Risk factors associated with short‐term mortality and recurrence of status epilepticus in dogs

Abstract

Background Status epilepticus (SE) is an emergency associated with serious consequences for both patient and owner. Data regarding risk factors for short‐term mortality or recurrence in dogs with SE is limited. Objective Identify risk factors associated with short‐term mortality (euthanasia or spontaneous death) and recurrence of SE in dogs. Animals One hundred twenty‐four client‐owned dogs that sustained an episode of SE. Methods Retrospective multicenter study using data collected from medical records of dogs presented in SE to the contributing institutions. Multivariable logistic regression analysis was performed using a manual backwards stepwise approach to identify risk factors associated with short‐term mortality and recurrence of SE after discharge. Results Short‐term mortality for affected dogs was 29.8%. Factors significantly associated with short‐term mortality included increased patient age, shorter duration of hospitalization, development of SE before arrival, and SE caused by a potentially fatal etiology. Status epilepticus recurred in 27% of dogs that survived to discharge. Factors significantly associated with recurrence of SE included prior history of pharmacoresistant epilepsy and predominance of a focal seizure phenotype. Conclusions and Clinical Importance Our results may be used to inform clinicians and dog owners regarding risk factors for both short‐term mortality and recurrence in dogs with SE.

Does switching brands matter? Complications associated with switching between phenobarbital brands in two dogs with idiopathic epilepsy

“…18,41,62 This could hopefully help in preventing the occurrence of severe ES manifestation such as CS and SE, which are associated with increased mortality and development of pharmacoresistance. 47,48,[63][64][65][66][67] Echoing what is described in human medicine, these cases raise concerns over possible therapeutic complications when switching PB brand in chronically treated dogs with IE. Therefore, careful considerations should be made when modulating antiseizure treatment in dogs.…”

“…Veterinary surgeons should be proactive in measuring SPBc before PB‐brand switching and after 14–20 days after the switching is implemented 18,41,62 . This could hopefully help in preventing the occurrence of severe ES manifestation such as CS and SE, which are associated with increased mortality and development of pharmaco‐resistance 47,48,63–67 …”

Constant rate infusion of diazepam or propofol for the management of canine cluster seizures or status epilepticus

“…This finding contrasts with other studies that reported a metabolic-toxic disease as the main cause of SE in the emergency settings ( 3 , 37 ). However, other literature sources seem to contest this information, reporting 40.3–59% of dogs affected by IE displaying episodes of SE ( 2 , 38 ). Furthermore, it must be noted that in our retrospective study both CS and SE were considered.…”

Management of status epilepticus in dogs

“…Intracranial causes of seizures are further broken down into functional (eg, idiopathic) and structural. Data from one recent study on SE documented the most common underlying aetiology to be idiopathic epilepsy (40.3 per cent), followed by structural (37.1 per cent) and reactive (22.6 per cent) (Fentem and others 2022). Table 1 outlines a list of common intra‐ and extracranial causes of seizures.…”

“…The mortality for SE in dogs can reach up to 29.8 per cent (Fentem and others 2022). In a recent study, for a population of dogs presenting to a referral hospital for seizures, SE was the cause in 16.5 per cent of cases, and for more than half of them (58 per cent), this was the dogs' first seizure event (Charalambous and others 2021).…”