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Peek SI, Meller S, Twele F, Packer RMA, Volk HA. Epilepsy is more than a simple seizure disorder: Parallels between human and canine cognitive and behavioural comorbidities. Vet J 2024; 303:106060. [PMID: 38123061 DOI: 10.1016/j.tvjl.2023.106060] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 12/02/2023] [Accepted: 12/15/2023] [Indexed: 12/23/2023]
Abstract
Psychiatric and cognitive comorbidities have been known to play a major role in human epilepsy for a long time. People with epilepsy (PWE) frequently express signs of varying psychiatric and cognitive disorders affecting their quality and quantity of life (QoL/QaoL). Over the last few years, research on behavioural comorbidities and their effect on the underlying disease have been performed in canine epilepsy. The following article reviews manifestations of comorbidities in canine epilepsy with an emphasis on patterns of clinical signs and their effects on QoL and QaoL. Cognitive and behavioural alterations in epileptic dogs are mainly represented by fear-/anxiety related behaviour and cognitive impairment (CI). Reduced trainability and altered reactions to daily situations are common results of comorbid changes posing obstacles in everyday life of owners and their dog. In addition, clinical signs similar to attention deficit hyperactivity disorder (ADHD) in humans have been reported. Canine attention-deficit-hyperactivity-disorder-like (c-ADHD-like) behaviour should, however, be evaluated critically, as there are no official criteria for diagnosis of ADHD or ADHD-like behaviour in dogs, and some of the reported signs of c-ADHD-like behaviour could be confused with anxiety-associated behaviour. Many intrinsic and extrinsic factors could potentially influence the development of behavioural and cognitive comorbidities in canine epilepsy. In particular, seizure frequency/severity, signalment and factors concerning disease management, such as pharmacotherapy and nutrition, are closely linked with the presence of the aforementioned comorbid disorders. Further studies of behavioural alterations in epileptic dogs are needed to comprehend the complexity of clinical signs and their multifactorial origin.
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Affiliation(s)
- Saskia I Peek
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Germany
| | - Sebastian Meller
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Germany
| | - Friederike Twele
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Germany
| | | | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Germany.
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2
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Kinsey N, Belanger JM, Mandigers PJJ, Leegwater PA, Heinonen T, Hytönen MK, Lohi H, Ostrander EA, Oberbauer AM. Idiopathic Epilepsy Risk Allele Trends in Belgian Tervuren: A Longitudinal Genetic Analysis. Genes (Basel) 2024; 15:114. [PMID: 38255002 PMCID: PMC10815166 DOI: 10.3390/genes15010114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/11/2024] [Accepted: 01/17/2024] [Indexed: 01/24/2024] Open
Abstract
Idiopathic epilepsy (IE) has been known to be inherited in the Belgian Tervuren for many decades. Risk genotypes for IE in this breed have recently been identified on Canis familiaris chromosomes (CFA) 14 and 37. In the current study, the allele frequencies of these loci were analyzed to determine whether dog breeders had employed a purposeful selection against IE, leading to a reduction in risk-associated allele frequency within the breed over time. The allele frequencies of two generational groupings of Belgian Tervuren with and without IE were compared. Allele frequencies for risk-associated alleles on CFA14 were unchanged between 1985 and 2015, whereas those on CFA37 increased during that time in the control population (p < 0.05). In contrast, dogs with IE showed a decrease (p < 0.05) in the IE risk-associated allele frequency at the CFA37 locus. Seizure prevalence in the Belgian Tervuren appears to be increasing. These results suggest that, despite awareness that IE is inherited, selection against IE has not been successful.
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Affiliation(s)
- Nathan Kinsey
- Department of Animal Science, University of California, Davis, CA 95616, USA; (N.K.); (J.M.B.)
| | - Janelle M. Belanger
- Department of Animal Science, University of California, Davis, CA 95616, USA; (N.K.); (J.M.B.)
| | - Paul J. J. Mandigers
- Department of Clinical Sciences, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands; (P.J.J.M.); (P.A.L.)
| | - Peter A. Leegwater
- Department of Clinical Sciences, Utrecht University, Yalelaan 108, 3584 CM Utrecht, The Netherlands; (P.J.J.M.); (P.A.L.)
| | - Tiina Heinonen
- Department of Medical and Clinical Genetics, University of Helsinki, 00014 Helsinki, Finland; (T.H.); (M.K.H.); (H.L.)
- Department of Veterinary Biosciences, University of Helsinki, 00014 Helsinki, Finland
- Folkhälsan Research Center, 00290 Helsinki, Finland
| | - Marjo K. Hytönen
- Department of Medical and Clinical Genetics, University of Helsinki, 00014 Helsinki, Finland; (T.H.); (M.K.H.); (H.L.)
- Department of Veterinary Biosciences, University of Helsinki, 00014 Helsinki, Finland
- Folkhälsan Research Center, 00290 Helsinki, Finland
| | - Hannes Lohi
- Department of Medical and Clinical Genetics, University of Helsinki, 00014 Helsinki, Finland; (T.H.); (M.K.H.); (H.L.)
- Department of Veterinary Biosciences, University of Helsinki, 00014 Helsinki, Finland
- Folkhälsan Research Center, 00290 Helsinki, Finland
| | - Elaine A. Ostrander
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA;
| | - Anita M. Oberbauer
- Department of Animal Science, University of California, Davis, CA 95616, USA; (N.K.); (J.M.B.)
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Potschka H, Fischer A, Löscher W, Volk HA. Pathophysiology of drug-resistant canine epilepsy. Vet J 2023; 296-297:105990. [PMID: 37150317 DOI: 10.1016/j.tvjl.2023.105990] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/04/2023] [Accepted: 05/04/2023] [Indexed: 05/09/2023]
Abstract
Drug resistance continues to be a major clinical problem in the therapeutic management of canine epilepsies with substantial implications for quality of life and survival times. Experimental and clinical data from human medicine provided evidence for relevant contributions of intrinsic severity of the disease as well as alterations in pharmacokinetics and -dynamics to failure to respond to antiseizure medications. In addition, several modulatory factors have been identified that can be associated with the level of therapeutic responses. Among others, the list of potential modulatory factors comprises genetic and epigenetic factors, inflammatory mediators, and metabolites. Regarding data from dogs, there are obvious gaps in knowledge when it comes to our understanding of the clinical patterns and the mechanisms of drug-resistant canine epilepsy. So far, seizure density and the occurrence of cluster seizures have been linked with a poor response to antiseizure medications. Moreover, evidence exists that the genetic background and alterations in epigenetic mechanisms might influence the efficacy of antiseizure medications in dogs with epilepsy. Further molecular, cellular, and network alterations that may affect intrinsic severity, pharmacokinetics, and -dynamics have been reported. However, the association with drug responsiveness has not yet been studied in detail. In summary, there is an urgent need to strengthen clinical and experimental research efforts exploring the mechanisms of resistance as well as their association with different etiologies, epilepsy types, and clinical courses.
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Affiliation(s)
- Heidrun Potschka
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University, Munich, Germany.
| | - Andrea Fischer
- Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Munich, Germany
| | - Wolfgang Löscher
- Department of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine, Hannover, Germany; Center for Systems Neuroscience, Hannover, Germany
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
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4
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Charalambous M, Fischer A, Potschka H, Walker MC, Raedt R, Vonck K, Boon P, Lohi H, Löscher W, Worrell G, Leeb T, McEvoy A, Striano P, Kluger G, Galanopoulou AS, Volk HA, Bhatti SFM. Translational veterinary epilepsy: A win-win situation for human and veterinary neurology. Vet J 2023; 293:105956. [PMID: 36791876 DOI: 10.1016/j.tvjl.2023.105956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 02/15/2023]
Abstract
Epilepsy is a challenging multifactorial disorder with a complex genetic background. Our current understanding of the pathophysiology and treatment of epilepsy has substantially increased due to animal model studies, including canine studies, but additional basic and clinical research is required. Drug-resistant epilepsy is an important problem in both dogs and humans, since seizure freedom is not achieved with the available antiseizure medications. The evaluation and exploration of pharmacological and particularly non-pharmacological therapeutic options need to remain a priority in epilepsy research. Combined efforts and sharing knowledge and expertise between human medical and veterinary neurologists are important for improving the treatment outcomes or even curing epilepsy in dogs. Such interactions could offer an exciting approach to translate the knowledge gained from people and rodents to dogs and vice versa. In this article, a panel of experts discusses the similarities and knowledge gaps in human and animal epileptology, with the aim of establishing a common framework and the basis for future translational epilepsy research.
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Affiliation(s)
- Marios Charalambous
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover 30559, Germany.
| | - Andrea Fischer
- Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University Munich, Munich 80539, Germany
| | - Heidrun Potschka
- Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-University, Munich 80539, Germany
| | - Matthew C Walker
- Institute of Neurology, University College London, London WC1N 3JD, UK
| | - Robrecht Raedt
- Department of Neurology, 4brain, Ghent University, Ghent 9000, Belgium
| | - Kristl Vonck
- Department of Neurology, 4brain, Ghent University, Ghent 9000, Belgium
| | - Paul Boon
- Department of Neurology, 4brain, Ghent University, Ghent 9000, Belgium
| | - Hannes Lohi
- Department of Veterinary Biosciences, Department of Medical and Clinical Genetics, and Folkhälsan Research Center, University of Helsinki, Helsinki 00014, Finland
| | - Wolfgang Löscher
- Department of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine Hannover, Hannover 30559, Germany
| | | | - Tosso Leeb
- Institute of Genetics, University of Bern, Bern 3001, Switzerland
| | - Andrew McEvoy
- Institute of Neurology, University College London, London WC1N 3JD, UK
| | - Pasquale Striano
- IRCCS 'G. Gaslini', Genova 16147, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
| | - Gerhard Kluger
- Research Institute, Rehabilitation, Transition-Palliation', PMU Salzburg, Salzburg 5020, Austria; Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schoen Clinic Vogtareuth, Vogtareuth 83569, Germany
| | - Aristea S Galanopoulou
- Saul R Korey Department of Neurology, Isabelle Rapin Division of Child Neurology, Dominick P. Purpura Department of Neuroscience, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover 30559, Germany
| | - Sofie F M Bhatti
- Faculty of Veterinary Medicine, Small Animal Department, Ghent University, Merelbeke 9820, Belgium
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Bongers JJ, Gutierrez-Quintana R, Hammond G, José-López R. Clinical and MRI findings of a suspected cortical malformation presented as a giant cerebral pseudomass in a German Shepherd dog. Clin Case Rep 2023; 11:e7057. [PMID: 36911639 PMCID: PMC9995673 DOI: 10.1002/ccr3.7057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Revised: 02/07/2023] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
A 5-month-old German Shepherd dog was presented with cluster seizures. MR imaging showed a large irregular pseudomass in the central region of the cranial cavity, compatible with a malformation of cortical development. Despite the extensive changes, the patient was neurologically normal interictally 1 year following diagnosis.
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Affiliation(s)
- Jos Jacqueline Bongers
- Small Animal Hospital, School of Veterinary Medicine, College of Medicine, Veterinary Medicine and Life Sciences University of Glasgow Glasgow UK
| | - Rodrigo Gutierrez-Quintana
- Small Animal Hospital, School of Veterinary Medicine, College of Medicine, Veterinary Medicine and Life Sciences University of Glasgow Glasgow UK
| | - Gawain Hammond
- Small Animal Hospital, School of Veterinary Medicine, College of Medicine, Veterinary Medicine and Life Sciences University of Glasgow Glasgow UK
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Loncarica T, Balducci F, Bernardini M. Prevalence of idiopathic epilepsy and structural epilepsy in 74 Boxer dogs in a referral hospital. Front Vet Sci 2022; 9:956648. [PMID: 36061109 PMCID: PMC9437913 DOI: 10.3389/fvets.2022.956648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/02/2022] [Indexed: 11/26/2022] Open
Abstract
The prevalence of idiopathic epilepsy and structural epilepsy in Boxer dogs is unknown. The aim of this retrospective study was to evaluate the prevalence of structural and idiopathic epilepsy in the Boxer population. A total of 74 Boxer dogs were included in the study from the database of one referral hospital and the following were recorded: signalment, history, clinical findings and results of advanced diagnostic imaging. Five dogs (6.8%) were diagnosed with idiopathic epilepsy, of which one was in the <6 months age group, three were in the 6–72 months age group and one was in the >72 months age group. Sixty-nine dogs (93.2%) were diagnosed with structural epilepsy. Sixty-six had a suspected intracranial neoplasia: Eight were in the 6–72 months age group and represent 66.7% of the dogs in that age group. The other fifty-eight were in the >72 months age group and represent 96.7% of the dogs in that age group. In our Boxer population, 81.8% of the patients had a suspected intra-axial tumor and 22.7% of dogs with an intracranial pathology nevertheless had a normal neurological examination. In conclusion, in the majority of boxer patients the cause of epilepsy is a suspected intracranial neoplasia regardless of the age at presentation. Considering the finding in this study of a low prevalence of presumed idiopathic epilepsy in the Boxer breed, it is recommended that patients who satisfy Tier I confidence level of the “International Veterinary Epilepsy Task Force” (IVETF) also undergo an MRI study of the brain.
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Affiliation(s)
- Tina Loncarica
- Neurology Unit, Anicura Portoni Rossi Veterinary Hospital, Bologna, Italy
- *Correspondence: Tina Loncarica
| | - Federica Balducci
- Neurology Unit, Anicura Portoni Rossi Veterinary Hospital, Bologna, Italy
| | - Marco Bernardini
- Neurology Unit, Anicura Portoni Rossi Veterinary Hospital, Bologna, Italy
- Department of Animal Medicine, Production and Health, Clinical section, University of Padua, Legnaro, Italy
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Santifort KM, Bertijn E, Bhatti SFM, Leegwater P, Fischer A, Mandigers PJJ. Phenotypic Characterization of Idiopathic Epilepsy in Border Collies. Front Vet Sci 2022; 9:880318. [PMID: 35647099 PMCID: PMC9133619 DOI: 10.3389/fvets.2022.880318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 03/23/2022] [Indexed: 11/13/2022] Open
Abstract
The prevalence of idiopathic epilepsy (IE) within the Border Collie (BC) dog breed is high. The aim of this retrospective study was to describe the phenotype of BCs with IE and assess correlations between phenotypic variables and owner-provided quality-of-life (QoL) scores. Data of BCs diagnosed with IE during the period of five consecutive years were retrospectively analyzed. All the dogs were presented at least once to a veterinary neurology specialist at one of three veterinary referral hospitals and most were under the continued medical care of that specialist. Owners were requested to complete a standardized online questionnaire including quality-of-life (QoL) scoring questions. Data of a total of 116 BC dogs were included for analysis. The median age at onset of the first epileptic seizure (ES) was 33.5 months (6–188). A total of 34/86 (40%) of medically treated dogs received 1 antiseizure medication (ASM) and 52/86 (60%) received ≥2 ASMs. Phenobarbital was the most commonly employed ASM, used in 70/86 of treated dogs (81%). Four or more side effects were observed in 20/86 (23%) of treated dogs. Age at onset of first ES was significantly lower for dogs having experienced cluster seizures (CSs), status epilepticus (SE), or both (median 27 months) vs. dogs that had not experienced CS or SE (median 43 months). The QoL of BC with IE was scored with a median score of 7 out of 10. Owners scored their dog's QoL to have declined by a median of 30% during the course of life with IE with 39% (37/95) of owners scoring their dog's QoL to have declined by ≥50%. This study confirms the association of age at onset of first ES with the severity of epilepsy (e.g., presence of CS and/or SE) and further characterizes the phenotype of IE in BC dogs. QoL of BC can be heavily impacted by IE.
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Affiliation(s)
| | - Elise Bertijn
- Department of Clinical Sciences, Utrecht University, Utrecht, Netherlands
| | - Sofie F. M. Bhatti
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Peter Leegwater
- Department of Clinical Sciences, Utrecht University, Utrecht, Netherlands
| | - Andrea Fischer
- Centre for Clinical Veterinary Medicine, Clinic of Small Animal Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Paul J. J. Mandigers
- Evidensia Small Animal Hospital, Arnhem, Netherlands
- Department of Clinical Sciences, Utrecht University, Utrecht, Netherlands
- *Correspondence: Paul J. J. Mandigers
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8
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Booth S, Meller S, Packer RM, Farquhar R, Maddison JE, Volk HA. Owner compliance in canine epilepsy. Vet Rec 2021; 188:e16. [PMID: 34651709 DOI: 10.1002/vetr.16] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/15/2020] [Accepted: 10/30/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Poor medication compliance by human epilepsy patients is one of the leading causes of treatment failure and increased seizure frequency. The aim of this cross-sectional study was to analyse owner compliance in pharmacological treatment of canine idiopathic epilepsy and to identify factors associated with poor compliance. METHODS The number of antiseizure drug tablets was recorded to determine if the patient received sufficient tablets to cover the time period between prescriptions and to assess compliant prescription cycles. Additionally, compliance was assessed by an online survey of owners. RESULTS For the prescription monitoring data from 94 cases from three small animal practices in the United Kingdom revealed an overall median compliance of 56%. Thirt-three per cent of owners were >80% compliant, while 21% were 100% compliant. During a non-compliant prescription cycle, a patient missed a median of 6 days (0.11-519 days) of treatment. Patients on polytherapy had higher compliance rates than on monotherapy (p = 0.031). The survey (229 respondents from online canine epilepsy groups) showed that low daily dosing was associated with better compliance (p = 0.049). CONCLUSION Owner compliance was subpar in this study and could represent a significant issue in epilepsy management, which needs to be considered by veterinary surgeons when treating canine epilepsy.
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Affiliation(s)
- Samantha Booth
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Sebastian Meller
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Rowena Ma Packer
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | | | - Jill E Maddison
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK.,Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
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Unger DM, Wiest R, Kiefer C, Raillard M, Dutil GF, Stein VM, Schweizer D. Neuronal current imaging: An experimental method to investigate electrical currents in dogs with idiopathic epilepsy. J Vet Intern Med 2021; 35:2828-2836. [PMID: 34623697 PMCID: PMC8692176 DOI: 10.1111/jvim.16270] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 09/04/2021] [Accepted: 09/10/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The diagnosis of idiopathic epilepsy (IE) in dogs is based on exclusion of other potential causes of seizures. Recently, a novel magnetic resonance imaging (MRI) sequence that utilizes a variant of the rotary saturation approach has been suggested to detect weak transient magnetic field oscillations generated by neuronal currents in humans with epilepsy. HYPOTHESIS/OBJECTIVES Effects on the magnetic field evoked by intrinsic epileptic activity can be detected by MRI in the canine brain. As proof-of-concept, the novel MRI sequence to detect neuronal currents was applied in dogs. ANIMALS Twelve dogs with IE and 5 control dogs without a history of epileptic seizures were examined. METHODS Prospective case-control study as proof-of-concept. All dogs underwent a clinical neurological examination, scalp electroencephalography, cerebrospinal fluid analysis, and MRI. The MRI examination included a spin-locking (SL) experiment applying a low-power on-resonance radiofrequency pulse in a predefined frequency domain in the range of oscillations generated by the epileptogenic tissue. RESULTS In 11 of 12 dogs with IE, rotary saturation effects were detected by the MRI sequence. Four of 5 control dogs did not show rotary saturation effects. One control dog with a diagnosis of neuronal ceroid lipofuscinosis had SL-related effects, but did not have epileptic seizures clinically. CONCLUSIONS AND CLINICAL IMPORTANCE The proposed MRI method detected neuronal currents in dogs with epileptic seizures and represents a potential new line of research to investigate neuronal currents possibly related to IE in dogs.
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Affiliation(s)
- Daniela M Unger
- Division of Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Roland Wiest
- Support Center of Advanced Neuroimaging (SCAN), Institute of Diagnostic and Interventional Neuroradiology, Inselspital Bern, University of Bern, Bern, Switzerland
| | - Claus Kiefer
- Support Center of Advanced Neuroimaging (SCAN), Institute of Diagnostic and Interventional Neuroradiology, Inselspital Bern, University of Bern, Bern, Switzerland
| | - Mathieu Raillard
- Division of Clinical Anesthesiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Guillaume F Dutil
- Division of Clinical Neurology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Veronika M Stein
- Division of Clinical Neurology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
| | - Daniela Schweizer
- Division of Clinical Radiology, Department of Clinical Veterinary Medicine, Vetsuisse Faculty, University of Bern, Bern, Switzerland
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10
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Jones GMC, Volk HA, Packer RMA. Research priorities for idiopathic epilepsy in dogs: Viewpoints of owners, general practice veterinarians, and neurology specialists. J Vet Intern Med 2021; 35:1466-1479. [PMID: 33960544 PMCID: PMC8162594 DOI: 10.1111/jvim.16144] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/07/2021] [Accepted: 04/19/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Epilepsy is the most common chronic neurological disease in dogs that adversely affects the quality of life (QoL) of affected dogs and their owners. Research on epilepsy in dogs is expanding internationally, but where best to focus limited research time, funds, and expertise to achieve better outcomes for affected dogs and their owners has not been studied. OBJECTIVE To explore idiopathic epilepsy (IE) research priorities of owners of dogs with IE, general practice veterinarians, and veterinary neurologists. METHODS An international online survey was conducted in 2016 and repeated in 2020. Participants rated the absolute importance and relative rank of 18 areas of IE research, which were compared between groups and time points. RESULTS Valid responses were received from 414 respondents in 2016 and 414 respondents in 2020. The development of new anti-seizure drugs (ASD) and improving the existing ASD management were considered the most important research priorities. Areas of research with increasing priority between 2016 and 2020 included non-ASD management, with the greatest potential seen in behavioral and dietary-based interventions. Disagreements in priorities were identified between groups; owners prioritized issues that impacted their and their dog's QoL, for example, adverse effects and comorbidities, whereas general practitioner vets and neurologists prioritized clinical issues and longer-term strategies to manage or prevent IE, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE Ensuring that voices of owners are heard in the planning of future research should be a broader goal of veterinary medicine, to target research efforts toward areas most likely to improve the QoL of the dog-owner dyad.
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Affiliation(s)
| | - Holger Andreas Volk
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHertfordshireUK
- Department of Small Animal Medicine and SurgeryUniversity of Veterinary Medicine HannoverHannoverGermany
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11
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Huenerfauth E, Nessler J, Erath J, Tipold A. Probable Sudden Unexpected Death in Dogs With Epilepsy (pSUDED). Front Vet Sci 2021; 8:600307. [PMID: 33987215 PMCID: PMC8112544 DOI: 10.3389/fvets.2021.600307] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 03/09/2021] [Indexed: 11/13/2022] Open
Abstract
Sudden unexpected death in human epileptic patients (SUDEP) is defined as death related to recurrent unprovoked seizures, death occurring unexpectedly, and suddenly in a patient with reasonable state of health, without an obvious medical cause of death, trauma, asphyxia, or intractable status epilepticus, and in post mortem examination no obvious reason for death can be found. “Probable SUDEP” (pSUDEP) is defined as SUDEP not confirmed pathologically. The adapted abbreviation for dogs is used in the following: “pSUDED” (probable sudden unexpected death in dogs with epilepsy). The aim of the present monocentric retrospective study using an online questionnaire was to evaluate the occurrence of pSUDED. Data of canine patients presented with seizures between 01/1998 and 05/2018 were retrospectively analyzed and classified according to their etiology (n = 1,503). Owners were contacted by telephone to participate in answering a validated questionnaire. A total of 509 owners were reached, and 373 owners completed the questionnaire. In addition to signalement (e.g., breed), special attention was paid to the frequency and presentation of seizures and seizures in the context of death. Fifty-one percent (191/373) of the dogs were dead at the endpoint of the study. A large proportion of the dogs was euthanized (149/191) because of seizure severity or health problems unrelated to seizures. Idiopathic epilepsy (IE) was diagnosed in 19/34 dogs which died unexpectedly. Of these seven animals had to be excluded for further investigation of pSUDED because of status epilepticus or aspiration pneumonia as a result of the seizures. In 12 dogs with IE the last seizure event occurred between 6 h and ~3 months before death. pSUDED was suspected in these dogs and an occurrence rate of 4.5–10% was calculated. pSUDED appears in a similar occurrence rate as human SUDEP and should be considered as a possible complication in epileptic dogs. The results of this study suggest that dogs with IE but especially those with brachycephalic syndrome and cluster seizures have an increased risk to die of pSUDED. Owners of dogs with seizures should be educated about the risk of sudden death in dogs with epilepsy.
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Affiliation(s)
- Enrice Huenerfauth
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Jasmin Nessler
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Johannes Erath
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, Hannover, Germany
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12
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Drexlin JC, Schweizer D, Stein VM. [Diagnostics in epilepsy - potential of magnetic resonance imaging]. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2021; 49:29-42. [PMID: 33588463 DOI: 10.1055/a-1322-9439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Epilepsy is a common neurologic disease frequently encountered by small animal practitioners. The disease comprises a multiplicity of clinical presentations and etiologies and often necessitates a comprehensive as well as cost-intensive diagnostic workup. This is mandatory in order to be able to diagnose or exclude a metabolic cause of the seizures and to distinguish between idiopathic and structural epilepsy. The examination by means of magnetic resonance imaging (MRI) represents a central component of the diagnostic workup, which in turn has essential effects on treatment and prognosis. In order to achieve standardized examination and comparable results, it is of utmost importance to use defined MRI protocols. Accordingly, communication and interaction between clinical institutions may be facilitated and as of yet undetected structural changes might be recorded in future MRI techniques. This review article sets particularly emphasis on the definition and classification of epilepsy as well as its diagnostic imaging procedures and refers to statistics and specialists' recommendations for the diagnostic workup in dogs.
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Affiliation(s)
- Jana C Drexlin
- Abteilung für Klinische Neurologie, Departement für klinische Veterinärmedizin, Vetsuisse Fakultät, Universität Bern
| | - Daniela Schweizer
- Abteilung für Klinische Radiologie, Departement für klinische Veterinärmedizin, Vetsuisse Fakultät, Universität Bern
| | - Veronika M Stein
- Abteilung für Klinische Neurologie, Departement für klinische Veterinärmedizin, Vetsuisse Fakultät, Universität Bern
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13
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Cagnotti G, Ferrini S, Ala U, Bellino C, Corona C, Dappiano E, Di Muro G, Iulini B, Pepe I, Roncone S, D'Angelo A. Analysis of Early Assessable Risk Factors for Poor Outcome in Dogs With Cluster Seizures and Status Epilepticus. Front Vet Sci 2020; 7:575551. [PMID: 33195572 PMCID: PMC7581674 DOI: 10.3389/fvets.2020.575551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/09/2020] [Indexed: 11/13/2022] Open
Abstract
Status epileptics (SE) and cluster seizures (CS) are serious neurological emergencies associated with poor outcome in epileptic patients. Data on risk factors associated with outcome in epileptic patients affected by CS and SE have not been studied extensively to date. In the present retrospective study potential risk factors predictive of negative outcome in a population of dogs affected by CS and SE were analyzed. Ninety-three dogs were included in the study: 21/93 patients (23%) presented with SE and 72/93 (77%) with CS. Based on multivariate statistical analysis, factors statistically associated with a poor outcome were the occurrence of the first epileptic seizure outside the defined idiopathic interval (6 months-6 years), a condition of hyperthermia at presentation and the absence of previous antiepileptic drugs (AEDs) in case of previous history of seizures. The results of the present study implement data on risk factors associated with poor outcome in dogs affected by CS or SE and can aid in the creation of an ad hoc scoring system, similar to systems currently applied in human medicine upon hospital admission to benchmark performances and establish protocols for triage and therapeutic management.
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Affiliation(s)
- Giulia Cagnotti
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Sara Ferrini
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Ugo Ala
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Claudio Bellino
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Cristiano Corona
- Istituto Zooprofilattico del Piemonte Liguria e Valle d'Aosta, Turin, Italy
| | - Elena Dappiano
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Giorgia Di Muro
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Barbara Iulini
- Istituto Zooprofilattico del Piemonte Liguria e Valle d'Aosta, Turin, Italy
| | - Ida Pepe
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Silvia Roncone
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
| | - Antonio D'Angelo
- Department of Veterinary Science, University of Turin, Grugliasco, Italy
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14
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Gagliardo T, Gandini G, Gallucci A, Menchetti M, Bianchi E, Turba ME, Cauduro A, Corlazzoli DS, Gianni S, Baroni M, Bernardini M, Gentilini F. ABCB1 c.-6-180T>G polymorphism and clinical risk factors in a multi-breed cohort of dogs with refractory idiopathic epilepsy. Vet J 2019; 253:105378. [PMID: 31685133 DOI: 10.1016/j.tvjl.2019.105378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 08/19/2019] [Accepted: 09/10/2019] [Indexed: 10/26/2022]
Abstract
Epilepsy is the most common chronic neurological disorder in dogs. Approximately 20-30% of dogs do not achieve satisfactory seizure control with two or more anti-epileptic drugs at appropriate dosages. This condition, defined as refractory epilepsy, is a multifactorial condition involving both acquired and genetic factors. The P glycoprotein might play and important role in the pathophysiological mechanism and it is encoded by the ABCB1 gene. An association between a single nucleotide variation of the ABCB1 gene (c.-6-180T>G) and phenobarbital resistance has previously been reported in a Border collie population with idiopathic epilepsy. To date, the presence and relevance of this polymorphism has not been assessed in other breeds. A multicentre retrospective, case-control study was conducted to investigate associations between ABCB1 c.-6-180T>G, clinical variables, and refractoriness in a multi-breed population of dogs with refractory idiopathic epilepsy. A secondary aim was to evaluate the possible involvement of the ABCB1 c.-6-180T>G single nucleotide variation this population. Fifty-two refractory and 50 responsive dogs with idiopathic epilepsy were enrolled. Of these, 45 refractory and 50 responsive (control) dogs were genotyped. The G allele was found in several breeds, but there was no evidence of association with refractoriness (P=0.69). The uncertain role of the c.-6-180T>G variation was further suggested by an association between the T/T genotype with both refractoriness and responsiveness in different breeds. Furthermore, high seizure density (cluster seizure) was the main clinical risk factor for refractory idiopathic epilepsy (P=0.003).
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Affiliation(s)
- T Gagliardo
- Department of Veterinary Medical Sciences, University of Bologna, 50 via Tolara di sopra, Ozzano dell'Emilia, BO 40064, Italy.
| | - G Gandini
- Department of Veterinary Medical Sciences, University of Bologna, 50 via Tolara di sopra, Ozzano dell'Emilia, BO 40064, Italy
| | - A Gallucci
- Department of Veterinary Medical Sciences, University of Bologna, 50 via Tolara di sopra, Ozzano dell'Emilia, BO 40064, Italy
| | - M Menchetti
- Department of Veterinary Medical Sciences, University of Bologna, 50 via Tolara di sopra, Ozzano dell'Emilia, BO 40064, Italy
| | - E Bianchi
- Department of Veterinary Medical Sciences, University of Parma, 80 via Tiglio, Parma, PR 43100, Italy
| | - M E Turba
- Genefast, Bologna, 17/d via Castelfranco, Valsamoggia, BO 40053, Italy
| | - A Cauduro
- Neurovet Professional Association, 29 via Maestri del lavoro, Legnano, MI 20025, Italy
| | - D S Corlazzoli
- Roma Sud Veterinary Clinic, 24 via Pilade Mazza, Rome, RM 00173, Italy
| | - S Gianni
- Gran Sasso Veterinary Clinic, 26 via Donatello, Milan, MI 20131, Italy
| | - M Baroni
- Valdinievole Veterinary Hospital, 123 via Nigra Costantino, Monsummano Terme, PT 51015, Italy
| | - M Bernardini
- Portoni Rossi Veterinary Hospital, 57/a via Roma, Zola Predosa, BO 40069, Italy
| | - F Gentilini
- Department of Veterinary Medical Sciences, University of Bologna, 50 via Tolara di sopra, Ozzano dell'Emilia, BO 40064, Italy
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15
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Qahwash M, Heller HLB. Seizure etiologic classification and long-term outcome for cats with juvenile-onset seizures. J Am Vet Med Assoc 2019; 253:763-767. [PMID: 30179086 DOI: 10.2460/javma.253.6.763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To identify seizure etiologic classification for cats that developed seizures at < 12 months of age and describe the long-term outcome of affected cats. DESIGN Retrospective cohort study. ANIMALS 15 client-owned cats with seizures that began at < 12 months of age. PROCEDURES Information on each cat was obtained from the medical records, veterinarians, and owners. Inclusion required an onset of seizures before 12 months of age and a complete medical record, including a final diagnosis. RESULTS 7 of the 15 cats had structural epilepsy, 4 had idiopathic epilepsy, and 4 had reactive seizures. Median age at seizure onset was 27 weeks (range, 0.4 to 41 weeks). Cluster seizures were reported in 6 cats, and status epilepticus was reported in 2. Age at the onset of seizures, presence of cluster seizures, and seizure semiology (ie, generalized vs focal seizures) were not significantly associated with seizure etiologic classification. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that cats that developed seizures at < 12 months of age were more likely to have structural epilepsy than idiopathic epilepsy or reactive seizures. Therefore, advanced diagnostic imaging is recommended in cats with juvenile-onset seizures if metabolic and toxic causes are excluded.
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Thomovsky SA, Chen AV, Deavila DM, Kiszonas AM. Serum Melatonin Values in Normal Dogs and Dogs with Seizures. J Am Anim Hosp Assoc 2019; 55:78-82. [DOI: 10.5326/jaaha-ms-6669] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
ABSTRACT
Epilepsy, or recurrent seizures, is reported to be the most common neurologic condition in dogs; 20–30% of epileptic dogs are considered to be pharmacoresistent to one medication. The hormone melatonin has been shown to have significant anticonvulsant effects; epileptic humans have lower serum melatonin levels than unaffected individuals. We hypothesize that serum levels of melatonin will be lower in dogs with seizures as compared with normal dogs. Sixty-two dogs were enrolled in the study: 29 normal dogs (Group 1) and 33 dogs with seizures (Group 2). Blood sampling was done at three separate time points (8:00 a.m., 12:00, and 4:00 p.m.). The majority of dogs in Groups 1 (69%) and 2 (76%) had serum melatonin levels <0.5 pg/mL as measured by radioimmunoassay. There were no significant differences in serum melatonin values between the groups or within groups when time of blood draw, length of sample freezing, time of day/year of sampling, or presence of anticonvulsant therapy were compared. There were no notable differences in daytime serum melatonin values in normal dogs versus dogs with seizures. The majority of daytime serum melatonin levels were <0.5 pg/mL in dogs with and without seizures.
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Affiliation(s)
- Stephanie Ann Thomovsky
- From the College of Veterinary Medicine, Purdue University, Lafayette, Indiana (S.A.T.); and College of Veterinary Medicine (A.V.C.), Center for Reproductive Biology (D.M.D.), and USDA Agricultural Research Service (A.M.K.), Washington State University, Pullman, Washington
| | - Annie Vivian Chen
- From the College of Veterinary Medicine, Purdue University, Lafayette, Indiana (S.A.T.); and College of Veterinary Medicine (A.V.C.), Center for Reproductive Biology (D.M.D.), and USDA Agricultural Research Service (A.M.K.), Washington State University, Pullman, Washington
| | - David M. Deavila
- From the College of Veterinary Medicine, Purdue University, Lafayette, Indiana (S.A.T.); and College of Veterinary Medicine (A.V.C.), Center for Reproductive Biology (D.M.D.), and USDA Agricultural Research Service (A.M.K.), Washington State University, Pullman, Washington
| | - Alecia M. Kiszonas
- From the College of Veterinary Medicine, Purdue University, Lafayette, Indiana (S.A.T.); and College of Veterinary Medicine (A.V.C.), Center for Reproductive Biology (D.M.D.), and USDA Agricultural Research Service (A.M.K.), Washington State University, Pullman, Washington
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17
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Cagnotti G, Odore R, Gardini G, Amedeo S, Bertone I, Guerriero G, Lentini L, Dappiano E, D'Angelo A. Pharmacokinetics of rectal levetiracetam as add-on treatment in dogs affected by cluster seizures or status epilepticus. BMC Vet Res 2018; 14:189. [PMID: 29914474 PMCID: PMC6006693 DOI: 10.1186/s12917-018-1522-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 06/12/2018] [Indexed: 12/02/2022] Open
Abstract
Background Levetiracetam can be used for seizure control alone or in combination with other antiepileptic medications. A previous study achieved the minimum targeted serum drug concentration after rectal administration of levetiracetam in healthy dogs. The purpose of the present study was to determine the pharmacokinetics of rectal LEV in dogs presented for cluster seizures or status epilepticus and potentially in treatment with other anti-epileptic drugs. Furthermore, preliminary information on response to this treatment as add-on to the standard treatment protocol is reported. Results Eight client-owned dogs were enrolled. Plasma levetiracetam concentrations (measured at 0, 30, 60, 90, 120, 180, 240, 360, 720, and 1440 min after drug administration) reached the minimum target concentration (5 μg/ml) at 30 min in all but one patient. At T1 (30 min) the mean concentration was 28.2 ± 15.5 μg/ml. Plasma concentrations remained above the targeted minimum concentration in all patients until 240 min and in 7/8 until 360 min. Six out of eight patients experienced no seizures in the 24-h period after hospitalization and were classified as “responders”. Conclusions Minimum plasma levetiracetam concentration can be reached after rectal administration of 40 mg/kg in dogs affected by cluster seizures and status epilepticus and concurrently receiving other antiepileptic drugs. These preliminary results may encourage the evaluation of rectal levetiracetam as an additional treatment option for cluster seizures and status epilepticus in a larger number of dogs. Electronic supplementary material The online version of this article (10.1186/s12917-018-1522-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Giulia Cagnotti
- Department of Veterinary Science, University of Turin, Via Largo Braccini 2, 10095, Grugliasco, Turin, Italy.
| | - Rosangela Odore
- Department of Veterinary Science, University of Turin, Via Largo Braccini 2, 10095, Grugliasco, Turin, Italy
| | - Giulia Gardini
- Department of Veterinary Science, University of Turin, Via Largo Braccini 2, 10095, Grugliasco, Turin, Italy
| | - Stefano Amedeo
- Department of Veterinary Science, University of Turin, Via Largo Braccini 2, 10095, Grugliasco, Turin, Italy
| | - Iride Bertone
- Department of Veterinary Science, University of Turin, Via Largo Braccini 2, 10095, Grugliasco, Turin, Italy
| | - Giulia Guerriero
- Department of Veterinary Science, University of Turin, Via Largo Braccini 2, 10095, Grugliasco, Turin, Italy
| | - Laura Lentini
- Department of Veterinary Science, University of Turin, Via Largo Braccini 2, 10095, Grugliasco, Turin, Italy
| | - Elena Dappiano
- Department of Veterinary Science, University of Turin, Via Largo Braccini 2, 10095, Grugliasco, Turin, Italy
| | - Antonio D'Angelo
- Department of Veterinary Science, University of Turin, Via Largo Braccini 2, 10095, Grugliasco, Turin, Italy
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18
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Affiliation(s)
- Rowena M A Packer
- Royal Veterinary College, Hawkshead Lane, Hatfield, Hertfordshire AL9 7TA, UK
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19
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Estey CM, Dewey CW, Rishniw M, Lin DM, Bouma J, Sackman J, Burkland E. A Subset of Dogs with Presumptive Idiopathic Epilepsy Show Hippocampal Asymmetry: A Volumetric Comparison with Non-Epileptic Dogs Using MRI. Front Vet Sci 2017; 4:183. [PMID: 29167797 PMCID: PMC5682304 DOI: 10.3389/fvets.2017.00183] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Accepted: 10/11/2017] [Indexed: 01/14/2023] Open
Abstract
MRI-acquired volumetric measurements from 100 dogs with presumptive idiopathic epilepsy (IE) and 41 non-epileptic (non-IE) dogs were used to determine if hippocampal asymmetry exists in the IE as compared to the non-IE dogs. MRI databases from three institutions were searched for dogs that underwent MRI of the brain and were determined to have IE and those that were considered non-IE dogs. Volumes of the right and left hippocampi were measured using Mimics® software. Median hippocampal volumes of IE and non-IE dogs were 0.47 and 0.53 cm3, respectively. There was no significant difference in overall hippocampal volume between IE and non-IE dogs; however, IE dogs had greater hippocampal asymmetry than non-IE dogs (P < 0.012). A threshold value of 1.16 from the hippocampal ratio had an 85% specificity for identifying IE-associated asymmetry. Thirty five percent of IE dogs had a hippocampal ratio >1.16. Asymmetry was not associated with any particular hemisphere (P = 0.67). Our study indicates that hippocampal asymmetry occurs in a subset of dogs with presumptive idiopathic/genetic epilepsy, suggesting a structural etiology to some cases of IE.
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Affiliation(s)
- Chelsie M Estey
- Department of Clinical Sciences, Cornell University Hospital for Animals, Ithaca, NY, United States
| | - Curtis W Dewey
- Department of Clinical Sciences, Cornell University Hospital for Animals, Ithaca, NY, United States
| | - Mark Rishniw
- Department of Clinical Sciences, Cornell University Hospital for Animals, Ithaca, NY, United States
| | - David M Lin
- Department of Biomedical Sciences, Cornell University, Ithaca, NY, United States
| | - Jennifer Bouma
- Rochester Veterinary Specialists, Rochester, NY, United States
| | - Joseph Sackman
- Long Island Veterinary Specialists, Plainview, NY, United States
| | - Erica Burkland
- Department of Clinical Sciences, Cornell University Hospital for Animals, Ithaca, NY, United States
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20
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Kelly D, Raimondi F, Shihab N. Levetiracetam monotherapy for treatment of structural epilepsy in dogs: 19 cases (2010-2015). Vet Rec 2017; 181:401. [DOI: 10.1136/vr.104190] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 06/27/2017] [Accepted: 07/29/2017] [Indexed: 01/11/2023]
Affiliation(s)
- Darren Kelly
- Department of Internal Medicine; Southern Counties Veterinary Specialists LLP; Ringwood UK
| | - Francesca Raimondi
- Department of Neurology and Neurosurgery; Southern Counties Veterinary Specialists LLP; Ringwood UK
| | - Nadia Shihab
- Department of Neurology and Neurosurgery; Southern Counties Veterinary Specialists; Ringwood Hampshire UK
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21
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Gallucci A, Gagliardo T, Menchetti M, Bianchi E, Bucci D, Gandini G. Long-term efficacy of imepitoin in the treatment of naive dogs affected by idiopathic epilepsy. Vet Rec 2017; 181:144. [DOI: 10.1136/vr.104187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2017] [Indexed: 01/21/2023]
Affiliation(s)
- A. Gallucci
- Department of Veterinary Medical Sciences; University of Bologna; Ozzano Emilia Italy
| | - T. Gagliardo
- Department of Veterinary Medical Sciences; University of Bologna; Ozzano Emilia Italy
| | - M. Menchetti
- Department of Veterinary Medical Sciences; University of Bologna; Ozzano Emilia Italy
| | - E. Bianchi
- Department of Veterinary Medical Sciences; University of Parma; Parma Italy
| | - D. Bucci
- Department of Veterinary Medical Sciences; University of Bologna; Ozzano Emilia Italy
| | - G. Gandini
- Department of Veterinary Medical Sciences; University of Bologna; Ozzano Emilia Italy
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22
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Blades Golubovic S, Rossmeisl JH. Status epilepticus in dogs and cats, part 1: etiopathogenesis, epidemiology, and diagnosis. J Vet Emerg Crit Care (San Antonio) 2017; 27:278-287. [PMID: 28445615 DOI: 10.1111/vec.12605] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 09/28/2015] [Accepted: 10/20/2015] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To review current knowledge of the etiopathogenesis, diagnosis, and consequences of status epilepticus (SE) in veterinary patients. DATA SOURCES Human and veterinary literature, including clinical and laboratory research and reviews. ETIOPATHOGENESIS Status epilepticus is a common emergency in dogs and cats, and may be the first manifestation of a seizure disorder. It results from the failure of termination of an isolated seizure. Multiple factors are involved in SE, including initiation and maintenance of neuronal excitability, neuronal network synchronization, and brain microenvironmental contributions to ictogenesis. Underlying etiologies of epilepsy and SE in dogs and cats are generally classified as genetic (idiopathic), structural-metabolic, or unknown. DIAGNOSIS Diagnosis of convulsive SE is usually made based on historical information and the nature of the seizures. Patient specific variables, such as the history, age of seizure onset, and physical and interictal neurological examination findings can help hone the rule out list, and are used to guide selection and prioritization of diagnostic tests. Electroencephalographic monitoring is routinely used in people to diagnose SE and guide patient care decisions, but is infrequently performed in veterinary medicine. Nonconvulsive status epilepticus has been recognized in veterinary patients; routine electroencephalography would aid in the diagnosis of this phenomenon in dogs and cats. CLINICAL SEQUELAE Status epilepticus is a medical emergency that can result in life-threatening complications involving the brain and systemic organs. Status epilepticus often requires comprehensive diagnostic testing, treatment with multiple anticonvulsant agents, and intensive supportive care.
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Affiliation(s)
| | - John H Rossmeisl
- Department of Small Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA, 24060
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23
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Hamamoto Y, Hasegawa D, Mizoguchi S, Yu Y, Wada M, Kuwabara T, Fujiwara-Igarashi A, Fujita M. Retrospective epidemiological study of canine epilepsy in Japan using the International Veterinary Epilepsy Task Force classification 2015 (2003-2013): etiological distribution, risk factors, survival time, and lifespan. BMC Vet Res 2016; 12:248. [PMID: 27829458 PMCID: PMC5103468 DOI: 10.1186/s12917-016-0877-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 11/02/2016] [Indexed: 02/07/2023] Open
Abstract
Background Epilepsy is the most common neurological disease in veterinary practice. However, contrary to human medicine, epilepsy classification in veterinary medicine had not been clearly defined until recently. A number of reports on canine epilepsy have been published, reflecting in part updated proposals from the human epilepsy organization, the International League Against Epilepsy. In 2015, the International Veterinary Epilepsy Task Force (IVETF) published a consensus report on the classification and definition of canine epilepsy. The purpose of this retrospective study was to investigate the etiological distribution, survival time of dogs with idiopathic epilepsy (IdE) and structural epilepsy (StE), and risk factors for survival time, according to the recently published IVETF classification. We investigated canine cases with epilepsy that were referred to our teaching hospital in Japan during the past 10 years, and which encompassed a different breed population from Western countries. Results A total of 358 dogs with epilepsy satisfied our etiological study criteria. Of these, 172 dogs (48 %) were classified as IdE and 76 dogs (21 %) as StE. Of these dogs, 100 dogs (consisting of 65 with IdE and 35 with StE) were included in our survival study. Median survival time from the initial epileptic seizure in dogs with IdE and StE was 10.4 and 4.5 years, respectively. Median lifespan of dogs with IdE and StE was 13.5 and 10.9 years, respectively. Multivariable analysis demonstrated that risk factors for survival time in IdE were high seizure frequency (≥0.3 seizures/month) and focal epileptic seizures. Conclusions Focal epileptic seizures were identified as a risk factor for survival time in IdE. Clinicians should carefully differentiate seizure type as it is difficult to identify focal epileptic seizures. With good seizure control, dogs with IdE can survive for nearly the same lifespan as the general dog population. Our results using the IVETF classification are similar to previous studies, although some features were noted in our Japanese canine population (which was composed of mainly small-breed dogs), including a longer lifespan in dogs with epilepsy and a larger percentage of meningoencephalomyelitis of unknown origin in dogs with StE.
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Affiliation(s)
- Yuji Hamamoto
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
| | - Daisuke Hasegawa
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan.
| | - Shunta Mizoguchi
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
| | - Yoshihiko Yu
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
| | - Masae Wada
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
| | - Takayuki Kuwabara
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
| | - Aki Fujiwara-Igarashi
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
| | - Michio Fujita
- Department of Clinical Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyonan-cho, Musashino-shi, 180-8602, Tokyo, Japan
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24
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Uriarte A, Maestro Saiz I. Canine versus human epilepsy: are we up to date? J Small Anim Pract 2016; 57:115-21. [PMID: 26931499 DOI: 10.1111/jsap.12437] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/21/2015] [Accepted: 08/13/2015] [Indexed: 02/04/2023]
Abstract
In this paper we analyse and compare features of canine and human epilepsy and we suggest new tools for better future understanding of canine epilepsy. The prevalence of epileptic seizures in dogs ranges between 0.5% and 5.7% and between 1% and 3% in the human population. Studies on human epilepsy provide a ready-made format for classification, diagnosis and treatment in veterinary epilepsy. Human studies highlight the value of a thorough seizure classification. Nevertheless, a matter of concern in canine epilepsy is the limited information regarding seizure description and classification because of the lack of EEG-video recording. Establishment of a consensus protocol for ambulatory home video-recording in dogs who suffer from epilepsy, mainly considering indications, duration of monitoring, the sufficient essential training for an optimal interpretation of ictal semiology and the methodology of recordings is needed. The ultimate goal is that the information gathered by these videos will be analysed to describe the epileptic seizures thoroughly, recognize patterns and move towards a better understanding and therefore classification of canine epileptic seizures.
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Affiliation(s)
- A Uriarte
- North Down Specialist Referrals, Surrey, RH1 4QP
| | - I Maestro Saiz
- Clinical Neurophysiology Department, Cruces University Hospital, Barakaldo, Biscay, 48903, Spain
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Taylor S, Minor K, Shmon CL, Shelton GD, Patterson EE, Mickelson JR. Border Collie Collapse: Owner Survey Results and Veterinary Description of Videotaped Episodes. J Am Anim Hosp Assoc 2016; 52:364-370. [PMID: 27685362 DOI: 10.5326/jaaha-ms-6436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Completed surveys were obtained from owners of 165 border collies experiencing repeated episodes of abnormal gait or collapse during strenuous exercise. Unremarkable veterinary evaluation and lack of disease progression over time made common systemic, cardiac, and neurologic causes of exercise intolerance unlikely. Survey questions addressed signalment, age of onset, description of episodes, and owner perception of factors associated with collapse. Most dogs were young adults (median 2 yr) when episodes began, and they had experienced from 2 to more than 100 episodes (median 6) prior to their owners completing the survey. Retrieving was the activity most commonly associated with episodes (112/165 dogs, 68%), followed by herding stock (39/165 dogs, 24%). Owners reported that high environmental temperatures (111/165 dogs, 67%) and excitement (67/165 dogs, 41%) increased the likelihood of their dog having an episode during strenuous activity. Veterinary evaluation of videotapes of presumed border collie collapse (BCC) episodes (40 dogs) were used to provide a description of the typical features of BCC episodes. Altered mentation, symmetrical ataxia affecting all four limbs, increased pelvic limb extensor tone and toe scuffing or knuckling, truncal swaying, and falling to the side were common features, suggesting that BCC may be an episodic diffuse central nervous system disorder.
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Affiliation(s)
- Susan Taylor
- From the Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (S.T., C.L.S.); the Department of Veterinary Clinical Sciences (K.M., E.E.P.) and the Department of Veterinary Biomedical Sciences (J.R.M.), University of Minnesota, St. Paul, Minnesota; and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California, San Diego, La Jolla, California (G.D.S.)
| | - Katie Minor
- From the Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (S.T., C.L.S.); the Department of Veterinary Clinical Sciences (K.M., E.E.P.) and the Department of Veterinary Biomedical Sciences (J.R.M.), University of Minnesota, St. Paul, Minnesota; and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California, San Diego, La Jolla, California (G.D.S.)
| | - Cindy L Shmon
- From the Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (S.T., C.L.S.); the Department of Veterinary Clinical Sciences (K.M., E.E.P.) and the Department of Veterinary Biomedical Sciences (J.R.M.), University of Minnesota, St. Paul, Minnesota; and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California, San Diego, La Jolla, California (G.D.S.)
| | - G Diane Shelton
- From the Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (S.T., C.L.S.); the Department of Veterinary Clinical Sciences (K.M., E.E.P.) and the Department of Veterinary Biomedical Sciences (J.R.M.), University of Minnesota, St. Paul, Minnesota; and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California, San Diego, La Jolla, California (G.D.S.)
| | - Edward E Patterson
- From the Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (S.T., C.L.S.); the Department of Veterinary Clinical Sciences (K.M., E.E.P.) and the Department of Veterinary Biomedical Sciences (J.R.M.), University of Minnesota, St. Paul, Minnesota; and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California, San Diego, La Jolla, California (G.D.S.)
| | - James R Mickelson
- From the Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada (S.T., C.L.S.); the Department of Veterinary Clinical Sciences (K.M., E.E.P.) and the Department of Veterinary Biomedical Sciences (J.R.M.), University of Minnesota, St. Paul, Minnesota; and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California, San Diego, La Jolla, California (G.D.S.)
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Taylor S, Shmon C, Su L, Epp T, Minor K, Mickelson J, Patterson E, Shelton GD. Evaluation of Dogs with Border Collie Collapse, Including Response to Two Standardized Strenuous Exercise Protocols. J Am Anim Hosp Assoc 2016; 52:281-90. [PMID: 27487345 DOI: 10.5326/jaaha-ms-6361] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Clinical and metabolic variables were evaluated in 13 dogs with border collie collapse (BCC) before, during, and following completion of standardized strenuous exercise protocols. Six dogs participated in a ball-retrieving protocol, and seven dogs participated in a sheep-herding protocol. Findings were compared with 16 normal border collies participating in the same exercise protocols (11 retrieving, five herding). Twelve dogs with BCC developed abnormal mentation and/or an abnormal gait during evaluation. All dogs had post-exercise elevations in rectal temperature, pulse rate, arterial blood pH, PaO2, and lactate, and decreased PaCO2 and bicarbonate, as expected with strenuous exercise, but there were no significant differences between BCC dogs and normal dogs. Electrocardiography demonstrated sinus tachycardia in all dogs following exercise. Needle electromyography was normal, and evaluation of muscle biopsy cryosections using a standard panel of histochemical stains and reactions did not reveal a reason for collapse in 10 dogs with BCC in which these tests were performed. Genetic testing excluded the dynamin-1 related exercise-induced collapse mutation and the V547A malignant hyperthermia mutation as the cause of BCC. Common reasons for exercise intolerance were eliminated. Although a genetic basis is suspected, the cause of collapse in BCC was not determined.
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Affiliation(s)
- Susan Taylor
- From the Department of Small Animal Clinical Sciences (S.T., C.S., L.S.) and the Department of Large Animal Clinical Sciences (T.E.), Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada; the University of Minnesota, Minneapolis, MN (K.M., J.M., E.P.); and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California-San Diego, La Jolla, CA (G.D.S.)
| | - Cindy Shmon
- From the Department of Small Animal Clinical Sciences (S.T., C.S., L.S.) and the Department of Large Animal Clinical Sciences (T.E.), Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada; the University of Minnesota, Minneapolis, MN (K.M., J.M., E.P.); and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California-San Diego, La Jolla, CA (G.D.S.)
| | - Lillian Su
- From the Department of Small Animal Clinical Sciences (S.T., C.S., L.S.) and the Department of Large Animal Clinical Sciences (T.E.), Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada; the University of Minnesota, Minneapolis, MN (K.M., J.M., E.P.); and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California-San Diego, La Jolla, CA (G.D.S.)
| | - Tasha Epp
- From the Department of Small Animal Clinical Sciences (S.T., C.S., L.S.) and the Department of Large Animal Clinical Sciences (T.E.), Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada; the University of Minnesota, Minneapolis, MN (K.M., J.M., E.P.); and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California-San Diego, La Jolla, CA (G.D.S.)
| | - Katie Minor
- From the Department of Small Animal Clinical Sciences (S.T., C.S., L.S.) and the Department of Large Animal Clinical Sciences (T.E.), Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada; the University of Minnesota, Minneapolis, MN (K.M., J.M., E.P.); and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California-San Diego, La Jolla, CA (G.D.S.)
| | - James Mickelson
- From the Department of Small Animal Clinical Sciences (S.T., C.S., L.S.) and the Department of Large Animal Clinical Sciences (T.E.), Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada; the University of Minnesota, Minneapolis, MN (K.M., J.M., E.P.); and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California-San Diego, La Jolla, CA (G.D.S.)
| | - Edward Patterson
- From the Department of Small Animal Clinical Sciences (S.T., C.S., L.S.) and the Department of Large Animal Clinical Sciences (T.E.), Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada; the University of Minnesota, Minneapolis, MN (K.M., J.M., E.P.); and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California-San Diego, La Jolla, CA (G.D.S.)
| | - G Diane Shelton
- From the Department of Small Animal Clinical Sciences (S.T., C.S., L.S.) and the Department of Large Animal Clinical Sciences (T.E.), Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada; the University of Minnesota, Minneapolis, MN (K.M., J.M., E.P.); and the Comparative Neuromuscular Laboratory, Department of Pathology, University of California-San Diego, La Jolla, CA (G.D.S.)
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Packer RM, Shihab NK, Torres BB, Volk HA. Risk factors for cluster seizures in canine idiopathic epilepsy. Res Vet Sci 2016; 105:136-8. [DOI: 10.1016/j.rvsc.2016.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 01/31/2016] [Accepted: 02/05/2016] [Indexed: 11/29/2022]
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Gesell FK, Hoppe S, Löscher W, Tipold A. Antiepileptic Drug Withdrawal in Dogs with Epilepsy. Front Vet Sci 2015; 2:23. [PMID: 26664952 PMCID: PMC4672179 DOI: 10.3389/fvets.2015.00023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 07/27/2015] [Indexed: 11/13/2022] Open
Abstract
Epilepsy is one of the most common neurological disorders in dogs and is treated by chronic administration of antiepileptic drugs (AEDs). In human beings with epilepsy, it is common clinical practice to consider drug withdrawal after a patient has been in remission (seizure free) for three or more years, but withdrawal is associated with the risk of relapse. In the present study, the consequences of AED withdrawal were studied in dogs with epilepsy. Therefore, 200 owners of dogs with idiopathic or presumed idiopathic epilepsy were contacted by telephone interview, 138 cases could be enrolled. In 11 cases, the therapy had been stopped after the dogs had become seizure free for a median time of 1 year. Reasons for AED withdrawal were appearance or fear of adverse side effects, financial aspects, and the idea that the medication could be unnecessary. Following AED withdrawal, four of these dogs remained seizure free, seven dogs suffered from seizure recurrence, of which only three dogs could regain seizure freedom after resuming AED therapy. Due to the restricted case number, an exact percentage of dogs with seizure recurrence after AED withdrawal cannot be given. However, the present study gives a hint that similar numbers as in human patients are found, and the data can help owners of epileptic dogs and the responsible clinician to decide when and why to stop antiepileptic medication.
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Affiliation(s)
- Felix Kaspar Gesell
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover , Hannover , Germany
| | - Sonja Hoppe
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover , Hannover , Germany
| | - Wolfgang Löscher
- Department of Pharmacology, Toxicology, and Pharmacy, University of Veterinary Medicine Hannover , Hannover , Germany
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover , Hannover , Germany
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Heske L, Körberg IB, Nødtvedt A, Jäderlund KH. Clinical characteristics of epilepsy of unknown origin in the Rottweiler breed. Acta Vet Scand 2015; 57:75. [PMID: 26546467 PMCID: PMC4636809 DOI: 10.1186/s13028-015-0168-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 10/29/2015] [Indexed: 12/16/2022] Open
Abstract
Background Epilepsy is one of the most common neurological conditions in dogs. Despite that epilepsy appears to be common in the Rottweiler breed, published literature about the phenotype of epilepsy in this breed is lacking. The aim of this questionnaire-based study was to describe the clinical characteristics of epilepsy in the Rottweiler breed including; signalment, pedigree, housing conditions and information about the seizures such as age at onset, seizure type, duration, and progression, as well as number of seizure days (24 h), effect and side effects of anti-epileptic drugs, and potential comorbidities. The diagnosis for epilepsy of unknown origin was based on the following inclusion criteria: ≥2 seizure days, starting between 6 months and 7 years of age, no known history of poisoning or serious head trauma, and (when available), pre-study routine serum biochemical parameters were within the reference intervals. Results A total of 37 cases (23 females and 14 males) were included in the study. The median age at onset of seizures was 36 months (range 8–84 months). The dogs suffered from generalized tonic–clonic seizures, and more than 50 % of the dogs had experienced cluster seizures (>1 seizure in 24 h). The dogs commonly started to seizure while resting (23/36) and/or sleeping (20/36). Only 3 of the 36 dogs experienced seizures during activities such as walking or training. All of the 24/37 (64.9 %) dogs on antiepileptic drugs received phenobarbital. Five dogs needed add-on treatment (n = 5), and of these: one dog was on 3 drugs (phenobarbital, potassium bromid and levetiracetam) (n = 1), three dogs were on phenobarbital and potassium bromide (n = 3), and one dog received phenobarbital and imepitoin (n = 1). Seizure frequency did not necessarily improve following antiepileptic treatment, and for six of 21 (28.6 %) of the dogs, seizure frequency increased. All of the Rottweilers in this study had relatives with epilepsy reported. Conclusions The Rottweilers suffering from epilepsy in this study presented with generalized tonic–clonic seizures, and their response to antiepileptic treatment was variable. More than 50 % of the dogs had experienced cluster seizures (>1 seizure in 24 h). Electronic supplementary material The online version of this article (doi:10.1186/s13028-015-0168-1) contains supplementary material, which is available to authorized users.
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Packer RMA, Volk HA. Epilepsy beyond seizures: a review of the impact of epilepsy and its comorbidities on health-related quality of life in dogs. Vet Rec 2015; 177:306-15. [DOI: 10.1136/vr.103360] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Rowena M. A. Packer
- Department of Clinical Science and Services; Royal Veterinary College, Hawkshead Lane Hatfield Hertfordshire AL9 7TA UK
| | - Holger A. Volk
- Department of Clinical Science and Services; Royal Veterinary College, Hawkshead Lane Hatfield Hertfordshire AL9 7TA UK
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De Risio L, Bhatti S, Muñana K, Penderis J, Stein V, Tipold A, Berendt M, Farqhuar R, Fischer A, Long S, Mandigers PJJ, Matiasek K, Packer RMA, Pakozdy A, Patterson N, Platt S, Podell M, Potschka H, Batlle MP, Rusbridge C, Volk HA. International veterinary epilepsy task force consensus proposal: diagnostic approach to epilepsy in dogs. BMC Vet Res 2015; 11:148. [PMID: 26316175 PMCID: PMC4552251 DOI: 10.1186/s12917-015-0462-1] [Citation(s) in RCA: 171] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 06/29/2015] [Indexed: 12/16/2022] Open
Abstract
This article outlines the consensus proposal on diagnosis of epilepsy in dogs by the International Veterinary Epilepsy Task Force. The aim of this consensus proposal is to improve consistency in the diagnosis of epilepsy in the clinical and research settings. The diagnostic approach to the patient presenting with a history of suspected epileptic seizures incorporates two fundamental steps: to establish if the events the animal is demonstrating truly represent epileptic seizures and if so, to identify their underlying cause. Differentiation of epileptic seizures from other non-epileptic episodic paroxysmal events can be challenging. Criteria that can be used to make this differentiation are presented in detail and discussed. Criteria for the diagnosis of idiopathic epilepsy (IE) are described in a three-tier system. Tier I confidence level for the diagnosis of IE is based on a history of two or more unprovoked epileptic seizures occurring at least 24 h apart, age at epileptic seizure onset of between six months and six years, unremarkable inter-ictal physical and neurological examination, and no significant abnormalities on minimum data base blood tests and urinalysis. Tier II confidence level for the diagnosis of IE is based on the factors listed in tier I and unremarkable fasting and post-prandial bile acids, magnetic resonance imaging (MRI) of the brain (based on an epilepsy-specific brain MRI protocol) and cerebrospinal fluid (CSF) analysis. Tier III confidence level for the diagnosis of IE is based on the factors listed in tier I and II and identification of electroencephalographic abnormalities characteristic for seizure disorders. The authors recommend performing MRI of the brain and routine CSF analysis, after exclusion of reactive seizures, in dogs with age at epileptic seizure onset <6 months or >6 years, inter-ictal neurological abnormalities consistent with intracranial neurolocalisation, status epilepticus or cluster seizure at epileptic seizure onset, or a previous presumptive diagnosis of IE and drug-resistance with a single antiepileptic drug titrated to the highest tolerable dose. This consensus article represents the basis for a more standardised diagnostic approach to the seizure patient. These recommendations will evolve over time with advances in neuroimaging, electroencephalography, and molecular genetics of canine epilepsy.
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Affiliation(s)
- Luisa De Risio
- Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, Suffolk, UK.
| | - Sofie Bhatti
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, 9820, Belgium.
| | - Karen Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27607, USA.
| | - Jacques Penderis
- Vet Extra Neurology, Broadleys Veterinary Hospital, Craig Leith Road, Stirling, FK7 7LE, Stirlingshire, UK.
| | - Veronika Stein
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Mette Berendt
- Department of Veterinary and Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
| | - Robyn Farqhuar
- Fernside Veterinary Centre, 205 Shenley Road, Borehamwood, SG9 0TH, Hertfordshire, UK.
| | - Andrea Fischer
- Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Sam Long
- University of Melbourne, 250 Princes Highway, Weibee, 3015, VIC, Australia.
| | - Paul J J Mandigers
- Department of Clinical Sciences of Companion Animals, Utrecht University, Yalelaan 108, 3583 CM, Utrecht, The Netherlands.
| | - Kaspar Matiasek
- Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Rowena M A Packer
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL9 7TA, Hertfordshire, UK.
| | - Akos Pakozdy
- Clinical Unit of Internal Medicine Small Animals, University of Veterinary Medicine, Veterinärplatz 1, 1210, Vienna, Austria.
| | - Ned Patterson
- University of Minnesota College of Veterinary Medicine, D426 Veterinary Medical Center, 1352 Boyd Avenue, St. Paul, MN, 55108, USA.
| | - Simon Platt
- College of Veterinary Medicine, University of Georgia, 501 DW Brooks Drive, Athens, GA, 30602, USA.
| | - Michael Podell
- Chicago Veterinary Neurology and Neurosurgery, 3123 N. Clybourn Avenue, Chicago, IL, 60618, USA.
| | - Heidrun Potschka
- Department of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximillians-University, Königinstr. 16, 80539, Munich, Germany.
| | - Martí Pumarola Batlle
- Department of Animal Medicine and Surgery, Veterinary Faculty, Universitat Autònoma de Barcelona, Campus UAB, Bellaterra, 08193, Barcelona, Spain.
| | - Clare Rusbridge
- Fitzpatrick Referrals, Halfway Lane, Eashing, Godalming, GU7 2QQ, Surrey, UK. .,School of Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, GU2 7TE, Surrey, UK.
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL9 7TA, Hertfordshire, UK.
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International Veterinary Epilepsy Task Force's current understanding of idiopathic epilepsy of genetic or suspected genetic origin in purebred dogs. BMC Vet Res 2015; 11:175. [PMID: 26316206 PMCID: PMC4552344 DOI: 10.1186/s12917-015-0463-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 06/29/2015] [Indexed: 12/20/2022] Open
Abstract
Canine idiopathic epilepsy is a common neurological disease affecting both purebred and crossbred dogs. Various breed-specific cohort, epidemiological and genetic studies have been conducted to date, which all improved our knowledge and general understanding of canine idiopathic epilepsy, and in particular our knowledge of those breeds studied. However, these studies also frequently revealed differences between the investigated breeds with respect to clinical features, inheritance and prevalence rates. Awareness and observation of breed-specific differences is important for successful management of the dog with epilepsy in everyday clinical practice and furthermore may promote canine epilepsy research. The following manuscript reviews the evidence available for breeds which have been identified as being predisposed to idiopathic epilepsy with a proven or suspected genetic background, and highlights different breed specific clinical features (e.g. age at onset, sex, seizure type), treatment response, prevalence rates and proposed inheritance reported in the literature. In addition, certain breed-specific diseases that may act as potential differentials for idiopathic epilepsy are highlighted.
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Jokinen TS, Tiira K, Metsähonkala L, Seppälä EH, Hielm-Björkman A, Lohi H, Laitinen-Vapaavuori O. Behavioral Abnormalities in Lagotto Romagnolo Dogs with a History of Benign Familial Juvenile Epilepsy: A Long-Term Follow-Up Study. J Vet Intern Med 2015; 29:1081-7. [PMID: 25945683 PMCID: PMC4895370 DOI: 10.1111/jvim.12611] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Revised: 03/25/2015] [Accepted: 04/14/2015] [Indexed: 11/28/2022] Open
Abstract
Background Lagotto Romagnolo (LR) dogs with benign juvenile epilepsy syndrome often experience spontaneous remission of seizures. The long‐term outcome in these dogs currently is unknown. In humans, behavioral and psychiatric comorbidities have been reported in pediatric and adult‐onset epilepsies. Hypothesis/Objectives The objectives of this study were to investigate possible neurobehavioral comorbidities in LR with a history of benign familial juvenile epilepsy (BFJE) and to assess the occurrence of seizures after the remission of seizures in puppyhood. Animals A total of 25 LR with a history of BFJE and 91 control dogs of the same breed. Methods Owners of the LR dogs in the BFJE and control groups completed an online questionnaire about each dog's activity, impulsivity, and inattention. Principal component analysis (PCA) served to extract behavioral factors from the data. We then compared the scores of these factors between the 2 groups in a retrospective case–control study. We also interviewed all dog owners in the BFJE group by telephone to inquire specifically about possible seizures or other neurological problems after remission of seizures as a puppy. Results Lagotto Romagnolo dogs with BFJE showed significantly higher scores on the factors Inattention and Excitability/Impulsivity than did the control group (P = .003; P = .021, respectively). Only 1 of the 25 BFJE LR exhibited seizures after remission of epilepsy in puppyhood. Conclusions and Clinical Importance Although the long‐term seizure outcome in BFJE LR seems to be good, the dogs exhibit behavioral abnormalities resembling attention deficit hyperactivity disorder (ADHD) in humans, thus suggesting neurobehavioral comorbidities with epilepsy.
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Affiliation(s)
- T S Jokinen
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - K Tiira
- Department of Veterinary Biosciences and Research Programs Unit, Molecular Neurology, University of Helsinki, Helsinki, Finland.,Department of Molecular Genetics, Folkhälsan Institute of Genetics, Helsinki, Finland
| | - L Metsähonkala
- Epilepsy Unit, Hospital for Children and Adolescents, Helsinki, Finland
| | - E H Seppälä
- Department of Veterinary Biosciences and Research Programs Unit, Molecular Neurology, University of Helsinki, Helsinki, Finland.,Department of Molecular Genetics, Folkhälsan Institute of Genetics, Helsinki, Finland
| | - A Hielm-Björkman
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
| | - H Lohi
- Department of Veterinary Biosciences and Research Programs Unit, Molecular Neurology, University of Helsinki, Helsinki, Finland.,Department of Molecular Genetics, Folkhälsan Institute of Genetics, Helsinki, Finland
| | - O Laitinen-Vapaavuori
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland
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De Risio L, Newton R, Freeman J, Shea A. Idiopathic epilepsy in the Italian Spinone in the United Kingdom: prevalence, clinical characteristics, and predictors of survival and seizure remission. J Vet Intern Med 2015; 29:917-24. [PMID: 25929270 PMCID: PMC4895410 DOI: 10.1111/jvim.12599] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Revised: 03/02/2015] [Accepted: 03/24/2015] [Indexed: 11/29/2022] Open
Abstract
Background There is lack of data on idiopathic epilepsy (IE) in the Italian Spinone (IS). Objectives To estimate the prevalence of IE in the IS in the United Kingdom (UK) and to investigate predictors of survival and seizure remission. Animals The target population consisted of 3331 IS born between 2000 and 2011 and registered with the UK Kennel Club (KC). The owners of 1192 dogs returned phase I questionnaire. Sixty‐three IS had IE. Methods Population survey. The owners of all UK KC‐registered IS were invited to complete the phase I questionnaire. Information from the phase I questionnaire and veterinary medical records was used to identify IS with IE and obtain data on treatment and survival. Additional information was obtained from owners of epileptic IS who completed the phase II questionnaire. Results The prevalence of IE in the IS in the UK was estimated as 5.3% (95% CI, 4.03–6.57%). Survival time was significantly shorter in IS euthanized because of poorly controlled IE compared with epileptic IS that died of unrelated disorders (P = 0.001). Survival was significantly longer in IS with no cluster seizures (CS) (P = 0.040) and in IS in which antiepileptic medication was initiated after the second seizure rather than after ≥3 seizures (P = 0.044). Seizure remission occurred only in 3 IS. Conclusions and Clinical Importance The prevalence of IE in IS (5.3%) is higher than in dogs (0.6%) in the UK. Idiopathic epilepsy in IS has a severe phenotype. Antiepileptic medication initiation after the second seizure and aggressive treatment of CS may improve survival.
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Affiliation(s)
- L De Risio
- Centre for Small Animal Studies, Animal Health Trust, Suffolk, UK
| | - R Newton
- Department of Epidemiology and Disease Surveillance, Animal Health Trust, Suffolk, UK
| | - J Freeman
- Centre for Small Animal Studies, Animal Health Trust, Suffolk, UK
| | - A Shea
- Centre for Small Animal Studies, Animal Health Trust, Suffolk, UK
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Packer RMA, Nye G, Porter SE, Volk HA. Assessment into the usage of levetiracetam in a canine epilepsy clinic. BMC Vet Res 2015; 11:25. [PMID: 25889090 PMCID: PMC4328478 DOI: 10.1186/s12917-015-0340-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 01/22/2015] [Indexed: 11/23/2022] Open
Abstract
Background Retrospective studies can complement information derived from double-blinded randomized trials. There are multiple retrospective studies reporting good efficacy and tolerability of the anti-epileptic drug levetiracetam (LEV) in human patients with epilepsy; however, reports of LEV's tolerability and efficacy in dogs with epilepsy remain limited. The purpose of this retrospective study was to describe the use of LEV in a canine epilepsy clinic and determine the long-term efficacy and tolerability of LEV in veterinary clinical practice. The electronic database of a UK based referral hospital was searched for LEV usage in dogs with seizures. Information and data necessary for the evaluation were obtained from a combination of electronic and written hospital records, the referring veterinary surgeons’ records and telephone interviews with dog owners. Only dogs that were reportedly diagnosed with idiopathic epilepsy were included in the study. Results Fifty-two dogs were included in this retrospective study. Two treatment protocols were recognised; 29 dogs were treated continuously with LEV and 23 dogs received interval or pulse treatment for cluster seizures. LEV treatment resulted in 69% of dogs having a 50% or greater reduction of seizure frequency whilst 15% of all the dogs were completely free from seizures. Seizure frequency reduced significantly in the whole population. No dog was reported to experience life-threatening side effects. Mild side effects were experienced by 46% of dogs and a significantly higher number of these dogs were in the pulse treatment group. The most common side-effects reported were sedation and ataxia. Conclusions LEV appears to be effective and well tolerated for reduction of seizures.
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Affiliation(s)
- Rowena M A Packer
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL97TA, UK.
| | - George Nye
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL97TA, UK.
| | - Sian Elizabeth Porter
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL97TA, UK.
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL97TA, UK.
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Heske L, Nødtvedt A, Jäderlund KH, Berendt M, Egenvall A. A cohort study of epilepsy among 665,000 insured dogs: Incidence, mortality and survival after diagnosis. Vet J 2014; 202:471-6. [DOI: 10.1016/j.tvjl.2014.09.023] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 09/23/2014] [Accepted: 09/25/2014] [Indexed: 01/22/2023]
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Armaşu M, Packer R, Cook S, Solcan G, Volk H. An exploratory study using a statistical approach as a platform for clinical reasoning in canine epilepsy. Vet J 2014; 202:292-6. [DOI: 10.1016/j.tvjl.2014.08.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2013] [Revised: 06/19/2014] [Accepted: 08/09/2014] [Indexed: 01/28/2023]
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Fredsø N, Koch BC, Toft N, Berendt M. Risk factors for survival in a university hospital population of dogs with epilepsy. J Vet Intern Med 2014; 28:1782-8. [PMID: 25252168 PMCID: PMC4895623 DOI: 10.1111/jvim.12443] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 06/17/2014] [Accepted: 07/29/2014] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Although a common neurological disorder in dogs, long-term outcome of epilepsy is sparsely documented. OBJECTIVES To investigate risk factors for survival and duration of survival in a population of dogs with idiopathic epilepsy or epilepsy associated with a known intracranial cause. ANIMALS One hundred and two client owned dogs; 78 dogs with idiopathic epilepsy and 24 dogs with epilepsy associated with a known intracranial cause. METHODS A retrospective hospital based study with follow-up. Dogs diagnosed with epilepsy between 2002 and 2008 were enrolled in the study. Owners were interviewed by telephone using a structured questionnaire addressing epilepsy status, treatment, death/alive, and cause of death. RESULTS Median life span was 7.6 years, 9.2 years, and 5.8 years for all dogs, and dogs with idiopathic epilepsy or dogs with epilepsy associated with a known intracranial cause (P < .001), respectively. Survival time for dogs with idiopathic epilepsy was significantly (P = .0030) decreased for dogs euthanized because of epilepsy (median: 35 months) compared to dogs euthanized for other reasons (median: 67.5 months). Neutered male dogs with idiopathic epilepsy had a significant (P = .031) shorter survival (median: 38.5 months) after index seizure compared to intact male dogs (median: 71 months). Treatment with two antiepileptic drugs (AED's) did not negatively influence survival (P = .056). CONCLUSION AND CLINICAL IMPORTANCE Dogs with idiopathic epilepsy can in many cases expect a life span close to what is reported for dogs in general. In dogs where mono-therapy is not sufficient, the need for treatment with two AED's is not linked to a poor prognosis.
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Affiliation(s)
- N Fredsø
- Department of Veterinary Clinical and Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark
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Affiliation(s)
- Mark Lowrie
- Davies Veterinary SpecialistsManor Farm Business ParkHigham GobionHertfordshireSG5 3HRUK
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40
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Clinical risk factors associated with anti-epileptic drug responsiveness in canine epilepsy. PLoS One 2014; 9:e106026. [PMID: 25153799 PMCID: PMC4143335 DOI: 10.1371/journal.pone.0106026] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 07/29/2014] [Indexed: 11/19/2022] Open
Abstract
The nature and occurrence of remission, and conversely, pharmacoresistance following epilepsy treatment is still not fully understood in human or veterinary medicine. As such, predicting which patients will have good or poor treatment outcomes is imprecise, impeding patient management. In the present study, we use a naturally occurring animal model of pharmacoresistant epilepsy to investigate clinical risk factors associated with treatment outcome. Dogs with idiopathic epilepsy, for which no underlying cause was identified, were treated at a canine epilepsy clinic and monitored following discharge from a small animal referral hospital. Clinical data was gained via standardised owner questionnaires and longitudinal follow up data was gained via telephone interview with the dogs’ owners. At follow up, 14% of treated dogs were in seizure-free remission. Dogs that did not achieve remission were more likely to be male, and to have previously experienced cluster seizures. Seizure frequency or the total number of seizures prior to treatment were not significant predictors of pharmacoresistance, demonstrating that seizure density, that is, the temporal pattern of seizure activity, is a more influential predictor of pharmacoresistance. These results are in line with clinical studies of human epilepsy, and experimental rodent models of epilepsy, that patients experiencing episodes of high seizure density (cluster seizures), not just a high seizure frequency pre-treatment, are at an increased risk of drug-refractoriness. These data provide further evidence that the dog could be a useful naturally occurring epilepsy model in the study of pharmacoresistant epilepsy.
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Ekenstedt KJ, Oberbauer AM. Inherited epilepsy in dogs. Top Companion Anim Med 2014; 28:51-8. [PMID: 24070682 DOI: 10.1053/j.tcam.2013.07.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Accepted: 07/01/2013] [Indexed: 12/15/2022]
Abstract
Epilepsy is the most common neurologic disease in dogs and many forms are considered to have a genetic basis. In contrast, some seizure disorders are also heritable, but are not technically defined as epilepsy. Investigation of true canine epilepsies has uncovered genetic associations in some cases, however, many remain unexplained. Gene mutations have been described for 2 forms of canine epilepsy: primary epilepsy (PE) and progressive myoclonic epilepsies. To date, 9 genes have been described to underlie progressive myoclonic epilepsies in several dog breeds. Investigations into genetic PE have been less successful, with only 1 causative gene described. Genetic testing as an aid to diagnosis, prognosis, and breeding decisions is available for these 10 forms. Additional studies utilizing genome-wide tools have identified PE loci of interest; however, specific genetic tests are not yet developed. Many studies of dog breeds with PE have failed to identify genes or loci of interest, suggesting that, similar to what is seen in many human genetic epilepsies, inheritance is likely complex, involving several or many genes, and reflective of environmental interactions. An individual dog's response to therapeutic intervention for epilepsy may also be genetically complex. Although the field of inherited epilepsy has faced challenges, particularly with PE, newer technologies contribute to further advances.
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Affiliation(s)
- Kari J Ekenstedt
- Department of Animal and Food Science, College of Agriculture, Food, and Environmental Sciences, University of Wisconsin - River Falls, River Falls, WI, USA.
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Van Meervenne SAE, Volk HA, Matiasek K, Van Ham LML. The influence of sex hormones on seizures in dogs and humans. Vet J 2014; 201:15-20. [PMID: 24878266 DOI: 10.1016/j.tvjl.2014.05.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 05/01/2014] [Accepted: 05/04/2014] [Indexed: 11/27/2022]
Abstract
Epilepsy is the most common chronic neurological disorder in both humans and dogs. The effect of sex hormones on seizures is well documented in human medicine. Catamenial epilepsy is defined as an increase in frequency and severity of seizures during certain periods of the menstrual cycle. Oestradiol increases seizure activity and progesterone is believed to exhibit a protective effect. The role of androgens is controversial and there is a lack of research focusing on androgens and epilepsy. Indeed, little is known about the influence of sex hormones on epilepsy in dogs. Sterilisation is believed to improve seizure control, but no systematic research has been conducted in this field. This review provides an overview of the current literature on the influence of sex hormones on seizures in humans. The literature on idiopathic epilepsy in dogs was assessed to identify potential risk factors related to sex and sterilisation status. In general, there appears to be an over-representation of male dogs with idiopathic epilepsy but no explanation for this difference in prevalence between sexes has been reported. In addition, no reliable conclusions can be drawn on the effect of sterilisation due to the lack of focused research and robust scientific evidence.
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Affiliation(s)
- Sofie A E Van Meervenne
- Läckeby Djursjukhus, Örntorp 201, 39598 Läckeby, Sweden; Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield AL9 7TA, UK
| | - Kaspar Matiasek
- Section of Clinical & Comparative Neuropathology, Ludwig Maximilians University, Veterinärstrasse. 13, D-80539 Munich, Germany
| | - Luc M L Van Ham
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Martlé V, Van Ham L, Raedt R, Vonck K, Boon P, Bhatti S. Non-pharmacological treatment options for refractory epilepsy: an overview of human treatment modalities and their potential utility in dogs. Vet J 2013; 199:332-9. [PMID: 24309438 DOI: 10.1016/j.tvjl.2013.09.055] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2012] [Revised: 08/20/2013] [Accepted: 09/20/2013] [Indexed: 01/01/2023]
Abstract
Refractory epilepsy is a common disorder both in humans and dogs and treatment protocols are difficult to optimise. In humans, different non-pharmacological treatment modalities currently available include surgery, the ketogenic diet and neurostimulation. Surgery leads to freedom from seizures in 50-75% of patients, but requires strict patient selection. The ketogenic diet is indicated in severe childhood epilepsies, but efficacy is limited and long-term compliance can be problematic. In the past decade, various types of neurostimulation have emerged as promising treatment modalities for humans with refractory epilepsy. Currently, none of these treatment options are used in routine daily clinical practice to treat dogs with the condition. Since many dogs with poorly controlled seizures do not survive, the search for alternative treatment options for canine refractory epilepsy should be prioritised. This review provides an overview of non-pharmacological treatment options for human refractory epilepsy. The current knowledge and limitations of these treatments in canine refractory epilepsy is also discussed.
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Affiliation(s)
- Valentine Martlé
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium.
| | - Luc Van Ham
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium
| | - Robrecht Raedt
- Laboratory for Clinical and Experimental Neurophysiology, Department of Neurology, Ghent University Hospital, Ghent 9000, Belgium
| | - Kristl Vonck
- Laboratory for Clinical and Experimental Neurophysiology, Department of Neurology, Ghent University Hospital, Ghent 9000, Belgium
| | - Paul Boon
- Laboratory for Clinical and Experimental Neurophysiology, Department of Neurology, Ghent University Hospital, Ghent 9000, Belgium
| | - Sofie Bhatti
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium
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Potschka H, Fischer A, von Rüden EL, Hülsmeyer V, Baumgärtner W. Canine epilepsy as a translational model? Epilepsia 2013; 54:571-9. [PMID: 23506100 DOI: 10.1111/epi.12138] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2013] [Indexed: 01/01/2023]
Abstract
Dogs with spontaneous diseases can exhibit a striking similarity in etiology, clinical manifestation, and disease course when compared to human patients. Therefore, dogs are intensely discussed as a translational model of human disease. In particular, genetic studies in selected dog breeds serve as an excellent tool to identify epilepsy disease genes. In addition, canine epilepsy is discussed as a translational platform for drug testing. On one hand, epileptic dogs might serve as an interesting model by allowing the evaluation of drug efficacy and potency under clinical conditions with a focus on chronic seizures resistant to standard medication, preventive strategies, or status epilepticus. On the other hand, several limitations need to be considered including owner-based seizure monitoring, species differences in pharmacokinetics and drug interactions, as well as cost-intensiveness. The review gives an overview on the current state of knowledge regarding the etiology, clinical manifestation, pathology, and drug response of canine epilepsy, also pointing out the urgent need for further research on specific aspects. Moreover, the putative advantages, the disadvantages, and limitations of antiepileptic drug testing in canine epilepsy are critically discussed.
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Affiliation(s)
- Heidrun Potschka
- Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-University, Munich, Germany.
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45
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Harcourt-Brown T. Canine epilepsy: integrating research in practice. Vet Rec 2013; 172:336-7. [DOI: 10.1136/vr.f1979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Tom Harcourt-Brown
- Langford Small Animal Referral Hospital; University of Bristol; Langford House Langford North Somerset BS40 5DU UK
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46
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Stalin K. Investigating epilepsy in dogs. Vet Rec 2012; 170:333-4. [DOI: 10.1136/vr.e2340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Kate Stalin
- Tighmonadh; Cardross Road Cardross Glasgow G82 5HD UK
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