Cat with open mouth
During a seizure, your cat may repeatedly open and close their mouth so that they look like they are chewing imaginary gum. Photo courtesy of Depositphotos
Watching your cat have a seizure is difficult. It is often a confusing and scary time for both you and your cat. This difficulty is especially true if you don’t know your cat is having a seizure and even if you do, it doesn’t necessarily make the experience less jarring. During the episode all sorts of questions can race through your mind, causing fear and panic. What is wrong with my cat? What do I do? Will they be okay?
What are Seizures?
Seizures are sudden fits of uncontrollable movement and can include twitching, shaking, and/or muscle spasms. Your cat can lose consciousness during a seizure, drool, vomit, urinate or defecate. Other signs of seizures in cats include uncontrolled running around the house, up the curtains, over the furniture, etc. Seizures are caused by abnormal changes in the electrical activity of the brain and most last a few seconds to a few minutes but some last hours.
Different Types of Seizures
There are two types of seizures your cat can have: focal and generalized. Focal or partial seizures only affect part of the brain. Only one side of your cat’s body will have abnormal movement. For example, your cat may move their left leg(s) strangely or their left eye, or lips or ear may twitch. Other signs of focal seizures include tail chasing, limb chewing, aggression, and strange behavior as if your cat were chewing imaginary gum. Focal seizures are more common in cats but can progress to the generalized form.
Generalized seizures affect the entire brain and thus both sides of the body. They result in loss of consciousness; sudden jerking of the neck, head or body; urination; defecation; falling to one side; vocalization; vomiting; and salivation. Your cat’s legs can be stiff and difficult to bend or your cat may constantly move their legs as if they were paddling or swimming on their side.
Recognizing Seizures in your Cat
Your cat may act unusual hours to days before a seizure. This includes increased nervousness, attention seeking or avoidance, and head turning. Be on the lookout for these behaviors as they serve as warning signs of a seizure to come in the near future. During the seizure, which usually lasts seconds to minutes, your cat may “stare off into space” and appear mentally not there. Afterwards, it will take some time for them to go back to normal. This post-seizure period can last 24-48 hours. During this time, your cat may show signs of hyperactivity, pacing, circling, head pressing, and other changes in behavior.
Seizures tend to occur when there are changes in brain activity such as when a cat is sleeping, waking, excited, or around feeding time. Paying close attention to your cat during these times will better help you identify a seizure.
Recurring Seizures and Epilepsy
A seizure can be a one-time event or repeated over time. Repeated seizures are called epilepsy. If your cat has epilepsy, their seizures may occur at regular intervals such as every five days or every other month. On the other hand, there may be no pattern to how often your cat’s seizures occur. Between seizures and after the post-seizure period, your cat will behave normally with no obvious signs of illness unless they have another disease going on.
What Causes Seizures?
One-time seizures can be caused by toxins, trauma, metabolic disease, low blood sugar, or triggering stimuli such as lights or high-pitched sounds. Metabolic issues are often linked to other diseases of the liver, kidney, or thyroid. These single seizures can progress to multiple seizures over time if the underlying cause is not treated.
Multiple seizures or epilepsy is either primary or acquired. Primary epilepsy has a known or suspected genetic basis. Acquired epilepsy does not; it is caused by factors that affect the brain. These factors can directly affect the brain and include trauma, infectious disease, cancer and abnormal brain development. Other factors affect the brain indirectly and include metabolic issues, low blood sugar, toxins and triggering stimuli. Sometimes your veterinarian will not be able to determine what is causing your cat’s seizures and will call them idiopathic. Idiopathic means there is not a known cause. These types of seizures, however, are not common in cats.
What Do you Do if your Cat is Having a Seizure?
Most seizures cats have are not medical emergencies. The most important things you can do are make sure your cat does not hurt themselves and take note of how they act. You will need to schedule an appointment with your veterinarian so it’s important to describe what happened before, during, and after the seizure as best as possible. A video is an excellent way to do so and help your veterinarian determine what happened. During the seizure, do not touch your cat unless they are at risk of hurting themselves. If this is the case, use a thick blanket to move them as some cats become aggressive when having a seizure.
Some seizures are medical emergencies. If your cat has a seizure that lasts longer than five minutes or has more than three seizures in a row without returning to normal between them, seek immediate veterinary care. This is called status epilepticus and is a medical emergency.
If your cat has more than one seizure within a 24-hour period and acts normal between each one, this is called a cluster seizure. Cluster seizures are not usually considered to be an emergency, but if you are in doubt, see a veterinarian.
A thorough history and description/record of the event are critical to diagnosis. These are important for confirming whether your cat had a seizure and if there was possible exposure to toxins. Your veterinarian will perform a physical examination of your cat and run several blood tests to rule out metabolic and infectious causes. A neurologic exam will also be performed. If diseases outside of the brain are ruled out, further diagnostics to evaluate brain function include advanced imaging such as computed tomography (CT) and magnetic resonance imaging (MRI). Your veterinarian may refer you to a veterinary neurologist.
Treatment of seizures depends on what caused them, how severe they are and how often they occur. If your cat is having a medical emergency, your veterinarian and veterinary team will stabilize them through use of fluid therapy, short-acting anti-convulsant drugs, and other measures to get the seizures under control. Once your cat is stable and if possible, their underlying issue will be treated. This can be as simple as removing a toxic substance to treating serious liver or kidney issues. Some cats with seizures respond well to this approach and will not have seizures again once the underlying cause is treated.
Other cats with seizures, particularly those with epilepsy, require long term anti-convulsant therapy. Preventing your cat from ever having another seizure in their life is often not possible; the goal of treatment is to reduce how severe their seizures are and how often they happen. Improving your cat’s seizures is done by using anti-convulsant medications, particularly phenobarbital. It takes time to determine the best dose and drug for your individual cat and several adjustments are made over time to control the seizures. It is important to work closely with your veterinarian and follow the recommended treatment schedule. Seizure therapy is often a lifelong necessity.
In general, cats have less side effects than dogs when it comes to seizure medication. Mild common side effects occur at the start of treatment or when changes are made to their treatment. These include drowsiness, incoordination, increased appetite and weight gain. Most of these effects are temporary so notify your veterinarian if they persist or seem severe.
Prognosis and Recurrence
Preventing your cat from having another seizure in their lifetime is difficult and often not possible. Even with excellent care and cooperation between you and your veterinarian, there may come a time when your cat’s current treatment plan no longer works. If this happens, your veterinarian will need to adjust the type of drug used or the dose given. You will need to have the drug levels monitored every year to see if they are in an acceptable range. Treating seizures takes a lot of effort but controlling them is important for your cat’s health; seizures can lead to permanent and irreversible brain damage so it is best if you seek treatment before this occurs.