Seizure Action Plan

This is our typical course of action when an epileptic seizure occurs. We have everything already in place all the time “just in case” and have learned this through trial and error really and what works best for Harrison. All dogs are different, but this is what seems to work for him.

Preparation takes the pressure off a little in a crisis

Advanced checklist: After a while you will do everything required on autopilot, but in the beginning it may help you function in a panic if you create yourself a checklist so you can methodically follow the steps.

Create a safe place: Our kitchen is Harrison’s safe place, as there are limited obstacles when we need to act fast. We switch the cooker hood/extractor fan light on (without the fan), which provides enough low level light without being dazzling. During the day, we shut the blinds to dim the light. He also has access to the garden easily from the kitchen for when he’s ready to go to the toilet. When a seizure strikes we pick up his water bowl (tipped over way too many times!) and move his bed and toys out to the hallway, then there is nothing left for him to fall over. We also lay down a couple of rugs which help him walk and stabilise on the floor, as he really struggles on the wooden floors after a seizure. We have 2 of these HULSIG rugs from IKEA which cover almost the entire kitchen floor and fit in the washing machine one at a time. Not bad for £9 a piece! 🙂

Emergency Meds: Always have your emergency meds ready to go. Packets and pills can be fiddly when you’re on red alert, so make your life easier by preparing so you can tend to your dog efficiently in a crisis.We keep Harrison’s emergency levetiracetam (keppra) tablets and valium tubes (diazepam)* in a specific container in the kitchen – ensure you always adhere to the drug storage instructions so they can remain as effective as possible. *Please note, this emergency medication was specifically prescribed and instructed by our neurology/canine epilepsy specialist.

Emergency veterinary attention: If things escalate at home, call your vet or out of hours emergency line ASAP. Save both numbers in your phone in advance so you can act fast. We have been advised to take Harrison to the vet should he suffer any more than 2 seizures within 24 hours, as he will need IV fluids & IV medication to stop the cluster of seizures.

Recording the seizure: It may help to keep a pen & notepad near the emergency meds. You need to make a note of the time, date, duration, any special characteristics of the seizure. You will need to keep a full seizure log to recording all of your dog’s seizure activity and if you visit your vet or a specialist they usually want to review this. There are lots of good seizure log templates available online, I found the templates available on the Epiphen website really good. I created my own version in Microsoft excel though, because I’m a geek! 🙂 Our specialist wanted a log which combined the seizure log and medication log as well, so was best to tailor it to suit our needs. Our first neurologist recommended the RVC epilepsy app tracker, but I found it a bit rigid and the export wasn’t in a very usable format either. It might work for some though 🙂

How you can help your dog

Remain calm and if you talk, make sure its relaxing and reassuring. Sometimes silence may be best. If you get any pre-ictal warning signs a seizure is incoming, turn off lights and other stimulus and take your dog to the safe place you have created for them. At this point, you can give them their emergency medication if they will eat it/take it (Harrison hasn’t ever been able to at this stage, as he’s already too spooked).

We have previously tried to put his Thundershirt on during the pre-ictal stage to see if it helped with his seizure or recovery or general distress. In our experience it didn’t seem to help much, but it did mean that he urinated during the seizure, which doesn’t normally happen (due to the compression I guess!). I will add, the Thundershirt has been effective in calming or relieving anxiety at times outside of seizures (when we started puppy class for example and  he wouldn’t sit still!:))

During and after the seizure your dog may overheat, so this is another factor when considering using the Thundershirt, as that will keep the heat in even further. We use ice packs and/or soaked towels to keep him cool. Its best to cool the ears & paws, an ice on the spine can help the seizure activity.

I should add, you need to react accordingly to your dogs seizures. If it lasts any longer than a few minutes and you have already tried diazepam to no avail, or don’t have any at home, then you need to call the vet ASAP. A prolonged seizure is called status epilepticus and can be very damaging/fatal. So read the signs and get the necessary help if you are worried. We had to do this when Harrison got stuck in a cluster, he had 9 seizures within 2 hours and needed IV drugs to break out of it.

Some people claim they have good results with natural calming products such as Pet Remedy or natural essential oils, even things like Bach Flowers Rescue Remedy. Rubbing essential oils into the ears or a few drops of rescue remedy in their water bowl or directly on the tongue can help.

Following the seizure your dog may be paralysed, deaf/blind, confused, disoriented but when they start come round you will want to get their blood sugar up. Some people suggest using a decent, organic ice cream but we found this too stimulating for Harrison, it made him go hyper. We find it most effective to give very small amounts of food often and scatter across the floor so he can sniff it out and find it. This helps to focus his attention and stop him going frantic or gulping it down too quickly.

When the seizure strikes:

  1. Stay calm.
  2. Turn off bright lights and other stimulus (mobile phones, games, tv, radio etc). If you have other animals, ensure they are kept away to avoid any unnecessary stress.
  3. Make a note of the time when things start kicking off.
  4. Take your dog to their safe place, as soon as its safe to do so (you may not always have this option before the seizure occurs).
  5. Protect their head and stop them hurting themselves during the seizure.
  6. Be careful around their mouth area in case they have a jaw snapping motion during the seizure, or in case they may bite out of fear.
  7. Administer emergency meds/remedies, if you are using any.
  8. Try to keep them cool.
  9. When they start to come round, remain clam and talk in soft, reassuring but positive tones telling them they’re a good boy/good girl. You may want to stroke them gently, but be wary as they may be a bit jumpy. Some dogs may show aggression as they’re so frightened, so be  very careful.
  10. Administer any post-seizure medication/remedies you have been advised to give as soon as you are able to.
  11. Give plenty of food, they will likely feel ravenous and you need to get their blood sugar up.
  12. Give your dog the time and space they need to recover and just ride it out together. Remember it is probably worse for you to witness, than for them to endure.
  13. If things don’t seem to be improving, call your vet/emergency line ASAP.

Harrison’s seizure events usually last 60 minutes from start to finish. This starts at the point of the seizure itself right through to end of the post-ictal pacing, restless period. After plenty to eat, some pacing about, toileting outside and a nice big drink of water, we know he is probably almost ready to crash out finally. We let him sleep and recuperate until he indicates to us he is ready for walkies or playtime. By the time he wakes up he is his happy go lucky, cheeky self again!

Further bumps in the road

I suppose it was foolish or blindly optimistic to think it would all be plain sailing since we consulted AHT on Harrison’s epilepsy.

Things have definitely been better, but the seizures keep coming, which we’re surprised and anxious about. Even Luisa seemed disappointed when I called to update her. She just explained she has a lot of work to do to get the right balance for him, but at the moment things are quite blind until we get true peak & trough blood samples taken to see how he is adjusting to his new dose, what kind of level does he have in his blood and is there more room to maneuver.

As ever, it never rains it pours, so amidst all of this Harrison has also had an upset tummy on and off too. In addition to the standard knock on effect that his ability to cope alone when we’re out at work seems to take a downward turn also (right back to square one).

So right now feels like groundhog day, we’re going over old ground with some of the behavioural changes and its so hard to see his separation anxiety exacerbated again, especially as we worked so hard to build him up to a good level. But, on a positive note the last couple of seizures (this morning and before that, on Monday morning) he has only suffered one fit in isolation (this is great progress!) thanks to the new seizure emergency plan we have with his meds and also he seemed to bounce back really quickly following the seizure too. He had his usual 1 hour of postictal pacing and bumbling into the walls, but after that was quite lively, energetic and coordinated. The devastating part is that both of these seizures occurred whilst we were out at work, he was alone in the kitchen. We have a camera setup so we can keep an eye on him, heartbreaking watching the footage of him convulsing on his own and coming round all confused and disoriented. Much harder than going through it in real life, to be honest!

 

 

The bad run continues

We should have been at the airport now, sipping complimentary drinks in the Aspire Lounge at London Gatwick, waiting to board our flight to New York. I was so excited about it, my first time in NYC!

Instead I’m sat at home in a filthy, dirty house too scared to get up and start tidying and cleaning up as Harrison has  finally settled off to sleep and I don’t want to wake him up. The poor lad is exhausted, well, so are we. This recent blip I have written about before turned into a very rocky week long patch and we felt completely helpless. Leaving us with no choice but to cancel our trip to NY and get H in to see a canine epilepsy expert ASAP, before we lose him.

I was scheduled to go to New York with school in October 2001, but they cancelled the trip after the terrorist attacks. Maybe its a sign? Maybe I am not really ever meant to make it to New York?

Anyway. Things kicked off last Wednesday evening around 21:00, but the seizures continued for about 14 hours and he never really recovered in between, even though the duration between was longer than normal. Our vet prescribed keppra as a cluster buster, but it barely touched the sides. Yes the seizures seemed to subside short term, but Harrison was manic, frantic, endlessly pacing around. The brain activity was clearly still going on and the keppra was fighting against it, but it didn’t seem to be enough.

Then the seizures kept coming, we never expected more when he was put on keppra, but sure enough seizure activity broke through. I said there and then I didn’t feel comfortable leaving to go on holiday and we needed to cancel/postpone/reschedule and do whatever necessary to get him sorted. Crisis point you could say. Not sure how much more of this he or we can take.

So we’re booked in to see Luisa De Risio, Head of Neurology at the Animal Health Trust Friday morning. Essentially, if she can’t help us then no one can! Luisa is a leading canine epilepsy expert and has even published a book on the subject, which I refer to on my Resources & Info page.

Feeling optimistic, but at the end of the road really, this is our last chance to get him hopefully the right help, or we have to call it a day. It’s not fair on him and he’s not himself at all.

He barks constantly, like a frustrated helpless bark and is even biting us accidentally during play, but much harder than a play bite, so we can’t sustain this for very long.

For anyone who’s ever been in this situation, my heart goes out to you. It’s absolutely awful and you constantly question whether its fair to even carry on for the time it will take to try and regain some control. This moral, ethical conflict is really hard!

At least he is asleep for the moment, so we get a minute’s peace. But we’re living in fear that the phone ringing or any other external noise will wake him up and we’ll be sent right back into that sick cycle of frustration, which takes him so long to snap out of and settle down from.

At least after Friday’s appointment we should know whether there is any hope, or whether we’re just prolonging the inevitable. I’ve already made my peace with it and don’t feel that sad as I write this or think about it now. I know I would be sad, devastated, if we had to have our poor, sweet boy put to sleep, but I would feel reassured that we had taken things as far as we physically and mentally could, sought the best advice and care available and tried everything we could for him, before making any rash decision.

 

The first seizure

That first seizure was actually not the worst one. Yes, the first one is definitely very scary and everything is unknown, but it feels perfectly reasonable that it could be a one off and then the vet leads you to believe that it could be a one off too. Then, your worst fears are realised and it keeps happening 😦 the second time was by far the worst. It catches you totally off guard, even though you have gone away and done your research, you’re still clinging on to the idea that it could have been a one off. Or at least, that it wouldn’t happen again for a long while. Witnessing your poor little pooch have a fit is truly horrific, you feel totally helpless, they are terrified and worst of all, you can’t explain to them what the hell is going on.

Since 23rd February (15 days ago), Harrison has had 7 seizures. The vet advised after the first one that any more frequent than once a month would require lifelong medication to manage the condition. So, he has started his first tablet trial today, something called pexion. Really hope it works out for him, otherwise we’ll have to try many more to find the most suitable and effective drug for him, or a combination. Personally I am fairly opposed to human medication, let alone for my animal. I prefer a more natural and holistical approach wherever possible, but the risk of long term damage is too high with such regular seizures, or by having several in quick succession (called “clusters”), so we have to try him with medication now.

The good news is that even though the condition is incurable, a dog with epilepsy can still lead a full and happy life, if you can learn how to manage their unique needs properly – every dog is different. So, this is the start of a new chapter for us!