Feline Epilepsy
Introduction to Feline Epilepsy
Idiopathic (genetic) epilepsy in cats is a condition in which a cat has repeated seizures over their lifetime, but even after extensive testing, no cause is found. This testing may include blood work, MRI, and a spinal tap. Idiopathic epilepsy is sometimes described as “faulty wiring” in the brain that causes a pet to have seizures.
Idiopathic epilepsy is more common in cats between three and six years old, but it can occur at any age. Cats with epilepsy commonly have partial (focal) seizures, where only part of the brain is seizing and only part of the body shows abnormal activity. For example, face and ear seizures are very common in cats. Some cats have generalized seizures, where the entire brain, and therefore the entire body, is seizing.
Birman cats get epilepsy more frequently than other types.
Is my cat going to be OK?
Many cats do well with treatment. Forty percent of cats become completely seizure-free on medication, another 40% have significant improvements on medication, and the final 20% can be very difficult to treat. Cats with difficult-to-treat epilepsy can have a decreased quality of life and, unfortunately, a shorter life span.
Research has shown that initiating antiseizure medication earlier can lead to better outcomes. If a cat is having seizures, Remedy recommends discussing a seizure medication plan with the neurology team.
Living With An Epileptic Pet
A diagnosis of epilepsy in cats can feel overwhelming, but it doesn’t have to rule your life or your pet’s life. A cat with seizures can still be left alone, and pet parents can still go to work or run errands. You may occasionally miss a seizure, but most seizures are brief and resolve spontaneously. Often, there’s a clue afterward, such as something being knocked over or drool on the floor.
It’s helpful to record any suspicious events in a seizure log or calendar and to share changes with your veterinarian. In general, it’s more important for a veterinary team to understand the overall trend in seizure frequency and severity than to capture every single event.
Do Cats Have Seizure Triggers?
In people, seizures can sometimes be triggered by specific stimuli, and some pet parents notice triggers in their cats as well. Triggers can vary widely, from a particular smell to an event like an owner leaving town. If a trigger is identified, it should be avoided whenever possible.
Remedy also recognizes that until a cat’s seizures are well controlled, stressful or especially exciting situations can trigger seizures. Until seizure control improves, it can help to limit overly stimulating activities. For instance, if a laser toy makes a cat extremely excited, switching to a calmer game, such as a feather toy, may be a better choice until seizure medication appears to be working.
Diagnosing Feline Epilepsy
There’s no single test for epilepsy. That means diagnosing feline epilepsy requires testing for other possible causes of seizures and finding no underlying disease. This is called a diagnosis of exclusion.
To evaluate the other causes of seizures in cats, recommended diagnostics may include blood work, brain imaging (CT or MRI), a spinal tap, and an infectious disease panel.
About 2% of cats will have a seizure in their lifetime. However, only about one quarter of cats who have had a seizure have epilepsy. That’s why this testing is important, to help ensure another disease is not being missed. Other causes of seizures can include cancers, strokes, and, rarely, infections. Some of these conditions are treatable, and some may even be curable. Others can be very serious, which is why diagnostics matter so much for cats with seizures.
Managing Epilepsy Over time
Managing a pet’s epilepsy is a partnership with a veterinary team. Treatment plans can vary somewhat from doctor to doctor, even when using the same medications, because the details of how a plan is put together can differ.
For that reason, it’s advisable to select one primary veterinarian to oversee seizure control and coordinate the long-term epilepsy plan. When multiple veterinarians are adjusting medications for the same patient, it can become difficult to stay organized and track what is helping.
If a pet is having a medical emergency, follow the emergency veterinarian’s instructions. Once the urgent situation has passed, schedule a follow-up with the veterinarian managing seizure care to adjust the plan as needed.
Before making any changes to seizure medications, please contact Remedy. These medications are safe when used correctly, but even small at-home dose changes can lead to serious problems. Remedy’s team is here to help you adjust the plan safely.
Other types of epilepsy in cats
There are a few other recognized epilepsy syndromes in cats. It’s unclear whether these are subsets of idiopathic epilepsy or separate diseases. In addition, many other causes of seizures in cats include metabolic disease and structural brain disease.
Feline Audiogenic Reflex Epilepsy
Feline audiogenic reflex epilepsy is more common in older cats, often over 10 years of age, and it’s also more common in Birman cats. In this condition, seizures are triggered by certain sounds. These seizures are often brief and may consist of a single or a few repeated jerking movements of the head and body. This type of seizure tends to respond better to Keppra than other medications.
Feline Hippocampal Sclerosis (Feline Temporal Lobe Epilepsy)
In feline hippocampal sclerosis, also called feline temporal lobe epilepsy, seizures are often limited to the face and mouth. A cat may drool, twitch, have dilated pupils, and make chewing motions. On MRI, changes are often observed in a part of the brain called the hippocampus. Cats with this condition may benefit from steroid therapy in addition to seizure medication.
Will my cat ever be cured?
A small number of cats, about 25%, can eventually be weaned off seizure medication. However, this typically requires months, and sometimes years, of therapy. Most cats will need seizure medication for life.
Technically, any flea and tick medication can cause seizures, but this is a very rare reaction. Pets have a blood-brain barrier, which helps keep substances like these medications out of the brain. If a pet has a mutation that makes this barrier “leaky,” the medication can reach the brain and trigger seizures.
If this is the case, a seizure would occur within 24 hours of receiving the medication for the first time. If seizures are not happening directly after a medication is given, then that medication isn’t the cause of the pet’s seizures.
Flea & Tick Medications & Seizures in Cats
There’s a lot of inaccurate information online about flea and tick medications and seizures. One of the most important points is this: If a cat has been on a flea and tick medication long-term, it’s still safe for that cat to remain on it.
Does Diet Matter for Seizures?
This area of science is still evolving. There are sporadic reports of food allergies triggering seizures in people, but this hasn’t been officially reported in dogs and cats. Some pet parents have occasionally found that dietary changes appear to help with seizures, but Remedy recommends making all diet changes slowly.
There are studies in people showing benefits from certain diets, such as the ketogenic diet for children with epilepsy. There’s new data on this type of diet for dogs, but there’s no research on a diet like this yet for cats.
Regular Checkups & Lab work
A veterinarian is an important partner in controlling a pet’s seizures. That includes regular checkups and blood work to monitor medication blood levels and watch for side effects. Typically, blood work is recommended two or three times a year, depending on a pet’s medications.
Keys to a Successful Appointment
Bring your pet’s seizure log.
Bring all medications with you.
When scheduling, ask whether your pet should be fasted and whether appointment timing relative to medications matters. Some blood tests require no food for up to eight hours before the appointment. Other tests require medication to be given at specific times before the visit.
When scheduling, ask how long the appointment may take. Some blood tests take several hours to perform.
