Feline Epilepsy: An update

antiepileptic treatment epilepsy feline seizures

Epileptic seizures are the most common neurological disorder in the clinical setting. Their etiology is multifactorial and is mainly divided into structural, reactive and idiopathic epilepsy. Structural epilepsy can be caused by vascular events, inflammatory conditions (encephalitis), traumatic injuries, neoplasia, congenital and inherited (degenerative) disorders. Reactive epilepsy is caused by exposure in toxins or metabolic derangements. Although idiopathic epilepsy was thought to be rare in cats, it is now established as a common cause. Epileptic seizures in cats appear with various clinical presentations including generalized, focal with or without secondary generalization epileptic seizures. Diagnostic investigation is crucial in order to establish final diagnosis and to determine the therapeutic plan. Diagnostics include physical and neurological examination with detailed history (drug or toxin exposure), routine hematology (CBC, biochemistry, urinalysis), specific laboratory tests if concurrent or metabolic disease are suspected, advanced diagnostic imaging (CT/MRI) whether intracranial disease is suspected and cerebrospinal fluid (CSF) analysis. Most commonly used antiepileptic drugs (AED) in cats are phenobarbital and levetiracetam. Bromide is contraindicated in cats due to severe respiratory disease caused as an adverse life-threatening reaction. Diazepam is an emergency AED used to eliminate cluster seizures or status epilepticus but it should be avoided as a long-term medication because it has been associated with fatal hepatotoxicity. Gabapentin in another potential antiepileptic drug however its longterm efficacy has to be evaluated. Prognosis depends on the underlying etiology and treatment response. In most cats quality of life is improved and (>50% reduction of epileptic seizures) regardless of etiology. The complete remission of epileptic seizures in cats is rare and most cats should be maintained on anti-epileptic therapy.

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Bailey KS, Dewey CW, Boothe DM, Barone G, Kortz GD (2008) Levetiracetam as an adjuct to phenobarbital treatment in cats with suspected idiopathic epilepsy. J Am Vet Med Assoc 232: 867-872.
Bailey KS and Dewey CW (2009) The seizuring cat diagnostic work-up and therapy. J Feline Med Surg 11: 385-394.
Barnes HL, Chrisman CL, Mariani CL, Sims M, Alleman A (2004) Clinical signs, underlying cause, and outcome in cats with seizures: 17 cases (1997-2002). J Am Vet Med Assoc 225:1723-1726.
Bateman SW, Parent JM (1999) Clinical findings, treatment and outcome of dogs with status epilepticus or cluster seizures:156 cases (1990-1995). J Am Vet Med Assoc 215: 1463-1468.
Berendt M, Gredal H, Ersbøll AK, Alving J (2007) Premature death, risk factors, and life patterns in dogs with epilepsy. J Vet Intern Med 21:754-759.
Berendt M, Farquhar RG, Mandigers PJJ, Pakozdy A, Bhatti SFM, De Risio L, Fischer A, Long S, Matiasek K, Munana K, Patterson EE, Penderis J, Platt S, Podell M, Potschka H, Pumarola MB, Rusbridge C, Stein VM, Tipold A, Volk HA (2015) International veterinary epilepsy task force consensus report on epilepsy definition, classification
and terminology in companion animals. Vet Res 182: 1-11.
Berg AT, Vickrey BG, Testa FM, Levy SR, Shinnar S, DiMario F, Smith S (2006)How long does it take for epilepsy to become intractable? A prospective investigation. Ann Neurol 60: 73–79.
Berg AT, Scheffer IE (2011) New concepts in classification of the epilepsies: entering the 21st century. Epilepsia 52:1058–1062.
Boothe DM, George KL, Couch P (2002) Disposition and clinical use ofbromide in cats. J Am Vet Med Assoc221:1131–1135.
Bradshaw JM, Pearson GR Gruffydd-Jones TJ (2004) A retrospective study of 238 cases of neurological disorders ofthe cat. J Comp Pathol 131: 112–120.
Braund KG, Clinical neurology in small animals: localization, diagnosis and treatment,2003, http://ww.ivis.org/advances/Vite/braund28/chapter_frm.asp?LA=1#cranial [Accessed Jan15, 2019].
Browand- Stainback L, Levesque D, McBee M (2011) Canine and Feline epileptic seizuresand the lumar cycle: 2,507 seizures (2000-2008). J Am Anim Hosp Assoc, 47: 324-328.
Center SA, Elston TH, Rowland PH, Rosen DK, Reitz BL, Brunt JE, Rodan I, House J, Bank S, Lynch LR, Dring LA, Levy JK(1996) Fulminant hepatic failure associated with oral administration of diazepam in 11 cats. J Am Vet Med Assoc 209: 618–625.
Costanzo C, Garosi LS, Glass EN, Rusbridge C, Stalin CE, Volk HA (2011) J Feline Med Surg 13: 672- 680.
Cizinauskas S, Fatzer R, Schenkel M, Gandini G, Jaggy A (2003) Can idiopathic epilepsy be confirmed in cats?. J Vet Intern Med 17: 246.
Cuff DE, Bush WW, Stecker MM, Williams C (2014) Use of continuous encephalography for diagnosis and monitoring of treatment of nonconvulsive status epilepticus in a cat. JAm Vet Med Assoc 244:708-714.
Cunningham JG, Farnbach GC (1987) Inheritance and idiopathic canine epilepsy. J Am Anim Hosp Assoc 23:421-424.
De Risio L, Brown R, Tennant B, Sparkes A, Matiasek L, De Stefani A, Weissenbock H, Matiasek K (2012) Slowly progressive lymphohistiocytic memingoencephalomyelitis in 21 adult cats presenting with peculiar neurological signs. J Feline Med Surg 14: 250-256.
Dewey CW (2006) Anticonvulsant therapy in dogs and cats. Vet Clin North Am Small Anim Pract36:1107–1127.
Ducote JM, Coates JR, Dewey CW, Kennis RA (1999) Suspected hypersensitivity to phenobarbital in a cat. J Feline Med Surg 1: 123-126.
Finnerty K, Barnes HL, Mercier MN, Giovanella CJ, Lau VW, Rylander H (2014) Evaluation of therapeutic phenobarbital concentrations and application of a classification system for seizures in cats: 30 cats (2004-2013). J Am Vet Med Assoc 244: 195-199.
Folger WR (2009) Treatment of the seizuring cat. J Feline Med Surg 11:779.
Foster SF, Charles JA, Parker G, Krockenberger M, Churcher RM, Malik R (2001) Cerebral cryptococcal granuloma in a cat. J Feline Med Surg3:31–44.
Gorden LE, Thacher C, Matthisen DT, Joseph RJ(1994) Results of craniotomy for the treatment of cerebral meningioma in 42 cases. Vet Surg 23:94-100.
Grohmann K, Schmidt MJ, Moritz A, Kramer M (2012) Prevalence of seizures in cats after head trauma. J Am Vet Med Assoc 241: 1467-1470.
Gunn-Moore D (2005)Infectious diseases of the central nervous system. Vet Clin North Am Small Anim Pract35: 103–128.
Gunn-Moore D, Reed N (2011) CNS disease in the cat. J Feline Med Surg13: 824-836.
Herman ST (2002) Epilepsy after brain insult: targeting epileptogenesis. Neurology 59:21–26.
Hoskins JD (1990) Clinical evaluation of the kitten: from birth to eight weeks of age.Compend Contin Educ Pract Vet 12:1215–1225.
Hughes D, Moreau RE, Overall KL, VanWinkle TJ (1996) Acute hepatic necrosis and liver failure associated with benzodiazepine therapy in six cats. J Vet Emerg Crit Care 6: 13–20.
Khanna C, Bienzle D (1994) Polycythemia vera in a cat: bone marrow culture merythropoietln-deficient medium. JAn Am Hosp Assoc 30:45-49.
Kinirons P, McCarthy M, Doherty CP, DelantyN (2006) Predicting drug-resistantpatients who respond to add-on therapy with levetiracetam. Seizure15:387–392.
Kline KL (1998) Feline Epilepsy. Clin TechSmall Anim Pract 13: 152-158.
Kluger EK, Malik R, Govendir M (2009) Veterinarian’s preference for anticonvulsant drugs for treating seizure disorders in dogs and cats. Aust Vet J 87: 445-449.
Kornegay JN (1991) Altered mental attitude, seizures, blindness, circling, compulsive walking. Forebrain diseases and multiple neurologic deficits. Problems in Vet Med 3:391-449.
Lavely JA (2014) Pediatric seizure disorders in dogs and cats. Vet Clin Small Anim 44: 275-301.
Lawrie M, Bessant C, Harvey RJ, Sparkes A, Garosi L (2016) Audiogenic reflex seizures in cats. J Feline Med Surg18: 328-336.
Matton JS and Wisner ER (2004) What’s under the cat’s hat: Feline intracranial neoplasia and magnetic resonance imaging. J Vet Inetrn Med 18: 139-140.
Munana KR (2013) Management of refractory epilepsy. Topics in Comp Anim Med 28: 67-71.
O’ Brien D (1998) Toxic and metabolic causes of seizures, Clin TechSmall Anim Pract 13: 159-166.
Pakozdy A, Leschnik M, Sarchahi AA, Tichy AG, Thalmammer JG (2010) Clinical comparison of primary versus secondary epilepsy in 125 cats. J Feline Med Surg12: 910-916.
Pakozdy A, Sarchahi AA, Leschnik M, Tichy AG, Halasz P, Thalhammer JG (2012) Treatment and long-term follow-up of cats with suspected primary epilepsy. J Feline Med Surg 0: 1-7.
Pakozdy A, Halasz P, Klang A (2014) Epilepsy in cats: theory and practice J Vet Intern Med 28: 255-263.
Parent JM, Quesnel AD (1996) Seizures in cats. Vet Clin North Am Small Anim Pract26: 811-825.
Pfohl JC, Dewey CW (2005) Intracranial Toxoplasma gondiigranuloma in a cat. J Feline Med Surg7:369–374.
Platt SR (2001) Feline seizure control. J Am Anim Hosp Assoc 37:515–517.
Quesnel AD, Parent JM, McDonell W (1997) Clinical management and outcome of cats with seizure disorders: 30 cases (1991–1993). J Am Vet Med Assoc 210:72–77(a).
Quesnel AD, Parent JM, McDonell W, Percy D, Lumsden JH (1997) Diagnostic evaluation of cats with seizure disorders: 30 cases (1991–1993). J Am Vet Med Assoc 210: 65–71(b).
Rand JS, Parent J, Percy D and Jacobs R (1994) Clinical, cerebrospinal fluid, and histological data from twenty-seven cats with primary inflammatory disease of the central nervous system. Can Vet J 35:103–110.
Rusbridge C (2005) Diagnosis and control of epilepsy in the cat. In Pract 27:208-214.
Schriefl S, Steinberg TA, Matiasek K, Ossig A, Fenske N, Fischer A (2008) Etiologic classification of seizures, signalment, clinical signs, and outcome in cats with seizure disorders:91 cases (2000-2004). J Am Vet Med Assoc 233: 1591-1597.
Schwab S, Herden C, Seeliger F, Papaioannou N, Psalla D, Polizopoulou Z, Braumgartner W (2007) Non-suppurative meningoencephalitis of unknown origin in cats and dogs: an immunohistochemical study. J Comp Pathol 136: 96–110.
Schwartz-Porsche D, Kaiser E (1989) Feline epilepsy. Probl Vet Med1: 628–649.
Shell LG (2000) Feline seizure disorders. In: Bonagura JD, Kirk’s current Veterinary therapy XIII: small animal practice. WB Saunders Co, Philadelphia: pp 963–966.
Syring RS, Otto CM, Drobatz KJ (2001) Hyperglycemia in dogs and cats with head trauma: 122 cases (1997–1999). J Am Vet Med Assoc 218:1124–1129.
Thomas WB, Dewey CW (2008) Seizures and narcolepsy. In: Dewey CW A practical guide to canine and feline neurology. 2nd ed. Wiley Blackwell, Ames: 193.
Timmann D, Cizinauskas S, Tokem A, Doherr M, Vandeverde M, Jaggy A (2008) Retrospective analysis of seizures associated with FelineInfectious Peritonitis in cats. J Feline Med Surg 10: 9-15.
Tokem A, Cizinauskas S, Doherr M, Gandini G, Jaggy A (2006) Intracranial neoplasia in 61 cats: localization, tumor types and seizure patterns. J Feline Med Surg 8: 243-253.
Volk HA, Matiasek LA, Feliu-Pascual AL, Platt SR, Chandler KE (2008) The efficacy and tolerability of levetiracetam in pharmacoresistant epileptic dogs. Vet J176: 310-319.
Wagner SO (2001) Lower airway disease in cats on bromide therapy for seizures. J Vet Intern Med15:562.
Watson AD, Moore AS, Helfand SC (1994) Primary erythrocytes in the cat: treatment with hydroxyurea. J Small Anim Pract 35:320-325.
Whittaker DE, Drees RBE (2018) MRI and clinical characteristics of suspected cerebrovascular accident in nine cats. J Feline Med Surg 20:674-684.
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