Welcome back! This post is a big one so we’ve split it into two parts and one checklist. This is Part Two: Mars' Epilepsy Diagnosis and is all about our experience with his neurology appointment and medication.
Part One: Mars' Seizures was all about Mars' seizures and what happened when he had his first seizure and we've also created a checklist.
They don't need to be read in any particular order, but I recommend every dog (and cat) owner read the checklist at a minimum, so they're not caught off guard like we were.
I wanted to write Part Two as a secondary blog post about our experience getting Mars' diagnosis for anyone who is waiting on a neurology appointment themselves and doesn't know what to expect or what to take. A lot of this post is going to mention the Small Animal Teaching Hospital, a specialist veterinary centre that belongs to Liverpool University. We had the most incredible experience there and cannot fault the staff or facility.
So let's get started! If you read Part One, we left it on New Year's Eve, and Mars had just had his 4th seizure. (Because of course our dog would develop epilepsy over the most major U.K. holiday break) After his cluster seizure episode- seizures 2 and 3- our vet put through a neurology referral for us. It was Tuesday 20th December, 3 working days until the Christmas break and we were not optimistic that we'd hear back before January. Surprisingly, I got a call the very next day offering us an appointment for Mars on Wednesday 4th January which obviously we accepted -and immediately emailed all of our clients that we'd be closed for the day because self-employed life.
Mars' appointment was about an hour drive for us, and I took everything. I wanted to be as prepared as possible so I took:
- The patient forms they sent in advance, filled out
- Mars' full vet history, printed out
- A summary list of his seizures, with details like duration and time
- All his insurance details
- The bed cam footage of his cluster seizures
The vet we saw was not only friendly and kind but unbelievably informative. His opinion was that he was 95% sure it was idiopathic epilepsy and that medication is required and he was happy to diagnose us with that, prescribe us and send us off but he gave us the option to get an MRI scan and spinal tap to clear up that tiny 5% chance that it isn't. As we had full coverage insurance for Mars, we decided it was worth it to know for certain and left him in SATH's capable hands for a few hours.
Important aside about idiopathic epilepsy: there is no test to diagnose for it. Idiopathic directly translates into: "a disease of it's own" i.e not connected to anything and is used in medical cases for a disease that they cannot find a cause or link for. The only way to get an idiopathic epilepsy diagnosis is to rule out everything else that could be causing seizures. Our initial vet did this with blood tests and physical checks, the specialist agreed that he wasn't acting like a dog with any kind of brain altering disease; his balance was fine, he was happy and energetic and eating etc. In all other ways, Mars appeared normal.
We'd driven an hour to Liverpool and had around three hours before we needed to pick up Mars- not quite enough time to be worth driving home and back so we drove to Chester, the nearest city, and shopped and got lunch and yes, it felt incredibly weird to be lunching and shopping in the middle of a work day while our pet was getting medical care.
We had to wait a little while to collect Mars because it took him time to come round from the anaesthetic but his test results came in clear and normal which was a relief, even if it was expected. This confirmed idiopathic epilepsy and we were prescribed phenobarbitol to take home with us. The vet listed every single drug treatment option, the pros and cons and even described how they worked, for instance: phenobarbitol is metabolised in the liver which is why in some cases it can cause liver disease and dogs taking it should have regular blood tests to watch for it.
Mars was given a medium dosage which we can adjust as needed but treating canine epilepsy is tricky; if you give the dog a high enough dose to cease all seizures, they can become zombies, with no quality of life. A medium dose means that Mars may still have some seizures, approx 2 a year is the expectation, but he'll retain his energy and have a full quality of life with it. A bit of a balancing act!
Finally Mars came round from the anaesthetic enough to come home and the only way to describe post-anaesthetic Mars is Drunk. We led him to the car and he was wobbling all over the place and incredibly drowsy. He slept the entire way back and had perked up a little by the time we got home so we gave him his first dose of meds with some food and now here we are! 7 months of meds and seizure-free!
Phenobarbitol can take up to two weeks for the dog to adjust to and in that time they can experience a range of side effects, fatigue is common but... this is Mars. Mars hit the much less common side effect of hyperactivity and he combined it with a lack of co-ordination and balance, as only Mars could. It was a lot like having Puppy Mars again and it was a long two weeks. He had a blood test one month after prescribing, then three months and now he has regular six monthly bloods. If his dosage or medication ever needs to change, he'll need to repeat the 1 month, 3 month, 6 month pattern to monitor.
Ever since then he's been completely fine, which we are so thankful for, especially because I know that this isn't everyone's experience. Our total bill, which went directly to our insurance, was around £2,500 and was mostly so high because of the MRI costs. Mars has coverage up to 7,000 with his insurance and it was a massive relief knowing we could get him all of the tests required. From a £2,500 bill, we paid his £99 excess and his blood test and prescriptions have been covered since.
Although Mars is a mixed breed, a husky and a german shepherd, both of his parents are perfect examples of their breed and have full health tests, including hips and elbows. There is no current genetic test for idiopathic epilepsy and neither of his parents, his parent's previous litter, or his parent's genetic lines have any instances of epilepsy. Mars was an accidental litter- his breeder would never intentionally mix those lines but we suspect it is in the mixing of the lines that the epilepsy has appeared, putting his litter of five at risk. Because Mars' breeder is so excellent, we have a group chat for the litter so I was able to check-in with and warn the other owners what to look out for. Since Mars' diagnosis, another of his litter has been diagnosed and because of our group chat they had a much easier time diagnosing it.
While Mars may have epilepsy, our experience still solidifies the importance of buying from a good breeder. Our breeder has been able to check the medical history of both of his genetic lines and the contact with the other litter owners has been invaluable. The same goes for insurance. By all reasoning, Mars should've been the picture of health. His parents have been tested for absolutely everything and come from incredible lines but this still happened.
You can find our Good Breeder Checklist here
And that's all for our Epilepsy mini-series! I truly hope none of you ever need this information but if you do, I hope it helps and I hope you have an experience as positive as we did.
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