The brain is made up of billions of nerve cells that communicate with each other through chemical and electrical signals. Epilepsy is a disease that occurs when these nerve cells become overactive. Epilepsy occurs in cats just as in humans and dogs.
Epileptic seizures can be focal or generalized depending on how much of the brain is involved in the individual seizure. In focal seizures, symptoms are seen only in one part of the body, while the whole body is involved in generalized seizures.
The incidence of epilepsy in the cat population is stated to be about 2%. Epilepsy affects female and male cats to about the same extent.
Cats often have focal seizures where the only symptoms may be twitching of the facial muscles, heavy salivation or affected consciousness. Sometimes the seizures are severe with severe seizures where the cat can fall over. Cats often have several seizures per day, so-called “cluster seizures”, but this does not necessarily mean that the prognosis is worse.
Causes of epilepsy in cats
Primary epilepsy, epilepsy of unknown cause
In dogs and humans, the term primary or idiopathic epilepsy has been used to describe an epilepsy syndrome that has a established or suspected genetic cause. There is currently no evidence that epilepsy in the cat population has a hereditary background. However, primary epilepsy is a common cause of epileptic seizures in cats. Primary epilepsy in cats can be both focal and generalized.
The number of seizures can vary greatly over time and is sometimes slightly higher at first. Some cats eventually become asymptomatic and can in some cases survive without treatment. Cats with primary epilepsy are on average 3.5 years old (1-12 years) when they debut with epileptic seizures.
Secondary epilepsy
Cats start with secondary epilepsy at a higher age than cats with primary epilepsy and are on average just over eight years old when they have their first epileptic seizure. The secondary epileptic seizures can occur as a result of diseases or injuries inside the brain or as a result of an effect on the brain, such as poisoning or a low blood sugar.
Diagnostics
Epilepsy is an exclusionary diagnosis as there is no diagnostic test to determine primary, idiopathic epilepsy. The investigation is thus to exclude other diseases in the body or in the nervous system that could cause epileptic seizures.
What characterizes primary epilepsy is that the cat in between seizures feels well, that the neurological examination and the diagnostic examinations that are performed do not show any abnormalities.
In cases where secondary epilepsy is suspected, the diagnosis is more important and may include blood tests, urine tests, X-rays, ultrasound examinations, advanced imaging diagnostics such as computed tomography, magnetic resonance imaging and spinal fluid tests.
Treatment of epilepsy in cats
As a rule, it is recommended that treatment be started if the patient has had seizures more often than every 6 to 8 weeks, if he has had cluster seizures (several seizures) or status epilepticus (one long seizure). Treatment is always started in consultation with animal owners who should be informed that treatment is not equal to freedom from seizures. The treatment is usually lifelong and aims for fewer and milder seizures.
As always, the benefit must be taken into account that some cats do not allow the pet owner to give tablets daily. The most common drug used to treat epilepsy in cats is phenobarbital.
Phenobarbital
Phenobarbital is considered as the first-line drug in the treatment of epilepsy in cats. A common side effect of fenemal is increased appetite and weight gain as well as increased thirst. Initially, increased fatigue and some instability are usually seen after initiating treatment with fenemal.
This side effect is usually transient within two to three weeks. Other less common side effects also occur but as a rule it is a preparation that is well tolerated by most cats. Cats being treated with phenobarbital should be examined by a veterinarian at least once a year.