Epsilon Archive for Student Projects

Abstract

Seizure conditions have been suggested to be the most common chronic neurological condition in dogs, with an estimated prevalence from 0.5% to 5.7%. One such condition is epilepsy. While epilepsy is not a diagnosis itself, it is a group of disorders that cause a predisposition for epileptic seizures. Idiopathic epilepsy (IE) is characterized by no indication of intracranial pathologies (including vascular, inflammatory/infectious, traumatic, anomalous/developmental, neoplastic and degenerative diseases) and a proven or suspected genetic background (A confirmed diagnosis of IE in genetically related individuals). There is a fair amount of terminology surrounding epileptic seizures, with ictus describing the seizure itself. The postictal phase refers to the period after ictus when the normal brain function is being restored.
There are reports of numerous symptoms and behaviors that are associated with the postictal phase in dogs with epilepsy, such as; hunger, fatigue, restlessness and ataxia, and the clinical manifestation varies largely between individuals. The International veterinary epilepsy task force (IVETF) current recommendation is to initiate medical treatment for patients with IE when the postictal symptoms are considered severe (for example aggression) or lasting over 24 hours. However, there is a paucity in the literature describing the postictal phase. To the authors knowledge there are no studies at the present time (2023) that describe postictal behavioral changes in detail and the existing reports regarding canine IE are only briefly mentioning the postictal period. Previous studies are based solely on dog owners’ reports and no observational behavior studies with a standardized ethogram have yet been conducted.
The objective of this study was to further investigate what symptoms and behaviors are exhibited by dogs with IE during the postictal phase, using both the owners’ descriptions of the postictal phase and observational study through video analysis. Additionally, this study investigated if some of the symptoms and behaviors can be missed by the pet owners. The purpose of this is to increase knowledge about the postictal phase that can be used by clinically practicing veterinarians to better evaluate an individual patient´s need for starting medical treatment and to give practicing veterinarians further support for gathering a complete anamnesis.
The hypothesis was that the dog being “tired” would be the most frequently described postictal change based on dog owners’ answers from the questionnaire, and that “resting” or “resting with eyes closed” would be the most registered behaviors from the video analysis.
A questionnaire was distributed to owners to epileptic dogs through social media, gathering information about their dog’s epilepsy including questions about how the diagnosis was made, what medication their dog is being treated with, how the epileptic seizures are manifesting and what postictal changes they see in their dog. Dogs that did not meet the Tier I confidence level of diagnostic criteria for IE were excluded from the study. Owners whose dogs had a duration of the postictal phase no longer than 60 minutes were invited to further participate in this study and to film their dog’s postictal phase. Dogs whose postictal period lasted for longer than 60 minutes were not invited to participate as the long period of filming in those cases was assessed to lower the dog owners’ compliance. An ethogram was constructed based on previous reports and the owner’s own description of the postictal phase and an observational behavioral study using continuous sampling
Abstract
was used to analyze the video material provided by the owners. Only one video was obtained and after the video analysis was conducted, the owner received a follow-up questionnaire asking them to choose the behaviors they see in their dog from a list based on the ethogram.
The most described behavior based on the owners’ answers was “restlessness”, thus rejecting the hypothesis that “tired” was the most described postictal change. Numerous behaviors were described by the owners that have not been previously reported, indicating a large variety of clinical manifestations of the postictal phase. No statistically significant behavioral difference was found when comparing male and female dogs in the postictal phase.
Only one video of the postictal phase was obtained. “Proximity to owner” was found to be the behavior with the longest duration based on the video analysis, closely followed by “resting” and “ears back”. When comparing the owner’s answers on the follow-up questionnaire with the registered behaviors, the more subtle behavioral cues (“ears back”, “wide eyes”, “lip licking” and “sham chewing”) were not recognized by the owner. In contrast, the more distinct behaviors (“proximity to owner”, “resting” and “trembling”) were correctly recognized and acknowledged by the owner. Further studies are required to investigate what behaviors dogs exhibit during the postictal phase and if some of these behaviors are harder to recognize by the owner.