VetCompass study explores epilepsy classification differences

Significant differences between how vets diagnose epilepsy compared with current scientific recommendations have been revealed in a new study.

Those behind the RVC VetCompass programme believe the results indicate the need for clearer diagnostic guidelines for application in clinical practice.

Unprovoked seizures

The study shows 1 in 160 dogs under first opinion veterinary care are affected by seizures each year, with many of those having underlying epilepsy, which is defined as dogs with two or more unprovoked seizures at least 24 hours apart.

Epileptic seizures can be secondary to idiopathic epilepsy, structural epilepsy or epilepsy of an unknown cause.

Classifications

Little information has been available in veterinary first opinion practice on the classifications of seizures, diagnostic approaches or clinical management of dogs.

Those behind the study explored anonymised clinical records from first opinion clinics in the UK, and identified 2,834 incident seizure cases from a population of 455,553 dogs attending VetCompass-participating practices in 2013.

Key findings

Key findings from the research included:

• The annual incidence risk of seizures in dogs was 0.62%.
• The most common breeds among seizure cases were Labrador retrievers (8.6%), Staffordshire bull terriers (6.1%), Jack Russell terriers (5.8%) and Yorkshire terriers (5.0%).
• A total of 579 (20.5%) seizure cases met the criteria for epilepsy based on the International Veterinary Epilepsy Task Force (IVETF) classification system, compared with 245 (8.6%) that were formally recorded with epilepsy by the attending veterinary teams.
• Overall, 1,415 (49.9%) cases received diagnostic evaluation equivalent to or higher than IVETF Tier 1 diagnostic testing.
• Being younger than 12 years of age and being insured were risk factors for receiving IVETF Tier 1 or higher diagnostic evaluation among seizure cases. In addition, being at or above the breed and sex mean bodyweight, a clinically recorded diagnosis of epilepsy and being in The Kennel Club (UK) terrier breed group were risk factors for receiving IVETF Tier 1 or higher.
• Dogs that received IVETF Tier 1 or higher diagnostic evaluation, MRI or CSF analysis were more likely to be recorded with epilepsy by the attending veterinary teams.
• Anti-seizure drug (ASD) treatment was not prescribed for 1,960/2,834 (69.2%) dogs in association with the incident seizure event. Of the remainder, 719 (25.3%) dogs received 1 ASD, whereas 155 (5.5%) an ASD combination.

‘Scary’

Dan O’Neill, senior lecturer in companion animal epidemiology at the RVC and author of the paper, said: “Watching your dog undergo a seizure can be an incredibly scary moment for any dog owner. It is really important that dogs that seizure are rapidly diagnosed to decide whether they need no further treatment beyond careful monitoring or alternatively require a clinical work-up to define the cause of the seizures.

“There are now some excellent treatments for many seizure-related diseases. This study helps up to understand the current state of play for seizure management in dogs and identifies opportunities for improved care of these affected dogs.”