TableĀ 1:

History taking for the epileptic animal

QuestionExplanatory notes
When was the first seizure?Establish duration of the problem
What does the seizure look like from start to finish?To establish whether the animal is having a seizure and what type it is. A focal seizure with secondary generalisation suggests that the seizure is generated from a focus that may be suggestive of intracranial disease
Can the owner obtain a video?Direct visualisation of the circumstances and character of the event is invaluable
Does the seizure affect all of the body at once?As above, asymmetry may suggest a focal lesion or a different paroxysmal event, eg, a dystonia
Do all the seizures look similar and if not how do they differ?Stereotypy is one of the most useful clues that a series of events are indeed seizures
Are there any autonomic signs?Autonomic signs (vomiting, salivation, urination, defecation) are strong evidence that the event was a seizure
How long does the ictus last?Most seizures last two to three minutes; longer episodes may be something else, eg, a paroxysmal dyskinesia
How long does the animal take to recover and what signs does it have?A seizure is a paroxysmal event characterised by transient signs and a recovery period that typically lasts five to 30 minutes. The animal is often hungry and thirsty during the immediate postictal period. This supportive history can be evidence that an event is a seizure.
In some instances, the postictal phase can be more distressing than the ictus, for example, some dogs compulsively walk, failing to avoid obstacles and/or have repeated vocalisation
What time of day do seizures occur?Most dogs with idiopathic epilepsy have seizures when they are resting, especially during the evening and early morning. Collapse or seizures during exertion could suggest syncope
Does anything trigger seizures?Important for management recommendations and if exercise or excitement triggers then consider other paroxysmal events
Does the dog lose consciousness/is the dog aware?If the dog remains responsive to the owner during the seizure then this suggests either a focal motor seizure or a different paroxysmal event. Note that complex focal seizures may result in altered consciousness and this can be difficult to assess objectively
Is the dog normal in between the seizures?Abnormal behaviour in the interictal period, eg, lethargy, stereotypic pacing, loss of training suggests intracranial pathology
How many seizures in an event?Clusters seizures require more aggressive and earlier treatment
Any previous injury?To help rule out underlying causes, eg, a history of head trauma
DietDetermine if there is any history of intolerance. Establish if the dog is receiving an appropriately balanced diet
Faecal consistency and frequencyAnecdotally there can be improvement in seizure control if comorbidities such as inflammatory bowel disease and food intolerance are managed
Other systemic signs, medical or surgical history, treatmentAnecdotally there can be improvement in seizure control if comorbidities are treated. Important to establish if any contraindication to antiepilepsy treatment etc
Vaccination and worming historyEstablish risk of infectious / parasitic disease