Friday evening, I finished evening chores and was looking forward to relaxing. I showered early and slipped into new pajamas I recently bought when the dog yard erupted.
I ran outside to find my beloved Big Brown - B.B. - in the midst of a grand mal seizure. A mean-looking storm was brewing on the horizon. It was exactly seven years ago that she had one isolated seizure, at this same time of year in the same weather conditions. Otherwise B.B. has lived a healthy happy life. She has been my main gee haw leader and run every race with me since 2009. This month, she and her sister, Ruffian, turn 10.
|B.B. (driver's right, spots) and her sister Ruffian (driver's left, white) leading the team during the Tahquamenon Country Sled Dog Race|
|The team returning from a training run|
Once inside, I hoped the seizure would be an isolated incident, but almost as quickly as I put her on the sofa, her legs began paddling again as if swimming, her face twitched and her mouth bared teeth in an eerie grimace. Drool foamed into a white froth from her mouth, and she urinated on herself. Her head turned involuntarily to the side and looked like it would spin completely around. This time, the seizure lasted longer.
Once it stopped, B.B. looked mildly surprised to find me cradling her on the sofa. She drank some water and shivered slightly; she looked exhausted. I hoped for a reprieve, but like waves, another seizure crashed in on us, and I held her so she wouldn't hurt herself from thrashing. Again, I hoped this was the last.
B.B. had eight seizures in 30 minutes.
On the ninth, when she hadn't come out of it in a few solid minutes, I gathered her up, still in my pajamas, and began the 40 minute drive to Metropolitan Veterinary Hospital, the 24 hour emergency vet clinic. In the car, she seized violently, continuously for the entire ride. This is called a status epilepticus, and requires immediate emergency care.
If you have not seen a grand mal seizure, let me tell you, it's terrifying. It's easy to understand why, during Medieval and Renaissance times, those afflicted by epilepsy were thought to be possessed by demons. B.B. writhed, the demon that gripped her forcing her mouth open, showing her impressive canine teeth. Drool frothed from her mouth, her eyes twitched back and forth; she urinated on herself again. I felt helpless and honestly feared she might die before we made it to the ER.
Finally, I zoomed into the driveway, picking her up into my arms and ran through the doorway of the animal hospital. It was 10:30 p.m. A code was called and a team of medical professionals rushed toward me from different doorways and took B.B. from me. I ran after and one of them said "Permission to cath?"
"Of course!" I said. They told me I wasn't allowed into the ICU. I stood even more helpless in the hospital and finally broke down in tears.
|B.B. greets a participant at one of our presentations this past March at Green Elementary in Logan Ohio|
|B.B. looks out over the entire student body of Green Elementary this past March|
All of these things scanned through my mind as I waited in the small exam room at the emergency vet. I watched the clock close in on midnight, when finally, Dr. Fox entered the room. She said the medical team managed to stabilize B.B. with Valium and some I.V. fluids.
"Did you happen to take her temperature when you were at home?" she asked.
"No," I responded. To be honest, I didn't even think about that.
Dr. Fox's face looked serious. "B.B.'s temperature on admittance was 103.8. 105 is the cut off where we start to get concerned about brain damage from fever."
That explained the shivering.
Turns out, fever is a symptom of persistent seizures according to Dr. Fox. Unfortunately, the fever is an indication of brain inflammation. I was so relieved I decided to bring her in when I did.
Dr. Fox went on to say that it's uncommon for older dogs to have acute "cluster" seizures without a serious underlying cause, like liver or kidney disease or even brain cancer. Despite having one seizure in 2011, Dr. Fox felt she did not have a history of seizure activity. She wanted to do an MRI, but that would cost $5,000 or more, and to what end? If I discovered B.B. had a brain tumor, I wouldn't elect to do chemotherapy.
We decided on a conservative medical plan that included an overnight stay for observation, lots of blood work to check liver and kidney function and, if there were no more seizures, I could pick her up by 10 the next morning.
I asked if I could see B.B. before leaving, and a vet tech led me through a series of doors into the ICU. Six cats sat in separate cages, and several dogs, including B.B. were along the back wall. B.B. was slumped in a stall covered in a blanket. I crawled into her enclosure and sat cross-legged on the floor with her. Her eyes brightened for a second and she lifted her head to look at me, then dropped it again, doped up on Valium.
"Hi, B.B." I said, trying to sound cheerful. "This is just like a checkpoint camp out. You even have a blankie!"
She raised her eyes to look up at me through her lids, then fell away again in repose. I felt so scared for her, but didn't want to let her know, so I kept my voice as cheery and up beat as possible.
This is all new territory for me. For having dogs all my life from the show ring to the starting chute of races, my dogs have all been relatively low maintenance and healthy. Navigating this terrain left me feeling helpless and ignorant to dealing with real health issues.
The next morning, I called the vet and was relieved to hear she didn't have anymore seizure activity overnight. I arrived at 9:45 to pick B.B. up, and as a tech walked her out into the lobby, I could see she wasn't quite herself. She was "wobbly" and seemed almost a bit drunk. She ran into the glass of the door as we attempted to leave. Apparently this "drunk-like" state is normal after a seizure. All of B.B.'s labs and blood work came back completely normal, however - a good sign. We left the hospital with a script for an anti-seizure medication called Keppra (Levetiracetam), which is also commonly used to treat seizure disorders in humans.
|My daughter, Sophie, and B.B. at Green Elementary for our dogsledding presentation in March|
There are three main phases of a tonic-clonic or "grand mal" (a term that's not frequently used anymore) seizure: the aura, ictus, and postictal state.
In the aura phase, there are marked behavioral changes in a dog, and the dog may become aware that something isn't right. They may act lethargic or nervous, may hide, whine, cling to the owner, shiver or salivate.
In the ictus phase, the actual seizure takes place. All of the muscles of the body contract, and the dog loses consciousness. Other symptoms include violent paddling of the legs as if swimming, grimacing or showing teeth, dilated pupils with a fixed stare, drooling, urinating, defecating and, in B.B.'s case, turning her head in an owl-like attempt at a 180 turn, and involuntary biting anything that approached her mouth.
In the postictal phase, there is often confusion, lethargy, disorientation, restlessness, and can even include temporary blindness.
When we returned home, unfortunately, B.B. had three more seizures that afternoon and one in the middle of Saturday night. Apparently it takes awhile for the proper amount of medication to build up in her system to effectively stop the seizures. So far, there were no seizures for Sunday and as of this writing.
|B.B. resting in bed with me on Sunday|