My Dog Had a Seizure (Part 5): Treatment, Seizure Medications, and Living With Epilepsy

How Are Seizures Treated?

When owners hear the word "seizure," one of the first questions they ask is:

"What can we do to stop this from happening again?"

The answer depends on why your dog had the seizure in the first place.

Remember, a seizure is a symptom—not a diagnosis.

If a seizure was caused by low blood sugar, treatment focuses on correcting the blood sugar.

If it was caused by a toxin, treating the poisoning is the priority.

If it's due to epilepsy, long-term anti-seizure medication may be recommended.

That's why diagnosing the underlying cause is such an important part of treatment.

Treating an Active Seizure

If your dog is actively having a seizure, your veterinarian's first priority is stopping the abnormal electrical activity in the brain while protecting the rest of the body.

In the hospital, treatment may include:

• Intravenous medications to stop the seizure
• Oxygen therapy if needed
• Intravenous fluids
• Blood sugar correction if necessary
• Body temperature monitoring
• Heart rate and blood pressure monitoring
• Treating the underlying cause whenever possible

Many dogs begin recovering within minutes after the seizure is controlled.

What Is Status Epilepticus?

Most seizures stop on their own within one to two minutes.

A seizure that lasts more than five minutes, or repeated seizures without your dog regaining consciousness in between, is called status epilepticus.

This is a true medical emergency.

During prolonged seizures, the body works incredibly hard.

Body temperature rises.

Oxygen demand increases.

Muscles continue contracting.

The brain remains under constant electrical stimulation.

Without prompt treatment, prolonged seizures can lead to:

• Dangerous overheating
• Brain injury
• Organ damage
• Breathing problems
• Heart complications
• Death

The sooner treatment begins, the better the chances of preventing these complications.

Cluster Seizures

Some dogs don't experience one prolonged seizure.

Instead, they have several separate seizures over a short period of time.

This is known as cluster seizures.

For example, a dog may have three seizures in a single afternoon while appearing to recover between each episode.

Although each seizure may be brief, cluster seizures can quickly become dangerous because the brain has repeated episodes of abnormal electrical activity.

Dogs experiencing cluster seizures often require hospitalization and additional medications to break the cycle.

Does Every Dog Need Seizure Medication?

No.

This surprises many owners.

A dog that experiences one short seizure and then returns completely to normal may not need lifelong medication.

Instead, your veterinarian may recommend:

• Monitoring for additional seizures
• Keeping a seizure diary
• Performing diagnostic testing
• Scheduling follow-up examinations

Medication is often recommended when:

• Seizures become more frequent.
• Your dog experiences cluster seizures.
• A seizure lasts longer than five minutes.
• Recovery becomes prolonged or abnormal.
• A diagnosis of epilepsy has been made.
• The frequency or severity of seizures begins affecting your dog's quality of life.

Every patient is different, and the decision is made after carefully weighing the benefits and potential side effects of long-term medication.

Common Anti-Seizure Medications

There are several excellent medications available today to help control seizures in dogs.

The "best" medication depends on your dog's overall health, seizure pattern, lifestyle, and any underlying medical conditions.

Phenobarbital

Phenobarbital has been one of the most commonly prescribed anti-seizure medications in veterinary medicine for decades.

It is highly effective for many dogs and remains an excellent first-line option.

Because it is processed by the liver, dogs taking phenobarbital require periodic blood testing to monitor drug levels and liver function.

Some dogs experience temporary side effects when starting treatment, including:

• Sleepiness
• Increased appetite
• Increased thirst
• Increased urination
• Mild wobbliness

These side effects often improve as the body adjusts to the medication.

Levetiracetam (Keppra®)

Levetiracetam has become increasingly popular because it is generally very well tolerated.

It is metabolized differently than phenobarbital, making it an excellent choice for many patients.

Some dogs require it every eight hours, although extended-release formulations may allow less frequent dosing in appropriate patients.

Side effects are usually mild but can include:

• Sleepiness
• Mild incoordination
• Decreased energy

Many dogs experience very few noticeable side effects.

Potassium Bromide

Potassium bromide has been used for many years, particularly in dogs that cannot take phenobarbital or need additional seizure control.

One important consideration is that dietary salt intake can affect bromide levels in the body.

For dogs taking potassium bromide, it's important to feed a consistent diet and avoid making major dietary changes without discussing them with your veterinarian.

Because bromide remains in the body for a long time, it may take weeks to months before its full effect is seen.

Zonisamide

Zonisamide is another medication commonly used to control seizures.

It may be prescribed by itself or in combination with other anti-seizure medications.

As with all seizure medications, your veterinarian will monitor your dog's response and make adjustments if needed.

Other Medications

Depending on your dog's specific needs, your veterinarian or veterinary neurologist may recommend additional medications or combination therapy.

The goal is always the same:

Control seizures while minimizing side effects and maintaining the best possible quality of life.

Will My Dog Be on Medication Forever?

Maybe—but not always.

If your dog is diagnosed with idiopathic epilepsy, long-term medication is often necessary.

The important thing to remember is that long-term doesn't mean hopeless.

Many dogs receiving seizure medication continue to:

• Play
• Hike
• Swim
• Travel
• Compete in sports
• Enjoy a completely normal family life

The medication simply becomes another part of their daily routine.

Why You Should Never Stop Medication Suddenly

One of the most important things I tell owners is this:

Never stop anti-seizure medication abruptly unless your veterinarian specifically instructs you to do so.

Stopping medication suddenly can actually trigger severe seizures or even status epilepticus.

If medication adjustments are needed, they are usually made gradually under veterinary supervision.

Monitoring Dogs on Seizure Medication

Treating epilepsy doesn't end when the prescription is filled.

Regular monitoring helps ensure that the medication remains both safe and effective.

Depending on the medication your dog is taking, monitoring may include:

• Blood tests
• Medication level checks
• Liver function testing
• Kidney function testing
• Periodic physical examinations
• Reviewing your seizure diary

These appointments allow us to make small adjustments before larger problems develop.

Keeping a Seizure Diary

One of the most valuable things you can do at home is keep a written record of every seizure.

Include:

• Date
• Time
• Duration
• What your dog was doing beforehand
• Description of the seizure
• Recovery time
• Possible triggers
• Medication changes

Patterns often become much easier to recognize when they're written down.

A seizure diary also helps your veterinarian determine whether treatment is working or needs adjustment.

What Is the Goal of Treatment?

Many owners hope medication will prevent every future seizure.

While that sometimes happens, it isn't always realistic.

Instead, our goal is usually to:

• Reduce the number of seizures
• Shorten seizure duration
• Reduce seizure severity
• Prevent status epilepticus
• Prevent cluster seizures
• Maintain an excellent quality of life

In many cases, a dog that experiences an occasional brief seizure but is otherwise happy and healthy is considered well controlled.

Success isn't always measured by zero seizures.

It's measured by helping your dog live the safest, happiest life possible.

From My Exam Room

One of my favorite conversations is when I see a family several months after starting seizure medication.

They're often nervous at the first appointment, wondering if life will ever feel normal again.

Then, a few months later, they'll smile and tell me:

"Honestly… we hardly think about it anymore."

Their dog is back to chasing tennis balls.

Sleeping on the couch.

Begging for dinner.

Going on walks.

Being exactly who they've always been.

The medication didn't change their dog's personality.

It simply gave their brain a better chance to function normally.

That's the outcome we're striving for.

Not perfection—but a full, joyful life with as few seizures as possible.