Epilepsy beyond seizures: a review of the impact of epilepsy and its comorbidities on health‐related quality of life in dogs

Abstract

dog's quality of life (QoL) is of greatest importance to them above their seizure frequency; however, 5 much of the research into canine IE to date has focussed on seizure frequency, and how to reduce it 6 via anti-epileptic drug treatment. In humans, the impact of epilepsy upon QoL has been widely studied, 7 exploring its impact on physical health, but also the psychological health and cognitive capabilities of 8 affected individuals. This paper reviews the existing literature on canine IE, identifying potential 9 threats to QoL, drawing parallels from human epilepsy research. We suggest that canine IE poses 10 threats to both quality and quantity of life, with treatment interventions posing a fine balance of 11 potential benefits and harms to the patient. At present, little is known about the neurobehavioural, 12 emotional and cognitive effects of IE upon affected dogs, with further studies needed to establish the 13 extent to which unknown QoL-inhibiting comorbidities exist in the dog, to avoid their undertreatment. 14 More in-depth studies are required to objectively quantify the effects of IE on QoL

Seizure occurrence in dogs under primary veterinary care in the UK: prevalence and risk factors

“…Causes including genetic and insult‐triggered brain diseases, peripheral diseases, electrolyte imbalances, intoxications and idiopathic . Seizure activity can have substantial impact on quality of life as well as causing emotional distress for owners . To date, most studies have focused on the subset of cases that are classified as epileptic …”

Comparing the effects of first‐line antiepileptic drugs on the gait of dogs with idiopathic epilepsy

“…The prevalence of IE within the UK dog population is reported at 0.62 per cent (Kearsley-Fleet and others 2013), and raw data from the Royal Veterinary Colleges (RVCs) VetCompass records found that seizures are the third most reported nervous system presentation in dogs (VetCompass 2016). While prevalence alone indicates the importance of this disease, IE also has potentially large welfare implications for the affected dog (Packer and Volk 2015) and can be distressing for owners to witness and manage (Lord and Podell 1999, Wessmann and others 2014). …”

Investigating the potential of the anti-epileptic drug imepitoin as a treatment for co-morbid anxiety in dogs with idiopathic epilepsy

“…Understanding whether using imepitoin in polytherapy with other AEDs leads to significant improvements in seizure frequency is of importance, as greater side effects were present in polytherapy patients in this study. Managing the balance of seizure control vs. the impact of side effects remains a challenge in the optimisation of quality of life in epilepsy patients [4, 51]. Exploring alternative management options, including dietary therapy, may be of benefit in the management of seizure activity and anxiety in dogs experiencing adverse effects of polytherapy.…”

“…There is mounting evidence that epilepsy is not simply a seizure disorder, with the prevalence of psychiatric disorders in people with epilepsy higher than in either the general population or patients with other chronic medical diseases [1–4]. The most common co-morbid psychiatric disorders of epilepsy in people are anxiety and depression [2, 5–8].…”