Seizures in Cats: Quality of Life Considerations

Seizures in cats can be frightening and heartbreaking to witness. They can range from occasional mild episodes to severe, frequent, and debilitating events that significantly affect a cat’s quality of life. Seizures can be caused by brain tumors, metabolic disorders, or unknown factors (idiopathic epilepsy). Regardless of the cause, when seizures become uncontrollable they can lead to a difficult and painful decision for pet owners: when is enough enough? Could euthanasia be the right decision? 

What Do Seizures in Cats Look Like?

Seizures in cats can range from subtle to dramatic. They may involve:

• • Sudden collapse or falling over.
  • Paddling of the legs
  • Uncontrolled twitching or jerking movements
  • Drooling or foaming at the mouth
  • Vocalization (crying or yowling)
  • Loss of bladder or bowel control
  • Disorientation or confusion after the seizure (called the postictal phase)

Some cats may also experience focal seizures, which involve only part of the body and may look like facial twitching, tail swishing, or odd behavioral episodes.

Treatment Options for Cats with Seizures

Treatment of seizures either focuses on addressing the underlying cause or managing the seizures with medications. If the underlying cause can be addressed, sometimes seizures can be cured. But in many cases, especially in older cats, treatment focuses on management rather than cure. When the underlying cause cannot be addressed, we turn to medications to control the seizures. Common drugs include:

• • Phenobarbital – Often the first choice for seizure control in cats.

  • Levetiracetam (Keppra) – Sometimes used alongside or instead of phenobarbital.

  • Zonisamide – An alternative in some cases.

Thankfully, many cats can get good control of their seizures with the use of medications. However, some cats experience side effects from the medications – such as sedation, weakness, increased appetite, and increased drinking – that can affect their quality of life. And some cats, despite being on numerous medications, continue to have severe and frequent seizures.

When it may be time to consider euthanasia: complicated seizures

While some cats with seizures get on one medication and never have another seizure, or have only a few seizures a year, some cats continue to have severe seizures despite being on multiple medications. 

If you have a cat experiencing severe seizures, I highly recommend making a comprehensive care plan. This is similar to an advanced directive in a human to help you with decision making should a crisis occur. It addresses important questions like: 

• • Would you hospitalize your cat for cluster seizures or status epilepticus if necessary? And if your pet has already been hospitalized, would you do it again?

  • Do you want to ensure your cat has a home euthanasia instead of passing away at the hospital?

  • What are the objective set of criteria you will choose for when to elect euthanasia so your cat does not suffer needlessly?

  • Is everyone in your family comfortable with the plan. 

It’s much easier to make these decisions when you are in a relatively calm frame of mind. When we are facing an immediate crisis of possibly losing our pets, it’s easy to make the wrong decision in a panic. 

Below are some situations that sometimes can lead to euthanasia being the most compassionate decision for a cat with seizures. 

• • Uncontrollable cluster seizures: Some cats with seizures experience repeated bouts of cluster seizures. Cluster seizures are when cats experience numerous seizures within a short time which can lead to brain damage and exhaustion. Cats experiencing cluster seizures also need to be hospitalized each time it occurs to get the cluster seizures to stop, which can be traumatic for the dogs as well as stressful and expensive for pet parents. When cats are having to be repeatedly hospitalized for multiple days for cluster seizures, it may come to the point where euthanasia is the kindest decision. 

  • Status epilepticus: Occasionally, cats with seizures can experience status epilepticus, a prolonged seizure lasting more than 5 minutes. This can lead to irreversible brain damage, coma, and death. If a seizure cannot be stopped, or if a seizure begins again as soon as a pet is woken up from an induced coma, euthanasia may be the kindest decision. 

  • Progressive neurological decline: If the underlying cause is a brain tumor or degenerative condition, seizures may worsen despite treatment. If a pet has a degenerative condition or a brain tumor and seizures are increasing in frequency despite medications, euthanasia may be the kindest decision before the seizures are becoming too frequent and severe. In particular if a patient has other neurologic symptoms such as head-pressing, disorientation, or blindness this may also contribute to the decision to euthanize. In these cases it is usually kindest to elect euthanasia before the patient is in severe distress or having seizures multiple times a week. 

  • Severe medication side effects: Some cats experience extreme sedation, fatigue, or weakness with seizure drugs, particular if they require multiple drugs at once. If a cat is on so many medications that he/she does not seem to be enjoying life, euthanasia may be the kindest decision With that said, whenever a drug regimen is changed it can take a few weeks for the cat to adjust to the new medication, so it is best to give them a couple weeks before making a decision if you’ve just added a new medication. 

  • Frequent emergency visits: If your cat requires frequent hospitalization due to uncontrolled seizures, euthanasia may be the best decision from a quality of life perspective. 

  • Personality changes, loss of awareness and functionality: If a cat no longer recognizes family members, struggles to walk, or experiences extreme anxiety, their quality of life may be significantly affected. 

Our comprehensive quality of life scale (https://pawsatpeace.com/quality-of-life-scale) can help you assess your cat’s quality of life. This quiz can be taken once to give you a snapshot of your cat’s quality of life, or taken multiple times to assess trends over time. 

Final Thoughts

Seizures in cats can often be managed, but not always. If seizures become frequent, severe, or are severely impacting your cat’s happiness and comfort, euthanasia may be the most loving gift you can give. 

If you are not sure what to do and would like guidance and support, schedule a comprehensive teleconsult with one of our compassionate veterinarians. We will review all your cat’s medical history, discuss your options, and help you formulate the most compassionate and loving plan for your family. 

And if it does come time for euthanasia, Paws at Peace offers gentle in-home euthanasia to help your cat pass peacefully at home, surrounded by family. Home euthanasia can provide your cat with a gentle and dignified transition without the stress of a veterinary visit.