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Mojarradi A, De Decker S, Van Meervenne S. Once-a-day oral treatment with phenobarbital in cats with presumptive idiopathic epilepsy. J Feline Med Surg 2023; 25:1098612X231196806. [PMID: 37747329 PMCID: PMC10812035 DOI: 10.1177/1098612x231196806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
OBJECTIVES Phenobarbital (PB) q12h is the most common treatment recommendation for cats with recurrent epileptic seizures. Medicating cats may be challenging and result in decreased quality of life for both cat and owner. The aim of this retrospective study was to evaluate treatment with oral PB q24h in cats with presumptive idiopathic epilepsy. METHODS Nine cats with presumptive idiopathic epilepsy, receiving oral PB q24h, were included in a retrospective descriptive study. RESULTS Seizure remission was achieved in 88% (8/9) of the cats and good seizure control in 12% (1/9) of the cats, treated with a mean dose of oral PB of 2.6 mg/kg q24h (range 1.4-3.8 mg/kg). No cats required an increase of their PB frequency at any time during a mean follow-up period of 3.5 years (range 1.1-8.0 years). No cats displayed side effects or issues with compliance at the last recorded follow-up. CONCLUSIONS AND RELEVANCE Once-a-day administration of PB for feline epilepsy was safe and resulted in satisfactory seizure control for the nine cats included in this study. The results of this study justify exploring this topic further in larger prospective studies.
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Affiliation(s)
- Abtin Mojarradi
- IVC Evidensia Referral Hospital in Helsingborg, Skåne, Sweden
| | - Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
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2
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Hasegawa D, Kanazono S, Chambers JK, Uchida K. Neurosurgery in feline epilepsy, including clinicopathology of feline epilepsy syndromes. Vet J 2022; 290:105928. [PMID: 36347391 DOI: 10.1016/j.tvjl.2022.105928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 11/04/2022] [Accepted: 11/04/2022] [Indexed: 11/07/2022]
Abstract
Feline epilepsy is treated with antiseizure medications, which achieves fair to good seizure control. However, a small subset of feline patients with drug-resistant epilepsy requires alternative therapies. Furthermore, approximately 50 % of cats with epileptic seizures are diagnosed with structural epilepsy with or without hippocampal abnormality and may respond to surgical intervention. The presence of hippocampal pathology and intracranial tumors is a key point to consider for surgical treatment. This review describes feline epilepsy syndrome and epilepsy-related pathology, and discusses the indications for and availability of neurosurgery, including lesionectomy, temporal lobectomy with hippocampectomy, and corpus callosotomy, for cats with different epilepsy types.
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Affiliation(s)
- Daisuke Hasegawa
- Laboratory of Veterinary Radiology, Nippon Veterinary and Life Science University, 1-7-1 Kyounancho, Musashino, Tokyo 180-8602, Japan; The Research Center for Animal Life Science, Nippon Veterinary and Life Science University, 1-7-1 Kyounancho, Musashino, Tokyo 180-8602, Japan.
| | - Shinichi Kanazono
- Neurology and Neurosurgery Service, Veterinary Specialists and Emergency Center, 815 Ishigami, Kawaguchi, Saitama 333-0823, Japan
| | - James K Chambers
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
| | - Kazuyuki Uchida
- Laboratory of Veterinary Pathology, Graduate School of Agricultural and Life Sciences, The University of Tokyo, 1-1-1 Yayoi, Bunkyo-ku, Tokyo 113-8657, Japan
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3
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Tenger M, Van Meervenne S, Varjonen K, Tidholm A, Rohdin C. Epilepsy in British Shorthair cats in Sweden. J Feline Med Surg 2022; 24:550-557. [PMID: 34431738 PMCID: PMC11104252 DOI: 10.1177/1098612x211036795] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The primary objective of this study was to investigate the prevalence of epileptic seizures and of presumed idiopathic epilepsy (PIE, describing epilepsy of unknown origin) in a cohort of British Shorthair (BSH) cats in Sweden. The secondary objective was to describe epileptic seizure characteristics and outcome for cats with PIE. METHODS Owners of BSH cats born between 2006 and 2016 and registered with SVERAK (the Swedish Cat Clubs' National Association) were invited to reply to a questionnaire about their cat's general health. Owners who indicated that their cat had experienced epileptic seizures were invited to participate in an in-depth telephone interview about the epileptic seizures. The clinical characteristics of epileptic seizures in BSH cats were determined from the results of the interview. RESULTS In this population comprising 1645 BSH cats (representing 28% of registered BSHs), the prevalence of epileptic seizures was 0.9% and for PIE it was 0.7%. BSH cats with PIE presented with infrequent but consistent epileptic seizures. Twenty-seven percent of BSH cats with epileptic seizures had cluster seizures but none presented with status epilepticus. None of the BSH cats was treated with antiepileptic drugs, and none of the owners reported epileptic seizure remission in their cat. CONCLUSIONS AND RELEVANCE The prevalence of PIE in this population of BSH cats was 0.7%. The prevalence of epileptic seizures was 0.9%. In general, PIE in the BSH cat displayed a relatively benign phenotype where progression of epileptic seizures was uncommon.
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Affiliation(s)
| | | | | | - Anna Tidholm
- Anicura Albano Small Animal Hospital, Stockholm, Sweden
| | - Cecilia Rohdin
- Anicura Albano Small Animal Hospital, Stockholm, Sweden
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
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4
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Pakozdy A. Improving the quality of life of epileptic cats and their owners through effective medication strategies. Vet Rec 2021; 189:436-437. [PMID: 34860373 DOI: 10.1002/vetr.1240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Akos Pakozdy
- Small Animal Clinic, Department of Internal Medicine, University of Veterinary Medicine, Vienna, Austria
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5
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Bakhtazad A, Garmabi B, Joghataei MT. Neurological manifestations of coronavirus infections, before and after COVID-19: a review of animal studies. J Neurovirol 2021; 27:864-884. [PMID: 34727365 PMCID: PMC8561685 DOI: 10.1007/s13365-021-01014-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/15/2021] [Accepted: 08/20/2021] [Indexed: 12/12/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This virus, which was first identified in December 2019 in China, has resulted in a yet ongoing viral pandemic. Coronaviridae could potentially cause several disorders in a wide range of hosts such as birds and mammals. Although infections caused by this family of viruses are predominantly limited to the respiratory tract, Betacoronaviruses are potentially able to invade the central nervous system (CNS) as well as many other organs, thereby inducing neurological damage ranging from mild to lethal in both animals and humans. Over the past two decades, three novel CoVs, SARS-CoV-1, MERS-CoV, and SARS-CoV-2, emerging from animal reservoirs have exhibited neurotropic properties causing severe and even fatal neurological diseases. The pathobiology of these neuroinvasive viruses has yet to be fully known. Both clinical features of the previous CoV epidemics (SARS-CoV-1 and MERS-CoV) and lessons from animal models used in studying neurotropic CoVs, especially SARS and MERS, constitute beneficial tools in comprehending the exact mechanisms of virus implantation and in illustrating pathogenesis and virus dissemination pathways in the CNS. Here, we review the animal research which assessed CNS infections with previous more studied neurotropic CoVs to demonstrate how experimental studies with appliable animal models can provide scientists with a roadmap in the CNS impacts of SARS-CoV-2. Indeed, animal studies can finally help us discover the underlying mechanisms of damage to the nervous system in COVID-19 patients and find novel therapeutic agents in order to reduce mortality and morbidity associated with neurological complications of SARS-CoV-2 infection.
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Affiliation(s)
- Atefeh Bakhtazad
- Cellular and Molecular Research Center (CMRC), Iran University of Medical Sciences, 1449614535 Tehran, Iran
| | - Behzad Garmabi
- School of Medicine, Shahroud University of Medical Sciences, Haft-Tir Sq, University Blv, 3614773947 Shahroud, Iran
| | - Mohammad Taghi Joghataei
- Cellular and Molecular Research Center (CMRC), Iran University of Medical Sciences, 1449614535 Tehran, Iran
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6
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Qahwash M, Heller HLB. Seizure etiologic classification and long-term outcome for cats with juvenile-onset seizures. J Am Vet Med Assoc 2019; 253:763-767. [PMID: 30179086 DOI: 10.2460/javma.253.6.763] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To identify seizure etiologic classification for cats that developed seizures at < 12 months of age and describe the long-term outcome of affected cats. DESIGN Retrospective cohort study. ANIMALS 15 client-owned cats with seizures that began at < 12 months of age. PROCEDURES Information on each cat was obtained from the medical records, veterinarians, and owners. Inclusion required an onset of seizures before 12 months of age and a complete medical record, including a final diagnosis. RESULTS 7 of the 15 cats had structural epilepsy, 4 had idiopathic epilepsy, and 4 had reactive seizures. Median age at seizure onset was 27 weeks (range, 0.4 to 41 weeks). Cluster seizures were reported in 6 cats, and status epilepticus was reported in 2. Age at the onset of seizures, presence of cluster seizures, and seizure semiology (ie, generalized vs focal seizures) were not significantly associated with seizure etiologic classification. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that cats that developed seizures at < 12 months of age were more likely to have structural epilepsy than idiopathic epilepsy or reactive seizures. Therefore, advanced diagnostic imaging is recommended in cats with juvenile-onset seizures if metabolic and toxic causes are excluded.
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7
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Reactive seizures in cats: A retrospective study of 64 cases. Vet J 2019; 244:1-6. [DOI: 10.1016/j.tvjl.2018.11.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 11/11/2018] [Accepted: 11/15/2018] [Indexed: 01/06/2023]
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Krull DP, Thomovsky SA, Chen AV, Mealey KL, Papich MG. Evaluation of Transdermal Administration of Phenobarbital in Healthy Cats. J Am Anim Hosp Assoc 2018; 55:1-7. [PMID: 30427717 DOI: 10.5326/jaaha-ms-6670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The purpose was to determine the safety and achievable serum concentrations of transdermally administered phenobarbital in healthy cats. The hypothesis was that transdermal phenobarbital would achieve therapeutic serum concentrations (15-45 µg/mL) with minimal short-term adverse effects. Enrolled cats had normal physical and neurologic exams and unremarkable bloodwork. Transdermal phenobarbital in a pluronic lecithin organogel-based vehicle was administered at a dosage of 3.0-3.1 mg/kg per ear pinna (total of 6.0-6.2 mg/kg) every 12 hr for 14 days. Serum phenobarbital concentrations were measured 3-6 hr after dosing at seven different times over 15 days. The mean and median serum concentration of phenobarbital at study completion were 5.57 and 4.08 µg/mL, respectively. Mean peak concentration and mean time to peak concentration were 5.94 µg/mL and 13.3 days, respectively. Mild adverse effects were observed. Potency was analyzed in three replicates of the transdermal phenobarbital gel administered; potencies ranged from 62.98 to 82.02%. Transdermal application of phenobarbital in healthy cats achieves a detectable, but subtherapeutic, serum concentration and appears safe in the short term. The use of therapeutic drug monitoring is recommended when this formulation of phenobarbital is used to ensure therapeutic serum concentrations are achieved.
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Affiliation(s)
- Daniel P Krull
- From the Department of Veterinary Clinical Studies, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana (S.A.T.); Columbia River Veterinary Specialists, Vancouver, Washington (D.P.K.); Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina (M.G.P.); and Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington (K.L.M., A.V.C.)
| | - Stephanie Ann Thomovsky
- From the Department of Veterinary Clinical Studies, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana (S.A.T.); Columbia River Veterinary Specialists, Vancouver, Washington (D.P.K.); Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina (M.G.P.); and Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington (K.L.M., A.V.C.)
| | - Annie Vivian Chen
- From the Department of Veterinary Clinical Studies, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana (S.A.T.); Columbia River Veterinary Specialists, Vancouver, Washington (D.P.K.); Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina (M.G.P.); and Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington (K.L.M., A.V.C.)
| | - Katrina L Mealey
- From the Department of Veterinary Clinical Studies, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana (S.A.T.); Columbia River Veterinary Specialists, Vancouver, Washington (D.P.K.); Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina (M.G.P.); and Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington (K.L.M., A.V.C.)
| | - Mark G Papich
- From the Department of Veterinary Clinical Studies, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana (S.A.T.); Columbia River Veterinary Specialists, Vancouver, Washington (D.P.K.); Department of Molecular and Biomedical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina (M.G.P.); and Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, Washington (K.L.M., A.V.C.)
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9
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Hazenfratz M, Taylor SM. Recurrent seizures in cats: Diagnostic approach - when is it idiopathic epilepsy? J Feline Med Surg 2018; 20:811-823. [PMID: 30139320 PMCID: PMC10816265 DOI: 10.1177/1098612x18791873] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Practical relevance: Seizures are one of the most common neurologic problems recognized in cats, affecting approximately 1-3% of the general population. Treatment options and prognosis are closely related to the underlying cause, so it is important that veterinarians are familiar with the diagnostic approach to cats with seizures and options for medical management. Series outline: This is the first of a two-part article series that reviews the diagnosis and treatment of seizures in cats. Part 1 outlines the classification and terminology used to describe epilepsy and epileptic seizures in cats, and discusses some of the most common and unique causes of recurrent seizures in cats. The diagnostic approach to cats with recurrent seizures is addressed, as are criteria for the diagnosis of idiopathic epilepsy. AUDIENCE This review of recurrent seizures in cats is intended for all veterinarians who are facing the challenges of seizure diagnosis and management in the feline patient. Evidence base: Recommendations for diagnosis and management of feline seizure disorders have historically been extrapolated from the canine and human literature. The information and guidance provided in this two-part series is based on a review of the recent published literature addressing seizure disorders and antiepileptic treatment in cats, as well as the authors' clinical experience.
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Affiliation(s)
- Michal Hazenfratz
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Canada
| | - Susan M Taylor
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N5B4, Canada
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10
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Hazenfratz M, Taylor SM. Recurrent seizures in cats: Treatment - which antiepileptic drugs are recommended? J Feline Med Surg 2018; 20:825-834. [PMID: 30139319 PMCID: PMC10816270 DOI: 10.1177/1098612x18791874] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Practical relevance: Seizures are one of the most common neurological problems recognized in cats, affecting approximately 1-3% of the general population. Treatment options and prognosis are closely related to the underlying cause, so it is important that veterinarians are familiar with the diagnostic approach to cats with seizures and options for medical management. Series outline: This is the second of a two-part article series that reviews the diagnosis and treatment of seizures in cats. Part 2 describes chronic medical treatment options and prognosis for cats with recurrent seizures, and acute treatment of status epilepticus. AUDIENCE This review of recurrent seizures in cats is intended for all veterinarians who are facing the challenges of seizure diagnosis and management in the feline patient. Evidence base: Recommendations for diagnosis and management of feline seizure disorders have historically been extrapolated from the canine and human literature. The information and guidance provided in this two-part series is based on a review of the recent published literature addressing seizure disorders and antiepileptic treatment in cats, as well as the authors' clinical experience.
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Affiliation(s)
- Michal Hazenfratz
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Canada
| | - Susan M Taylor
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N5B4, Canada
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11
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12
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Szelecsenyi AC, Giger U, Golini L, Mothersill I, Torgerson PR, Steffen F. Survival in 76 cats with epilepsy of unknown cause: a retrospective study. Vet Rec 2017; 181:479. [PMID: 29097567 PMCID: PMC5748884 DOI: 10.1136/vr.104281] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 08/12/2017] [Accepted: 08/18/2017] [Indexed: 11/04/2022]
Abstract
Survival of cats with epilepsy of unknown cause (EUC) has not been reported. Seizure semiology and its relationship to treatment outcome and survival was studied in a population of 76 cats. A questionnaire for seizure semiology was developed based on experimental data. Seizure semiology was characterised by owner interviews at least one year after discharge. Seizures were classified as (1) primary generalised and (2) focal without and (3) with secondary generalisation. Median age at seizure onset was four (range 0.3-18) years. One-third of cats with EUC presented with primary generalised seizures and 78 per cent of those with initially focal seizures progressed to secondary generalised seizures. Clinical signs of generalised seizures included sudden onset of loss of consciousness and tonic-clonic seizures, while cats with focal seizures had unilateral signs. Antiepileptic drug (AED) therapy was initiated in 62 cats. Complete remission rate was 42 per cent and the median survival time was 3.2 (range 1-11) years with or without AED, and 91 per cent were still alive at the time of interview. Neither semiology nor seizure type predicted survival, response to treatment and outcome in cats with EUC. A seizure-free status of more than 12 months was observed in 79 per cent of cats without AED.
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Affiliation(s)
- Arlette Cornelia Szelecsenyi
- Department of Clinical Veterinary Medicine, Small Animal Clinic, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Urs Giger
- School of Veterinary Medicine, Section of Medical Genetics, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Lorenzo Golini
- Department of Clinical Veterinary Medicine, Small Animal Clinic, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Ian Mothersill
- Department of Clinical Neurophysiology, Swiss Epilepsy Centre, Laboratory of EEG and Long Term Monitoring, Zürich, Switzerland
| | - Paul R Torgerson
- Section of Veterinary Epidemiology, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Frank Steffen
- Department of Small Animals, Neurology Service, VetSuisse Faculty - University of Zurich, Zurich, Switzerland
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13
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Raimondi F, Shihab N, Gutierrez-Quintana R, Smith A, Trevail R, Sanchez-Masian D, Smith PM. Magnetic resonance imaging findings in epileptic cats with a normal interictal neurological examination: 188 cases. Vet Rec 2017; 180:610. [DOI: 10.1136/vr.104142] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2017] [Indexed: 12/25/2022]
Affiliation(s)
- F. Raimondi
- Southern Counties Veterinary Specialists (SCVS); 6 Forest Corner Farm, Ringwood Hampshire BH24 3JW UK
| | - N. Shihab
- Southern Counties Veterinary Specialists (SCVS); 6 Forest Corner Farm, Ringwood Hampshire BH24 3JW UK
| | | | - A. Smith
- Langford Small Animal Referral Hospital; Langford Road Bristol BS40 5DU UK
| | - R. Trevail
- Southern Counties Veterinary Specialists (SCVS); 6 Forest Corner Farm, Ringwood Hampshire BH24 3JW UK
| | | | - P. M. Smith
- Davies Veterinary Specialists, Manor Farm Business Park; Higham Gobion Hitchin SG5 3HR UK
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14
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Stanciu GD, Packer RMA, Pakozdy A, Solcan G, Volk HA. Clinical reasoning in feline epilepsy: Which combination of clinical information is useful? Vet J 2017; 225:9-12. [PMID: 28720302 DOI: 10.1016/j.tvjl.2017.04.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Revised: 04/01/2017] [Accepted: 04/08/2017] [Indexed: 10/19/2022]
Abstract
We sought to identify the association between clinical risk factors and the diagnosis of idiopathic epilepsy (IE) or structural epilepsy (SE) in cats, using statistical models to identify combinations of discrete parameters from the patient signalment, history and neurological examination findings that could suggest the most likely diagnosis. Data for 138 cats with recurrent seizures were reviewed, of which 110 were valid for inclusion. Seizure aetiology was classified as IE in 57% and SE in 43% of cats. Binomial logistic regression analyses demonstrated that pedigree status, older age at seizure onset (particularly >7years old), abnormal neurological examinations, and ictal vocalisation were associated with a diagnosis of SE compared to IE, and that ictal salivation was more likely to be associated with a diagnosis of IE than SE. These findings support the importance of considering inter-ictal neurological deficits and seizure history in clinical reasoning.
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Affiliation(s)
- Gabriela-Dumitrita Stanciu
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield AL9 7TA, UK; University of Agricultural Sciences and Veterinary Medicine "Ion Ionescu de la Brad", Faculty of Veterinary Medicine, Department of Internal Medicine/Neurology, Iasi, 8 M. Sadoveanu Alley, 700489, Iasi, Romania
| | | | - Akos Pakozdy
- Clinic for Internal Medicine and Infectious Diseases, University of Veterinary Medicine, Neurology Service, Veterinarplatz 1, A-1210 Vienna, Austria
| | - Gheorghe Solcan
- University of Agricultural Sciences and Veterinary Medicine "Ion Ionescu de la Brad", Faculty of Veterinary Medicine, Department of Internal Medicine/Neurology, Iasi, 8 M. Sadoveanu Alley, 700489, Iasi, Romania
| | - Holger Andreas Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield AL9 7TA, UK.
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15
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Doenges SJ, Weber K, Dorsch R, Fux R, Fischer A, Matiasek LA, Matiasek K, Hartmann K. Detection of feline coronavirus in cerebrospinal fluid for diagnosis of feline infectious peritonitis in cats with and without neurological signs. J Feline Med Surg 2016; 18:104-9. [PMID: 25736448 PMCID: PMC11149007 DOI: 10.1177/1098612x15574757] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES The objective of this study was to evaluate the sensitivity and specificity of a real-time reverse transcriptase polymerase chain reaction (real-time RT-PCR) detecting feline coronavirus (FCoV) RNA in cerebrospinal fluid (CSF) of cats with and without neurological and/or ocular signs for the diagnosis of feline infectious peritonitis (FIP). METHODS This prospective case-control study included 34 cats. Nineteen cats had a definitive histopathological diagnosis of FIP (seven of these with neurological and/or ocular signs), and 15 cats had other diseases but similar clinical signs (three of these with neurological and/or ocular signs). Real-time RT-PCR was performed on the CSF of all cats, and sensitivity, specificity, and positive (PPV) and negative predictive values (NPV) were calculated. RESULTS Real-time RT-PCR of CSF showed a specificity of 100% in diagnosing FIP, a sensitivity of 42.1%, a PPV of 100% and an NPV of 57.7%. The sensitivity of the real-time RT-PCR of CSF in cats with neurological and/or ocular signs was 85.7%. CONCLUSIONS AND RELEVANCE Although it is known that RT-PCR can give false positive results, especially if performed using serum or plasma, this real-time RT-PCR detecting FCoV RNA in CSF can be considered a reliable specific tool for the diagnosis of FIP. If only cats with neurological involvement are evaluated, the sensitivity of this real-time RT-PCR in CSF is also high.
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Affiliation(s)
| | - Karin Weber
- Clinic of Small Animal Medicine, LMU University of Munich, Munich, Germany
| | - Roswitha Dorsch
- Clinic of Small Animal Medicine, LMU University of Munich, Munich, Germany
| | - Robert Fux
- Institute for Infectious Diseases and Zoonoses, LMU University of Munich, Munich, Germany
| | - Andrea Fischer
- Clinic of Small Animal Medicine, LMU University of Munich, Munich, Germany
| | - Lara A Matiasek
- Clinic of Small Animal Medicine, LMU University of Munich, Munich, Germany
| | - Kaspar Matiasek
- Institute of Veterinary Pathology, LMU University of Munich, Munich, Germany
| | - Katrin Hartmann
- Clinic of Small Animal Medicine, LMU University of Munich, Munich, Germany
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16
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Barfield DM, Gibson AD, Lipscomb VJ. Multiple acquired portosystemic shunts in a cat secondary to chronic diaphragmatic rupture. JFMS Open Rep 2015; 1:2055116915585020. [PMID: 28491353 PMCID: PMC5362922 DOI: 10.1177/2055116915585020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2014] [Indexed: 11/18/2022] Open
Abstract
Case summary A cat with a chronic diaphragmatic rupture presented with neurological signs, including twitching and focal seizures. Blood ammonia level was markedly elevated and therefore neurological signs were thought to be related to hepatic encephalopathy. Exploratory laparotomy revealed that the left lateral and medial liver lobes were herniated into the thorax and multiple acquired portosystemic shunts (MAPSS) were present. The hernia was reduced and the diaphragm repaired. Neurological signs gradually resolved following surgery and 1 year postoperatively the cat was clinically normal, was not on any medication and had no evidence of hepatic dysfunction. Relevance and novel information This is the first report of a chronic diaphragmatic rupture leading to MAPSS in a cat.
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Affiliation(s)
- Dominic M Barfield
- Department of Clinical Science and Services, The Royal Veterinary College, North Mymms, UK
| | - Andrew D Gibson
- Department of Clinical Science and Services, The Royal Veterinary College, North Mymms, UK
| | - Vicky J Lipscomb
- Department of Clinical Science and Services, The Royal Veterinary College, North Mymms, UK
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17
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Wagner E, Rosati M, Molin J, Foitzik U, Wahle AM, Fischer A, Matiasek LA, Reese S, Flegel T, Matiasek K. Hippocampal sclerosis in feline epilepsy. Brain Pathol 2014; 24:607-19. [PMID: 24698012 PMCID: PMC8029488 DOI: 10.1111/bpa.12147] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Accepted: 03/31/2014] [Indexed: 01/01/2023] Open
Abstract
Hippocampal sclerosis (HS) refers to loss of hippocampal neurons and astrogliosis. In temporal lobe epilepsy (TLE), HS is a key factor for pharmacoresistance, even though the mechanisms are not quite understood. While experimental TLE models are available, there is lack of models reflecting the natural HS development. Among domestic animals, cats may present with TLE-like seizures in natural and experimental settings. With this study on the prevalence, segmental pattern and clinicopathological correlates of feline HS, we evaluated the translational value for human research. Evaluation schemes for human brains were applied to epileptic cats. The loss of neurons was morphometrically assessed and the degree of gliosis was recorded. Hippocampal changes resembling human HS were seen in about one third of epileptic cats. Most of these were associated with infiltrative diseases such as limbic encephalitis. Irrespective of the etiology and semiology of seizures, total hippocampal sclerosis was the most prevalent form seen in epileptic animals. Other HS types also occur at varying frequencies. Segmental differences to human HS can be explained by species-specific synaptic connectivities and a different spectrum of etiologies. All these variables require consideration when translating results from feline studies regarding seizure-associated changes of the temporal lobe and especially HS.
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Affiliation(s)
- Eva Wagner
- Section of Clinical & Comparative NeuropathologyInstitute of Veterinary PathologyCentre for Clinical Veterinary MedicineLudwig Maximilians University of MunichMunichGermany
| | - Marco Rosati
- Section of Clinical & Comparative NeuropathologyInstitute of Veterinary PathologyCentre for Clinical Veterinary MedicineLudwig Maximilians University of MunichMunichGermany
| | - Jessica Molin
- Section of Clinical & Comparative NeuropathologyInstitute of Veterinary PathologyCentre for Clinical Veterinary MedicineLudwig Maximilians University of MunichMunichGermany
| | - Ulrike Foitzik
- Section of Clinical & Comparative NeuropathologyInstitute of Veterinary PathologyCentre for Clinical Veterinary MedicineLudwig Maximilians University of MunichMunichGermany
| | - Andrea M. Wahle
- Section of NeurologySmall Animal Medical ClinicCentre for Clinical Veterinary MedicineLudwig Maximilians University of MunichMunichGermany
| | - Andrea Fischer
- Section of NeurologySmall Animal Medical ClinicCentre for Clinical Veterinary MedicineLudwig Maximilians University of MunichMunichGermany
| | - Lara A. Matiasek
- Section of NeurologySmall Animal Medical ClinicCentre for Clinical Veterinary MedicineLudwig Maximilians University of MunichMunichGermany
| | - Sven Reese
- Institute of Veterinary AnatomyDepartment of Veterinary SciencesLudwig Maximilians University of MunichMunichGermany
| | - Thomas Flegel
- Neurology ServiceDepartment of Small Animal MedicineUniversity of LeipzigLeipzigGermany
| | - Kaspar Matiasek
- Section of Clinical & Comparative NeuropathologyInstitute of Veterinary PathologyCentre for Clinical Veterinary MedicineLudwig Maximilians University of MunichMunichGermany
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18
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Moore SA. Seizures and epilepsy in cats. VETERINARY MEDICINE-RESEARCH AND REPORTS 2014; 5:41-47. [PMID: 32670845 PMCID: PMC7337200 DOI: 10.2147/vmrr.s62077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 04/23/2014] [Indexed: 11/23/2022]
Abstract
Seizures are a common presenting complaint in cats, although causes and options for the treatment of seizures in this species have been historically poorly described in the veterinary literature. Seizure manifestation in cats may be different than what is typically seen in dogs, but the underlying causes of seizure activity are the same. These include primary epilepsies, structural epilepsies, and reactive seizures. Although primary epilepsy was once believed to be rare in cats, we now commonly appreciate this syndrome, albeit at a lower frequency than in dogs. Because of this, a complete diagnostic work-up is recommended for all cats presenting for initial evaluation of seizures. Symptomatic treatment of seizures in cats is similar to dogs, with only a few limitations related to species-specific antiepileptic drug toxicities. The goal of this review is to summarize the recent veterinary literature related to feline seizures, with a focus on seizure classification, clinical manifestation, diagnostic evaluation, and treatment options.
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Affiliation(s)
- Sarah A Moore
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
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19
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Moore SA. A clinical and diagnostic approach to the patient with seizures. Top Companion Anim Med 2014; 28:46-50. [PMID: 24070681 DOI: 10.1053/j.tcam.2013.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2013] [Accepted: 07/07/2013] [Indexed: 11/11/2022]
Abstract
Seizures are one of the most common neurologic problems encountered by the small animal practitioner. Successful management of the patient with seizure is facilitated by an appropriate diagnostic workup to identify underlying causes when they exist. Veterinary patients with seizures can be divided in to 3 main categories based on underlying cause: those with primary epilepsy, those with structural epilepsy, and those with reactive seizures. Additionally, some patients may be given a label of unknown epilepsy when they do not meet the criteria for a diagnosis of primary epilepsy, but no structural or reactive cause of seizures can be identified. This article reviews the key clinical findings associated with each of the 3 main categories of seizures and suggests a standardized approach to the diagnostic workup for patients with seizure based on their signalment and neurologic examination findings.
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Affiliation(s)
- Sarah A Moore
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.
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20
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Mariani CL. Terminology and classification of seizures and epilepsy in veterinary patients. Top Companion Anim Med 2014; 28:34-41. [PMID: 24070679 DOI: 10.1053/j.tcam.2013.06.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Accepted: 06/25/2013] [Indexed: 11/11/2022]
Abstract
The classification of epileptic seizures and epilepsy is a controversial and dynamic topic that has undergone many iterations in human medicine. The International League against Epilepsy is a multinational organization that has formed a number of task forces and subcommittees to study this issue, and has ratified several reports outlining recommended terminology and classification schemes for human patients. Veterinary publications on this issue have generally adapted these schemes to fit small animal patients, but a formally endorsed system to classify seizures and epilepsy has never been developed for veterinary patients. This review outlines the classification systems that have been published for human patients and summarizes previous efforts by veterinary authors to utilize these methods. Finally, a set of definitions and terminology for use in veterinary patients is proposed, which includes a glossary of descriptive terminology for ictal semiology and a diagnostic scheme for classification of individual patients. This document is intended as a starting point of discussion, which will hopefully eventually result in a formally ratified document that will be useful for communication between health professionals, the design of clinical trials and for guiding treatment decisions and prognostication for veterinary patients with seizures.
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Affiliation(s)
- Christopher L Mariani
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, USA.
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21
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Pakozdy A, Halasz P, Klang A. Epilepsy in cats: theory and practice. J Vet Intern Med 2014; 28:255-63. [PMID: 24438024 PMCID: PMC4857998 DOI: 10.1111/jvim.12297] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 11/14/2013] [Accepted: 12/04/2013] [Indexed: 11/29/2022] Open
Abstract
The veterinary literature on epilepsy in cats is less extensive than that for dogs. The present review summarizes the most important human definitions related to epilepsy and discusses the difficulties in applying them in daily veterinary practice. Epileptic seizures can have a wide range of clinical signs and are not necessarily typical in all cases. Whether a seizure event is epileptic can only be suspected based on clinical, laboratory, and neuroimaging findings as electroencephalography diagnostic techniques have not yet been developed to a sufficiently accurate level in veterinary medicine. In addition, the present review aims to describe other diagnoses and nonepileptic conditions that might be mistaken for epileptic seizures. Seizures associated with hippocampal lesions are described and discussed extensively, as they seem to be a special entity only recognized in the past few years. Furthermore, we focus on clinical work‐up and on treatment that can be recommended based on the literature and summarize the limited data available relating to the outcome. Critical commentary is provided as most studies are based on very weak evidence.
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Affiliation(s)
- A Pakozdy
- University Clinic for Small Animals, Clinical Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
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22
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Finnerty KE, Heller HLB, Mercier MN, Giovanella CJ, Lau VW, Rylander H. Evaluation of therapeutic phenobarbital concentrations and application of a classification system for seizures in cats: 30 cases (2004–2013). J Am Vet Med Assoc 2014; 244:195-9. [DOI: 10.2460/javma.244.2.195] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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23
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Tamura M, Hasegawa D, Uchida K, Kuwabara T, Mizoguchi S, Ochi N, Fujita M. Feline anaplastic oligodendroglioma: long-term remission through radiation therapy and chemotherapy. J Feline Med Surg 2013; 15:1137-40. [PMID: 23651604 PMCID: PMC10816470 DOI: 10.1177/1098612x13488383] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A 10-year-old spayed female Abyssinian cat was presented with cluster limbic focal seizures with secondary generalisation. From magnetic resonance imaging (MRI) findings, the cat was diagnosed clinically as having a glioma in the left piriform lobe, and hypofractionated radiation therapy (RT) was performed using a linear accelerator. Although the tumour size had reduced significantly at 4 months after RT, recurrence was observed at 11 months after RT. Additional RT was performed and was effective; however, recurrence was observed at 11 months after the additional RT. Chemotherapy was started using nimustine (ACNU; 30 mg/m(2), every 6 weeks). Tumour regression was confirmed by follow-up MRIs from 2 to 5 months after starting chemotherapy. Four years and 2 months after the first presentation the cat died as a result of tumour lysis syndrome following treatment of a high-grade lymphoma. Histopathological diagnosis of the brain tumour confirmed anaplastic oligodendroglioma.
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Affiliation(s)
- Masahiro Tamura
- 1Department of Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan
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24
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Wahle AM, Brühschwein A, Matiasek K, Putschbach K, Wagner E, Mueller RS, Fischer A. Clinical characterization of epilepsy of unknown cause in cats. J Vet Intern Med 2013; 28:182-8. [PMID: 24237601 PMCID: PMC4895554 DOI: 10.1111/jvim.12250] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2013] [Revised: 09/15/2013] [Accepted: 10/08/2013] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The diagnosis of feline epilepsy of unknown cause (EUC) requires a thorough diagnostic evaluation, otherwise the prevalence of EUC could be overestimated. HYPOTHESIS Feline EUC is a clinically defined disease entity, which differs from feline hippocampal necrosis by the absence of magnetic resonance imaging (MRI) signal alteration of the hippocampus. The objectives of this study were (1) to evaluate the prevalence of EUC in a hospital population of cats by applying well-defined inclusion criteria, and (2) to describe the clinical course of EUC. ANIMALS Eighty-one cats with recurrent seizures. METHODS Retrospective study--medical records were reviewed for cats presented for evaluation of recurrent seizures (2005-2010). Inclusion criteria were a defined diagnosis based on laboratory data, and either MRI or histopathology. Final outcome was confirmed by telephone interview with the owner. Magnetic resonance images were reviewed to evaluate hippocampal morphology and signal alterations. RESULTS Epilepsy of unknown cause was diagnosed in 22% of cats with epilepsy. Physical, neurologic, and laboratory examinations, and either 1.5 T MRI and cerebrospinal fluid analysis or postmortem examination failed to identify an underlying cause. Cats with EUC had a higher survival rate (P < .05) and seizure remission occurred frequently (44.4%). CONCLUSION AND CLINICAL IMPORTANCE A detailed clinical evaluation and diagnostic imaging with MRI is recommended in any cat with recurrent seizures. The prognosis of cats with normal MRI findings and a clinical diagnosis of EUC are good. Standardized imaging guidelines should be established to assess the hippocampus in cats.
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Affiliation(s)
- A M Wahle
- Clinic of Small Animal Medicine, Ludwig-Maximilians University, Munich, Germany
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25
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Williamson BG, O'Brien DP. What is your neurologic diagnosis? Porencephaly. J Am Vet Med Assoc 2013; 242:1641-3. [PMID: 23725423 DOI: 10.2460/javma.242.12.1641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Baye G Williamson
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA.
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26
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Pakozdy A, Sarchahi AA, Leschnik M, Tichy AG, Halasz P, Thalhammer JG. Treatment and long-term follow-up of cats with suspected primary epilepsy. J Feline Med Surg 2013; 15:267-73. [PMID: 23090332 PMCID: PMC10816773 DOI: 10.1177/1098612x12464627] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
We report an evaluation of the treatment and outcome of cats with suspected primary epilepsy. Phenobarbital therapy was used alone or in combination with other anti-epileptic drugs. Outcome after treatment was evaluated mainly on the basis of number of seizures per year and categorised into four groups: seizure-free, good control (1-5 seizures per year), moderate control (6-10 seizures per year) and poor control (more than 10 seizures per year). About 40-50% of cases became seizure-free, 20-30% were considered good-to-moderately controlled and about 30% were poorly controlled depending on the year of treatment considered. The duration of seizure events after treatment decreased in 26/36 cats and was unchanged in eight cats. The subjective severity of seizure also decreased in 25 cats and was unchanged in nine cats. Twenty-six cats had a good quality of life, nine cats an impaired quality of life and one cat a bad quality of life. Despite being free of seizures for years, cessation of treatment may lead to recurrence of seizures in most cats.
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Affiliation(s)
- Akos Pakozdy
- Department for Companion Animals and Horses, Small Animal Clinic, Internal Medicine, University of Veterinary Medicine, Vienna, Austria.
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27
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Brauer C, Kästner SBR, Kulka AM, Tipold A. Activation procedures in the electroencephalograms of healthy and epileptic cats under propofol anaesthesia. Vet Rec 2012; 170:360. [DOI: 10.1136/vr.100113] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- C. Brauer
- Department of Small Animal Medicine and Surgery; University of Veterinary Medicine Hannover; Germany, Bünteweg 9, D - 30559 Hannover Germany
| | - S. B. R. Kästner
- Department of Small Animal Medicine and Surgery; University of Veterinary Medicine Hannover; Germany, Bünteweg 9, D - 30559 Hannover Germany
| | - A. M. Kulka
- Department of Small Animal Medicine and Surgery; University of Veterinary Medicine Hannover; Germany, Bünteweg 9, D - 30559 Hannover Germany
| | - A. Tipold
- Department of Small Animal Medicine and Surgery; University of Veterinary Medicine Hannover; Germany, Bünteweg 9, D - 30559 Hannover Germany
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28
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Pákozdy A, Leschnik M, Sarchahi AA, Tichy AG, Thalhammer JG. Clinical comparison of primary versus secondary epilepsy in 125 cats. J Feline Med Surg 2010; 12:910-6. [PMID: 20822944 DOI: 10.1016/j.jfms.2010.07.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2010] [Accepted: 07/04/2010] [Indexed: 11/16/2022]
Abstract
In the present study 125 cats with recurrent seizures were analysed. The main goal was to investigate the aetiology and compare primary epilepsy (PE) with secondary epilepsy (SE) regarding signalment, history, ictal pattern, clinical and neurological findings. Seizure aetiology was classified as PE in 47 (38%) and SE in 78 (62%) cats. SE was caused mainly by intracranial neoplasia (16), hippocampal necrosis (14), toxicosis (eight), and encephalitis (seven). A significant difference between PE and SE was found in: age, body weight, duration of seizure, occurrence of status epilepticus and neurological deficits. Status epilepticus, altered interictal neurological status and seizure onset over the age of 7 years indicated SE more frequently than PE. If the seizures occurred during resting conditions and rapid running occurred the aetiology was more likely to be PE than SE.
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Affiliation(s)
- Akos Pákozdy
- Clinic for Internal Medicine and Infectious Diseases, University of Veterinary Medicine, Neurology Service, Veterinärplatz 1, A-1210 Vienna, Austria.
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29
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Abstract
PRACTICAL RELEVANCE Although seizures occur less commonly in cats compared with dogs, they are one of the most common forms of neurological disease in the feline patient. Cats may experience both focal (partial) and generalized seizures and causes are divided into primary disorders, in which there is no underlying cause (ie, idiopathic epilepsy), and secondary disorders. Cats with secondary seizure disorders have either an underlying structural lesion or metabolic disease. PATIENT GROUP Seizures affect cats of all ages. Cats with idiopathic epilepsy tend to be younger (approximately 3.5 years) than cats with secondary seizure disorders (approximately 8 years). AUDIENCE This review of feline seizures is directed at all veterinarians who treat cats, both in an emergency setting as well as in general practice. CLINICAL CHALLENGES Refractory seizures are often a diagnostic and therapeutic challenge. A systematic approach to the seizuring cat is described, easing the task of diagnosing the cause of the seizures. In addition, novel antiepileptics are discussed, which can be used as add-on drugs in challenging feline seizure cases. EVIDENCE BASE Compared with the canine counterpart, the literature regarding treatment of feline seizures is less established. Recent clinical trials and studies are focusing on new treatment options for feline seizures. Specifically, these studies, some of which are ongoing, have led to the use of levetiracetam, zonisamide and pregabalin as add-on antiepileptics in cases that are refractory to phenobarbital.
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Affiliation(s)
- Kerry Smith Bailey
- Department of Neurology, Oradell Animal Hospital, 580 Winters Avenue, Paramus, NJ 07652, USA.
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30
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Penning VA, Connolly DJ, Gajanayake I, McMahon LA, Luis Fuentes V, Chandler KE, Volk HA. Seizure-like episodes in 3 cats with intermittent high-grade atrioventricular dysfunction. J Vet Intern Med 2009; 23:200-5. [PMID: 19175741 PMCID: PMC7166599 DOI: 10.1111/j.1939-1676.2008.0231.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- V A Penning
- Department of Veterinary Clinical Sciences, Royal Veterinary College, University of London, Hatfield, UK.
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31
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Schriefl S, Steinberg TA, Matiasek K, Ossig A, Fenske N, Fischer A. Etiologic classification of seizures, signalment, clinical signs, and outcome in cats with seizure disorders: 91 cases (2000–2004). J Am Vet Med Assoc 2008; 233:1591-7. [DOI: 10.2460/javma.233.10.1591] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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32
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Seizures and Sleep Disorders. HANDBOOK OF SMALL ANIMAL PRACTICE 2008. [PMCID: PMC7152292 DOI: 10.1016/b978-1-4160-3949-5.50026-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Timmann D, Cizinauskas S, Tomek A, Doherr M, Vandevelde M, Jaggy A. Retrospective analysis of seizures associated with feline infectious peritonitis in cats. J Feline Med Surg 2007; 10:9-15. [PMID: 17765591 PMCID: PMC7128422 DOI: 10.1016/j.jfms.2007.06.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2007] [Indexed: 11/29/2022]
Abstract
Seizures have been reported frequently in feline infectious peritonitis (FIP) but have not been studied in detail in association with this disease. The purpose of this study was to perform a retrospective analysis of neurological signs in a population of 55 cats with a histopathologically confirmed neurological form of FIP. Seizure patterns were determined and it was attempted to relate occurrence of seizures with age, breed, sex and neuropathological features. Fourteen cats had seizure(s), while 41 cats had no history of seizure(s). Generalised tonic–clonic seizures were seen in nine cats; and complex focal seizures were observed in four patients. The exact type of seizure could not be determined in one cat. Status epilepticus was observed in one patient but seizure clusters were not encountered. Occurrence of seizures was not related to age, sex, breed or intensity of the inflammation in the central nervous system. However, seizures were significantly more frequent in animals with marked extension of the inflammatory lesions to the forebrain (P = 0.038). Thus, the occurrence of seizures in FIP indicates extensive brain damage and can, therefore, be considered to be an unfavourable prognostic sign.
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Affiliation(s)
- Doris Timmann
- Department of Clinical Veterinary Medicine, Division of Animal Neurology, Vetsuisse Faculty, University Bern, Bremgartenstrasse 109a, 3012 Bern, Switzerland.
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Abstract
This article reviews anticonvulsant therapies in current use for dogs and cats and briefly describes new modes of anticonvulsant therapy that are being investigated or pending publication. Most of the information contained within the article is based on published information. Some of the information, however, is based on the author's clinical experience and is identified as such.
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Affiliation(s)
- Curtis W Dewey
- Department of Clinical Sciences, Cornell University, College of Veterinary Medicine, Ithaca, NY 14853, USA.
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35
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Tomek A, Cizinauskas S, Doherr M, Gandini G, Jaggy A. Intracranial neoplasia in 61 cats: localisation, tumour types and seizure patterns. J Feline Med Surg 2006; 8:243-53. [PMID: 16600653 PMCID: PMC10822545 DOI: 10.1016/j.jfms.2006.01.005] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2006] [Indexed: 10/24/2022]
Abstract
The purpose of this study was to analyse retrospectively a feline population with intracranial neoplastic diseases, to document seizure patterns in these animals and to determine whether partial seizures were more frequently associated with structural brain lesions then generalised seizures. In addition, a comparison was made within the population with intracranial neoplasia between two groups of cats: one with and one without seizures. Special emphasis was given to the evaluation of tumour type, localisation and size of the lesion and its correlation with seizure prevalence. Sixty-one cats with histopathological diagnosis of intracranial tumour were identified. Fourteen cats (23%; group A) had a history of seizure(s). Forty-seven cats (77%; group B) had no history of seizure(s). Generalised tonic-clonic seizures were seen in eight cats (57%) and were the most common seizure pattern in our cats with intracranial neoplasia. Clusters of seizures were observed in six cats. Status epilepticus was observed in one patient. The mean age of the cats was 7.9 years within group A (median 8.5) and 9.3 years (median 10) within group B. The cats with lymphoma within both groups were significantly younger than cats with meningioma. In both groups meningioma and lymphoma were confirmed to be the most frequent tumour type, followed by glial cell tumours. The prevalence of the seizures in patients with glial cell tumours was 26.7%, 26.3% in patients with lymphomas and 15% in cases with meningiomas. In 33 cases (54.1%) the tumours were localised in the forebrain, 15 tumours (24.6%) were in the brainstem, four (6.6%) in the cerebellum and nine tumours (14.7%) had multifocal localisation. Parietal lobe and basal ganglia mostly affected group A. In group B tumours were most frequently located in the parietal and frontal lobes as well as in the diencephalon. A positive association was documented between the localisation of a tumour in the forebrain and seizure occurrence.
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Affiliation(s)
- Ales Tomek
- Department of Clinical Veterinary Medicine, Division of Animal Neurology, University of Bern, Switzerland.
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36
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Abstract
Fungal infections of the central nervous system (CNS) in dogs and cats are uncommon. The purpose of this paper is to review the clinical signs, diagnostic tests, and therapeutic options of fungal infections of the CNS in the dog and cat. Clinical signs are dependent on lesion location and are often multifocal. Extraneural involvement is common. Antemortem diagnosis can be difficult and is definitively made via cytology, biopsy, or culture of an affected organ or cerebrospinal fluid (CSF). Magnetic resonance imaging can support a diagnosis and may assist in therapeutic decisions. Fungal serology can support a diagnosis when direct visualization of the organism is not possible. Long-term azole maintenance therapy is suggested to enhance survival and prevent relapse. Serial cerebrospinal fluid evaluation and magnetic resonance imaging may identify early relapse.
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Affiliation(s)
- James Lavely
- Department of Neurology, The Animal Care Center, Rohnert Park, CA 94928, USA.
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