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The diagnostic approach to determining the cause of the seizure activity should start with an evaluation of the animal’s signalment, history, physical examination, and neurological examination. Extracranial disease is ruled out prior to pursuing intracranial disease.
Some rule outs are more common in a given age group. For example, in dogs less than one year of age, we
are more likely to consider causes such as congenital anomalies (e.g. hydrocephalus), infectious diseases, metabolic diseases of young dogs (e.g. hypoglycemia or porto-systemic shunts), toxins, or trauma. In 1 to
5 year old dogs, we would be more likely to consider idiopathic epilepsy, in ammatory diseases (infectious and non-infectious), trauma, and metabolic diseases. Finally, in dogs older than 5 years old, causes such as neoplasia, in ammatory disease, metabolic disease, and vascular disease may be more likely. It is important to question the owner about the current episode to ensure that the abnormal activity is indeed seizure activity (and not, for example, syncope, transient vestibular attacks, or narcolepsy). Ask for a description of the abnormal activity, including the duration, severity, and whether autonomic signs of salivation, urination, or defecation were seen. A description of motor movements is often very helpful. Knowledge of what the animal was doing prior to the event can sometimes help differentiate causes. For example, a 2 year old male Boxer dog that comes running out extremely excited to see its owner and suddenly collapses with little rigidity likely is having a syncope. While a 10 year old Labrador that is calmly laying on the  oor, slowly rises to its feet, then falls over paddling is more likely to be having a seizure.
Relevant questions pertaining to the patient’s history should include the following:
1. Has the animal been previously healthy or had a history of systemic illness?
2. What was the age of onset of seizure activity?
3. What is the frequency of seizure activity?
4. How has the condition progressed?
5. Is the animal normal in between seizures?
6. Has there been a history of trauma or possible toxin exposure?
7. Is the animal taking any medications (for seizures or for other conditions)?
Seizure Therapy/Management
If underlying disease is present, this should be treated appropriately. If seizures are recurrent, anti-convulsant therapy should be considered for the patient.
An Urban Experience
Goals of anti-convulsant therapy:
• To maintain seizure “control” and limit unacceptable side effects (seizure control does not necessarily mean elimination of seizure activity)
• To decrease seizure frequency (to less than one seizure every 6 weeks or one cluster every eight weeks)
• To decrease the seizure severity and duration
• Ideally, to eliminate cluster seizures

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