Epilepsy Beyond Seizures: Behavioral and Cognitive Co-morbidities of Canine Epilepsy (Interactive Session)

As the most common, chronic neurological disorder in the dog, epilepsy is a familiar and challenging disorder for neurology specialists and general veterinary practitioners alike. Although recurrent seizure activity may be the hallmark of epilepsy, it is well recognized in human medicine that epilepsy is rarely just a seizure disorder, with patients commonly presenting with, or going on to develop a complex network of co-morbidities in addition to their seizures. These co-morbidities include affective (‘mood’) disorders (e.g. depression and anxiety), neurodevelopmental disorders (e.g. attention-deficit hyperactivity disorder; ADHD), and impairments in cognition (e.g. memory deficits).

Over the past decade, research at the Royal Veterinary College (RVC, London) has used both objective behavioral testing and large scale epidemiological studies to identify behavioral and cognitive changes associated with epilepsy in dogs. To date, co-morbidities identified include increases in anxiety, ADHD-like behavior, and signs of cognitive dysfunction including impairments in learning, trainability and spatial memory. Although some of these behavioral and cognitive changes are attributable to the effects of potent anti-epileptic drugs, others are observed in drug-naïve patients, or occur before seizure onset. Mechanisms for their co-occurrence may include shared genetic risk factors, bi-directional effects, causative and resultant mechanisms.

This presentation will explore current knowledge in this area, including cutting-edge research to better characterize and understand these co-morbidities using behavioral testing and electroencephalography (EEG). Finally, potential management tools including pharmacological interventions (including the use of anxiolytics), and non-pharmacological interventions including behavioral therapy and dietary management options (such as medium-chain triglyceride enriched diets) will be discussed.