Lowchen's epileptic seizures

For a long time now I have been wondering about the health status of the Löwchen, and more specifically about the prevalence of epilepsy in the breed. Despite the fact that this condition seems to be fairly rare, in a small and genetically uniform population it is something to be taken seriously. Unfortunately, I have personal experience of the condition through my late dog Iris who became epileptic at the age of 2 ½ years.

It is not easy for me to write this because putting things down on paper brings back all the anxiety from the time when I didn’t yet know what was wrong with Iris, as well as the unanswered questions that arose after the diagnosis had been made. Is my dog suffering during a seizure? Is she in pain during an episode or afterwards? What is her quality of life like with this condition? These same questions have undoubtedly played in the minds of the owners of those dogs whose seizures I will describe later on in this text.
 

This text is going to be long, but I hope those who truly care for this wonderful breed will take the time to read it. My intention is not to point fingers or lay blame, but to spark an open and honest discussion about the health status of the breed. In the past I have perhaps also been blinkered and closed my eyes to the health issues in dire need of attention. My own dog’s illness and eventually the exhausting three-month-long battle of life and death, which ended in heartbreak, finally prompted me to look at things more critically. At this point I have to clarify that Iris did not die of epilepsy but instead of a total failure of the immune system.

Iris’s seizures

Gwaihir's Azizia, FIN14543/03

Let’s go back in time to 2005. Iris had been scratching her head for a while. At times with such ferocity that she broke her skin and matted and damaged the hairs on her head. The problem was investigated and allergies identified as the suspected cause, but despite an elimination diet and treatment with cortisone, the scratching continued. In the autumn Iris’s symptoms waned, and when she came into season they all but stopped. Iris was mated and by the time the puppies were born the hairs on her head had grown long enough to be tied up. Her skin improved and looked healthy. Once the puppies were old enough to go to their new homes Iris started scratching her head again. By early summer of 2006 she had also started tensing her legs. The first time it happened she held one of her hind legs in the air and I thought her patella had luxated. Upon palpation the patella seemed fine and in no time so did Iris. I noticed nothing else out of the ordinary. Iris seemed to be her normal self. As the summer went on, similar episodes with hind and now also front legs occurred. Mid July we were at a dog show in Helsinki on a scorching hot day. When photographing the dogs after the show I noticed that Iris suddenly went off balance for a few steps. I immediately stopped and noticed that she was once again holding her leg up in the air. Her back was also arched. I took her to the show vet, but by that time she was back to her normal self again. She did not seem to have any pain on palpation and moved normally. I had already earlier started suspecting she might have focal epilepsy so I mentioned this to the vet, but she did not think the symptoms fitted. On the following Monday I immediately booked an appointment for Iris with an internist and managed to get one for the very next day. The clinical examination, blood tests and x-rays showed nothing remarkable except for a very feint heart murmur, which the vet thought could not have caused the symptoms Iris had been exhibiting. In short, nothing was found that would explain the episodes. 

The following night Iris had two seizures, both of which involved lifting of legs, unsteady gait and slightly lowered level of consciousness. Right there and then, in the middle of the night, I called a vet hospital specialising in the diagnosis and treatment of neurological conditions and agreed that I would take Iris in for more tests first thing in the morning. The clinical, orthopaedic and neurological examinations were all unremarkable. To get a better idea of what was causing the seizures we decided Iris was going to have an MRI scan. The couple of hours I spent in the nearby mall, drinking coffee and waiting, felt like an eternity. In the end I returned to the hospital and just sat in the waiting room. Eventually the examination room door opened and it was time for the diagnosis. The MRI scan with contrast medium showed no structural changes, and the spinal fluid was normal. However, the EEG revealed wide areas of focal epileptic activity. The bomb had dropped. My beloved Iris had epilepsy. According to the vet Iris’s seizures were somewhat unusual, and surprisingly mild considering the extent of the area of the brain involved.

Once I reached my car with the still groggy Iris, I burst into tears. I also realised I would have to make four very hard phone calls, one to each of the owners of Iris’s puppies. Turned out the phone calls, although difficult to make, were also encouraging. Each of the calls was long as I explained in length the situation and what it meant as far as the puppies were concerned. Each call ended with the owners thanking me for being open and honest. I knew then that I really had found the best possible homes for Iris’s pups.

Iris’s seizures continued throughout her life despite the medication. They varied from just leg-lifting to balance and co-ordination disturbances and lowered state of consciousness. Iris never convulsed, lost consciousness or bladder/bowel control nor foamed at the mouth during her seizures. It just goes to show how different seizures can be in different individuals.

One noteworthy thing in Iris’s behaviour was the almost constant lip-smacking. It seemed like a compulsive behaviour. It often increased before seizures, but occurred during seizure-free periods also.

Musti’s seizures

Portrait Amour Eternel, FIN21256/06

Unfortunately my worst fears came true for one of the puppies I had bred. She started having seizures almost identical to those of Iris. Luckily her owner was aware of Iris’s diagnosis and knew to take Musti to the vet for tests. Based on the background information and the symptoms the vet prescribed medication, even though she also thought the seizures were somewhat atypical. Musti is currently doing well with occasional seizures that are not very severe. Musti’s diagnosis confirmed in my mind that Iris’s epilepsy had a hereditary component. 

The following are descriptions of episodes experienced by other dogs I know. The stories have been written by the dogs’ owners and are published with names by permission of the owners. One of the stories touches me especially, as it is that of my best friend’s dog, Ada. We spend a lot of time together and care about each others’ dogs as if they were our own.

Ada’s seizures

Royalgrowl Thanks To Elle, FIN15025/04

"About six months before Ada’s seizures started I had noticed that she sometimes seemed absent. She might just sit in one place and stare into the distance. I remember remarking about it to some of my friends, saying she seemed strange, like a different dog altogether.

In July of 2007 I was on holiday and went off on a walk with the dogs. There had been nothing unusual about Ada’s behaviour that day, apart from the fact that she had been following me everywhere I went. We only got about 200 metres down the road when she suddenly slowed down and her nails started scratching at the asphalt. Straight after that her gait got unsteady and I managed to help her down onto the ground before she fell over. I immediately picked her up and ran into the house. She seemed to be unconscious. She was totally limp with white gums and laboured breathing. Her eyes were open but she was unresponsive. This lasted for approximately 5-10 minutes. All the while I was receiving instructions over the phone on what to do and what to look out for. Luckily Ada started coming to, and recovered quickly back to normal. I took her straight out so she could do her business. She had no loose bowel movements and seemed completely normal for the rest of the day, as if nothing had ever happened. The vet told me to monitor her closely and to bring her straight in if any further episodes occurred. The next day we went to the vet’s where they ran comprehensive blood analyses and a bile acid test. Ada also had an abdominal ultrasound examination. Apart from some liver values all test results were normal. After the holiday we went in for a follow-up visit and at that time all the values were back within normal ranges.

Summer 2009: A month before midsummer Ada had had a simple partial seizure, which lasted for less than a minute. She lifted her leg and seemed unsteady on her feet. After this she was back to normal. On midsummer’s eve we were at my friend’s house and Ada was sitting in my lap while we were waiting for the food to be served. Suddenly she straightened her neck and it went completely stiff. She was staring up at the ceiling and her eyes seemed glazed over. I realized that something was wrong and placed her on her side on the floor, at which time she started tensing her legs straight. She seemed as if her entire body was cramping. It was a terrifying sight, witnessed by many of my friends. The episode lasted 1-2 minutes after which Ada started to relax and gradually return back to normal. She went straight outside to do her business and during the next 24 hours she had diarrhoea in the house twice. Other than that she seemed normal. I spoke with the vet again and booked an appointment at the veterinary hospital for a thorough examination, including an MRI scan. The diagnosis was idiopathic epilepsy.

After these two severe seizures Ada has had mild seizures approximately once every six months. I can usually tell a couple of days before that a seizure is on its way. They tend to last less than a minute after which Ada goes back to normal. She may be a little tired if anything.

I don’t know if this has something to do with the epilepsy, but Ada has been lip-smacking almost all her life. She does this more whenever something unusual or outside of her normal routine happens.

We have not started Ada on any medication because the situation has stayed under control and Ada’s seizures very mild."

Hymy’s seizure

Parfait Fleur Hymne L´amour FIN49675/04

"One May evening Hymy had an inexplicable seizure that came out of the blue with no warning. Suddenly her legs gave away and she fell on the lawn unconscious. She was totally limp and showed no signs of cramping or trying to get back on her feet. I rushed to her and lifted her in my lap. She was unresponsive and limp with a glazed-over gaze. When I was carrying her into the house I was sure she was dead. Those were the longest 5 metres of my life. Once inside I placed Hymy on her side on the floor. She still showed no signs of life. I clapped my hands next to her head and got no reaction at all. I grabbed her paws one by one and shook them, nothing. I then shook a little harder and started massaging her firmly (the way they tell you to massage a newborn puppy), and finally she started showing some signs of life. All this lasted approximately 5-10 minutes. I’m not sure exactly how long because I was very worried. Of course all the vets had already closed. Eventually Hymy got back on her feet, drank a huge amount of water, and within an hour she was back to normal.

The following day I took Hymy to the vet’s for tests. The only thing the vet was worried about was the potassium level, which can be an indication of heart problems. However, on auscultation the heart sounded perfectly normal. The vet suspected that Hymy might have dilated cardiomyopathy, commonly seen in large breed dogs. As far as I know it is rare in small breed dogs. There is no cure or effective treatment for this condition and dogs suffering from it often die suddenly following an episode like the one I’ve described above, within 6-24 months of the first episode. We received a referral for further testing but decided there was no point in having them done since there is no cure and if this is what is going to take Hymy from us, she will go quickly and relatively painlessly. If that happens, we will have her autopsied.

Until then we will enjoy life to the fullest, one day at a time. The first and so far only episode was in May of 2011 and since then there have been no signs of further episodes.

All of the dog’s information can be published by owner’s permission."

Paavo’s seizure

Elansse Big Trouble FIN50753/08

"Just over a month ago Paavo had some sort of a seizure on a walk in the woods. It was not particularly hot, and he has a short coat and had just had a drink from the ditch. He fell flat on his left side and could not get up. I was so shocked I just went and picked him up and lifted him onto his feet, so I can’t say how long it would have taken him before he was able to get up on his own. If there are any further episodes I will have to see what happens without interfering. I myself was behind Paavo, but my friend was in front of him and saw the episode better than me. She says that Paavo was convulsing. I thought he was just trying to get up. Whatever the case, the episode lasted only a very short time. Afterwards Paavo didn’t want to walk any further and was "out of it" for some time. Luckily he’s a small dog so I was able to carry him out of the woods and back home.

After this episode I started wondering about a time in the spring when I had come home from work and let the dogs out onto the yard. When I went outside I found Paavo lying on his side. I seem to remember he got up on his own. At the time I was thinking he must have fallen following a strong gag reflex (it had happened once before), but I didn’t find any vomit despite looking for it. I now think it’s likely that the episode in question was similar to the one we saw in the woods.

Paavo also has a habit of chewing and licking his paws. This may of course be related to an earlier back problem. He also eats grass and licks his lips, which may be signs of indigestions or digestive upsets. On the other hand they may be behavioural signs of some other physical illness.

Paavo’s brain and spinal cord have been thoroughly examined in an MRI scan last December and found to be clinically normal. After the episode in the woods we had blood tests done, which also came back normal. In addition to the complete blood count he was tested for Addison’s disease, borreliosis and erlichiosis. Paavo’s heart and lungs were also x-rayed and nothing out of the ordinary was found. The vet could not say what was causing the seizures. Could Paavo have had low blood sugar and simply collapsed (unlikely, I think) or could it be epilepsy? Vet recommended that we monitor the situation and start medication if there are any further episodes."

The owners of the following two Löwchens did not want their dogs’ names published. I respect their decision and thank them for their willingness to share their experiences.

First unnamed Löwchen’s seizures

"In the morning after a short stroll my dog uncharacteristically peed in front of the entrance door to the apartment building, and as soon as we got in, lay down stiffly. I picked him up and set him down on a ventapad, where he settled, still stiff. His gums were pale and his temperature was approximately 36 ºC. He also soiled himself. After the episode he was very thirsty.

The same thing happened last summer, but was thought to have been caused the heat although the possibility of a mild epileptic fit was not totally discounted. This was the conclusion reached over the phone based on the signs observed.

Both times my dog recovered very quickly and went back to normal. He was not nauseous and didn’t show any other signs out of the ordinary. This time his breathing seemed a little laboured and we were getting ready to take him to the vet’s, but since the situation resolved so quickly, and since he had recovered so fast the previous time, I opted to wait and see.

The third episode happened about a week after the second one. The seizure was otherwise very similar, but his breathing seemed more laboured."

Second unnamed Löwchen’s strange behaviours

"My dog has not had seizures, as such, but there are many characteristics in his behavior, which can be associated with epilepsy. He may seem absent for long periods at a time. Sometimes he tries to squeeze himself behind furniture. He also licks his lips a lot. Quite a few times he has also been lying on the sofa completely relaxed and seemingly enjoying himself and then suddenly attacked my hand, biting it hard. The next moment he’s back to himself, seems confused and leaves the scene. "

Out of the seven dogs discussed above, three have veterinarian-confirmed diagnoses of epilepsy. The seizures and behaviours exhibited by the other four dogs have not been confirmed epileptic. However, these behaviours include characteristics of typical epileptic seizures. Even if not epileptic, they are a long way from normal. There are also eight additional cases of epilepsy in Finland. In 2005 Löwchen Finland ran a health survey for Löwchen owners. The results revealed five cases of epilepsy and three single epileptic seizures. I have no knowledge of the identity of these dogs or their owners.
 

Thank you from the bottom of my heart to the owners of these dogs for telling their experiences in public. We share a concern for the future of this wonderful breed.

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