Original Question: Jake has been having seizures for a few years, maybe 1 year now. Until last week he had one and then yesterday his severest ever continued for 3-4 hours. Now he walks with his head tilted to one side and is usually panting and sometimes he staggers when he walks. We took him to a vet in town here with the following summary. Vet summary: Yesterday, when I saw Jake, he had a right-sided head tilt and a nystagmus (the flickering of the eyes), and he seemed to be falling to the right side. These signs are suggestive of vertigo/vestibular disease. The ear itself did not look like there were any abnormalities but you can get an inner ear inflammation without any external signs. The majority of signs usually improve in 3-7 days but mild signs may persist for a few weeks. This disease also causes nausea due to motion sickness, which is why I administered an injection of Cerenia, an anti-nausea medication. I also recommended Gravol for continuing treatment of the nausea at half to one full 50mg tablet up to three times daily for at least 5 days. His blood work was largely normal yesterday, other than mild elevation in ALP at 264 U/L (normal range is 20-150 U/L). This elevation without any elevations in the other liver values is usually due to benign liver changes due to age. In regards to the seizures he has been having, it would be great if we could get a video of it. You told me he had had a seizure lasting 2-3 hours early yesterday morning at 4 am in the morning and then he vomited three times later in the morning. He also had another 30 min seizure earlier last week. If these are indeed seizures (and again, it would help to have a video to ensure that it is what he is having and to ensure we are treating the right condition), then for seizures that often and that prolonged, I would recommend considering anti-seizure medications to decrease the frequency and duration. I have sent you home with the Valium/diazepam (glass vial in the plastic vial with the syringe) to administer to him rectally in the case of a seizure to stop the seizure. Seizures in an older animal who hasn’t had them before, or worsening in older age, can be indicative of brain tumours or other neurological disease, and they usually get worse in frequency as time progresses. Other diseases that can cause seizures in older dogs also include organ dysfunction, which we have largely ruled out with blood work. A definitive diagnosis of brain tumour or other neurological disease would require a referral to a neurologist specialist. If he still seems very anxious, we can certainly try gabapentin, which is a medication that has mild anti-seizure activity, as well as possibly sedation and pain medication. Jack Hurst comments: I have heard that maybe medical marijuana for pets might help. Your thoughts? Thanks. - Jack
