What is a Seizure?

Seizures in cats treatment addresses abnormal electrical activity in the brain. Several types of seizures exist, each with specific terminology. The term epilepsy refers to recurrent seizures originating from the brain. Typically, seizures in cats are subtler than those seen in dogs or humans.

• Idiopathic epilepsy: Rare in cats, occurs without visible brain lesions or other symptoms.
• Symptomatic epilepsy: More common; caused by identifiable brain lesions.
• Probable symptomatic epilepsy: Suspected lesions without confirmed diagnosis.
• Cluster seizures: Several seizures occurring within 24 hours.
• Status epilepticus: Continuous or closely recurring seizures without recovery in between.

Types of Seizures in Cats

Clinical presentation varies based on the affected brain area. A focal seizure impacts a specific region, while generalized seizures involve both hemispheres. Frequent seizures increase neuronal damage, making the brain more susceptible to future episodes.

In cats, focal seizures are common, characterized by involuntary facial movements (eyelids, whiskers, ears), tremors, asymmetrical limb movements, hair standing on end (piloerection), and pupil dilation. Some cats run erratically and collide with objects.

During generalized tonic-clonic seizures, the cat loses consciousness and collapses. Muscles contract rhythmically in a paddling motion, accompanied by hyperextension of the neck. Additional signs may include salivation, urination, defecation, tongue biting, and claw injuries.

Causes of Seizures

Identifying the cause is crucial for appropriate treatment. Seizures can be extracranial (due to systemic imbalance) or intracranial (direct brain dysfunction):

• Extracranial causes: toxins, hypoglycemia, hypocalcemia, hypertension, liver diseases.
• Intracranial causes: congenital abnormalities, metabolic diseases, tumors, infections, trauma, intoxications, vascular diseases.

The cat’s age at the first seizure, seizure type, and frequency guide diagnosis. For example:

• Metabolic diseases often cause generalized seizures.
• Intoxication often leads to excitability and tremors before seizures, sometimes fatal.
• Focal lesions typically result in asymmetric movements.
• Hormonal imbalances can cause seizures linked to hypoglycemia, renal failure, or liver disease.

Diagnosing Seizures in Cats

Diagnosis involves several steps:

• Complete physical and neurological exam.
• Blood tests to identify abnormalities like elevated red blood cells, low glucose, or electrolyte imbalances.
• Cerebrospinal fluid analysis sometimes reveals pathogens.
• Imaging: Chest X-rays and abdominal ultrasound to detect tumors or organ abnormalities. MRI provides precise identification of brain lesions.

Treating Seizures in Cats

Treatment depends on seizure frequency. If the cat remains healthy between seizures occurring every 6-8 weeks or more, medication may be unnecessary. Otherwise:

• Anticonvulsant medication: Phenobarbital is the first-choice medication, given twice daily. Side effects include sedation, increased hunger, thirst, and urination, which diminish over time.
• Hospitalization: Required for cluster seizures or status epilepticus, involving IV fluids and medications under veterinary monitoring.
• Emergency treatment: Ongoing seizures are initially managed with intravenous Valium (diazepam), followed by continuous infusion or high-dose phenobarbital.

Follow-Up and Prognosis

A blood test to measure phenobarbital levels is needed two weeks after initiating treatment, repeated after dosage adjustments. Blood counts (white blood cells and platelets) are recommended 4-6 weeks into treatment to monitor hypersensitivity reactions.

If symptomatic epilepsy’s underlying cause is resolved, gradual medication withdrawal over six months may be possible. However, idiopathic epilepsy typically requires lifelong treatment.

Alternatives to phenobarbital are available if seizure control remains insufficient. The prognosis depends on the underlying cause and treatment response.