Epilepsy and seizures in Boston Terriers
Boston Terriers are prone to seizures, but the Boston Terrier Club Of America is working to try and fund research to find possible genes we can identify so we can eliminate the problem in the breed. I think it's one of the worst problems a Boston can have, and of course it is devastating and heart-wrenching for owners to watch their beloved Boston go through seizures.
Seizures in Bostons can have many causes. Sometimes there can be a brain tumor, or sometimes it can be caused by an overweight dog who has sleep apnea and simply putting the dog on a reducing diet can cause the apnea to stop, which then causes the seizures to stop. It can be caused by a high fever or by low blood sugar. It can be caused commonly by vaccines, which is why it is very important to not overvaccinate and to use vaccines that do not contain Lepto. Also, do not use any vaccines your breeder says you should stay away from. Of course any kind of chemical or toxin the dog is exposed to especially yard chemicals and oral and topical flea and tick preventatives, (especially Comfortis!) can cause seizures. Many of these drugs cause neurotoxicity to the bugs and they also cause neurotoxicity to your dog. Head trauma or kidney failure can cause seizures. But very often, there is no known cause, and it is simply termed idiopathic epilepsy. I get so many Boston owners at large writing to me asking about seizures, so I decided to put up a page of info to help anyone who needs it.
Your Dog Has Had A Seizure
If your dog has a seizure, do not try to pull the dog's tongue out, put your fingers in it's mouth or do anything other than to protect the dog from hurting itself such as from falling off a bed or couch or hitting itself on a table leg. REMOVE ANY OTHER DOGS FROM THE AREA IMMEDIATELY. A seizuring dog is a target for other dogs to attack, and even a doggie best friend will still try and sometimes attack the seizuring dog-friend. Move the dog to a safe area, and you can hold the dog gently on his or her sides and talk to him telling him that it's ok. STAY CALM - do NOT freak out. There is nothing you can or should be doing except monitoring the time and making sure your dog is safe. Only if the worst of the seizure lasts more than 10 minutes should you take the dog in to your vet for emergency meds to stop the seizure or if he/she is having cluster seizures - one right after another or more than 1 in 24 hours. Again, stay calm, your dog will not die, he almost assuredly will come out of it. Take note of the time so you can see how long it goes on. The dog may lose control of bladder or bowel, and this is normal. He also may drool, turn in a circle, twitch in the face and shake. After the seizure is over, take the dog to the vet right away and have the dog examined and follow your vet's instructions. Very often he will run bloodwork and do a complete neurological exam. Normally, unless the dog is still suffering from the seizure when you get there, they will not start the dog on any medication. He will most likely ask you to make sure to start marking seizures on the calendar so you can begin to keep track of their frequency if any more ever occur. You should also make notes of how long a seizure lasts, and how severe it appears (did the dog fall over and start paddling, or did he/she just start to shake and look dazed but did not lose complete balance or conscience).
In the most serious cases, your dog may go into status epilepticus which is a seizure that happens but does not stop after a reasonable amount of time. The dog may look like it is coming down from the seizure, only for it to start up again repeating this pattern over and over, or it may be in full grand mal status with no lessening at all. This is a medical emergency and you must rush your dog to your vet or emergency clinic immediately. Call ahead so they can be prepared when you arrive. If you have an ice bag or plastic bag that you can fill with ice for the trip, do so and place it in the middle of the dog's back, over the spine (more info on the Guardian Angels site). The ice should start a little before the level where the last rib is and should cover back to a little after where the last rib ends (placing the ice on top of the spine). This can sometimes break a seizure while you are in-transit. A dog's body temperature can rise very fast during a seizure, and with a long seizure, it can go even higher. Any sustained temp over 105 F will cause brain damage, so bring some cold wet towels with you or whatever you can to cool their head, neck and chest. In the summer, make sure the dog is put into a cool car with the AC running when you leave for the vet. When you get to the vet they should immediately take your dog in, start an IV, administer Valium and fluids, give oxygen, put a heart monitor on and take the temperature of the dog. They may have to give multiple doses of Valium or they have have to add other drugs such as Propofol or an inhalent gas to get the seizure under control.
If seizures occur regularly or the dog has cluster seizures, the dog must be started on an anti-seizure medication. Each time a dog has a grand-mal seizure or bad cluster seizures, the seizure "fries" the brain just a little more, and after many assaults on the brain over time, your dog is no longer the dog you once knew. It also takes a great toll on their hearts. Sometimes when when seizures have caused so much damage over time, the dog may suffer a heart attack and die during a seizure. That is why it is important to lessen or totally stop the seizures if at all possible. Below I will give you some important information and links so you can be armed with the most up-to-date treatments.
If a dog has seizures starting as an older dog, it is often a brain tumor. This can be confirmed by having an MRI. An MRI will cost in the neighborhood or $1500-$2000. It is the best money you can spend because it will give you a definitive answer so you can know how to proceed with treatment. Do it sooner than later before you are charged tons of money for other tests, treatments or hospitalizations that may not be needed or useful. If your dog is diagnosed with a brain tumor and the dog gets through the initial week or two on medications after showing the first signs (usually seizures, circling, inability to see or other unusual behaviors), the dog will probably have between 1-2 months of life if only medication is used. Of course this depends on the tumor type and how much if any damage was done when the dog first had the initial crisis. Towards the end the dog's life, the tumor basically outgrows what the prednisone can keep at bay in terms of swelling, so symptoms quickly worsen and the dog may start having continuous seizures or other serious complications such as cardiac and breathing problems.
Treatments for brain tumors depend on the size and type of tumor, but there is medical treatment available (prednisone for swelling and seizure medications) and also Stereotactic Radiation Therapy (SRT). This is the newest type of radiation to be used on brain tumors in dogs and it is akin to the "cyber knife" or "gamma knife" in humans. It is a very finely targeted radiation therapy that is done from 1 to 4 times and it has been quite successful in shrinking brain tumors that are either inoperable or if the owners cannot or do not want to have surgery done. Many Veterinary Oncologists offer this service. It costs approximately $6,000 for the treatments and also the price of at least one more MRI and/or CT scan ($1,200-$1,500). I personally know of someone with a Boston in Texas (see picture below) that did just one treatment and it shrunk the tumor by 70% and the dog is doing well. So this is a viable option in certain cases.
Make sure to rent or buy the movie starring Meryl Streep called "First Do No Harm (1997)". Anyone who has a Boston with seizures needs to see the information conveyed in this film. You will see the whole picture differently after you watch the movie. It is based on a true story, it's inexpensive, and it is available on DVD at Amazon here.
Changes in Diet Can Control or Eliminate Seizures in Some Dogs
What I tell people after their dog has been thoroughly checked by their vet, is that sometimes seizures can be completely controlled by diet, and this is what I tell people to try first in the period after the first seizure before more occur. There are two ways to go - you can cook the diet yourself (best), or if you are not able to do this, you can find a commercial diet that has the basic ingredients recommended for dogs having seizures. I believe that even if the diet alone doesn't work, one should still keep the dog on these diets. Very often seizures are lessened, even if not stopped. This counts for a lot! And if nothing else, your seizuring Boston deserves the very best care and a good, clean diet as it's a great step towards helping him stay healthy and strong through the seizures. The complete rationale (no EXACT recipes per se, but necessary rationale) for how diet can both cause and relieve seizures can be read here Glutamate Aspartate Restricted Diet info. Please read this so you fully understand how the G.A.R.D. diet works. Many vets are not aware of this diet, so don't forego it just because it is not mentioned by your vet. NOTE: on a page of Dogtor J's site, it lists commercial diets he approves of - this is quite outdated and not all apply to seizures. Only Duck and Potato should be used for seizures. Only 2 commercial foods contain the correct ingredients for seizures, see below. Remember, chicken does not = duck and potato does not = rice.
Three commercial diets can be used if seizures are being caused by diet:
1. Dick Van Patten's Natural Balance Potato and Duck formula (available at Petco) - it comes in canned and dry - try the canned first, it is very high quality and my first choice. It is very important with any specialized diet that you restrict ALL treats unless they contain only these ingredients. If you feed any table scraps or other dog food treats, the diet will be of no use. More info on this commercial diet can be found here Natural Balance Potato and Duck formula information
2. Acana's Duck and Bartlett Pear dry formula (try only the new formula that does not contain oats, available summer 2014). No one I know has had any experience with this new formulation, so I cannot comment on it. It is a single protein diet and is duck based, so if you cannot get the Natural Balance, try this.
3. Royal Canin's Veterinary Diet Potato and Duck Formula ("PD") NOTE: This food contains duck by-products, the Natural Balance and Acana does not. Click here Available from your vet or online.
4. A page for information on the home-cooked anti-seizure diet with recipes can be found here Info on Diet recommended by the Canine Epilepsy Guardian Angels This diet also follows the principals of the G.A.R.D. diet.
Medications used for Epilepsy
Phenobarbital and Potassium Bromide are the most common medications used for seizuring dogs but they are older and there are others used including the newer drug Zonisamide which was approved for human use in 2000 and also Gabapentin. Phenobarbital doesn't always work well and it can make your dog sleepy and not himself. Potassium Bromide usually has to be made up by a compounding pharmacy and it is very salty, so watch the salt intake with the food you use and be aware that they will drink a lot of water on it. This drug also has to be measured regularly in the dog's blood to make sure the levels stay normal. Ask your vet if he or she is ok trying Zonisamide and/or Gabapentin first. Information on Zonisamide can be found here. It has fewer side effects that Phenobarbital and Potassium Bromide and can also be used alone or with other medications. Gabapentin can also work well especially in dogs with brain tumors and helps to calm them down if any of the drugs are causing them to be hyper (which mainly happens with Valium) or if the dog is getting overly excited for whatever reason, setting off a seizure.
Emergency Medications Used For Epilepsy
There is a home protocol for rectal Valium that can be a great comfort to those handling their dog's cluster seizures. It means you will not have to run to the emergency vet for treatment of cluster seizures. Injectible valium is given rectally to stop the seizures. Some dogs do well on this. But the Valium, even though a tranquilizer, can cause nervousness in the dog and not help the seizures either. But it should always be tried so you can see how your dog reacts. Please read this information on rectal Valium. You must request the exact protocol by e-mail. This is one of the best sites for information and support on the web. Spend a lot of time there and read everything. The main page is here The Epi Guardian Angels Site
The Best Links to More Detailed Information On Canine Epilepsy
1. The Canine Epilepsy Guardian Angels Site This is the very best site on the net.
2. Canine Epilepsy Resource Center
3. Understanding Your Pet's Epilepsy Information from Dennis O'Brien, DVM, PhD, Diplomate, ACVIM, Specialty of Neurology University of Missouri, College of Veterinary Medicine. He is a researcher.
4. Another research site: Ned Patterson, DVM University of Minnesota, College of Veterinary Medicine and Gary Johnson, DVM, PhD University of Missouri, College of Veterinary Medicine Click here.
5. Information on brain tumors
6. Epilepsy and Diet - Dogtor J