Canine Epilepsy Research

Epilepsy is the most common long-term neurological disorder experienced by dogs, affecting around 50,000 dogs in the UK. Epilepsy is an extremely debilitating condition for dogs and greatly distressing for their owners. Research in this area, therefore, has enormous benefits for the canine population and also can have benefits for human patients and for other species.

Over the past decade, RVC research has led the way in understanding epilepsy using a holistic approach, studying not only affected dogs, but the veterinary team involved in their management and canine caregiver impacts and perspectives, as well as pioneering novel methods to manage epilepsy using rigorously tested non-drug interventions, and understanding the wider comorbidities of epilepsy, to maximise quality of life.

Understanding epilepsy diagnosis and management

Despite epilepsy affecting so many dogs, seizure activity can easily be misinterpreted. RVC research, published in BMC Veterinary Research, illustrated a lack of consistency among vets in the diagnoses of epilepsy. Many owners record their dog or cat having seizures, post footage online and show it to their vets in the hope of assisting diagnosis. The RVC research compared different vet’s interpretation of footage. As well as investigating if vets could agree if filmed animals were having epileptic seizures, without further case information, the study asked observing vets which type of seizures they thought had taken place. There was a low level of agreement on whether or not the episodes were epileptic seizures. Specialists were less likely than non-specialists to diagnose a seizure and more likely to diagnose less common conditions. The only seizure characteristic to achieve good agreement between observers was that an animal salivated during an episode. Signs like aggression, anxiety and hallucinations were least agreed upon by participants. The study emphasised the need for improved seizure classification systems to help vets make better diagnoses.

Since the article was published, in February 2015, the RVC has driven international consensus on the research, diagnosis and treatment of canine and feline epilepsy. The consensus was facilitated by the establishment of an international body composed of veterinary practitioners and neuropharmacology, neuropathology and neurology experts. The International Veterinary Epilepsy Task Force, which was established by the RVC, has produced seven ‘consensus statements’ outlining recommendations and classifications on all aspects of the condition. The guidelines establish a framework and standards for future trials. Because classifications, definitions, therapeutic outcome measures, neuroimaging and neuropathological standards have historically differed between studies, it has been difficult to draw comparisons. This has limited their scientific and clinical impact.

Following on from this, RVC studied the future research priorities for canine epilepsy to maximise quality of life of affected dogs. An international online survey was conducted in 2016 and repeated in 2020. Participants rated the absolute importance and relative rank of 18 areas of IE research, which were compared between groups and time points. The development of new anti-seizure drugs (ASD) and improving the existing ASD management were considered the most important research priorities. Areas of research with increasing priority between 2016 and 2020 included non-ASD management, with the greatest potential seen in behavioural and dietary-based interventions. Disagreements in priorities were identified between groups; owners prioritised issues that impacted their and their dog's QoL, for example, adverse effects and comorbidities, whereas general practitioner vets and neurologists prioritized clinical issues and longer-term strategies to manage or prevent IE, respectively. Ensuring that voices of owners are heard in the planning of future research should be a broader goal of veterinary medicine, to target research efforts toward areas most likely to improve the QoL of the dog-owner dyad. RVC research has endeavoured to fill these priority research gaps, including recent research quantifying increased appetite as a side effect of anti-seizure drugs for the first time, using a validated questionnaire tool that could be used by owners and veterinary surgeons to objectively monitor food motivation over time.

More recently, RVC research explored the owner-veterinary surgeon relationship in the management of canine epilepsy using a qualitative approach. Current owners of dogs with epilepsy were interviewed to explore the impact of veterinary surgeons on their decision making and management. Many owners felt that more precise expectations could have improved interactions with their veterinary surgeon(s), and their experiences of caring for their dog. Most owners referred to a specialist reported a positive experience, often due to specialists being perceived to have greater experience or knowledge. Owners who reported predominantly negative experiences were often less trusting of the veterinary profession, and more likely to perform self-directed research. Owners appear to value the formation of partnerships of care with their veterinary surgeon, and greater availability of educational resources could further improve owner satisfaction. RVC have led in this area, including the development of a Pet Epilepsy Tracker app, described below.

Developing new non-drug therapies for epilepsy

Given the growing importance of non-drug management options for epilepsy, as evidenced in the above study, RVC has pioneered several new interventions aimed at reducing seizure frequency in dogs with epilepsy, while minimising side effects and addressing behavioural comorbidities of epilepsy.

Nutrition studies

An RVC-led food trial involving dogs has implications for human diet and epilepsy management as well as veterinary patients. A six-month dietary trial compared a ketogenic (high fat, low carbohydrate) medium-chain TAG [triacylglycerol] diet (MCTD) with a standardised placebo diet in dogs treated for idiopathic epilepsy. Dogs were fed either a MCTD or placebo diet for three months, followed by a switch of diet for the remaining three months. Clinical and laboratory data were collected and evaluated for 21 participating dogs. The researchers found that seizure frequency was significantly lower when dogs were fed the MCTD. The study demonstrated that medium chain triglycerides are effective in treating drug-resistant epilepsy in dogs, and a similar diet could make a difference for epilepsy in human patients.

More recently, RVC expanded this work to run a dietary trial comparing the efficacy of MCT oil added as a supplement to dog’s base diets to a control dietary supplement free of MCTs. A 6-month multicentre, prospective, randomized, double-blinded, placebo-controlled crossover trial was completed. The study demonstrated that dogs fed this dietary supplement experienced a significantly reduced seizure frequency, that this supplement was highly palatable to dogs, and that it improved cognitive function, which is often impaired in canine epilepsy patients, and that the intervention led to metabolic changes in lipid, amino-acid and ketone metabolism.

Behavioural interventions study

Based on evidence that behavioural interventions can reduce seizure frequency in people with epilepsy, this novel study investigated the impacts of two behavioural interventions, aimed at reducing stress and anxiety in canine IE patients, on seizure activity, anxiety, cognition and quality of life, using a prospective six-month randomised controlled trial. The trial involved a three-month baseline monitoring period followed by a three-month intervention period, in which two intervention groups followed distinct sets of advice (‘Relax’ and ‘Therapy’), alongside an extended monitoring control group. In total, 64 completed the full six-month trial. Intention-to-treat analyses and generalised estimating equation (GEE) statistical models found both intervention groups resulted in significant decreases in owner-reported focal seizure activity over time and compared to the Control group. Additionally, Therapy group participants reported a significant decrease in their dog’s anxiety, and dogs in the Relax group significantly improved in problem-solving ability. Finally, both intervention groups reported significant improvements in the impacts on their lives as caregivers. These results provided evidence that behavioural interventions can benefit dogs with epilepsy and their caregivers, offering new non-invasive interventions that tackle epilepsy and its comorbidities in tandem. 

Quality of life in canine epilepsy

Epilepsy is known to have severe negative effects on both the patient and their caregivers in human medicine. RVC research has explored the impacts of epilepsy on canine patients and their human caregivers in a range of studies. Studies have identified that dogs with higher seizure frequencies and those receiving three or more anti-seizure drugs are at highest risk of quality-of-life compromise. Furthermore, dog and owner quality of life is intrinsically linked, with those dogs experiencing worse quality of life due to their epilepsy resulting in worse quality of life in their caregivers. Qualitative studies that followed identified the emotional impact upon caregivers in-depth, with distress, fear, sleep disruption, and major lifestyle changes commonplace in this owner group. RVC researcher Dr Rowena Packer authored a book chapter aimed at the veterinary team exploring the impact of epilepsy upon affected dogs and their caregivers to raise awareness of these widespread effects.

Comorbidities of epilepsy

Epilepsy has long been acknowledged to be part of a wider web of comorbidities in human epilepsy, including neurodevelopmental disorders including ADHD and autism, and emotional disorders such as anxiety. RVC has pioneered research characterising a comparable array of behavioural differences in dogs with epilepsy compared to healthy control dogs, including predispositions to anxiety. Furthermore, a suite of studies for the first time identified cognitive deficits in dogs with epilepsy using a range of practical testing and owner-reports. Following these initial discoveries, the aforementioned randomised clinical trials of non-drug interventions have found that both diet and behavioural therapies are able to improve cognition in this population.

More recently, in collaboration with researchers at the University of Guelph, RVC researcher Dr Rowena Packer conducted a study of Border Collies, a breed predisposed to severe, drug-resistant epilepsy, to explore the presence of co-morbid neurodevelopmental disorders, ADHD and autism. In a cohort of 30 Border Collies with idiopathic epilepsy, and a sex and aged matched cohort of 30 healthy control dogs, the study characterised the epilepsy and co-morbid behavioural/cognitive phenotype, in combination with MRI (magnetic resonance imaging) of their brains and minimally invasive EEG (electroencephalography) of their neural activity to identify within-breed differences in these parameters. As the dogs needed to be anaesthetised briefly for the MRI scans to be taken, and healthy control dogs underwent EEG testing, both of which were primarily for research purposes, this work was undertaken under the Animals (Scientific) Procedures Act with owner informed consent. Border Collies with epilepsy were found to exhibit greater behavioural and cognitive signs indicative of an ADHD-like disorder, including impaired learning abilities, impulsivity and attention deficits, further confirming their suitability as a naturally occurring model of human epilepsy. In addition to the core study questions, EEG data derived from this study have provided a first step toward the standardization of EEG protocols in veterinary epileptology, finding that independent component analysis was feasible for EEG source localisation, which will be key for future development of epilepsy surgery in dogs.

Epilepsy app helps dogs, owners, vets and aids research

RVC researchers launched the first ever app that allows owners of dogs with epilepsy to monitor their pet to improve the quality of their lives, inform veterinary decisions and support research into the condition. The ‘RVC Pet Epilepsy Tracker’ enables owners to map seizure activity and medication requirements on mobile phones and tablet devices. It was developed in collaboration with the Epilepsy Society, which previously created an equivalent app for human patients.

The app contains information about the condition, diagnostic methods and practical advice on what to do in the event of a seizure. It can also remind owners about each medication their dog is due. The app supports vets because owners can convert their dog’s medical history, seizure diary and medication diary into a pdf file and send it directly to practices. There is also the option of recording detailed information of epileptic episodes, including what happened during and after the seizure, how long it lasted and how severe the owner rated it to be.

The epilepsy app could lead to breakthroughs in the understanding of how epilepsy progresses in dogs and patterns of seizure activity because owners can share seizure diaries with RVC researchers. This enables data to be collected from long-term studies of seizure activity, something that researchers have previously been unable to collect for a large number of dogs.

The app has been updated several times based on user feedback, most recently in 2025, and has been translated to several languages to increase its use internationally.

References

International Veterinary Epilepsy Task Force consensus report on epilepsy definition, classification and terminology in companion animals http://doi.org/10.1186/s12917-015-0461-2

International Veterinary Epilepsy Task Force Consensus Proposal: Diagnostic approach to epilepsy in dogs http://doi.org/10.1186/s12917-015-0462-1

International Veterinary Epilepsy Task Force current understanding of idiopathic epilepsy of genetic or suspected genetic origin in purebred dogs http://doi.org/10.1186/s12917-015-0463-0

International Veterinary Epilepsy Task Force consensus proposal: Medical treatment of canine epilepsy in Europe http://doi.org/10.1186/s12917-015-0464-z

International Veterinary Epilepsy Task Force Consensus Proposal: Outcome of therapeutic interventions in canine and feline epilepsy http://doi.org/10.1186/s12917-015-0465-y

International Veterinary Epilepsy Task Force recommendations for a veterinary epilepsy-specific MRI protocol http://doi.org/10.1186/s12917-015-0466-x

International Veterinary Epilepsy Task Force recommendations for systematic sampling and processing of brains from epileptic dogs and cats http://doi.org/10.1186/s12917-015-0467-9

Packer, R M; Berendt, M; Bhatti, S; Charalambous, M; Cizinauskas, S; De Risio, L; Farquhar, R; Hampel, R; Hill, M; Mandigers, P J; Pakozdy, A; Preston, S M; Rusbridge, C; Stein, V M; Taylor-Brown, F; Tipold, A; Volk, H A. (2015) Inter-observer agreement of canine and feline paroxysmal event semiology and classification by veterinary neurology specialists and non-specialists. BMC Veterinary Research, 11;1:356. http://dx.doi.org/10.1186/s12917-015-0356-2

JONES GMC; VOLK HA; PACKER RMA(2021) Future research priorities for canine idiopathic epilepsy: viewpoints of owners, general practice veterinarians and neurology specialists. Journal of Veterinary Internal Medicine. https://doi.org/10.1111/jvim.16144

MORROS-NUEVO A; PACKER RMA; REGAN N; RAFFAN E (2024) Increased food motivation and adiposity based on caregiver survey in dogs receiving anti-seizure drugs. Veterinary Record. e4907. https://doi.org/10.1002/vetr.4907

BERK BA; OTTKA C; LAW TH; PACKER RMA; WESSMANN A; BATHEN-NOTHEN A; JOKINEN TS; KNEBEL A; TIPOLD A; LOHI H; VOLK HA (2022) Metabolic fingerprinting of dogs with idiopathic epilepsy receiving a ketogenic medium-chain triglyceride (MCT) oil. Frontiers in Veterinary Science.

BERK BA; LAW TH; PACKER RMA; FRITZ J; VOLK HA (2022) Oral palatability testing of a medium-chain triglyceride oil supplement in a cohort of healthy dogs in a non-clinical setting. Animals. 12 (13), 1639;

BERK BK; PACKER RMA; LAW TH; WESSMANN A; BATHEN-NOTHEN A; JOKINEN TS; KNEBEL A; TIPOLD A; PELLIDAND L; VOLK HA (2021) Medium-chain triglycerides dietary supplement improves cognitive abilities in canine epilepsy. Epilepsy & Behavior. 114, 107608. https://doi.org/10.1016/j.yebeh.2020.107608

BERK BA; LAW TH; PACKER RMA; WESSMANN A; JOKINEN T; KNEBEL A; TIPOLD A; PELLIGAND L; MEADS Z; VOLK HA (2020) A multicenter randomised controlled trial of a medium-chain triglycerides dietary supplement to improve management of canine epilepsy. Journal of Veterinary Internal Medicine 34 (3) 1248-1259 doi.org/10.1111/jvim.15756

BERK BA; PACKER RMA; LAW TL; WESSMANN A; BATHEN-NOTHEN A; JOKINEN TS; KNEBEL A; TIPOLD A; PELLIGAND L; VOLK HA (2019) A double-blinded randomised dietary supplement crossover trial design to investigate the short-term influence of medium chain fatty acid (MCT) supplement on canine idiopathic epilepsy. BMC Veterinary Research 15 (1). DOI: 10.1186/s12917-019-1915-8

PACKER RMA; HOBBS SL; BLACKWELL EJ (2019) Behavioural interventions as an adjunctive treatment for canine epilepsy: a missing part of the epilepsy management toolkit? Frontiers in Veterinary Science. DOI: 10.3389/fvets.2019.00003

HOBBS SL; BLACKWELL EJ; WETZ K; PACKER RMA (2022) Owner reported management of inter-ictal anxiety behaviours in canine epilepsy. Veterinary Record. https://doi.org/10.1002/vetr.1321

PERGANDE AE; BELSHAW Z; VOLK HA; PACKER RMA (2022) Owner perspectives on the impact of veterinary surgeons upon their decision-making in the management of dogs with idiopathic epilepsy. Veterinary Record e2482. https://doi.org/10.1002/vetr.2482

PERGANDE A; BELSHAW Z; VOLK HA; PACKER RMA (2020) “We have a ticking time bomb”: A qualitative exploration of the impact of canine epilepsy on dog owners living in England. 16, 443.

PACKER RMA (2022) Quality of Life in Canine Epilepsy. In: A practical guide to seizure disorders in dogs and cats (Eds: Karen Munana and Luisa De Risio). Edra, Spain.

WESSMANN A; VOLK HA; PACKER RMA; ORTEGA M; ANDERSON TJ (2016) Quality of life aspects in idiopathic epilepsy in dogs. Veterinary Record:10.1136/vr.103355

WATSON F; PACKER RMA; RUSBRIDGE C; VOLK HA (2019) Behavioural changes in dogs with idiopathic epilepsy. Veterinary Record 186, 93.

PEEK SI; MELLER S; TWELE F; PACKER RMA; VOLK HA (2024) Epilepsy is more than a simple seizure disorder: Parallels between human and canine cognitive and behavioural comorbidities. The Veterinary Journal 303: 106060

PEEK SI; TWELE F; MELLER S; PACKER RMA; VOLK HA (2024) Epilepsy is more than a simple seizure disorder: Causal relationships between epilepsy and its comorbidities. The Veterinary Journal 303: 106061

SCHMIDT T; MELLER; TALBOT SR; PACKER RMA; VOLK HA (2023) Urinary neurotransmitter analysis and canine behaviour assessment. Frontiers in Veterinary Science. 10: 1124231.

PACKER RMA, LAW TH, DAVIES E, ZHANGI B, PAN Y, VOLK HA (2016) Effects of a ketogenic diet on ADHD-like behaviour in dogs with idiopathic epilepsy. Epilepsy & Behavior 55: 62-68.

PACKER RMA, VOLK HA (2015) Epilepsy beyond seizures: a review of the impact of epilepsy and its comorbidities on health-related quality of life in dogs. Veterinary Record 177 : 306-315.

HOBBS SL; LAW TH; VOLK HA; YOUNIS C; CASEY RA; PACKER RMA (2020) Impact of canine epilepsy on judgement and attention biases. Scientific Reports. 10, 17719. https://doi.org/10.1038/s41598-020-74777-4

WINTER J; PACKER RMA; VOLK HA (2018) A preliminary assessment of cognitive impairments in canine idiopathic epilepsy. Veterinary Record 182, 633

PACKER RMA; MCGREEVY PD; SALVIN HA; VALENZUELA M; CHAPLIN C; VOLK HA (2018) Cognitive dysfunction in naturally occurring canine idiopathic epilepsy. PLoS ONE 13(2): e0192182

PACKER RMA; MCGREEVY PD; PERGANDE A; VOLK HA (2018) Negative effects of epilepsy and antiepileptic drugs on the trainability of dogs with naturally occurring idiopathic epilepsy. Applied Animal Behaviour Science 200: 106-113.

WATSON F; COPPI AA; VOLK HA; PACKER RMA; TAURO A; RUSBRIDGE (2021) Comparison of volume of the forebrain, subarachnoid space and lateral ventricles between dogs with Idiopathic Epilepsy and Controls using a stereological approach: Cavalieri’s principle. Canine Medicine and Genetics, 8: 3. https://doi.org/10.1186/s40575-021-00101-6