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Case Study - Seizuring Dog
Case Study - Seizuring Dog
Case Study - Seizuring Dog
Rebecca M. England
A long-term client calls our clinic regarding his 3-year-old Springer spaniel, named
Chase. The owner reports that Chase is on the kitchen floor shaking and kicking, in addition to
urinating and defecating. The owner also mentions that he has been doing this for two minutes,
he is not improving, and he has never seen him do anything like this in the past (Rockett &
Christensen, 2010).
Information should be given over the phone to help the owner in helping his pet and
protecting himself from physical harm. The owner should attempt to transport his pet to the
clinic as soon as possible, as a seizure that is not resolving can be a life-threatening emergency;
the help of another person may be useful in moving him to a vehicle. The owner (and assistant)
need to be cautious, especially when handling the pet, to prevent the possibility of being bitten.
Some pets exhibit flea-biting movement behavior of the mouth, so people or other animals
nearby may become injured. Placing a light towel temporarily over the pets face may calm the
pet, allow for easier transport, and assist with bite prevention. The owner should avoid any
attempts to give the pet any oral medications as well, to avoid being bitten. If possible, the owner
should also surround the patient with ice or cold packs, as this will aid in the prevention of
hyperthermia which may be caused by the prolonged seizure. Avoiding loud sounds may also be
helpful during this time, such as talking in a quiet voice and turning down the car radio; these
may help the pet be less reactive to stimuli during the seizure.
Seizures are not always emergencies. Those patients experiencing multiple seizures
should be considered and treated as true emergencies. These patients require immediate
stabilization because they are at risk for developing hyperthermia, permanent neurological
damage, cardiac arrhythmias, pulmonary edema, and hypoxemia (Battaglia, 2007). In terms of
SEIZURING DOG 3
the subject of this case study, Chase requires immediate medical attention because he continued
to convulse and was not improving. If the owner came home and found signs that the pet may
have had a seizure (such as urine or stool on pets coat or the floor, bruises on the body, bleeding
tongue, etc.) monitoring the pet at home may be an option, if the pet was now behaving
normally. The pet should still be seen by a veterinarian to rule out other problems; bloodwork,
monitoring, or other things may be recommended after a complete physical exam. However, if
the patient looks and behaves normally after suspect seizure activity, it is probably not necessary
The acronym, LOC, stands for level of consciousness. The LOC is a measurement of a
patients arousability and responsiveness to stimuli from the environment (Norkus, 2012). There
These terms have been described above, and they can be useful in helping us evaluate our
patients when comparing these standards to what is considered normal mentation for these
patients at home.
Seizures result from abnormal electrical activity within the brain. They may be congenital
or acquired later in life. Another name for a seizure episode is a convulsion (Rockett, et al.,
2009). Prolonged seizure activity is called status epilepticus (Moore & Rudd, 2008).
The owner brings Chase into the clinic. Chase is no longer thrashing and kicking but still
has some uncontrolled muscle movements and seems very disoriented (Rockett & Christensen
2010). Because of the signs that Chase is exhibiting now, he is in the post-ictal phase. There are
SEIZURING DOG 4
three time periods associated with a seizure: the pre-ictal period (before the seizure), the ictus
(the actual seizure), and the post-ictal period, which occurs after the seizure (Rockett, et al.,
2009). During the post-ictal period, clinical signs (other than what Chase is already exhibiting)
1. Weakness
2. Blindness
3. Depression
4. Nervousness
5. Pacing
Residual twitching may also still occur after the primary muscle tremors have resolved. Any of
these clinical signs may be present up to a few hours after the ictus; however, they may last for
days, depending on the severity of the seizure and the underlying cause.
Upon physical examination, Chase is found to have a HR of 145 bpm, RR panting, and
T of 103.8 F. He is still having neurologic signs, has a few scrapes on his left shoulder, hip and
muzzle, and is dirty from having urinated and defecated on himself. He currently weighs 45
pounds (Rockett & Christensen, 2010). At this point, it would be difficult to do a thorough
neurologic physical exam on Chase because he is in the post-ictal phase. During this phase, as
just discussed previously, disorientation and other neurologic deficits may be present (Battaglia,
2007). The presence of any of these signs would alter the accuracy of the neurological exam.
The cause of Chases hyperthermia is easily explained, as dogs that exhibit seizures
secondarily are succumbed to hyperthermia. As seizure activity occurs, the prolonged rapid
muscle contractions and activity cause the body to overheat (Rockett, et al., 2009). In addition,
because the body is in a convulsive state, it is unable to activate natural cooling mechanisms
such as panting. Other technician assessments that are related to prolonged or consecutive
1. Altered mentation
2. Hypovolemia
3. Risk of aspiration
4. Anxiety
5. Inappropriate elimination
Depending on the severity and whether they are resolving, some of these problems may need to
be addressed with medical intervention that may include monitoring, blood work, IV fluid
Mr. Castro leaves Chase at the clinic for monitoring, blood work, and IV fluids. He was
cleaned up and had an IV catheter placed in his cephalic vein, and is now receiving IV fluids.
Your veterinarian gives you a standing order to administer 0.5 mg/kg of 5 mg/ml diazepam IV if
Chase seizures again. An hour later, Chase has another seizure (Rockett & Christensen, 2010).
Given the calculation steps above, Chase would receive 2 ml of diazepam IV.
After this seizure, Chases temperature is 105 F (Rockett & Christensen, 2010). There are
These include:
1. Cooling the extremities with the application of isopropyl alcohol to the feet, tail, and ears
care must be taken to not get alcohol in the eyes and prevent the fumes from being
inhaled by the patient
2. Placing a damp towel over the trunk of the body and placing ice packs near the flanks,
axillary regions, and groin
Hyperthermic patients should be cooled (Moore & Rudd, 2008). This will help prevent the
negative and possible permanent side effects that may be associated with a prolonged elevated
temperature.
Chase is monitored for the rest of the day and throughout the night, and has no more
seizures (Rockett & Christensen, 2010). In addition to monitoring for seizures, it is important
that Chase be monitored for other possible problems. These things may include (Rockett, et al.,
Chases blood work values are all within normal ranges and there is no sign of his seizure being
provided to the owner regarding his medication regimen and care at home. Chase should be
monitored for recurring seizures at home indefinitely; and even when Chase is at home alone, the
owner should look for signs associated with seizure activity (as discussed previously) when he
returns home. It is also important that Chase should not be allowed to swim, since he is on
anticonvulsant therapy this is to prevent the possibility of drowning (Rockett, et al., 2009). The
owner should keep a seizure log or calendar at home that details the date, time, severity, and
length of any seizures he may have (Tilley & Smith, 2011). This can help the owner and
The owner should not skip doses of medication unless told to do so otherwise, even if his
pet is doing well and not having seizures. Doing this may suddenly cause Chase to seizure. When
starting phenobarbital, the patient may be drowsy or agitated for several days to weeks. As their
body adjusts to the medication, these signs should resolve (Plumb, 2011). If it doesnt, the owner
should notify the veterinarian, as a trial of another medication may be necessary. Chase may also
exhibit increased thirst, urination, and appetite, which should also resolve over time. Regarding
long-term medication use, Chases liver values should be monitored regularly (Tilley & Smith,
2011), as anticonvulsant therapy may cause liver problems. It is also important for the owner to
understand that even with the use of medication, the seizures may not go away or resolve
completely. Unless the cause of the seizures is determined, it can be difficult to control them. So,
the goal of medication is to reduce the frequency, length, and severity of the seizures, so as to
References
Battaglia, A. (2007). Small animal emergency and critical care for veterinary technicians, 2nd ed.
Moore, A. H., and Rudd, S. (2008). BSAVA manual of canine and feline advanced veterinary
nursing, 2nd ed. Gloucester, UK: British Small Animal Veterinary Association.
Norkus, C. L. (2012). Veterinary technicians manual for small animal emergency and critical
Plumb, D. C. (2011). Plumbs veterinary drug handbook, 7th ed. Ames, IA: Wiley-Blackwell.
Rockett, J., Lattanzio, C., and Anderson, K. (2009). Patient assessment, intervention, and
documentation for the veterinary technician. Clifton Park, NY: Delmar Cengage
Learning.
Sirois, M. (2010). Principles and practice of veterinary technology, 3rd ed. St. Louis, MO:
Mosby Elsevier.
Tilley, L. P. and Smith, F. W. K. Jr. (2011). Blackwells five-minute veterinary consult: canine