A study led by the Royal Veterinary College’s VetCompass programme has revealed a significant difference between how clinicians diagnose epilepsy compared with current expert recommendations, supporting a call for clearer diagnostic guidelines for greater consistency of diagnosis and treatment in clinical practice.

For the study, 2,834 seizure incident cases  were identified from a population of 455,553 dogs attending VetCompass participating practices in 2013. 

The study found that that approximately 1 in 160 dogs under first opinion veterinary care are affected by seizures every year.

Many of those dogs will have underlying epilepsy, defined as dogs with two or more unprovoked seizures at least 24 hours apart. Seizures can be secondary to idiopathic epilepsy, structural epilepsy or epilepsy of unknown cause.

Until now, however, there has been little information on the classifications of seizures, diagnostic approaches, or clinical management of dogs with seizures in the veterinary first opinion population.

TmThe main findings from the research were:

  • The annual incidence risk of seizures in dogs was 0.62%.
  • The most common breeds among seizure cases were Labrador Retrievers (8.6%), Staffordshire Bull Terriers (6.1%), Jack Russell Terriers (5.8%) and Yorkshire Terriers (5.0%).
  • 579 (20.5%) seizure cases met the criteria for epilepsy based on the International Veterinary Epilepsy Task Force (IVETF) classification system, compared with just 245 (8.6%) that were formally recorded with epilepsy by the attending veterinary teams.
  • Overall, 1,415 (49.9%) cases received diagnostic evaluation equivalent to or higher than IVETF Tier 1 diagnostic testing.
  • Being under 12 years of age and being insured were risk factors for receiving IVETF Tier 1 or higher diagnostic evaluation among seizure cases. In addition, being at or above the breed and sex mean bodyweight, a clinically recorded diagnosis of epilepsy and being in the UK Kennel Club Terrier breed group were risk factors for receiving IVETF Tier 1 or higher.
  • Dogs that received IVETF Tier 1 or higher diagnostic evaluation, MRI or CSF analysis were more likely to be recorded with epilepsy by the attending veterinary teams.
  • Anti-seizure drug (ASD) treatment was not prescribed for 1,960/2,834 (69.2%) dogs in association with the incident seizure event. Of the remainder, 719 (25.3%) dogs received 1 ASD, whereas 155 (5.5%) an ASD combination.

Dr Dan O’Neill, Senior Lecturer in Companion Animals Epidemiology at the RVC, and author of the paper, said: "Watching your dog undergo a seizure can be an incredibly scary moment for any dog owner. It is really important that dogs that seizure are rapidly diagnosed to decide whether they need no further treatment beyond careful monitoring or alternatively require a clinical work-up to define the cause of the seizures.

"There are now some excellent treatments for many seizure-related diseases. This study helps up to understand the current state of play for seizure management in dogs and identifies opportunities for improved care of these affected dogs."

Reference

  1. Erlen A, Potschka H, Volk HA, Sauter-Louis C, O'Neill DG. Seizures in dogs under primary veterinary care in the United Kingdom: Etiology, diagnostic testing, and clinical management. Journal of Veterinary Internal Medicine. 2020 doi.org/10.1111/jvim.15911

The full paper is freely available from Journal of Veterinary Internal Medicine and can be accessed here: https://onlinelibrary.wiley.com/doi/full/10.1111/jvim.15911


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