STATUS EPILEPTICUS AND CLUSTER SEIZURES
PLEASE NOTE: The following are "textbook" definitions of
status epilepticus and cluster seizures. Since every dog is different and every seizure
can be different, we have added descriptions from various Guardian Angels so that you can
get a better idea of exactly how our own dogs look and act during seizures. Those
descriptions follow immediately after the formal definitions. We hope this is helpful to
A life threatening situation that is defined as a seizure lasting 5 to 10
minutes or even 20 minutes, which is an estimation of the duration necessary to
cause brain damage. However, treatment needs to begin well before 20 minutes has
elapsed. A more practical definition of Status is a continuous seizure lasting
at least 5 minutes, or two or more discrete seizures without full recovery of
consciousness between seizures lasting at least 5 minutes or more.
Treatment of Status Epilepticus:
As stated above, status epilepticus is a special case where seizures occur one
after another without abatement. If these seizures are not stopped, the
resultant hypoxia may result in irreparable brain damage. The goal, then, is to
stop the seizures. This requires injectable medications: diazepam and
phenobarbital from an emergency room or your vet. Although propofol is not an
anticonvulsant, it can sedate the patient long enough for phenobarbital to work.
Give diazepam (to effect) at 0.5-1.5 mg/kg IV. If the seizures continue, repeat
and give both propofol and phenobarbital at 2 mg/kg IV. Remember to check the
glucose level and give if low and consider calcium glucconate if the seizure
don't seem to be controlled. Once the seizures are under control, the patient
should be examined to determine the cause of the seizures and anticonvulsant
therapy with phenobarbital and/or KBr continued while achieving the diagnosis.
Cluster Seizures: Two or more seizures occurring over a
brief period of time (minutes to hours) but with the patient regaining consciousness
between the seizures.
Seizure descriptions provided by Guardian Angels
Mary Jane and Maggie May (Beagle):
Clusters: As I have always been right next to Maggie during the initial seizure, she
will come toward me or look to me and have that glassy look in her eyes. If
she is standing or sitting upright, I will ease her down into a recumbent position. At
this point she is salivating and typically loses bladder control. Maggies head is
always bobbing at this point. Maggie will grow rigid now and be unresponsive. She has
complete loss of consciousness. She proceeds to the tonic-clonic phase. After this initial
seizure (3-10 minutes), Maggie will have a period where she is coherent but never attempts
to get up (20 minutes 1 hour). At this point Maggie has frequent (up to 25)
tonic-clonic phases of short duration (10-20 seconds). Maggie is recumbent during this
entire time (2-2 1/2 hours). Maggie vomited just prior to the tonic phase during her last
received Valium at the onset of each episode. I can only say what her post-ictal behavior is with the Valium. She has exhibited exhaustion,
drowsiness, pacing (only once), increased hunger, and increased clinginess.
exhibits muscle twitching (front legs) up to 2-3 days post-ictal.
This could possibly be from the Valium. Maggie receives either iv
or rectal Valium as well as oral Valium for 24 hours (Valium Protocol).
For more information about Maggie's seizures, click here.
Nancy and Tahoe
Tahoe, being an Aussie, has seizures that are very hard to control. Border Collies also
have seizures which are hard to control. Tahoe has always had seizures every 14 to 20 days
and at least 3 seizures in a cluster within a few hours. Early on with Tahoe's epilepsy he
would have a grand mal seizure that lasted anywhere from 1 to 4 minutes. During the
seizure we would see an array of behaviors... from simple shaking to paddling, rigid and
twisted body, mouth snapping, salivation, choking sounds, and loss of urine. Then he would
lie there slowly paddling. Afterwards he would have a period of time in between where he
would come out of it, get up and then usually he would go down again in another seizure.
This would be repeated and then there was always a third seizure. This was prior to a vet
allowing us to treat him at home with rectal and oral valium.
Once we had the rectal and oral valium we were able to stop cluster seizures from
happening for 4 years. Last year Tahoe had one episode where he started clustering with 2
seizures a day, 12 hours apart for 2 weeks straight. He had been given valium but it took
Clonazepam to break that particular cycle.
Cluster seizures and Status can be a life threatening situation. A prolonged seizure
(Status) can cause brain damage or death. Some pups, once they start to cluster, can be
hard to control and could end up in a Status situation. This is why the rectal and oral
valium protocol is so important to use.
Luckily for Tahoe, he only had one Status situation before we
started using the valium protocol. He spent 4 hours at the vets on a valium IV to stop the
Status. I know that by treating him at home with rectal and oral valium we have avoided
Status on several occasions.
Cathy and Zak (Lhasa Apso):
started with him having just one at a time but within a few
months he started having clusters. During these first months he was put
on Pb. The seizures would come every ten days to two
weeks and every time he
would have another seizure our vet would increase the Pb. When the clusters
started they were very violent and they totally wiped Zak out for days.
The Pb simply wasn't working to control Zak's seizures
and he was having more and more seizures with less
amount of time between episodes. Our vet, that we had
at the time, did not give me much encouragement for finding a way to
help Zak; he felt we would continue doing what we were
doing and when it got too
bad we would have to put Zak to sleep.
Eight months after Zak's seizures started he had his one and only status
episode. It is without question the most terrifying experience I've ever
had. I will note here that this is before we found the Guardian Angels
and I had NO knowledge on how to stop this cluster.
Always before Zak would have three, maybe four
seizures and then they would stop. But this time they
just kept coming, and coming, and coming. Our vet was not available
and the only other vet in our community wasn't available either. We live
in a small rural community and the closest ER was 70
miles away!! After wasting precious time trying to
find someone to help we decided that if we didn't get
started to the ER, Zak was going to die. In the two
hours that Zak was having one seizure right after
another, he must have had 60, 70, or
more seizures. He had bit his tongue, he had bit me (we were both
bleeding), he had urinated, he was foaming at the
mouth, his eyes were rolled back in his head, he was
burning up with a temperature...the hour that it took us to
drive to the ER was terrifying!! Zak had seizures all the way until we
got about 10 minutes from the ER and he just went limp
in my arms. I thought he had died but we continued on
to the ER.
The ER vet rushed to our car as we pulled in the parking lot and as I handed
Zak to him, I told him I thought he was already
gone, but as he was running
inside he said he thought he was still alive...and he was as he started to
seize again and again. The ER vet was very young and the first thing he
ask me was if I had given Zak any valium. Within just
a few minutes in this ER clinic talking with this very
young vet, with my Zak very close to death, I started
to learn how to deal with and handle cluster seizures. Zak was put
on a valium drip and the seizures finally slowed down.
Within the days after this episode, Zak
continued to have seizures, but they
were much milder and they got further and further apart. It was during
this time I found Joanne on the internet and was able
to learn about the valium protocol. I found a vet that
was able to help me with the valium protocol and was
willing to help me explore alternate treatments for Zak...through
which we were
eventually able to reduce Zak's Pb and we added Kbr.
It took Zak a long time to recover from this episode. I feared for weeks
that Zak had brain damage. He was so weak, he was so lethargic, he simply
wasn't the pup he had been before this episode,
but Joanne kept telling me to not give up and she was
right...slowly Zak got better and returned to his
Since this episode and learning about the valium protocol Zak has never had
another cluster seizure!!