A new study, published in the Journal of Small Animal Practice (JSAP), has revealed that veterinary surgeons only prescribe anti-epileptic drugs (AEDs) after a seizure cluster in 44% of cases, despite International Veterinary Epilepsy Task Force recommendations to the contrary1.

The study “Approach to initial management of canine generalised epileptic seizures in primary-care veterinary practices in the United Kingdom” used the Small Animal Veterinary Surveillance Network to review electronic health records equating to 3,150,713 consultations (917,373 dogs) from 224 veterinary practices2.

Five hundred and seventeen cases were included. Dogs older than 6 years were excluded. 

Of 321 dogs presented for a single seizure, seven (2.1%) were prescribed AEDs, which is in accordance with International Veterinary Epilepsy Task Force recommendations.

20% of the dogs in this group which had at least a 6-month follow-up, 20% did not have subsequent seizures recorded.

However, of 86 dogs which had suffered a seizure cluster at first presentation, only 38 (44%) were prescribe an AED, despite the task force recommendation that long term treatment in dogs with idiopathic epilepsy should be started immediately in the case of 2 or more seizures within 6 months, status epilepticus or a seizure cluster, severe post-ictal signs, or a deteriorating epileptic presentation. 

Imepitoin was frequently selected in the treatment of cluster seizures despite no authorisation for this purpose.

Nicola Di Girolamo, Editor of JSAP said: “Studies like this one are instrumental to understand how primary care clinicians comply with current recommendations.

"Additional efforts may be required to fully adhere to the International Veterinary Epilepsy Task Force recommendations; being aware of these gaps is the first step towards improvement.”

References

  1. Bhatti, S.F., De Risio, L., Muñana, K. et al. International Veterinary Epilepsy Task Force consensus proposal: medical treatment of canine epilepsy in Europe. BMC Vet Res 11, 176 (2015). https://doi.org/10.1186/s12917-015-0464-z 
  2. Green M, Lowrie M, Singleton D, Garosi L and McConnell K (2022) Approach to initial management of canine generalised epileptic seizures in primary-care veterinary practices in the United Kingdom Journal of Small Animal Practice, available at: https://onlinelibrary.wiley.com/doi/epdf/10.1111/jsap.13543 

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