. What if she does this to Oskar? I'm not liking what I'm having to think of here, not at all. I love my little crazy girl, but this is getting pretty scary here.
For now, I'm keeping on eye on her and Oskar, and when we're not home, everyone is separate anyway (I'm a super paranoid dog person after years of dealing with Bel's crazies; no dogs are left together unsupervised).
eta: just talked to my vet who has no idea, but I'm bringing Bel in again on Monday. He did say an xray would do very little right now--wouldn't be able to see a tumor on the xray most likely anyway. We're upping her dose of pheno a bit in the meantime.
I'm thinking of you guys...
All along, though, her odd behavior has been something that could be from a brain tumor, so this worries me. My vet confirmed that a head xray would probably be useless, but MRI/CT scans are $700 and up, so I guess we just won't know.
My poor little girl. She's only 5.
Just a thought...
And you guys are still in my thoughts. Hopefully something will come of this soon. *Hugs*
http://www.vetstreamcanis.com/ACI/November08/VMD1/dis02955.asp
Also you may want to look into Vestibular disease in dogs which can be managed until your girl feels better and passes. I believe someone suggested this the Shiba forum side. http://www.vetinfo.com/vestibular-disease-dogs.html
Snf
and she's weak now in the rear legs. More on right side than the left. She's moving like an old dog--can't quite get in a sit position, has trouble getting up, etc. Poor girl!
We don't have a vet school here, but part of the problem I'm having, anyway, is simply that I don't have the money for the expensive diagnostic testing. There is a vet (VCA of course--I hate them too!) that has the capacity to do a CT scan and/or MRI, but it's looking like that would start around $800 and I don't have it, so we're kind of stuck with going with less definitive diagnostics. But I'm going back next week, with a couple of things to have them look for, including vestibular disease (though it was something my vet mentioned, she just couldn't see anything to indicate it at that point).
Well, just got back from the vet and there was good news and bad news. Good news: no signs of a brain tumor, which I was really worried about.
Bad news: super super bad luxating patella, so bad that she really MUST have the surgery. That's why she's been irritable, seemed down, why she was having problems with getting up, etc. We knew she had them, but they were very mild on both knees. Now, on the right knee, it's about as bad as it can get. Right now, we've upped her thyroid dose a bit as it was low normal last time we tested, and the vet feels it certainly will help to get her in optimum health before we do any surgery. I also need to wait moneywise, and it would be easier on all of us if it were not winter when she is recovering from surgery.
So we're going to wait. Luckily my vet is not super expensive: she'll do the surgery with all follow up visits for $700, and we'd wait a year and do the other knee. I still have to wait and save up the $, but it is, at least, within the realm of possibility. The hardest part of the talk was just the vet saying that I need to think about the fact that Bel has severe behavioral issues that are unexplained, that she's been having seizures, and she said she wanted me to be absolutely sure I was committed to Bel for doing the surgery, because she said some people would euthanize her rather than spending yet more money on her.
I don't want to do that, but I did think it was important that she brought it up, esp. she said that the recovery from surgery will take a lot of committment on my part, making sure Bel doesn't run and jump, etc.
But mostly, I'm just happy that this is something we can fix, and potentially give her many more years ahead, instead of something that we can't fix. I'll still need time to think about everything, but I'm pretty sure we'll go ahead with surgery in the spring.
I'm glad to hear that it's not a brain tumor. Pain can truly alter one's personality.
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@shibamistress
I've been pretty quiet on the forum about Lucy's current problems because that's just my personality. But, I'm in the same boat as you right now. To anybody unfamiliar with Lucy and her situation she appears pretty much fine. But I've watched a continuing downward spiral over the past 3.5 years to where she's now having about as many bad days as good days. Her IBD is increasingly drug resistent, she's eating the most food she's ever eaten and continuing to loose weight, she's now having occasional LP issues in her other knee, she's got cataracts, has increasing behavioral issues due to long-term steroid use, and is just generally depressed and lethargic. When I take a step back and look at her situation objectively, I can intellectually rationalize that the best thing for her is to put her to sleep before she wastes away completely. But when I start to visualize the process of taking her to the vet, saying goodbye, etc. I break down emotionally.
I'm not trying to tell you that you should be making the decision to put Bel down. As has often been advised on this forum, you, as her owner, are the only one who can possibly know when it's time. I guess I'm bringing it up to point out that sometimes taking a step back and looking at the bigger picture, the trajectory, and total situation can paint a different picture. The decision to put a dog down at a young age seems to me to be the toughest of some already extremely tough decisions. I wouldn't wish any of the emotions I'm experiencing right now on anybody. So I feel for you, especially when it comes at a time where you thought you had her on the right track. You guys are in my thoughts.
(Sorry if this came across as overly negative, I guess I just needed to get it off my chest.)
I'm really sorry to hear about the LP issues. We had Ahi's knees done at Colorado Canine Orthopedics, they were really great (but not cheap - tho they take CareCredit): http://www.veterinaryspecialty.com
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Brad, yeah. Does seem like we're both having some bad luck with dog health. Kind of sucks to be in this club, doesn't it?
Today Bel was outside and wouldn't come in, and I needed to get her in since I know she shouldn't be running around on that leg (today she wasn't putting weight on it). Oskar is too big, and he doesn't mean to hurt her, but he does simply because of his sheer size. He knocked her down, and she was on her side, and she cried, and I went out to pick her up, and they both ran away. I got Oskar in and asked my husband to get Bel, but she clearly had slipped into another phase--she didn't recognize him. She barked at him and tried to run away, but she can't run. Thank god when I went out, she did recognize me and she came to me and crawled up in my lap and I brought her in and put her upstairs alone to rest (and gave her a tramadol).
Yesterday I was thinking there's no question! I'll do the surgery! (my vet, btw, is only $700 on this, which I'll still have to save up for, but it's pretty reasonable as this includes everything including the many after care visits, and she says they've done many, many of these, including on her dogs and had really good success rates). But since I have to wait anyway, I'll need to watch her and think about it. Like Dave, even the thought of euthanasia is just....well, I can't quite face it. But I do need to think about the fact I have a dog that has many, many other health issues. For a long time I've thought of her behavioral issues as separate (so much so that it's only now that I've even told my vet about how bad they are--and she was shocked), but I do have to think about the fact that they are not separate in terms of Bel's quality of life. In terms of quality of life, Bel has many days when she is overwhelmed with anxiety and fear, when she doesn't recognize people, etc. And then she has days when she does recognize us, but she's so scared she ends up climbing up on my lap because she wants to be protected. Then she has days when she's fine mentally--a lively little girl--but her knee bothers her so she can't get around much. The days when everything are ok are starting to get less. I believe we can fix the knee but then the other one probably needs to be done. That's a two year process (my vet prefers a year between surgeries). And she's taking a lot of drugs these days: thyroid meds, phenobarb for the seizures, now tramadol for pain and a muscle relaxant too...None of that can be good for her.
But on her good days, damn, she is the sweetest, most eccentric and charming dog....By far the sweetest and most affectionate of my three....And I can't think much further than that.
I'm glad I don't have to decide anything right now.