Neurologist Matthew James from CVS's Dovecote Veterinary Hospital has been given BSAVA PetSavers Veterinary Achievement Award 2024 for research into the initial management of epileptic dogs in first opinion practice.

Matthew’s award is in recognition of his paper Approach to initial management of canine generalised epileptic seizures in primary-care veterinary practices in the United Kingdom, co-authored with Laurent Garosi, which was selected by the BSAVA Committee as being the most valuable to veterinary practice.

James’ study explored data collected as part of the Small Animal Veterinary Surveillance Network (SAVSNET) at the University of Liverpool.

In total, clinical records concerning 3,150,713 consultations (917,373 dogs) were collected and analysed from 224 UK veterinary practices.

This included the management of canine generalised epileptic seizures in 517 dogs up to 6 years of age.

The study concluded that 98% of dogs presenting for a single epileptic seizure were not started on long-term therapy, in accordance with the approach recommended by the International Veterinary Epilepsy Task Force (IVETF).

Other findings from the study included:

  • Sixty-seven dogs (13.0%) received ASDs at first presentation. Prescription of ASDs was significantly more likely in dogs presenting with cluster seizures.
  • Phenobarbital and imepitoin were the most frequently chosen ASDs.
  • Eighty-six dogs were presented with cluster seizures; less than half of these were prescribed anti-seizure drugs, most frequently imepitoin (n= 19) and phenobarbital (n=17). Imepitoin was frequently selected in the treatment of cluster seizures despite no authorisation for this purpose.
  • Presentation for a single epileptic seizure occurred in 321 dogs; seven were prescribed anti-seizure drugs. Primary care clinicians rarely prescribed anti-seizure drugs following a single epileptic seizure in accordance with International Veterinary Epilepsy Task Force recommendations.
  • Of the dogs presenting with a single seizure and at least 6-month follow-up (n=165), 33 (20%) did not have subsequent seizures recorded.

The paper also reported on factors potentially associated with prescription of ASDs.

It stated that dogs who presented for cluster seizures (more than one epileptic seizure in a 24-hour period) were more likely to be prescribed ASDs, or to be referred to a specialist, than dogs without cluster seizures.

Dogs that were neutered or microchipped were more likely to be started on ASDs following the initial presentation, perhaps suggesting that owners who take part in regular preventative healthcare prior to the onset of their dog’s seizures could be more willing to start therapy in the earlier stages of the disease.

In addition, more than half of dogs with cluster seizures were not prescribed any ASDs.

Given that the presence of cluster seizures is typically considered an indication to start long-term therapy by the IVETF, Matthew says this may be one aspect of seizure management that could be improved in primary care practice.

Regarding the choice of anti-seizure drugs (ASDs), imepitoin was more frequently prescribed than phenobarbital in response to cluster seizures.

But unlike phenobarbital, the paper highlighted that the market authorisation for imepitoin does not include the treatment of cluster seizures.

Therefore vets should be aware that the use of imepitoin for cluster seizures should be considered as “off-licence” - and has additional implications for obtaining informed consent.

Matthew said: We believe this research contributes to an improved understanding of the current management strategies for canine epilepsy in general practice and how this compares to the current guidelines advised by the IVETF.

"Given the prevalence of epileptic seizures within the UK canine population, as well as the large proportion of dogs that will be managed entirely within general practice without referral to a neurologist, it is vital to ensure that the level of care being provided is optimal.

"We therefore hope that this research ultimately supports and guides general practitioners in their approach to canine epilepsy, thereby improving the quality of life of affected dogs and their owners.”

PS: Whilst you're here, take a moment to see our latest job opportunities for vet nurses.