At the Animal Clinic at Thorndale, seizures are one of the most frequently seen neurological problems in cats. A seizure is also known as a convulsion or fit. A seizure represents a period of abnormal brain wave activity that leads to a variety of clinical signs.
Prevalence
Seizures in cats occur less frequently than seizures in dogs. However, they do occur and are seen on a fairly regular basis by veterinarians in private practice.
Clinical Signs
A number of signs may be observed when a cat is having a seizure. Signs usually start suddenly and end abruptly. They may involve the whole body or just parts of the body, such as one limb or particular muscles of the face. Some of the more common signs include:
- Loss of consciousness or a change in level of consciousness
- Contractions of all the muscles in the body, paddling of the legs, chewing
- Changes in mental awareness from non-responsiveness to hallucinations
- Behavioral changes, including non-recognition of owner, viciousness, pacing, and running in circles
Components of a Seizure
A seizure occurs in three phases:
- The pre-ictal phase, or aura, is a period of altered behavior in which the cat may hide, appear nervous, or seek extra attention from people it knows. It may be restless, nervous, shaking, or salivating. This may last a few seconds to a few hours.
- The ictal phase describes the seizure itself and lasts from a few seconds to about five minutes. During this period, all of the muscles of the body contract strongly. The cat usually falls on its side and seems paralyzed while shaking. The head will be drawn backward. Urination, defecation, and salivation often occur. If it is not over within five minutes, the cat is said to be in status epilepticus, or a prolonged seizure. Status epilepticus is a medical Emergency.
- During the post-ictal phase, there is confusion, disorientation, salivation, pacing, restlessness, and/or temporary blindness. There is no direct correlation between the severity of the seizure and the duration of the post-ictal phase. Cats who do not receive medical attention with status epilepticus are at risk for serious complications because of the physiological changes that occur. Most significant is the rise in body temperature that occurs from continuous strong muscle activity. This can lead to hyperthermia and death.
Causes/Transmission
There are many, many causes of seizures. For this reason, when we first begin an evaluation of the cat with seizures, we think less in terms of the specific disease and focus more on categories of diseases. For example, if this is a young cat, could there be an anatomic cause, such as hydrocephalus? In an older animal, could it be a degenerative disease or a brain tumor? For outdoor cats, what is the potential for exposure to toxins such as antifreeze? Unvaccinated cats may be exhibiting seizures due to rabies. Exercise extreme caution if this is a possibility.
Epilepsy is the most common and of least consequence to the cat. The other extreme includes severe diseases such as brain tumors or rabies. Fortunately, most seizures are due to epilepsy.
Evaluation of the Cat with Seizures
When a seizure occurs, it is important that you give us a thorough history, especially vaccination history, recent exposure to any toxins, poisons, plants, medications, hallucinogenic substances or history of head trauma. A physical examination, a basic battery of blood tests, and an electrocardiogram (EKG) are also commonly performed. These tests rule out disorders of the liver, kidneys, heart, electrolytes, and blood sugar level.
If these tests are normal and there is no exposure to poison or any history of trauma, further diagnostics may be performed depending on the severity and frequency of the seizures. Occasional seizures are of less concern than when the seizures are increasing in severity and frequency. In this instance, a spinal fluid tap and fluid analysis may be performed. Depending on availability, specialized imaging of the head with a CAT scan or MRI might be performed. Fortunately, these additional tests are usually not needed.
Treatment
The cat may be discharged with no medications or with a 1 -2 week course of anticonvulsant therapy. If there are no more seizures during that time, the anticonvulsants may be discontinued. The next treatment is based on when, or if, another seizure occurs. That may be days, months, or years. At some point, many cats have seizures frequently enough to justify continuous anticonvulsant therapy. Since that means that medication must be given every 12 to 24 hours for the rest of the cat’s life, we do not recommend that until seizures occur about every 30 days or unless they last more than five minutes.
t is important to avoid sudden discontinuation of any anticonvulsant medication. Even normal cats may be induced to seizure if placed on anticonvulsant medication and then abruptly withdrawn from it. We will outline a schedule for discontinuing the medication if warranted.
Additional Treatments
Some cats with seizures are known to have non-suppurative meningoencephalitis. This is a disease that causes inflammation in the brain and the tissue coverings around the brain. It is not caused by infection. The only way to make a confirmed diagnosis is with an autopsy. However, it usually responds well to corticosteroids (“cortisone ” or “steroids”). Therefore, corticosteroids may be tried when phenobarbital is not effective.
Prognosis
The prognosis is dependent upon the cause. In some cases, the cause cannot be identified so the prognosis in uncertain. In this situation, the frequency and severity of the seizures is monitored to assess progression of the underlying disease process.
Transmission to Humans
There are some infectious causes of seizures in cats that would pose a health risk to humans; most notable is rabies.
Many owners are bitten by the seizing animal because of a well-intentioned effort to help. Despite the dramatic signs of a seizure, the cat feels no pain, only bewilderment. Cats do not swallow their tongues. If you put your fingers into its mouth, you will not help the cat and will run a high risk of being severely bitten. The important thing is to keep the cat from falling and hurting itself. As long as it is on the floor or ground, there is little chance of harm occurring.