Toby was a darling three-month-old puppy when he had his first seizure. His guardian placed a frantic call to the vet, and the receptionist told her to snuggle him carefully in a blanket, avoid getting bitten, and bring him right over. Thankfully, upon arrival at the clinic, the seizure had passed. But he would go on to have many more, and with increasing frequency.
The veterinarian performed a battery of screening blood tests to rule out the many problems that can cause seizures, but it did not produce any definitive answers or specific therapeutic management. The assumption was that Toby had idiopathic epilepsy, which means the cause is unknown.
Toby was fed a variety of premium diets, and conventional anticonvulsants (phenobarbital and potassium bromide), were prescribed. Despite the medication, he was experiencing seizures multiple times a week, and also suffered from pancreatitis due to the potassium bromide.
Toby’s heartbroken guardians felt they had done all they could and he was presented for euthanasia. But he was too young to give up on. His guardians agreed to relinquish him and my daughter adopted him. Together, we began to try some holistic options to manage Toby’s condition, and met with great success.
What happens during a seizure?
Few things are more distressing than watching your dog have a seizure. The first time you witness it, you may fear he is dying or will need to be euthanized. But it’s important not to jump to conclusions. Many seizure disorders can be successfully managed.
If you suspect your dog has had a seizure of any kind, take him to your veterinarian immediately. A prolonged seizure can cause permanent brain damage. During the seizure itself, however, the dog is not in any pain. In fact, most humans who have had a seizure say that all they experienced was a lapse in time. They often “wake up” and wonder why everyone is staring at them.
During a seizure, dogs do lose control of their jaw muscles and could bite accidentally. They commonly lose colon and bladder control as well. So it is not unusual for them to drool profusely, and urinate or defecate during a seizure episode.
Not all seizures are epilepsy
A lot of people assume that seizures and epilepsy are the same thing, but many seizures are not caused by epilepsy. Unfortunately, there is no specific test for epilepsy, so it’s what we call a diagnosis of “rule outs”. In other words, your veterinarian needs to “rule out” the myriad other causes of seizures before you can assume your dog has epilepsy. The distinction is important because it affects treatment options and prognosis.
Conventional treatment means anticonvulsant drugs
Mainstream veterinarians will usually prescribe anticonvulsant drugs for seizures, but they are not without risks. Phenobarbital is a commonly recommended, addictive narcotic with potential liver side effects. Potassium bromide is often piggy-backed onto phenobarbital, but can cause pancreatitis, as in Toby’s case. Both can be quite sedating.
For patients that must remain on a conventional anticonvulsant, an integrative veterinarian can recommend nutritional support to protect the liver and pancreas. A popular Chinese herbal is prescribed by Oriental practitioners to assist with liver metabolism. This formula is called Bao Hu Jiang Jun Tang and can help prevent liver failure associated with phenobarbital usage. The formula contains milk thistle, bupleurum, schisandra, licorice root, salvia root, white peony and skullcap. You might recognize milk thistle as a commonly used liver supportive herbal.
When beginning our integrative treatment of Toby, we first stopped giving him potassium bromide; it diminishes slowly from the body on its own, so a slow withdrawal was not necessary. However, individuals can experience withdrawal side effects if phenobarbital is discontinued abruptly, or even if a dose is late or missed. Discontinuing this medication should be done under veterinary supervision. Herbal care can be initiated while the dog is still on phenobarbital.
Identify the triggers
When getting to the root of Toby’s seizures, the most important additional diagnostic tool we used was journaling. I cannot overemphasize how useful it can be for a diligent dog parent to note every seizure. Record the date, time of day, the current weather, and what the dog has eaten recently, including treats. Also record household activities or environmental exposures that occur just prior to each seizure. Just as there are multiple causes for seizures, there are also multiple triggers for epileptic seizures such as Toby was experiencing. Much as an allergic individual is often allergic to several things, an epileptic individual can be stimulated to seizure for many different reasons. Therefore, one of the main goals of therapy is to identify as many triggers as possible and eliminate them.
1. Food triggers
A weekend of close observation quickly revealed that Toby had a sensitivity to chicken. Eliminating all chicken and replacing it with beef led to a substantial decrease in the frequency of seizure activity! Although Toby had been given many different diets, they all contained chicken and a starch such as corn or rice. Toby was now being fed a balanced all-beef, starch-free raw diet.
2. Environmental triggers
Careful observation and long term journaling also made it clear that lawn treatments and particular household floor cleaners would trigger seizure activity in Toby. Like many epileptics, Toby would also frequently seizure at the time of a full moon. The former triggers could be eliminated or avoided. For those that are unavoidable, like the moon phase, knowing about their involvement allows you to be prepared and predict a seizure. It is also possible to add an herbal or use another modality to try and intervene with the seizure pattern.
For example, if you know a dog has a seizure every three weeks in the evening, an acupuncture treatment could be scheduled for the anticipated day, or an extra dose or additional type of calming herbal might be given. Toby’s mom, who is also an acupuncturist, was able to pre-empt a seizure onset with acupressure at GV 26, an acupoint found at the groove between the nostrils. If necessary, even an extra quantity of anticonvulsant might be given pre-emptively.
Western herbs and Eastern medicine
• Western herbals used to manage seizure activity have a calming influence. These are helpful when stressful situations trigger the seizures. Most popular in this category would be skull cap, valerian, passion flower and oat straw. They are safe to use with phenobarbital; they may potentiate its effectiveness, but this is generally desirable. It may allow an integrative veterinarian to decrease the dose of phenobarbital.
• Oriental medicine should first involve a tongue and pulse diagnosis, and a diagnosis of the dog’s constitution. Seizure activity is considered “internal wind” originating from the liver. To understand this theory, think of heat producing fire with a rising wind. A dog with a Fire constitution, red tongue and fast pulse may have internal wind triggered by hot foods such as chicken, lamb or venison. As in Toby’s case, a neutral food choice such as beef or bison might be ideal. An herbal blend that includes cooling and “shen”-calming herbals may be beneficial. “Shen” means mind. A shen disturbance may trigger a seizure.
Toby had a red, thin tongue and a rapid pulse. His nose, pads and skin were commonly dry. These are all heat signs. He preferred cool areas like the floor or basement. He had a great appetite. The Oriental diagnosis for him was liver yin deficiency with internal wind, and kidney jing deficiency due to the early onset of his disorder. This diagnosis helped with the selection of a Chinese herbal formulation for Toby.
The initial herbal formula we gave Toby was Tian Ma Gou Teng Yin with added schisandra for liver protection. This formula contains 11 herbs. Chinese medical practitioners commonly prescribe it for human patients with internal wind caused by high blood pressure and its associated headaches and dizziness. Di Tan Tang, meanwhile, is commonly called “herbal valium”, and Ding Xian Wan is classically used for phlegm conditions.
Toby received a rotation of several different Chinese herbal formulations, and as the frequency and severity of his seizures diminished, he was weaned off the phenobarbital.
Toby’s journey is just one example of what can be accomplished with the cooperation of a integrative or holistic veterinarian, and a diligent guardian who is able and willing to identify and manage her dog’s seizure triggers. Toby went on to live a full and happy life, and so can many other dogs with similar conditions.
Veterinarian Dr. Jodie Gruenstern graduated from UW-Madison in 1987. She is a veterinary acupuncturist and food therapist certified by the Chi Institute; vice president of the Veterinary Medical Aromatherapy Association; and a member of the AHVMA. Dr. Jodie owns the Animal Doctor Holistic Veterinary Complex, is a nationally renowned speaker, author, TV and radio personality, and authored the book Live with Your Pet in Mind (DrJodiesNaturalPets.com, AnimalDoctorHolistic.com, iPAWaid.com).