Brain Storms: Anatomy of a Seizure, Part 1
A Terrifying Discovery
He was walking towards Stolze, and suddenly his eyes widened. He took five or six steps, and his right front leg seemed to weaken and bend, then he collapsed. Terrified, Ms. Stolze yelled out "Kruezer" as her dog lay down on the ground, his back arching, his front feet paddling the air.
"I had no idea what what going on," Stolze explains, her voice revealing the terror of that first day, when she began living with an epileptic dog. "We went to the vet and he prescribed phenobarbital. We thought that would solve the problem, but it didn't."
Stolze began an odyssey to improve her dog's life. She collected information that took her further and further afield with each passing week. "I researched medicines and foods. I began cooking special meals for him. I'd keep going to the vet with information, and the vet told me I had to stop. I was just obsessed with it."
It has now been three years since Kruezer's first seizure. "But it feels more like 10," Stolze says with restrained humor. Kruezer has had several more seizures, and each time, Stolze says, "He becomes completely dazed and can't see."
A retired registered nurse, Stolze sought patterns. "I keep a log of his seizures," she explains. "I write down the time, date, and place of each one." After doing this for several months, she admits it is difficult to discern anything conclusive. "For a while, his seizures all occur at night. Then the pattern changes and they happen in the afternoon." She continues to keep the log, just in case.
Toni McCurley's Greater Swiss Mountain Dog, Oso, began having seizures when he was about two and a half years old, a typical age of onset. "We were getting ready for bed, and suddenly Oso lost control of his bladder and started drooling and flopping around on the floor. My husband and I tried to hold him. We were both screaming and trying to figure out what to do. He gnawed all the way through one of the posts on our bed. He bit my husband, and I wasn't sure whether to take my dog or my husband to the emergency room!"
When the McCurleys got to the veterinary hospital, they received medications to control the seizures, which they, like the Stolzes, assumed were a cure. But it was not long before Oso had another seizure, one that made his first appear mild by comparison. Like Kruezer, Oso had "cluster seizures," a relentless cycle of one attack after another. They are also of the "grand mal" type, which means his entire body convulses.
"He just would not come out of it," McCurley explains. "At the hospital, they shot him with so much Valium he was unconscious."
Over the next eight days, Oso remained under watch at the veterinary hospital. He regained consciousness on the second day. "But he was blind and couldn't walk," McCurley says. "He couldn't lift his head." After four days, Oso regained his eyesight. But he had to be lifted up by a hoist, his legs too weak to stand.
The McCurleys took Oso home, along with a prescription for two drugs, phenobarbital and potassium bromide (KBr), the classic combination for controlling seizures. "But he was not the same dog," McCurley explains. "He had no muscle coordination. We were scared to death because he would bang his head on things. He was so weak, it was an effort just getting to the end of the driveway. He forgot his commands, and he forgot he was housebroken."
Over the next seven months, the McCurleys retrained Oso and built up his strength. Today, according to Ms. McCurley, Oso is "90% normal. He runs and plays. He knows his commands. It's amazing when we think about what he was like in the hospital and what he's like now."
The Definition of Terror
The danger of more seizures is never very distant for the McCurleys. One night, they heard Oso's cage rattling at two o'clock in the morning. "I have this liquid Valium I'm supposed to give him if he has a seizure," Ms. McCurley explains. "Well, I had to extract the Valium from the bottle, get it into the syringe, then get it into a tube and insert it rectally." She was shaking with fear while trying to do all this. Amazingly, she is able to laugh as she describes the tragic scene. "I stabbed myself with the needle and was bleeding all over the place. By the time I had the medicine ready, Oso was looking at me like he was saying, 'What are you doing?'"
Luckily, this was a mild seizure, a single attack that lasted only two minutes. But McCurley says she is in constant fear of another cluster. "If I hear anything in the middle of the night, I'm awake and running over to see if he's all right."
Dr. Dennis O'Brien, DVM, Ph.D., is a clinical neurologist at the University of Missouri College of Veterinary Medicine and a leading researcher in canine epilepsy. He also runs a private veterinary clinic. "I see far too many patients with this disease. It's frustrating, and I'd like it to end."
Dr. O'Brien says epilepsy is uniquely disturbing. "If you ask psychologists what makes a terrifying situation, this is what they'll list: something that happens to a loved one, that you have no control over, and that you cannot predict. They will also cite sleep deprivation. With epilepsy, people are torn up watching their dogs have seizures, not knowing when it will happen next, and it frequently occurs in the middle of the night."
Unlike other diseases, an epileptic dog will usually have a normal life span, so the owner's fear, vigilance, and hope must be sustained over many years. Marion Mitchell knows this well. She has a 14-year-old Dalmatian, Emma, who began having seizures at 15 months. As Mitchell puts it, "There is something about epilepsy that strikes the psyche." Mitchell founded a support group, a source of information for people learning to deal with epileptic dogs. "My entire life for the past 13 years has been dedicated to dealing with this issue," Mitchell explains.
Anita Stolze is the kind of person who seeks out support groups like Mitchell's. She administers regular doses of phenobarbital and KBr. "But no owner really knows why the medications sometimes work and sometimes don't. The vets don't seem to know either. What I've found is that trying to get answers takes over your life."
Dr. O'Brien concurs with Stolze's observation, adding, "People want a diagnosis, and from the veterinarian's point of view, epilepsy is a helpful label. But from a research point of view, we really don't have a clue what's going on in the brain that makes this happen."
Casting a Wide Net
Frustrated with the lack of options, wanting to prevent the return of her dog's seizures, Stolze experimented with numerous dietary supplements and countless techniques, ranging from physical manipulation of her dog's body to a variety of untested medications and methods.
Kruezer's seizures are less frequent now, last under two minutes, and he has not had any more clusters. Asked whether there is a connection between Kruezer's improvements and the methods she has been trying, Stolze says, "I just don't know. It almost feels like the seizures simply have to run their course."
Ms. Mitchell was skeptical of alternative treatments, preferring scientifically proven ideas. But after five years of watching Emma seize, she says, "It got so bad, I was desperate to try something else. That's when someone asked me if I'd be willing to try raw food. I was ready for anything to keep Emma from suffering."
According to Mitchell, raw food made a dramatic change. "Emma used to get seizures once a week. After switching to raw food, she's only had eight seizures in eight years. She's never gone back to her old level."
Mitchell was administering high doses of phenobarbital and KBr. "Emma was a zombie," she describes. "She couldn't smell, she couldn't walk right. It was horrible." After switching to raw food, Mitchell reduced the KBr by over 50%, and the phenobarbital by about 75%.
But Mitchell is still skeptical. She accepts the mystery of this disease, the lack of answers, even as she clings to the possible benefits of raw food. "I can't say for sure that anything is true. I've always said Emma is a chemistry lesson in progress, because I never know what will happen next."
Toni McCurley also experimented with various methods, ideas gleaned from the Internet, from her vet, and in casual conversations. "I've tried herbal supplements. I give him vitamins before he goes to sleep, and he started sleeping through the night." She names numerous other feeding techniques and supplements she has tried. She says Oso's condition has improved. But can she prove that this is because of her experimental efforts? She admits, "I have no idea. Maybe it was just the passing of time. You really go crazy trying to figure out what works and what doesn't. But once you start using something, and the bad things go away, you think, 'Well, maybe I should just keep doing it.' You want to stop, but you feel guilty."
Anyone who has experienced epilepsy sympathizes with owners' desire to try unproven treatments. Even a trained scientist is susceptible. Dr. Beverly Mains, DVM, was a practicing veterinarian for 25 years, and saw many dogs with seizures. But when her own Giant Schnauzer, Layla, began having seizures, her training did not help her deal with it. "As a veterinarian, I'd think about how to approach the problem. But as an owner, I'd just have the pain of going through all this. I'd flip between the two personalities. One moment, I'd be all clinical, the next moment I was hysterical."
Layla had what Mains describes as "Walking seizures, almost like she was blind and would just crash into things. Or she would act as if there was a bone in front of her. She'd lunge at it and try to bite it. But nothing was there. It was completely unpredictable."
A Life Out of Balance
Having an epileptic dog changes an owner's entire life. "We can't go on trips any more," Stolze explains. "There's no one we can leave Kruezer with. It got to the point where I couldn't walk out the door of the house. At night, I'd be up worrying about the medicines, the foods, every chemical that goes into his body, everybody's opinion about what I should do."
Toni McCurley reports a similar feeling. "If I needed to get out of bed, I'd lie there instead because I didn't want to disturb him and cause a seizure. People would invite me out for a short trip, but I wouldn't go because I was afraid to leave him behind."
Dr. O'Brien, speaking as both a researcher and a veterinarian, says he has often seen an entire household deteriorate because of this disease. "If it was just the dog's life, that would be bad enough. But I have some clients who have not been away from home for years. We have to realize the wear and tear on the people as well as the dogs."
Considering the constant fear of another seizure, the sleeplessness, the frustrations of unpredictable medical results, it is no wonder that some owners choose to euthanize their epileptic dogs. But for Stolze, this was not a consideration. "I believe that when you get a dog, you're responsible for their care no matter what, even if that dog is more difficult than any dog you've ever had."
Stolze somehow reached a healthy level of acceptance, and she began to enjoy her life again. She also began to enjoy her dog again. In fact, she feels that the epilepsy brought her closer to Kruezer. "I've taken such care of him and all his needs. That's made me much more protective."
Ms. McCurley describes how her constant vigilance with Oso gave them a greater connection. "I can tell if there's the least little thing wrong with him. I'm always highly conscious of his behavior, his movements, how he's walking, if he does anything out of the ordinary. It definitely forms a stronger bond."
Ms. Mitchell says that Emma is living proof that there are ways to live a good life with epilepsy. "She's not even supposed to be alive right now, but she'll be 15 this year, and she still gives me so much joy. She has changed my life. She's climbed 14,000-foot mountains in Colorado. She still goes hiking with my husband and me every day. She still jumps up onto the bed."
Stolze says that focusing too much on the seizures can make the owner miss out on the dog's entire life. "Yes, Kruezer has seizures, and when it happens it's upsetting. But still, most of his life is not about seizures. He loves his life. He enjoys going for walks, and even after everything he's been through, he's never nasty. During those times when he has seizures, you deal with it. But other times, you focus on something else. That way, everyone can still be happy."