Understanding Pet Seizures: Expert Insights | SOP Ep. 120 – Dr. Missy Carpentier

Witnessing your beloved pet experience a seizure is undeniably terrifying, but understanding what’s happening in their brain can make all the difference. Is it a sudden health emergency, or a condition that can be managed at home? In this comprehensive look at seizures in pets, we sit down with renowned veterinary neurologist Dr. Missy Carpentier to separate fact from fiction.

From the subtle facial twitching often seen in cats to the more dramatic tonic-clonic (grand mal) seizures in dogs, we explore the spectrum of abnormal brain activity. You will learn:

• The “Rowdy Kids” Theory: Why seizures often occur while your pet is resting or sleeping, rather than while they are active.
• Actionable Steps: How to keep your pet safe during an episode—and what you should never do, including debunking the dangerous myth about pets “swallowing their tongue”.
• Why Video is Vital: How capturing a video of the event helps your veterinarian distinguish true seizures from other neurological or syncopal (cardiac) events.
• Treatment and Outlook: From understanding idiopathic epilepsy to managing long-term care and medication, discover how you can support your pet in leading a high-quality life despite a diagnosis.

Whether you are a new owner or a seasoned pet parent, this guide provides the expert clarity you need to stay calm and act effectively when your pet needs you most.

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All footage is owned by SLA Video Productions.

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Watch the episode here

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Understanding Pet Seizures: Expert Insights – Missy Carpentier

Everyone, welcome in. What would you do if your pet had a seizure? Would you know what to do, Janet?

I have to stop saying I’m having a seizure because I do not even know medically what a seizure is, and it’s not a good thing.

We are going to find out. We have Dr. Missy Carpentier, our favorite veterinary neurologist and owner and founder of Minnesota Veterinary Neurology, with us. We have got questions like, “What is a seizure? What are other things that look like seizures? Is there a difference between a young dog having a seizure versus an old dog as to what veterinarians think is going on? Janet, this is going to be a neurology-packed hour talking about all seizures.

My question is, a cat would never share that they’re having a seizure. We will be the scenes having a seizure and be like, I’m fine.

Anyway, Lindsy, Dr. Carpentier, thank you so much for taking the time to talk all about seizures.

Thank you so much.

Thank you.

Is she a two-peter, or a three-peter? What is she?

She’s getting the green jacket.

We need a paw print jacket.

I like that. That will be great.

With a lot of brains and a spinal cord. All departments.

Neurons have different synapses.

Astrocytes.

Lucky you.

Look at us.

Big words, doctors. Big words for us.

I know. I looked them up.

Anyway, Dr. Carpentier, please. What is a seizure? How can we tell if our pet is having a seizure versus something else, like fainting?

Defining Seizures And Behavioral Signs

A seizure, regardless of the underlying cause for why it happens, is something of an abnormal activity in your brain. Your pet is having abnormal activity in the brain that caused them to have this seizure. With seizures, they are a wide spectrum of presentations. It can be something like a little facial twitching, which is very common in kitties. They will have what we call oral facial seizures, where it’s just one side of their face grimacing at you. Versus, it can be more of what we call the classic tonic colonic, or also known as grand mal seizures.

If your pet loses consciousness, they will be hyper salivating, they often will urinate, or they will defecate. Most often, what people do not realize is that it’s very common. The most common time an animal will have a seizure is when they’re sleeping or when they’re resting. The best way I like to think about it is if you think about this abnormal area in the brain that is having, you can think of it like the rowdy kids, it’s the best way.

The rowdy kids are kind of going, and that’s what drives the seizure when they’re awake. The other parts of the brain can dampen it down and calm down those rowdy kids. When they’re sleeping, the other parts of the brain are sleeping, so they cannot calm down those rowdy kids. That’s what can drive those seizures to be able to occur more so at that time than at other times.

Could you miss your pet having a seizure? Our Libby’s outside all the time. How would I know?

You definitely can, especially if they’re more of the focal ones, because there is not necessarily what we call our pre and our post time, and those situations. When I say pre-ictal, meaning pre-seizure, what are the things that you can look for? It’s very common for animals, if they’re not sleeping and they are awake, that they’ll seek out their owners because they feel something that’s about to happen, and they feel off. My own personal dog, she never went to my husband for anything. She had seizures. If she went and was seeking or searching for my husband, I knew she was going to have a seizure within 24 hours.

There are little things. I’ll have some owners say, “They never get in. They’ll jump into the shower.” There are just weird behaviors. They’re almost trying to fight because they feel off. That’s something that you can watch for. Is there anything leading up to it? Usually, I will say the post-ictal is honestly one of the most helpful times for post-seizure activity because a lot of dogs or cats are going to be confused, they’re going to be disoriented. You can see if there is any urination, defecation, or salivation where there shouldn’t be.

That’s a lot of times when owners have pets that they know have seizures. They’ll come home, and you’re like, “There’s a urinary accident,” “There’s a huge puddle of drool here.” Oftentimes, they think that their pet had a seizure when they went there. Those are things that you can look for after the fact to be able to say, “What’s going on?” A lot of animals will not be able to see appropriately after a seizure, too. It’s short-lived.

It can be minutes to hours to days for some, depending on the severity of how many they have. Most seizures overall should be less than two minutes. It feels like an eternity. I know when my dog had her first seizure, I swear I was just a vet student at the time. I called the ER saying that my dog just had, I probably set a 60-minute seizure. It’s very nerve-wracking. Honestly, it was only a couple of minutes, but it feels like an eternity. It’s also important to pay attention to “My pet’s having a seizure. How long has it lasted?” Most seizures should be less than two minutes.

What should you do? Should you just leave the pet alone?

Do you restrain them?

Do not try to hug it or anything like that? You turn them on their side.

Safety Protocols During A Seizure Event

The biggest thing to do is to make sure they’re in a safe place because if we’re sleeping, are they on the bed with you? If they start really having a very active seizure, I’ve seen dogs go flying off the bed because they’re running so aggressively. They’re paddling so aggressively. Make sure they’re in a safe place. Making sure they’re away from stairs is also going to be the big one. I want to make sure that if I have a pet that has seizures, especially if the owner is not there, that we know they’re in a safe area.

If they have one after the fact, we cannot have them stumbling down the stairs. You want to be there. I do think they can hear you and that it’s nice for them to hear your voice as they’re coming back with it because they lose consciousness. That’s one of the big things during our full tonic-clonic or grand mal seizures is that they will completely lose consciousness. When they kind of get their wits about them again, I think it’s reassuring that you are there. You do have to be cautious because some animals can be violent or fractious, aggressive after a seizure, because they do not know what just happened. They’re getting back to it.

Making sure that they’re in a nice, safe area is going to be huge for them. Making sure you’re safe, too, as well, though. Most animals are going to want to pace and wander, figure things out. Again, they just used a ton of energy having a seizure. They usually want food or water after as well. I always make sure you’re offering them some water, and then usually they’re going to want to get outside and just pace and wander a little bit to get their legs back underneath them.

Can I make a comment about you talking to them during the seizure? I’ve mentioned this to you before. My friend Joan had a brain tumor and did not know it, and she was unloading the dishwasher when she just fell on the floor in a seizure. Her very Italian husband, Frank. “Joan, what’s wrong? What are you doing? What?” I said to Joan, “What did it feel like when you were having a seizure?” She said, “I did not feel anything. All I could hear was Frank saying, “Joan, what’s happening?” They can hear you when you’re having a seizure. I’m sure they do not know what’s going on, but hearing your voice, I’m sure your pet would be reassuring.

That’s really what I think it is, it’s just that constant for them, like, “It’s okay. I’m coming back to it. I hear a familiar voice. I’m okay.” Just reassuring them. When you witness your pet having a seizure for the first time, you’re going to get nervous. You’re going to get anxious. You’re going to be all over them. You’re not going to know what to do. It is important for us to be able to try and stay calm, as calm as we can, because we’re going to get amped up, and we get anxious. It’s very common that our pets read us. They respond to how we’re feeling. It’s important for us to try to stay calm so that they can also reenter our energy. “It’s okay. It’s all going to be okay. We just have to get through this.”

Somebody keeps walking in and out of it.

It’s almost like they’re trying to act like a turtle.

It’s my dachshund.

I could not tell if it was a cat or a dog. I thought that animal was trying to crawl like a turtle.

She’s just very low to the ground.

No problem.

Got her legs to the normal height.

Missy, you’ve always said to me when I’ve asked you about neurologic diseases in pets to have the owners take a video, because to you, I can imagine how helpful that is, because what other things can look like a seizure but really are not a seizure?

The Importance Of Video Evidence For Diagnosis

The biggest differential that we have anytime a dog has a seizure is whether it was a sinkable or cardiac event. Did they have an abnormal rhythm, and is that what it was? They can look very similar. That’s why I always tell, we used to look for what we call autonomic dysfunction to be able to say it was a seizure versus a sinkable event. With autonomic dysfunction, basically, urination, salivation, and defecation. That being said, I had a dog who was born with a congenital heart defect, and he had sinkable episodes.

During that episode, it looked exactly like a seizure. I would not know the difference. For me, a lot of it is what led up to the events and then after the event. That’s where it’s huge because he would have them, he’d get really excited. He would pass out, he would urinate, he would defecate, and he’d pop right back up, and he would be fine. Versus if that was a seizure, I’d expect a longer post-seizure timing. I wouldn’t have expected it’s not common for dogs to have excitement-induced seizures, though they absolutely can.

Usually, excitement is more related to something going on in the heart. Getting a video is super helpful. I’ll be honest, though, I’ll see some videos, and I’ll say, “I do not know, is it a seizure? Is it sinkable? Is it a movement disorder?” All these things can look very similar to that. If it’s a true tonic, clonic, or grand mal, usually that’s easy to be able to say, “Yes, this is what it is, hands down. There’s just a wide variety, but a video is always going to be helpful for us.

Thank God for the videos. I was watching a neurology webinar the other day, and two vets were on it talking, and one of them said that this dog was on anti-seizure meds for years when it was really a reverse sneeze. Janet, do you know how they do that?

We did not have videos back then. It’s hard to describe.

How does the veterinarian determine what kind it is?

Basically, what we do is you listen to the owners. If they do not have a video, you’re going to ask certain questions. What were they doing before, during, and after? That’s really going to be us being the little detectives to be able to say, “What were they doing?” A lot of it is if I’m having a hard time knowing it’s not a classic seizure, I’ll say, “What were they doing after?” If there are any changes in their behavior after, and it especially lasts for more than a minute or so, usually then I’m thinking it’s more likely going to be some sort of seizure event that happens.

Now, movement disorders, that’s a whole other category. Those patients do not lose consciousness, but they can have abnormal limb movements as well. Those episodes, though, usually last very long. They’re 10 to 15 minutes or so. A seizure is short. A seizure should last less than two minutes. Longer than two minutes, you start getting your pet packed up to head to the ER.

Initial Evaluation And Determining Potential Causes

Seizures, I do not want cured, is not the right word. Can they be treated?

The biggest thing is what’s causing the seizure? Whenever you have a pet that has a seizure, you bring them in to be evaluated and assessed. First thing they’re going to do is run blood work and make sure there’s nothing going on systemically or metabolically that’s causing a senior seizure. Making sure the glucose is okay, electrolytes are okay, and there’s no liver disease. That’s really important in our young patients who can have a liver shunt that’s causing the seizure. We always do a good metabolic workup.

If that is all clear, and then we’re saying “We’re not finding anything there. Is something going on?” Specifically in the brain, a pathology that’s causing this, whether or not it’s idiopathic or genetic epilepsy, they were born with a seizure disorder. Is there something else, an inflammatory disease like meningitis? Could there, unfortunately, have been a stroke? Could there be a mass in the brain?

A lot of it will be determined, too, based on the neurologic evaluation because we see a lot of dogs with idiopathic or genetic epilepsy, so being born with a seizure disorder, especially in purebred dogs. If we see those cases, they come in, they’re normal in between seizures, they’ve got a normal neurologic evaluation, then usually we’re going to have idiopathic epilepsy high in our list.

Versus if I have a dog that comes in and when I’m checking his ability to know where his feet are in space, he has a hard time knowing where they are in the right side of his body and he’s circling to the left or something like that, then I’d be worried there’s something focally going on in the left part of the front part of his brain. There are a lot of questions.

What do you tell, like your family members or your dog sitter, your pet sitter? Let’s say you’re not home and you have the pet sitter. You’d have to find somebody who would know what to do.

A lot of times, if you have a pet that has seizures and let’s say they’ve been started on seizure medication, most of the time the expectation is they’re going to continue to have seizures. We cannot stop that, but we want to decrease the frequency of the seizures and severity of the seizures. Usually, some pets tend to have long seizures, or if they have what we call cluster seizures. One seizure, then they recover, and shortly after, they have another. They may have what we call cluster buster medications.

We have these protocols that owners can have at home to give oral medications, additional orals to try to stop another seizure from occurring, or they may have medications they can shoot up the nose, even. We commonly do that so that we can stop the seizure so that we do not have to worry about it being if it does end up being too long or one after the other. The other thing, though, a lot of the time in these cases, you just let them know to just be there with the pet, have them in a safe place.

As long as they recover, if they have had one seizure and they’re already being managed for seizures, they usually do not need to bring the pet into an ER. If they just recovered quickly and they did it, the expectation is they’re going to have seizures. Of course, we want to try to save them from ER visits as much as possible. As long as the pet’s doing okay. Usually, after one seizure, the pet recovers. It’s a known seizure pet. Usually, that pet sitter is going to know what to do. Just keep them comfy, give them their medications as such. If it’s one, the pet has no history of seizures, first-time seizure, then you definitely want to get them flipped at.

Our neighbors have a Springer Spaniel, epileptic, and we take care, we switch, we take care of each other’s pets, and I’d always go over and be like, “Listen up, Hunter, not on my watch.” You’d better put the medicine in the cheese ball.

Janet, you’d better be looking for saliva and pee around the house in case he had one. Then you did not know it.

Hunter lived to fourteen.

He’s no longer with us. Missy, talking about certain breeds. I remember in vet school in ICU, we had a border collie that was just on continuous pentobarbital because it was so hard to control. Are there certain purebred dogs that are harder to control with seizures?

Border Collie is definitely top of the list. Australian Shepherds and Labrador Retrievers are very much so kind of climbing that list as well. My hardest-to-control seizure pets are border collies for sure. They’re usually refractory.

Can I ask you, when you say laboratory retrievers, any color preference?

Nope.

I’ve always thought that, at least in dermatology, yellow labs were much harder to control with their allergies when I had them on immunotherapy. I would always say to the owner, most breeds we tell you, stay with these allergy shots for at least a year, but yellow labs, two years. I also thought they were more sensitive to medications.

Interesting.

It’s like the blond-haired, blue-eyed child.

Are there any things in veterinary medicine in the future that look really promising for seizures?

Yes. We’re always finding new medications. We still have the classic medications that we’re going to reach for, but we do always find new medications, as they’re developed for people, and then eventually, when they are no longer cost-prohibitive, they’re generic, and then we can pull them into vet med. It’s hard, though, because animals and people metabolize drugs very differently. A lot of medications that are great in people we cannot use in dogs and vice versa, or in cats.

There’s definitely always something on the horizon that we can be looking at regarding medications. There are different vagus nerve stimulators, too, that they’re looking into doing for. There are some studies ongoing. I know TUS has one right now to see if we’re able to help in these refractory cases and help get seizure control. They’re currently studying that. Dominic Fistler is doing that at TUS, and so they’re very early on in the stages, but looking into that as well to see if that’s going to be helpful.

What are some myths about seizures in pets?

Myths about seizures. The biggest one is that if you put an ice pack on their head, it’ll stop the seizure. There are some crazy things out there. That will not stop it.

When they’re flailing in the seizure, and you’re getting by the face.

There’s a lot of that. A lot of people will say that if they do this with their pet during a seizure, it’ll stop the seizure, but as I said, most seizures are going to be less than two minutes. Regardless of what you think you’re doing during that time, it should stop.

By the time you get the ice pack and come back, it’s done.

Something with the tongue. In people, they’re always like do not let them choke on their tongue. I’m not reaching there. They’re not going to swallow their tongue.

They’re not going to swallow their tongue. Do not put your hands in their mouth. Just leave them be. That’s actually a really good one. It’s very uncommon for a pet to die or pass from a seizure. A lot of people are very worried about that.

Good to know.

It’s very uncommon. If they do, I always say a seizure should be less than 2 to 3 minutes because at that point, if it starts being longer than that, that’s when we want to start getting to the ER because that’s when it starts to get to 5, or 6 minutes, and they’re in what we call status. We cannot get them out of a seizure. If their temperature goes up really high, their lack of oxygen. Those are when we worry about it, and they can start to have abnormal rhythms of the heart. That’s when they’re likely to pass. Again, it’s not common for them to pass from having a seizure, especially one, but those are the instances. Seizures back-to-back or seizures that are prolonged.

If an old lifestyle changes, like exercise or the right food, can any of that help?

Unfortunately, no. It’s usually not. I like to keep my patients healthy as much as possible. I tell owners that some pets have excitement-induced seizures. I’ll have some hunting dogs that only have seizures when it’s hunting season. They go, and they just get so amped up, they’ll have the seizure then. I have some patients that only have seizures when they go to the vet or to the groomers. They’re totally fine every other time. We can do pulse therapy for those pets to try to make it so that they can prepare for the events they can do.

I’ll ask my owners to look for any triggers in case they happen to have a pet that has excitement-induced triggers. It’s not uncommon during the holiday season, actually, because we’re more stressed. People coming to the house and everything, there’ll be a big uptake. I always say Christmas time is the season of seizures. Honestly, it’s crazy. We’ll pay attention to those things as well, but no, a well-balanced diet, a healthy diet, and exercise. I really do not usually change their day-to-day activities much unless they have something that we know is a trigger. We’ll try to limit it.

I have a question. When an old dog comes to see you with normal blood work, and they’ve been healthy their whole life, and now they’re seizuring is the first thing you think of a brain tumor.

Unfortunately, it has to be our top differential because that is the most common.

What else could that be?

The more I say, the more dogs, especially the older dogs, I imagine. I have this conversation with my owners all the time, that I am imagining more and more older dogs every day, and I am finding beautiful brains, and there is no mass, there is nothing. Mass is always going to be at the top of our list. Unfortunately, it is the most common, but we can have dogs that maybe had a stroke or a vascular event, and that’s what drove it, and then we’re going to be able to get them through that. I also have what I call my late-onset idiopathic epileptics.

They were born with a seizure disorder. We’re seeing signs of it later on, or maybe they were having small focal seizures throughout their life, and we were not seeing them. We do not know. We’re not with them 24/7 as much as we can be. Maybe there were these smaller ones that we missed, and so now they’ve gotten to the point that they’ve progressed to full tonic-clonic. Definitely, unfortunately, yes, a mass is at the top of our list, but other things too. Inflammation, a stroke, or potentially just late-onset epilepsy.

Why do you think cats do not seem to have as many seizure problems as dogs? Your hypothesis, if you have one.

If you think about it,  yes, there are purebred cats, but how many more purebred dogs are there than cats? There is a component, right? Most cats are truly nuts if we look at it that way. I definitely see seizures in purebred cats. We do not see as many purebred cats just out there in the world, but I definitely see it. Usually though, if a cat has seizures, they can have, we do not really call it idiopathic epilepsy because we do not believe it’s genetic.

We call it epilepsy of unknown cause in cats, but about a quarter of them will have epilepsy for an unknown reason. We will always strongly recommend working cats up just because they’re more commonly going to have inflammation going on, unfortunately, a mass or a stroke, or congenital developmental abnormalities. We will always look for something in a cat if they’re having seizures or at least recommend it because it’s less likely for them to be our classic idiopathic epileptics.

What you said before about your dog going to your husband when he feels a seizure coming? It’s so important. Janet, you and I have learned this with these podcasts. No matter what specialist we’re talking to, anything that’s out of the ordinary routine, and my example is the first golden I adopted at Golden Rescue, Cindy. I adopted her at age eleven. We walked around Hinkley Lake three miles every day.

About three years into it, when she was fourteen, all of a sudden, we’d be walking, and she would just stop. She did not want to walk like, “Come on.” Did you know shortly after that she developed a brain tumor circling in the area. Janet, like Missy was saying, one day we came home and I saw a pile of saliva in front of the window, and I said to my husband, “She had a seizure while we were gone.” You do not want to leave the house then because you’re just not want them to be alone.

Who would think she just did not want to walk? Brain tumor was not on my list of differentials. Fourteen-year-old, very fit, thin dog, “Maybe her joints are bothering her.” You just never know. When they’re such creatures of habit, and when they are doing something out of their wheelhouse. That should go on looking for something. I know phenobarbital is very common. Is that drug forever?

That drug has been around forever.

Medication Options And Long-Term Management

It’s a great anti-seizure medication, and that’s one of the main reasons that it’s still around because it does work really well. Downsides of it, of course, are long-term. You do have to watch the effects on the liver. As well as effects on, usually I think about my labs and putting them on phenobarbital because they already want to eat and drink everything, and that’s going to be one of the side effects of phenobarbital. It does come with monitoring lab work.

We have to make sure we’re monitoring drug levels within their body as well as monitoring liver enzymes. It’s a great medication, and as long as it’s monitored appropriately, it’s one that we’ll commonly use, especially for the patients that I see who are not usually ones that have had one seizure and then are coming to see me. They’re the ones that are already on medication or are on two medications, and they need me. Phenobarbital will commonly be used. The nice ones, too.

There are newer medications out there that are safer. I like using pregabalin in my young patients. The human form of Lyrica for seizures. It’s great. Now that it’s generic, minimal side effects, as well as no need to worry about monitoring blood levels or anything like that. Keppra or levetiracetam is really safe. We have zonisamide. We have topiramate and potassium bromide. You cannot use that on kitties. There are many options out there for our pets. Phenobarbital is still as hard as it is sometimes, with the side effects and things with it. You just have to find that right balance between the side effects of the medications and seizure control. It is still one of the most popular ones out there because it is good.

It’s cheap too, isn’t it? Isn’t it still inexpensive?

Yes.

Do you put your Fenibar patients on a liver protector?

I do not put them on a liver protectant. I just monitor their liver enzymes really well. We monitor what the blood level is doing as well as their liver enzymes. I expect certain enzymes to go up. It’s weird if they do not because of what phenobarb does to the liver to kick certain enzymes into gear to metabolize it. I do not necessarily take a liver supplement.

Now, are there some drugs, and I can think of one that can actually cause seizures in dogs. I had a Dalmatian that was owned by a human surgical resident in Pittsburgh. He called me one day. He was just freaking out because I saw the dog for allergies. His vet had put the dog on metronidazole for some stomach issues, and now the dog was seizing, and it was due to the metronidazole.

There’s definitely some medication. Metronidazole, I usually think of making them vestibular, but though they can definitely have seizures. The main ones are going to be your flea and tick preventatives. What I always tell people is they’re not necessarily causing the seizures themselves. Usually, what they do is they’re altering the seizure threshold. You already have a patient who is predisposed to having seizures.

Maybe having a mild form of idiopathic epilepsy is the best way to think about it. They get their monthly flea and tick medication, and then they have a seizure shortly thereafter. If that’s the case, then we just have to alter what flea and tick preventative they’re on to our heartworm preventative. Certain ones can, like I said, alter that seizure threshold so they’re more likely, but I do not usually think of certain medications necessarily causing a seizure unless you have some patients that have like MDR1.

I was just going to ask you about that.

What’s MDR1?

It’s basically a gene that they have where they cannot metabolize certain drugs appropriately. If you give them things like ivermectin, which is in classic flea and heartworm medication or tick medication, they can end up having a seizure because of the effects that it’ll have on their brain. Most clients will know if their dog has that. A lot of times, standard dosing is not going to cause seizures in those breeds. If they got into higher dosing, like I’ll have some hurting breeds that, “The horses were just dewormed and then the dogs go, and they eat the feces, or they got into the dewormer, and they’ll come in having seizures.”

I totally forgot about that, because really, as specialists, we do not see a lot of farm dogs. Sadly, because some of them are very allergic. Would you comment, because I have to say I would get and I still get helping these rescues get a lot of questions about idiopathic vestibular syndrome and what that is. Janet, you’ve had a lot of vertigo problems, so you probably would love to hear it.

I know what idiopathic means. I know vestibular has to do something.

These dogs are not doing yoga like you were.

No.

Exercises, though it was not yoga.

Vestibular is a problem with their balance. Similar to vertigo in people. Idiopathic vestibular is usually what we see in older animals when they acutely basically lose their balance, and they’re falling. They may have a head tilt, and their eyes are darting back and forth, which we call nystagmus. Usually, they have really significant effects, and then they improve within a couple of days. Sometimes the head tilt can take weeks to get better, but that’s idiopathic vestibular, which sometimes we can have patients that come in say, “My dog just had a seizure,” because all of a sudden they came on really suddenly, and they’re just rolling, and it can look very much like a seizure.

Usually, if there’s a head tilt, their eyes are darting back and forth, they’re circling and rolling. Usually, that’ll be a sign of vestibular disease, and usually they’ll get better over a couple of days. It’s very classic in your older dogs, where we’ll have that. There are many other causes for a dog to lose their balance or have vestibular signs, whether it’s something to do with the middle ear or something going on at the level of the brain stem itself. An idiopathic vestibular can look like it.

What’s hard is that we’ve actually just found there are vestibular seizures as well. That’s just thrown a whole other little chaos into the scenario. There are dogs, pugs, in particular, who can have vestibular seizures. With these episodes, they have a vestibular episode. It’s short. They take a little bit to get out of it, but then they’re back to normal. When you have an animal that has a vest, these vestibular signs, and then they quickly improve, usually we’re more thinking could have been some seizure, because in most vestibular cases they’re not just going to have an episode and then get better. They’re going to have signs for a while.

It’s not like Janet, like what you had with you to correct the little crystals in the ear. It’s not like that, Missy.

Not like that.

I do not want people trying to turn the dog’s head or putting him upside down.

It’s called the Epley maneuver.

Thank you.

In humans, it’s like this inside.

We could have your husband demonstrate how he did the Epley.

He’s an engineer, and he’s like, “We’ve got to fix this.”

No, thank you. You know the other thing, too, Missy, when I was in vet school, which was way far past when you were, but we were always like, “No, dogs and cats cannot have strokes,” but they can, right?

Understanding Vascular Events And Strokes

Yes. It’s very common. They’ll have strokes, or we call them cerebrovascular accidents. It can be the first onset, which could be them presenting with seizures, them presenting with circling, or any signs. It all depends on where it is in the brain. They can be either what we call ischemic or hemorrhagic. Ischemic means that we’ve blocked a blood vessel, and they’ve lost oxygen to that area, or hemorrhagic basically means they’ve had a little brain bleed.

We’ll try to identify the underlying cause of why it happens. Most dogs and cats, though, if they have a stroke or a vascular event, they’re able to get through it and do wonderfully, which is great. They are pretty remarkable. If you think about it, too, dogs and cats, they do. I always say cover their ears if they’re listening. Do not let your dogs hear, or cats hear this, but they do not use a large portion of their forebrain. They can actually have quite a bit happening in their forebrain, and they are still totally normal.

They are very much brain stem or hindbrain animals, and that’s what drives them to do the majority of their things. I’ve had dogs that have had tumors taking up the majority of the front part of their brain, and the only sign is a seizure. It’s because they just do not use that part of it. If they have a stroke or a vascular event, we can see subtle signs, or they can be more dramatic, of course, depending on where it is, but they can do very well.

Will they have more strokes? As in humans, once you’ve had a stroke, you’re always worried you’re going to have another one. We do not put them on blood thinners or anything like that, right?

We try to find the underlying cause. We usually say about 50% of the time we can find an underlying cause for why they happened. If it was ischemic, if it was hemorrhagic, or if bleeding usually occurs about 40% of the time. We can find a reason why it happens. If we can find the reason and we’re able to identify and treat that underlying reason, whether it’s high blood pressure, hypothyroidism, kidney disease, liver disease, a clotting abnormality, and we can treat it, then they’re less likely to have another one.

If it’s one and I work them up and I cannot find an underlying cause for the stroke, excuse me, then it’s a lot less likely for them to have another one. If I find an underlying cause, it can just be treated tricky to be able to regulate and control the disease that originally caused it. I do expect those pets to have another stroke.

How do you know if, like the medication you prescribe for seizures, it’s working? They’re not going to have seizures.

They’re still going to have seizures. We want to decrease the frequency and the severity. For all my patients, a lot of owners are great, and they’ll have seizure logs, but for all my patients, their pet has a seizure, they email or call us and let us know. We have a seizure log. If we’re tracking everything and we’re able to say, “If you are having one seizure a week, let’s see if we can get you out to one seizure a month,” let’s see, every case is different. I have some dogs that’ll have one seizure, once I have one seizure a year. I have other dogs. If I can get them to go a couple of weeks without having a seizure, it’s good. It’s very case-dependent and patient-specific.

You have to be careful. When I’m helping out at Golden Rescue. We have a golden that has seizures, and she’s on I think zonisamide, and I’ve got her on something for her allergies, and she was fine for the past three years, and the owner just called me the other day, and she had a seizure. Actually, she was doing so well that they lowered the zonismide dose, and I think now they just took it back up. I’m always concerned that a drug that I may be adding, you always need to tell your veterinarian or your new veterinarian or your specialist that you’re seeing what drugs your dog or cat is on, so that when they’re prescribing another drug for a different condition, it does not interact.

It’s very important just so that we know. Luckily, a lot of the seizure medications will go well with most other medications, which is great, but it is important to know to make sure, mainly to monitor the side effects, so that we’re not having a dog, we do not want the patient being a zombie, right, we want to still be able to live and have a good life. It’s that fine balance of controlling the seizures’ side effects and medications, adding other medications even if they’re not for seizures, they’re going to have their own side effects, so it’s making sure we’re balancing all of it together.

That goes for humans, too. The doctor cannot prescribe something if it’s going to interact with medication.

At least adjust the dose. This is going with myths again. Are there any holistic meds that you see people seeking out so that their dog does not have to be on anti-epileptic drugs?

There’s definitely a lot out there. The list would be like 100 pages long of what owners can try because they want to help their pet. There’s nothing wrong with doing it. The hard thing that I always just say is that you never know how a pet’s going to react to certain supplements or medications or anything. If I start taking medication, I know how it’s going to affect my body. If you’re adding in other things, I do not know how they’re going to interact.

I try to keep things as simple as possible. If I do not know that medication is going to help or that supplement is going to help, I’d rather not give it and muddy the waters, so to say, and just keep it nice and simple so that we know exactly what we’re getting. It’s the same thing with looking at CBD right now. There’s a lot of research going into it. Colorado is doing a lot. It’s there’s many different places.

The hard thing is that there are so many different manufacturers out there. There’s so many different varieties. There are so many different amounts in each medication that until we get it more structured, until we know exactly how not only is it helping with seizures, but also how it interacts with all of the other medications that we’re giving, until we have all that data. That’s what I tell clients. I cannot recommend it really, because I do not know how it’s going to potentially affect things.

Nobody is supervising it. We had Dr. Cooperman on Janet from Consumer Labs, and he was telling us some of the supplements that they check out. Some of them didn’t even have any of the supplements in there. For example, probiotics. They had no probiotic in this particular probiotic.

The probiotic I was taking was like way at the bottom of their list.

Is that right?

I switched brands.

The other day, I had a client ask me about mushrooms. The new falsehood for that is that it can help lipomas.

I do not know about you guys, but there’s like mushroom tea here, ground sprinkled mushrooms.

Janet, you didn’t know this, but I emailed Dr. Cooperman, and I said, “Have you guys looked at any of these mushrooms?” He said, “Alice, we haven’t looked at them because we cannot even establish a standard for it.” That’s how far-fetched it is.

That’s why it’s so hard to be able to be there, there’s so much out there, especially like you can get it I mean, anywhere, and there are so many different varieties. That’s why I just said, “This brand is the one that I would use, and this is the dosing.” That I know, then I am not comfortable doing it.

It’s all about the marketing. It has nothing to do with what is in there, and even if it did work, you do not know if the next batch is going to have as many ingredients in it as the one you’re giving.

We’ve got to wrap it up. Allison, I have to ask Dr. Carpentier here.

I want to see that dog passing behind you several times.

I missed it.

Wait, I got to see.

It’s a blonde.

Can they call them lemon dachshunds like they do beagles?

We call her blondes.

She’s adorable.

She’s pretty cute.

Lemon beagles. When they’re light colored, they call them lemon beagles.

That’s weird.

It’s kind of cute. What’s her name, Missy?

This is Henrietta Ash Mario Anderson. The kids had to make sure they had each gotten to name a middle name.

I named our rescue golden Libby of Buckeye to make her sound like those show dogs, and then we have Attacus Catacus.

Janet, you’d better hope those cats never have seizures because Janet cannot pill those cats.

The female’s fine.

They’re almost feral.

Isabelle’s great. He’s coming around.

What is he like, twelve years old, and he’s finally coming to you now?

Something like that. We’re getting there. She will cuddle with me. He’s like this. He hangs out with the men in my life, but not me.

Differentiating Seizures From Movement Disorders

Can I ask about one more disease? One more disease, and I asked you about it before, but I’m fascinated by it. Paroxysmal dyskinesia.

What the hell is that?

I know she’ll tell you.

It’s a movement disorder. It’s one of the things that we can get confused with seizures. Is it a seizure or not? Basically, what the animal will do is very commonly, they’ll look scared, but they’ll still be conscious. That’s how it’s one of the main differences between a true tonic-clonic or grand mal seizure and a paroxysmal dyskinesia. They’ll usually lift up either their most commonly used pelvic limb or a back leg, and hold it up. Sometimes people think their dog is lame or something like that.

They’ll hold it up very stiff, and then oftentimes they will lie down during the episodes. They’re very nondescript, which is the best way I can describe them. The good thing is that they’re usually as long as the rest of the dog is okay. Usually, they are benign, and they’re not doing anything to cause any harm. They usually do not have a sinister cause going on in the brain. If there are other neurologic signs, then we want to look further into the nervous system.

Neurology, like I always used to think in Dermatology, where there’s a new disease every day, but neurology’s got us beat on that. You guys are always identifying something new, which is good because it means you can treat it.

What’s different too, now we’re just now that we are able to have MRI abilities, so much more readily available. That’s really because before we were just like, “I do not necessarily know. If you do it, you’d maybe find a postmortem.” You cannot go from there and help out that patient or the next one. It’s really nice to be able to have access to that. It’s really changed the way we’ve been practicing.

Janet, next time you need an MRI, you need to go to Dr. Carpentier because they have to sedate you for their MRIs, and Janet gets claustrophobic.

I did a 90-minute one on Ativan at an event with contrast.

There you go.

I came out, and I’ve never taken an Ativan.

You lived.

I came out. My husband was there, and I hugged him, and I just started bawling because I was like, “I did it.” I was so proud. One of my proudest moments, whatever project I did at work, doing the 90-minute MRI was like, “Woo.” The ladies, I guess, like 60% of the people who do them are terrified, like me. They were like, “Look at the prism and the prism’s going to reflect a beach scene.” I’m like, “I’m not at the beach.”

Honey, you’re not in Kansas anymore.

Sometimes you have to pretend.

Before we go, Missy, tell us the most unusual animal that you’ve seen lately.

Not even lately. We haven’t talked to you for like a year or so.

I’ve seen some unusual humans lately, but that’s okay. They’re no fun.

I just see cats and dogs.

Has the zoo called you or something for anything?

We haven’t had anything from the zoo. When I was traveling last year, I helped with a llama.

What was going on there?

Ataxic llama.

Ataxic- Janet means it’s walking like it’s strong.

A wobbly llama basically.

I will help you with that. That’s really the main one.

Humorous Veterinary Experiences And Clinical Reflections

I have a guest question. This is our guest question. What’s the funniest thing that’s ever happened to you as a veterinarian?

We could write books on that.

I was going to say I do not know.

When I went to the vet once, our old cat and I had a very friendly cat, they were like dogs. She climbed up as a mink stole around our vet, and I was horrified. I’m going, “Let me get her.” She goes, “No.” She was a cat person, and I was horrified. The other one got up on the display case.

I got to tell you, that’s like an everyday thing for Missy and me. That’s not unusual.

I’m like, “Yeah, that we have.” We have our cat room. They’re all over the place. It’s funny now in our exam rooms because we have, of course, the automatic paper towel dispensers and soap dispensers in the cat room.

You mean like the stupid human trick where you have to go like this?

Yes. In the cat room, though, the cats love to jump up on the counters. They go under there, and so they’re getting covered in soap, and I’m like, “Good to know. For in the future, the cat room cannot have an automatic soap dispenser.”

That is funny.

Wait, I got to tell you my quick, funny story. I was traveling around before I got into vet school. I have to get the large animal experience. I was traveling around with the horse vet, a really nice guy, Dr. Dave. He’s doing the rectal exam on the horse, and after his arm is out, the horse passed gas, and he just got out of the way in time because he went, “That’s how you get freckles.”

Doesn’t the arm reverberate in there?

No, it’s tight. It actually clenches down on you. Remember that, Missy?

Yes.

You’re feeling stuff, and you’re like, “Yeah.”

Dr. Carpentier, I was like in the fashion business, and Alice was going to vet school, and I remember talking on the phone one day, and I’m like, “We got a whole new line in, I do not know, V-necks are in or cashmere, whatever I was saying.” I’m like, “How was your day?” She goes, “I had this big glove on, and it was inside a cow.” I was like, “Yeah.” I had, but outside of vet school, I was very well dressed because she would send me all the Espirit sample sales.”

I used to go to all the big sample sales, like in New York.

It was great.

The best part was that all the model shoes were size nine. My size.

They put holes in the bottom so they did not have to pay a duty on them.

They came through. I would just take black electrician’s tape. That was there, and I wore them.

A couple of new pairs of shoes. Good to go.

I was fine. It was like a little drilled hole.

This has been fascinating.

I have learned so much every time.

A seizure scares me. I’ve never seen one. I’ve been posting on a human. I have seen one on Ann’s Black Lab once.

Missy, being a neurologist, and I, being a vet, it’s still horrifying.

It’s so out of control like that.

You just want to be there to comfort them. What I always tell people is to remember they do not know what’s going on during the seizure.

They can hear after.

It’s after the fact that you just want to be there for them.

Thank you.

You’re welcome. It’s good to be here.

Thank you for the great work you do. I appreciate you. Thanks for tuning in. Do not forget to email us your questions at SOPPodcast.com. It’s on our website. Do not forget, it’s two P’s in there. I know it’s weird, but it’s the best we could get.

Speaking of Pets Podcast, SOP.

Thanks for tuning in. Share with us. Like us. We love likes. This week, we’re number three in the animal and pet category. We get really excited. Thank you, Dr. Carpentier. Alice, anything else?

No, just give your pets a kiss for us and tune in next week.

Thanks for tuning in. Bye.

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