Seizures & Epilepsy

Seizures look different depending on their type and severity. Owners often describe a blank stare or sudden behavior change just before an episode — called the aura. The seizure itself may include:

• Sudden collapse, loss of consciousness, or rigid limbs
• Involuntary paddling, running, or chewing motions
• Drooling, foaming at the mouth, or chomping the jaw
• Urination or defecation during the episode
• Vocalizing (crying or howling)
• A post-ictal period of confusion, temporary blindness, circling, or excessive thirst that can last minutes to hours after the seizure ends
• Focal (partial) seizures — twitching of one limb or face, fly-biting behavior, or repetitive head-turning without full collapse

Cluster seizures (two or more within 24 hours) and status epilepticus (a seizure lasting more than five minutes) are emergencies.

Identifying the underlying cause shapes the entire treatment plan. Causes fall into three broad categories:

• Idiopathic (primary) epilepsy — a genetic or inherited tendency with no detectable structural brain disease; most common in dogs aged one to five years and in breeds such as Labrador Retrievers, Border Collies, Beagles, Australian Shepherds, and Dachshunds
• Structural (secondary) epilepsy — caused by a brain lesion such as a tumor, inflammatory disease, or trauma identified on advanced imaging
• Reactive (extra-cranial) seizures — the brain is normal but a systemic problem triggers seizures: low blood sugar (hypoglycemia), liver disease (including portosystemic shunts), kidney failure, or toxin ingestion
• In cats, seizures are less often idiopathic; inflammatory brain disease, hypertension (high blood pressure), and hyperthyroidism-related vascular events are important causes to rule out

A thorough workup separates the treatable from the manageable. The team begins with a complete history — seizure frequency, duration, timing, and any triggers — followed by a full neurological and physical exam. Diagnostics typically include:

• Complete blood panel, chemistry, and urinalysis to screen for metabolic causes (liver, kidney, glucose, electrolytes)
• Blood pressure measurement, especially in cats
• Thyroid levels in cats older than six years
• Bile acids test when a liver shunt is suspected
• Digital radiographs and abdominal ultrasound when a systemic cause is on the differential

When metabolic causes are ruled out and a structural brain lesion is possible, referral for MRI and cerebrospinal fluid (CSF) analysis is recommended. The findings guide whether treatment targets the brain directly or an underlying disease.

Treatment is tailored to the cause, the seizure frequency, and the individual patient. Options include:

• Anti-epileptic drugs (AEDs) — phenobarbital and potassium bromide are the most established in dogs; levetiracetam (Keppra) is preferred in cats and is commonly added in dogs when first-line drugs don't fully control seizures. The goal is to reduce seizure frequency by at least 50% while maintaining quality of life
• Management of the underlying cause — correcting hypoglycemia, treating hypertension, managing liver disease, or referring for surgery in portosystemic shunts can eliminate or dramatically reduce seizures
• Emergency protocol — owners of known epileptic pets receive guidance on home rectal or intranasal diazepam for cluster events, and clear instructions on when to head to an emergency clinic

Medication levels and liver function are monitored by regular blood tests. Most pets stabilize within weeks of starting the right drug at the right dose, though true seizure elimination is not always achievable.

Any pet experiencing a first-ever seizure deserves a veterinary examination — even if the pet looks completely normal afterward. Bring a short video of the episode if possible; it often clarifies the diagnosis faster than a description alone. Our team at Dog & Cat Hospital Calabasas can work up the cause, start an anti-epileptic plan, and monitor long-term drug levels in-house. If a first seizure lasts more than five minutes or if your pet has back-to-back seizures, go directly to an emergency facility, then follow up with us for long-term management. Book an appointment to get started.