Diet and epilepsy

So far 2015 has been a rough start for Reggie. He had been on a hunger strike for about two weeks, which culminated in a seizure on New Year’s Day. Off to the vet we go where I learned that Reggie actually had a staph infection!

Before everyone thinks I’m a bad pet parent, Reggie’s IBD will cause him gastric distress and diarrhea. Couple that with food and environmental allergies, and he frequently suffers from a lack of appetite and can easily get secondary infections.

This time around his skin was off the charts. I had noticed that he was shedding like it was summer- I mean he should be bald- despite the frigid temps. Then the hunger strike. Then the seizure. Then the vet.

We were at the vet the day after the seizure, and he another (small) seizure at the vet’s office. Bottom line? It was good that I brought him in when I did. He had a staph infection and had to get an antibiotic shot that stays in his system for 2 weeks. He also had to go on a hypoallergenic prescription diet, with no treats, to eliminate inflammation and heal his stomach.

This brings me to healing diets and epilepsy. Allergies and IBD are linked to epilepsy in the sense that chronic inflammation and infection can lower the seizure threshold. Does a diet that reduces inflammation and has anti-convulsant benefits really exist? Turns out, it can.

Vitamins, Minerals, and Amino Acids
Vitamins help release nutrients in food into the body. When food is cooked, vitamins are destroyed by heat. Commercial dog food is generally vitamin deficient because of this- just like human food. It’s a fact of the manufacturing process. Vitamins B, C, and E have been implicated in seizure activity. Vitamin E protects cell membranes from damage. In humans it has been shown that anti-convulsant drugs can reduce Vitamin E levels, and adding Vitamin E to the diet of epileptics can reduce seizure frequency.

Minerals are not made in the body, but only obtained through food. Again, the manufacturing process results in a loss of minerals. There are several mineral deficiencies that can be problematic for seizures, number one being magnesium. Magnesium is critical for nerve function and works with other vitamins.

Amino acids also can only be obtained through food. High quality animal protein in the least processed form will give the best amino acid profile. Taurine is an amino acid that is critical to the nervous system and deficiencies have been shown to be a cause of seizures. It is possible to have a diet deficient in amino acids due to the manufacturing process which is why it is critical (if you buy commercial dog food) to read labels and choose a high quality food.

Protein and Grains
A dog needs protein to survive. Proteins are then broken down into the amino acids mentioned above. The source and quality of the protein is important. Most dog foods provide their protein from meat, by-products, fish, and dairy. By now, we know that by-products are a low quality source. Choose whole food (human grade) meat sources for the best profile. Something I just learned: if your dog has a beef allergy, they likely have a mild allergy to dairy as well (still a cow). We never never did a food trial for dairy products but now have to remove all cheese and milk products from Reggie’s diet.

The grains are corn, wheat, soy, and rice. While dogs are dogs and not wolves, dogs do not have the ability to digest a high-grain diet. Wolves in the wild did not eat grain. Grains have a high phytate content which impairs mineral absorption which is important for magnesium. Dogs that have corn, wheat, or soy allergies can have lower seizure thresholds. When the formula of Reggie’s food changed from duck and rice to duck and oatmeal he had a hard time. I knew he would have a hard time anyway because of his issues, but through this learning process I now know that oats are much harder for his stomach to digest than rice is.

Reggie is still on his hypoallergenic diet, but it has been two weeks now and he is infection free. He loves the prescription food that costs about the same as my mortgage. I don’t know if he will go back to the duck and oatmeal- it is a delicate balance for his stomach, allergies, and seizure control. For detailed and GREAT information, check out this article about diet. It also addresses the benefits of a raw diet for dogs with epilepsy. Until next time!

Advertisements

Seizure triggers in dogs

As the seasons begin to change (yes begin, we had snow here last week!) triggers for things like allergies, migraines, and even seizures become topics of conversation. What are common seizure triggers? Are they the same for everyone? Are human triggers the same for canines? Let’s look…

Environmental

The environment plays a big role. For humans you often hear about photosensitivity; flashing or bright lights. Dogs are very sensitive creatures, physically and emotionally. They can be triggered by barometric pressure changes, extreme heat or cold, and even the bright or flashing lights. Reggie is very sensitive to heat and low barometric pressure.

Physical

Physical factors are very similar for dogs and humans. Fatigue is a big factor for humans. This generally isn’t an issue for dogs, but research shows that the most common time of day for animals to have seizures is morning or night, as the body is changing from its sleep/wake cycle. Reggie has always had seizures in the afternoon/evening. Missing or skipping meals can cause low blood sugar, which is a trigger.

Diet

Humans can be triggered by alcohol and certain drugs and cheeses. For dogs specifically, eating too salty of a diet (don’t give bacon, hot dog treats, etc.) particularly if your dog takes potassium bromide as an anti-convulsant, can be detrimental as this can lead to salt toxicity and cause seizures and pancreatitis. If your dog already has food allergies (like Reggie) processed, low grade dog foods can cause systemic inflammatory responses that decrease the seizure threshold from the synthetic chemicals, preservatives, and emulsifiers that may be contained in the food. There are also some foods and herbs that have been shown to decrease the seizure threshold such as rosemary, sage, fennel, walnuts, and even turkey.

Emotional

Who wants stress? Stress trumps everything, for everyone, for any ailment. Stress is the number one trigger for humans (followed closely by fatigue), and since we can’t ask our dogs if they are stressed out we have to assess their stress levels in a different way. Prolonged periods of excitement, changes in routine, loud arguments, and separation anxiety are examples of emotional stress. During the holidays, Reggie had a seizure in the car after leaving my mom’s house on Christmas. It was a long day, full of people and presents and dog toys and food and not his house- and it was just too much. He had another seizure after we got home. His body and brain were just “relaxing” after being jacked up all day. When Reggie’s dad and I were divorcing and I moved out, the first few weeks were rough. Reggie’s dad told me he would sit in the kitchen and stare and he had a seizure in that first week. It took about three weeks for me to get settled and the regular rotation to begin but Reggie didn’t understand that, he just knew that I was gone and that stressed him.

Other Factors

Some things that are specific to dogs that can cause seizures are their heartworm medications, flea and tick preventives, even vaccinations. Pine can be toxic to dogs and cause seizures; beware of pine scented or infused cleaners, and don’t let your dog drink the water out of the bottom of the Christmas tree. One last item is rawhides and pig’s ear or feet treats. Many commercially produced chews are bleached first, and flavored chews have chemical additives.

Keeping a seizure diary can help track and diagnose triggers. Establishing predictors can actually help you avoid situations and seizures in the first place. Happy health!

Canine seizure medications

About two years after Reggie first presented with epilepsy he had another major episode of cluster seizures which required a trip to the ER. His dosage was increased. He had a seizure just two months later, and another just three months after that. That frequency was just too frequent and it was decided that a second medication needed to be added for better control. The rule of thumb is no more than one seizure every three months.

In discussing the secondary medication options, it was decided that a different approach would be taken- a traditionally human medication. It had been used in dogs with some success, and some failure. Given the other options and the possible side effects it seemed the best option and thankfully it has worked well.

So for canine control, what are your options- to be reviewed with your vet of course?

Phenobarbital

The gold standard, the go-to, the most common primary control drug. Dosage will be different for every dog because in order to reach a therapeutic level in the blood stream it is based a bit on weight. The maximum level is 30 micrograms/mL so a 100 pound dog can handle a higher dose than a 12 pound dog but still have the same level in their blood stream. Reggie takes 100 mg twice a day and is at a maximum therapeutic level of 27.2. Phenobarbital is very tough on the liver and levels are measured every six months. Side effects can be increased appetite, weight gain, sedation, increased thirst and urination.

Potassium Bromide

Commonly used as a secondary control drug, not a primary drug. Diet has to be monitored closely because of the salt content of the drug. This was considered first as the secondary drug for Reggie. When I spoke with several pharmacies I found that the local pharmacy will compound and add pork or chicken flavor to it! Side effects, initially, can be behavioral changes, gait instability or muscle twitches.

Valium

This is NOT a control medication but a break-through medication. If your dog is having cluster seizures, or a particularly long seizure, Valium is used to break the seizure. The body can become resistant to Valium over time and this is not appropriate for the long term. I have read of seizure therapies that rely on Valium treatments; this seems like an incredibly bad idea if your dog has persistent and/or frequent seizures. Discuss options with your vet. When Reggie has gone to the ER he has been given Valium to break the cluster seizure cycle. If this didn’t work anymore…

Neurontin

This is a human drug now being used for dogs as a secondary medication. The benefit is that there is virtually no sedation side effect; however, not all dogs that take it see an effect.

Keppra

This is a human drug now being used for dogs as a secondary medication. It is considered quite safe with very few (and uncommon) side effects such as an unstable gait during the acclimation period. The downside is that the best control is frequent dosing. This is ultimately what we decided to put Reggie on; he started taking 250 mg three times a day. We did have to increase his dosage to 375 mg after a couple months (it just wasn’t enough). We recently switched to an extended release tablet (500 mg twice a day) so we will see how that works!

Felbatol

This is another secondary medication, human drug. The benefit of this drug is that is does not cause drowsiness; however it has to be frequently dosed for ultimate effectiveness.

Zonegran

Another secondary medication human drug, it has few side effects but is only sometimes effective. When it is effective, the phenobarbital dosage can reportedly be drastically reduced.

Discuss all options with your vet. What works for Reggie won’t work for everyone. But be aware that there are options- and human options are becoming available to help your furry friends too!