Dog seizures: what to do during the fit and when it is an emergency

Quick answer

Between seizures most epileptic dogs look completely normal. Herding breeds, including Border Collies, are among those in which inherited epilepsy is well recognised.

During a seizure there are only four things that help: note the time, clear hard and sharp objects away, keep your hands away from the mouth, and film it. Everything else can wait.

The clock is the decision. A convulsion that is still going at five minutes, or a second seizure before the dog has properly recovered from the first, is an emergency that needs a vet now rather than an appointment tomorrow.

• Time the convulsion itself, from first twitch to the moment the dog stops jerking. Owners routinely overestimate it by several minutes.
• Do not put your hands, a spoon or anything else in the mouth. Dogs cannot swallow their tongue, and a seizing dog bites without knowing it.
• Do not restrain the dog. Move furniture away from the dog instead of moving the dog away from furniture, unless it is near stairs, water or a road.
• Film from a distance, with the whole body in frame, and keep filming into the recovery period. That video often decides the diagnosis.
• Shut other dogs out of the room. Dogs commonly attack a seizing housemate.

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Five minutes is the line, and a first seizure over the age of about seven changes the whole picture.

A convulsion that does not stop within about five minutes is status epilepticus. The brain's own braking mechanisms are failing, body temperature climbs from the muscle activity alone, and the longer it runs the harder it becomes to stop with drugs. Get to a vet immediately, and phone ahead so they are ready.

Two or more separate seizures within 24 hours is cluster seizuring and also needs same-day veterinary care, even if the dog is bright between them.

A dog having its first seizure in middle or older age is much less likely to have inherited epilepsy and much more likely to have a structural or metabolic cause, including a brain mass, liver disease or low blood sugar. That dog needs investigation, not just reassurance.
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Decide in 60 seconds

Why a seizure looks the way it does

Normal brain activity is asynchronous: different groups of neurons fire at different moments. A seizure is a loss of that asynchrony. A population of cortical neurons discharges together and recruits its neighbours.

Where that discharge starts and how far it spreads decides what you see. If it stays in one region, the dog stays conscious and only part of the body is involved: a twitching face, a flicking ear, one limb paddling, snapping at invisible flies, or a sudden burst of fear. That is a focal seizure and it is easy to dismiss as a behaviour quirk.

If it spreads across both hemispheres, consciousness goes. The dog falls, extends or paddles all four limbs, and the muscles of the jaw and face contract rhythmically. The chewing motion is why dogs bite their tongues and why anything, including your fingers, is at risk near the mouth.

Salivation happens because swallowing stops while saliva production continues. Urination and defecation happen because the autonomic outflow that holds them fires along with everything else. Neither tells you how serious the seizure is.

Dogs cannot swallow their tongue. The tongue is anchored to the floor of the mouth by the frenulum. The idea that you must hold it forward comes from human first aid folklore and, applied to a dog, produces deep bite wounds and broken teeth.

Once the fit stops, the brain does not simply switch back on. Neurotransmitter stores are depleted and the cortex is temporarily disordered. That is the postictal phase, and it is the feature that separates a seizure from almost everything else.

The three phases, and what each one looks like

Prodrome, minutes to days before. Some dogs change before a seizure. Clinginess, restlessness, hiding, pacing or seeking the coolest room in the house are the common ones. Owners who keep a diary often learn to predict their own dog.

Ictus, the seizure itself. Usually between about thirty seconds and two minutes for a generalised convulsion. It feels far longer. This is where the timing matters, and this is what to film.

Postictal, minutes to a day or more. The dog is disoriented, may be temporarily blind, bumps into furniture, paces, drinks heavily, is often ravenous, and can be defensive or even aggressive because it does not recognise you. Recovery is gradual rather than instant.

A long postictal phase does not mean a worse prognosis, but a postictal phase that does not resolve within a day, or that leaves the dog with a persistent head tilt, circling, blindness or weakness on one side, points to structural disease and needs investigation.

What is not a seizure

This is where most owner reports go wrong, and where the video pays for itself.

The single most useful discriminator is what happens in the minute after it stops. A dog that gets straight up and walks off normally probably fainted. A dog that is confused, blind, pacing or ravenous had a seizure.

What to do while it is happening

Note the time on a clock or start the stopwatch on your phone. Say the time out loud on the video if that is easier.

Clear the space. Slide a coffee table away, push a chair back, move a heavy lamp. Do not drag the dog unless it is on stairs, near a pool, on a hard edge or in traffic, and if you must move it, pull by the collar area and body together, from behind, away from the head.

Turn off the television, dim the lights and keep voices low. Sensory input can prolong or trigger seizure activity in some dogs.

Do not restrain the limbs. Holding a dog still does not shorten a seizure, and it puts your hands and face near a mouth that is clamping rhythmically.

Remove other dogs from the room. A convulsing dog smells, sounds and moves wrongly to a housemate, and attacks on the seizing dog are common and severe.

Watch the temperature. In a warm room, or in a large or thick-coated dog, a prolonged seizure builds heat fast. A fan directed at the dog and cool water on the paws, groin and armpits is reasonable while you wait.

If your vet has prescribed rescue medication for use at home, this is what it is for. Follow the written protocol you were given, note the time you used it, and tell the practice. Never give a human sedative or a leftover medication from another animal.

After it stops

Stay with the dog and keep the room quiet and dim. Talk in a low voice and do not crowd its face, because a postictal dog may snap without recognising you and will not remember it.

Block access to stairs, pools and balconies until the dog is walking normally. Postictal blindness and ataxia cause more injuries than the seizure does.

Offer water once the dog can hold its head up and swallow properly. Wait until swallowing is clearly normal before offering food, however hungry the dog seems, because aspiration is a real risk in a dog that is still uncoordinated.

Ravenous hunger after a seizure is normal and is part of the postictal phase. Wait until the dog is alert and swallowing normally before feeding, rather than feeding to settle it.

Causes, and how age changes the odds

Under six months. Congenital and acquired causes dominate. A portosystemic shunt, where blood bypasses the liver, causes neurological signs that are often worse after a protein-rich meal, alongside poor growth and a small stature. Low blood sugar in toy breeds, hydrocephalus in small domed-headed breeds, infection and toxin exposure all belong here.

About six months to six years. This is the window in which idiopathic epilepsy, the inherited kind with no visible lesion, typically declares itself. It is diagnosed by ruling other things out and by the pattern: a normal dog between seizures, a normal neurological examination, normal bloods.

Several breeds have a well documented inherited predisposition, including Border Collies, Belgian shepherds, Labrador and Golden Retrievers, Beagles and Australian Shepherds. Breed does not diagnose anything on its own, but it changes what is likely.

Middle aged and older, first seizure. The probability shifts toward structural disease, especially a brain tumour, and toward metabolic causes: liver failure, kidney failure, low blood sugar from an insulin-producing tumour, or severe electrolyte disturbance. A first seizure in an older dog justifies bloodwork and a conversation about advanced imaging.

Any age: poisons. The common seizure-causing exposures are metaldehyde slug bait, mouldy food and compost, chocolate in quantity, sugar-free products containing xylitol, nicotine, some rodenticides, and permethrin products intended for dogs applied to the wrong species or at the wrong strength. Herding breeds carrying the MDR1 variant are dangerously sensitive to certain wormers and other drugs, which is worth knowing before any medication is given.

Any age: heat. Heatstroke causes seizures, and seizures cause hyperthermia. If a dog seizes in hot weather, after hard exercise or after time in a car, treat it as heat-related until a vet says otherwise.

The diary that changes the treatment

A notebook and an accurate current weight are the two things a seizure plan runs on. Anti-seizure medication is dosed by weight, so a dog that has gained or lost weight may be under or over dosed.

Epilepsy is managed on patterns, not on single events. The decision to start medication, to change a dose or to add a second drug is made from the record you keep.

What the vet will ask for

The video, and the duration you actually timed rather than your impression of it.

Age at the first ever event, and how many there have been since.

Whether the dog is normal between episodes, and specifically whether it circles, presses its head against walls, has become clumsy on one side or has lost vision.

Access to toxins: slug bait, compost heaps, medication left within reach, the neighbour's shed, and whether any dog in the household has recently been treated for parasites.

Current weight, because every anti-seizure drug is dosed by it.

Diet and any recent change, and the exact timing of meals relative to seizures.

Vaccination and travel history, which matters for infectious causes of brain inflammation in some regions.

Whether any littermate or parent has seizures.

What never to do

Never put anything in the mouth. Not your hand, not a wallet, not a wooden spoon. It achieves nothing and causes bites, broken teeth and aspiration.

Never throw water over a seizing dog. It does not stop the seizure and it complicates the situation if the dog is also overheating.

Never hold a dog down through a seizure. If the goal is to stop it hurting itself, move the objects, not the dog.

Never stop prescribed anti-seizure medication suddenly, or skip doses because the dog has been well. Abrupt withdrawal can precipitate a severe cluster or status epilepticus.

Never give human sedatives, herbal calming products or another animal's medication.

Never assume a single brief seizure in an older dog needs no investigation. That is the population where a treatable underlying cause is most likely to be found.

Never let other dogs stay in the room, however well they normally get on.

When to get help

Go immediately for a convulsion still running at five minutes, for a second seizure before full recovery, for two or more seizures in 24 hours, for seizures with a known or suspected poison, and for any seizure in a dog that is hot, collapsed or not breathing normally.

Go the same day for a first ever seizure at any age, for a dog whose seizures have changed in character or frequency, and for a dog that is still abnormal several hours after the event.

Book promptly for focal signs that keep repeating, such as facial twitching, fly biting or sudden unexplained fear episodes, since these are seizures too and are commonly missed for months.

Take the video, the diary, the dog's current weight and the packaging of anything it may have eaten. Phone ahead so the practice can prepare, and drive with the car cool and the dog on a flat surface where it cannot fall.