Managing Cats With Epilepsy and/or Seizures

Seizures can occur in cats and have many different causes. Uncovering the underlying cause of your cat's seizures can help you and your vet find out the best treatment options. However, in many cases, treating the underlying cause of feline seizures may not be possible. Your cat may suffer from a disease or condition which cannot be cured, so the best approach may be to manage the seizures with medication. Your cat may also suffer from idiopathic epilepsy, meaning no underlying cause is identified but the cat has recurring seizures.

Cats with frequent recurrent seizures may need to be treated with anticonvulsant medications. However, there are a few things to consider before starting your cat on an anticonvulsant.

Should Your Cat Be Treated for Seizures?

The decision to start medication will be based on several factors:

• Does your cat have frequent seizures? How often? If the seizures are occurring infrequently (less than once every four to six weeks), it may not be necessary to treat your cat for the seizures.
• Are your cat's seizures severe? If your cat's seizures are especially severe, meaning they last more than 1 minute, or result in a prolonged state of disorientation or more severe signs, regardless of how frequently they occur, it may be advisable to start treatment.
• Has your cat suffered from status epilepticus? This is defined as a single seizure lasting more than 5 minutes or multiple seizures in a short time period without fully recovering in between. Or has she had cluster seizures (more than two seizures in a 24 hour period)?

If the answer to any of these questions is yes, then your cat should likely be started on medication to improve its quality of life and reduce the risk of serious complications from seizures.

Managing Seizure Medications for Your Cat

Understand that once your cat starts on an anticonvulsant medication to treat his seizures, he will likely need to be on medication for the rest of his life.

Discontinuing an anticonvulsant medication suddenly can be quite dangerous for your cat. Never stop giving the medication or change the dosage without checking with your veterinarian first. When anticonvulsant medications do need to be discontinued, it is best to withdraw the medication in a slow and gradual manner, weaning your cat off the meds under the supervision of your veterinarian.

Medications Used to Treat Feline Seizures and/or Epilepsy

Phenobarbital is generally considered to be the first choice in treating seizures in cats. Currently, it is the most commonly used anticonvulsant drug for cats. It can have potential side effects so it is important to discuss this with your veterinarian to ensure it is the right choice for your cat.

Levetiracetam (Keppra) has also been used in cats to control seizures. It is a newer anticonvulsant medication that is usually used as an add-on medication for cats whose seizures are not well controlled with just one medication. Some veterinarians are now using levetiracetam as a first choice drug because they believe it may have fewer side effects, however, it has not been studied as thoroughly as some other drugs for this purpose.

Zonisamide is another seizure medication that is being used more commonly in cats. Research into the use of this medication in cats is still in its early stages, but so far it appears to be reasonably effective and safe. It also has the benefit and convenience of once a day dosing in cats, as opposed to some of the others that may require every 8 or 12 hour dosing.

Diazepam (Valium) used to be used to treat seizures in cats but is no longer recommended. While rare, it can cause a severe, fatal reaction in the liver of some cats. Due to the availability of newer, safer medications, diazepam is not recommend for ongoing treatment. It is sometimes used in an emergency setting to temporarily stop status epilepticus.

Potassium Bromide is not recommended for use in cats. While it is used in some dogs with seizures, in cats it can cause lung disease.

Medications such as chlorazepate, pregabalin, and gabapentin have not been well-studied in cats for their anticonvulsant properties. Some veterinarians do use them to control seizures, especially as an add-on treatment in cats who are still having seizures while on another anticonvulsant. There is not a lot known about how these medications work in cats, and what types of side effects to expect long-term. As research continues with these drugs, they may become more widely recommended for cats with seizures. For now, they should be reserved for refractory cases where seizures are not well controlled with another medication, or cats who cannot tolerate the more widely used medications for some reason.

Note: This article has been provided for informational purposes only. If your pet is showing any signs of illness, consult a veterinarian as quickly as possible.