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Epilepsy, Idiopathic 301

cell carcinoma, demodicosis, dermatophy- • Surgical excision and laser therapy can be • Oronasal communication may result after
tosis, bacterial pyoderma, mycobacterial attempted for single oral lesions. surgical excision of palatal lesions.
VetBooks.ir • Indolent ulcer: squamous cell carcinoma; Acute General Treatment PROGNOSIS & OUTCOME Diseases and Disorders
infection
herpesvirus, calicivirus, feline leukemia virus
• Oral glucocorticoids: prednisolone or pred-
(FeLV), or Cryptococcus infections
taper to lowest effective dose. Prednisolone
• Lip/oral cavity lesions: squamous cell carci- nisone 1-2 mg/kg PO q 12h initially, then Good
noma, fibrosarcoma, focal inflammation due is a superior choice in cats (unpredictable PEARLS & CONSIDERATIONS
to a foreign body, trauma, or an infectious absorption or metabolism of prednisone).
agent • Injectable glucocorticoids (cats): methyl- Comments
prednisolone 4 mg/kg (maximum, 20 mg, • Feline eosinophilic granuloma complex is not
Initial Database Depo-Medrol) can be given up to 2-3 times, a specific diagnosis. A primary underlying
• Microscopic exam of plucked hair (trichog- 2 weeks apart. This should not be a standard cause is likely and should be investigated.
raphy [p. 1091]), acetate tape preparation, therapy. Adverse reactions include congestive • Squamous cell carcinoma and eosinophilic
skin scraping, and flea-combing samples heart failure, diabetes mellitus, secondary granuloma of the tongue and sublingual
to rule out ectoparasites; alternatively, an infection, and iatrogenic hyperadrenocorticism tissues can clinically appear very similar.
improvement after appropriate empirical • Oral clavulanic acid–potentiated amoxicil- Biopsy and histopathologic exam are essential
ectoparasiticidal therapy also supports lin q 12h for 3 weeks has been shown to to obtain an accurate diagnosis.
parasitosis. significantly decrease size of eosinophilic
• Cytologic exam of the surface of lesions cutaneous plaques in cats. Prevention
may reveal large numbers of eosinophils • Oral cyclosporine (Atopica) approved for the If an underlying allergic cause can be deter-
and bacterial or Malassezia overgrowth. treatment of allergic dermatitis in cats at a mined and controlled, the problem can be
• Mild to moderate eosinophilia may occa- dosage of 7 mg/kg PO q 24h initially, then prevented from reoccurring.
sionally be noted on CBC (rare in cats and taper to q 48-72h based on clinical response.
inconsistent in dogs with oral lesions). Main side effects include vomiting, diarrhea, Technician Tips
• Feline immunodeficiency virus/FeLV testing weight loss, decreased appetite, and lethargy. Explain how to institute a rigorous program
• Off-label use of oclacitinib (Apoquel) at a of flea control.
Advanced or Confirmatory Testing dosage of 0.4-0.6 mg/kg PO q 12h for up
• Skin biopsies reveal a superficial to deep to to 14 days and q 24h thereafter may be Client Education
interstitial to diffuse predominantly eosino- effective in some cases. • Because skin lesions tend to wax and wane,
philic dermal infiltrate +/− flame figures reoccurrence is unpredictable (sometimes
(collagen fibers surrounded by eosinophilic Chronic Treatment seasonal).
material). • Rigorous flea control program if fleas are • Because glucocorticoids mask the problem
• Oral biopsy is indicated to rule out neoplasia present or suspected. rather than eliminating it, efforts should be
such as squamous cell carcinoma and fibro- • Allergen-specific immunotherapy (hyposen- made to identify the cause.
sarcoma and to establish a diagnosis. sitization) for treatment of atopic dermatitis • Cats can (rarely) outgrow the disease over
• Adverse food reaction: improvement with based on results of intradermal test and/or time.
8-10 weeks of elimination diet trial; relapse aeroallergen-specific immunoglobulin E
on challenge serum test SUGGESTED READING
Buckley L, et al: Feline eosinophilic granuloma
TREATMENT Nutrition/Diet complex(ities): some clinical clarification. J Feline
Strict hypoallergenic diet in proven cases of Med Surg 14:471-481, 2012.
Treatment Overview adverse food reaction
• Treatment of choice consists of early and AUTHOR: Vincent E. Defalque, DVM, DACVD
EDITOR: Manon Paradis, DMV, MVSc, DACVD
aggressive glucocorticoid therapy. Possible Complications
• Treat secondary infection and underlying • Inadequate initial therapy may result in
cause where appropriate. refractory lesions.

Epilepsy, Idiopathic Client Education
Sheet

BASIC INFORMATION in which there is incomplete recovery of GENETICS, BREED PREDISPOSITION
consciousness A genetic basis is known or suspected in many
Definition • Cluster seizures (i.e., serial or acute repeti- breeds, although in most cases, the precise
A syndrome characterized by chronic recurrent tive seizures): two or more isolated seizures genetic mutation has not been identified. Any
seizures for which there is no identifiable cause occurring within 24 hours breed of dog, including mixed breeds, can be
other than a suspected genetic origin affected.
Epidemiology
Synonyms SPECIES, AGE, SEX Clinical Presentation
• Primary epilepsy • Dogs: common (≈0.75% prevalence in HISTORY, CHIEF COMPLAINT
• Genetic epilepsy: used when genetic factors general population), 6 months to 6 years • Two or more unprovoked seizures occurring
are known to play a major role old, slightly more common in males > 24 hours apart
• Status epilepticus: one seizure lasting more • Cats: less common than in dogs, but not • Most common are generalized tonic-clonic
than 5 minutes or two or more seizures rare, 1-5 years old, no sex predisposition seizures characterized by loss of consciousness

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