When Seizures in Dogs Become Too Much: When might euthanasia be the kindest decision?

Seizures in dogs can be frightening and heartbreaking to witness. They can range from occasional mild episodes to severe, frequent, and debilitating events that significantly affect a dog’s quality of life. Seizures may 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 Seizures Look Like

Seizures in dogs can present in different ways, including:

• Grand Mal Seizures: Full-body convulsions, loss of consciousness, drooling, urination, or defecation.

 

• Focal Seizures: Localized twitching or abnormal movements in one part of the body.

 

• Cluster Seizures: Multiple seizures occurring within a short period, often indicating worsening neurological disease.

 

• Status Epilepticus: A prolonged seizure lasting more than five minutes or multiple seizures without recovery in between—this is a medical emergency.

 

Treatment Options

• Anti-Seizure Medications: Drugs like phenobarbital, potassium bromide, levetiracetam (Keppra), and zonisamide help control seizures in many dogs.

 

• Addressing Underlying Conditions: If seizures are caused by liver disease, brain tumors, or toxins, treating the root cause can sometimes reduce or eliminate seizures.

 

• Emergency Medications: For dogs with frequent or severe seizures, rectal or intranasal diazepam or midazolam may be prescribed for use during a seizure crisis.

 

Many, if not most, dogs with seizures can get on a medication regimen that controls the seizures while the dog is still able to maintain a good quality of life. Usually we aim for a balance of no more than a few seizures a year and minimal medication side effects. Medications sometimes can have side effects such as sedation/lethargy, weakness, increased appetite, and increased drinking. But for most dogs, the benefits outweigh the side effects.

And even with the best treatments, some dogs continue to suffer from severe, unpredictable seizures. In these cases, the focus shifts from management to assessing overall well-being.

When it’s time to consider euthanasia: complicated seizures

While some dogs with seizures get on one medication and never have another seizure, or have only a few seizures a year, some dogs continue to have severe seizures despite being on multiple medications. Some dogs on multiple medications experience such severe side effects that the dog’s quality of life is significantly affected. Below are some situations that often lead to euthanasia being the most compassionate decision for the dog.

• Uncontrollable Cluster Seizures: Some dogs with seizures experience repeated bouts of cluster seizures. Cluster seizures are when dogs experience numerous seizures within a short time which can lead to brain damage and exhaustion. Dogs 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 dogs are having to be hospitalized for multiple days repeatedly for cluster seizures, it is reasonable to consider that euthanasia may be the kindest decision.

 

• Status Epilepticus: Occasionally, dogs with seizure 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, or if the dog experiences multiple bouts of status epilepticus.

 

• 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 before it gets worse. 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 dogs experience extreme sedation, fatigue, or weakness with seizure drugs, particular if the dog requires multiple drugs at once. If a dog is on so many drugs 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 dog to get used to the new drugs, so it is good to give your dog a couple weeks to adjust to new medications before making a decision.

 

• Occasionally seizure drugs can cause liver failure. If a dog develops liver failure on seizure meds and it cannot be managed, euthanasia is often the kindest decision.

 

• Frequent Emergency Visits: If a dog 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 dog no longer recognizes family members, struggles to walk, or experiences extreme anxiety, their quality of life is significantly affected.

 

Quality of Life and Euthanasia Considerations

Deciding when to euthanize a dog with severe seizures is one of the hardest choices a pet owner can make. While there is no single right answer, assessing a dog’s daily quality of life is crucial. Some questions to consider include:

• Is my dog experiencing more bad days than good days?

 

• Are seizures happening so frequently that my dog is unable to enjoy life in between?

 

• Does my dog seem scared, confused, or distressed most of the time?

 

• Am I constantly worried about leaving my dog alone for fear of seizures?

 

• Is my dog no longer responding to treatment?

 

• Am I prolonging my dog’s life for my own sake, rather than for their well-being?

 

Final Thoughts

Seizures in dogs can be managed in many cases, but when they become severe and unrelenting, they can drastically reduce a pet’s quality of life. If you would like more guidance, schedule a 45 minute teleconsult with one of our compassionate veterinarians who can review your pet’s medical records and history and help you formulate the most compassionate and loving plan for your family.