title: Idiopathic epilepsy in the dog: Reasons for referral and assessment from the owner's perspective
Creators: name: Chang, Ya-Pei
Publisher: name: University of Glasgow
Year: 2001
Subjects: subject: Veterinary science, dogs, epilepsy.

description: Seizures are the most common neurological disorder in small animal medicine, of which 40 to 50% of affected dogs are diagnosed as having idiopathic epilepsy. Dogs with epilepsy represent a large proportion of the caseload for the neurology service of the Small Animal Hospital of University of the Glasgow Veterinary School (SAH-UGVS). The aims of this study were to clarify the reasons for owners requesting a second opinion for dogs with idiopathic epilepsy. This was undertaken by reviewing seizure management regimens instigated at primary veterinary clinics and examining the owners' perspective of the reasons for referral and the seizure management regimen used in SAH-UGVS. Information from the owners' perspective was also thought of value to clinicians in assessing seizure management regimens and could potentially raise issues of relevance to dogs with epilepsy and their owners, which may be the basis for developing an alternative assessment of long-term seizure treatment in veterinary medicine. A total of 48 dogs referred to SAH-UGVS between March 1999 and April 2001 for evaluation of seizures and diagnosed or tentatively diagnosed with idiopathic epilepsy were included in this study. Breed, gender, age at the onset of seizure activity, seizure type, reasons for referral and previous antiepileptic drug (AED) therapy were reviewed for these cases. For 32 cases, the owners' perspective on reasons for referral to and the seizure management regimen used in SAH-UGVS, as well as the exploration of other issues relevant to dogs and their owners, were sought by mailed questionnaires. Behavioural changes were reported by 11 respondents to the first questionnaire, and the second mailed survey was undertaken to clarify the nature and potential causes of behavioural changes in these patients. The study demonstrated that "dogs' quality of life", "adequate seizure frequency" and "acceptable AED side effects" were the three main concepts considered important by owners in assessing the outcomes of seizure management. Furthermore, owning an epileptic dog did not have a major impact on owners' work/day-to-day activities and free time. The majority of owners did not consider the administration of the medication a nuisance and coped well with administering medication more than once daily. For more than half of owners, regular veterinary examination and blood sampling for serum AED concentrations monitoring did not cause a significant problem. Further diagnostic procedures did help most owners understand their dogs' condition and provided owners with more confidence in AED therapy adjustment and accepting the balance between AED efficacy and side effects. The majority of owners agreed the cost of further diagnostic procedures was worthwhile. The study suggests that in both undergraduate and post-graduate education, the value of measuring AED serum concentrations, as well as the use of bromide in canine epilepsy, should be emphasised. The study also demonstrated that dogs on potassium bromide alone exhibited fewer side effects than dogs on phenobarbitone. A relatively large proportion of cases studied exhibited behavioural changes, which mainly appeared to be AED-related. Clinicians should be aware of the potential for behavioural change in idiopathic epileptic patients on AED therapy. Once patients exhibit AED-related behavioural changes, a dose reduction or discontinuation of the particular AED may be necessary.