Epilepsy and the Cavalier King Charles Spaniel

Epilepsy in Cavalier King Charles Spaniels

CavalierHealth.org Copyright © 2004 Blenheim Company Epilepsy refers to repeated seizures. Seizures are a sign of brain disease. Idiopathic epilepsy is an inheritable disorder which is prevalent in Cavalier King Charles Spaniels. It is caused by a mutation in a specific gene which the dogs have inherited from their parents.

According to a report in the June 2005 issue of the Journal of Small Animal Practice, idiopathic epilepsy has been found to occur more frequently in descendants from bloodlines originating from whole-colored CKCS ancestors from the late 1960s, especially from matings of blood relatives, such as half-siblings.

Symptoms

There are many different types of seizures in dogs. The most common is the generalized major motor seizure, characterized by paddling of the limbs. The dog may cry, bark or whine during the seizure, and it may snap or bite, not quite fully aware of its surroundings. Urination and defecation are common during a generalized seizure. Post seizural signs may last from a few minutes to an hour.

The onset of epilepsy in Cavaliers is most common between the ages of six months and five years.

The most common form of hereditary epilepsy in Cavaliers is flycatcher's syndrome which is discussed on its own webpage.

Diagnosis

Diagnosing epilepsy in dogs is difficult. It begins by attempting to rule out other causes for the seizures. The electroencephalogram (EEG) is a frequently used device in diagnosing epilepsy, but has serious drawbacks in animals. Advanced imaging, such as magnetic resonance imaging (MRI) or CT scans, is necessary to be able to actually see the brain. By imaging the brain, veterinarians are able to diagnose diseases such as brain tumors or hydrocephalus (water on the brain) which can cause seizures. Apart from the EEG or MRI or CT scans, there is no health test for epilepsy.

Treatment

Immediately after a seizure, the dog should be handled with caution. The dog likely will pant after a seizure, due to heat generated by the intense brain activity and seizure. Cool, wet compresses place at the base of the skull and in the groin area will help decrease the body temperature. The dog should be offered a drink of water, but should not be left unattended with a water bowl.

All dogs should be examined by a veterinarian after their first seizure for determination of the cause. Anti-convulsant therapy (usually oral phenobarbital and/or bromide) may be started once the seizures recur frequently. The owner should keep a calendar noting the frequency of the seizures, and the dog that seizures more than once a month should treated long term with anti-convulsants. In some cases, higher powered anti-convulsants, such as levetiracetam (Keppra) or topiramate (Topamax) may be prescribed.

A recent study of the use of acepromazine maleate (i.e., acetylpromazine), which is a common sedative administered to dogs, involved administered it for tranquilization during hospitalization to 36 dogs with a prior history of seizures and to 11 other dogs to decrease seizure activity. No seizures were observed within 16 hours of its administration in the 36 dogs that received the drug for tranquilization, and seizures abated for from 1.5 to 8 hours or did not recur in 8 of 10 of the 11 dogs that had been actively seizing. Also, excitement-induced seizure frequency was reduced for 2 months in one dog.

Medication will usually eliminate seizures entirely, and is considered effective if a seizure occurs no more than every four to six weeks. Any time the dog exhibits a cluster of seizures, the veterinarian should be consulted, and may require immediate emergency treatment by the veterinarian, due to the possibility of permanent brain damage.

The Canine Inherited Disorders Database (www.upei.ca/~cidd/intro.htm) recommends that Cavaliers which have had seizures should not be bred, nor should their parents and siblings.

The Canine Epilepsy Project, led by Dr. Ned Patterson, of the University of Minnesota's College of Veterinary Medicine, and by Dr. Gary Johnson, of the University of Missouri's College of Veterinary Medicine, is a collaborative study into the causes of epilepsy in dogs. Its goal is to find the genes responsible for epilepsy in dogs so that wise breeding can decrease the incidence of the disease in dogs, and that, knowing what genes regulate epilepsy in dogs may help better tailor therapy to the specific cause. Participation by owners of affected dogs and their relatives is essential to the success of this project. Researchers need DNA samples from dogs who have experienced seizures, and immediate relatives, both normal and affected. Specifically, they need samples from all available siblings, parents, and grandparents. If the affected dog has been bred, all offspring and mates should be sampled as well. Useful research families are explained in more detail here. Participation in this research project is confidential - the names of individual owners or dogs will not be revealed. Data and DNA sample collection instructions and sample submission forms are available on www.canine-epilepsy.net, or the packet will be mailed or faxed upon request. Contact Liz Hansen, at the Animal Molecular Genetics Laboratory, University of Missouri - College of Veterinary Medicine, email hansenl@missouri.edu

Profs. Chris Rundfeldt, Andrea Tipold, Wolfgang Loscher, and others, of the Department of Small Animal Medicine and Surgery, University of Veterinary Medicine, and Center for Systems Neuroscience, Hannover, Germany, have researched, developed, and have been studying the efficacy of a new antiepileptic and anxiolytic drug, ELB138, which is a low-affinity partial BZD-receptor agonist, formerly called AWD 131-138; 1-(4-chlorophenyl)-4-morpholino-imidazolin-2-one. They and others hold a U.S.patent (20050070537) for this drug. They report that "the reduction in seizure frequency using ELB138 in dogs with newly diagnosed idiopathic epilepsy was comparable to the reduction in dogs treated either with phenobarbital or primidone. In dogs with chronic epilepsy and add-on therapy with either ELB138 or potassium bromide, such supplementation reduced the seizure frequency and the duration and severity of seizures" with reportedly rare side effects.

Control of Canine Genetic Diseases, Padgett, G.A., Howell Book House 1998, pp. 198-199, 235.

Inheritance of occipital bone hypoplasia (Chiari type I malformation) in Cavalier King Charles spaniels, Rusbridge C., Knowler S. P.; J. Vety.Int. Med. 18, 673-678 (2004)

"Seizures" (Podell, M.) in: Manual of Small Animal Neurology, 3d ed. Editors Olby N., Platt S., British Small Animal Vety Assn (2004). pp 97-112.

Anticonvulsant efficacy of the low-affinity partial benzodiazepine receptor agonist ELB 138 in a dog seizure model and in epileptic dogs with spontaneously recurrent seizures. Loscher W, Potschka H, Rieck S, Tipold A, Rundfeldt C. Epilepsia. 2004 Oct;45(10):1228-39.

Neurological diseases of the Cavalier King Charles spaniel, Rusbridge, C. J Small Animal Practice, June 2005, 46(6): 265-272(8).

Anticonvulsant activity and tolerance of ELB138 in dogs with epilepsy: A clinical pilot study. Rieck S, Rundfeldt C, Tipold A. Vet J. 2005 May 16.

A Retrospective Study on the Use of Acepromazine Maleate in Dogs With Seizures. Karen M. Tobias, Katia Marioni-Henry, and Rebecca Wagner. J. Am.An. Hosp. Assn. (2006) 42:283-289.

Epil-K9's Canine Epilepsy Resources website: www.canine-epilepsy.com/Resources.html