title: International veterinary epilepsy task force consensus proposal: diagnostic approach to epilepsy in dogs.
abstract: This article outlines the consensus proposal on diagnosis of epilepsy in dogs by the International Veterinary Epilepsy Task Force. The aim of this consensus proposal is to improve consistency in the diagnosis of epilepsy in the clinical and research settings. The diagnostic approach to the patient presenting with a history of suspected epileptic seizures incorporates two fundamental steps: to establish if the events the animal is demonstrating truly represent epileptic seizures and if so, to identify their underlying cause. Differentiation of epileptic seizures from other non-epileptic episodic paroxysmal events can be challenging. Criteria that can be used to make this differentiation are presented in detail and discussed. Criteria for the diagnosis of idiopathic epilepsy (IE) are described in a three-tier system. Tier I confidence level for the diagnosis of IE is based on a history of two or more unprovoked epileptic seizures occurring at least 24 h apart, age at epileptic seizure onset of between six months and six years, unremarkable inter-ictal physical and neurological examination, and no significant abnormalities on minimum data base blood tests and urinalysis. Tier II confidence level for the diagnosis of IE is based on the factors listed in tier I and unremarkable fasting and post-prandial bile acids, magnetic resonance imaging (MRI) of the brain (based on an epilepsy-specific brain MRI protocol) and cerebrospinal fluid (CSF) analysis. Tier III confidence level for the diagnosis of IE is based on the factors listed in tier I and II and identification of electroencephalographic abnormalities characteristic for seizure disorders. The authors recommend performing MRI of the brain and routine CSF analysis, after exclusion of reactive seizures, in dogs with age at epileptic seizure onset <6 months or >6 years, inter-ictal neurological abnormalities consistent with intracranial neurolocalisation, status epilepticus or cluster seizure at epileptic seizure onset, or a previous presumptive diagnosis of IE and drug-resistance with a single antiepileptic drug titrated to the highest tolerable dose.This consensus article represents the basis for a more standardised diagnostic approach to the seizure patient. These recommendations will evolve over time with advances in neuroimaging, electroencephalography, and molecular genetics of canine epilepsy.
authors: Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, Suffolk, UK. luisa.derisio@aht.org.uk.
authors: Luisa
authors: L
authors: De Risio
authors: Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, 9820, Belgium. sofie.bhatti@ugent.be.
authors: Sofie
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authors: Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27607, USA. krmunana@ncsu.edu.
authors: Karen
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authors: Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany. Veronika.Stein@tiho-hannover.de.
authors: Veronika
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authors: Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany. Andrea.Tipold@tiho-hannover.de.
authors: Andrea
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authors: Department of Veterinary and Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark. mbe@sund.ku.dk.
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authors: Fernside Veterinary Centre, 205 Shenley Road, Borehamwood, SG9 0TH, Hertfordshire, UK. robyn.fernside@googlemail.com.
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authors: Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany. andreafischer@lmu.de.
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authors: University of Melbourne, 250 Princes Highway, Weibee, 3015, VIC, Australia. snlong@unimelb.edu.au.
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authors: Department of Clinical Sciences of Companion Animals, Utrecht University, Yalelaan 108, 3583 CM, Utrecht, The Netherlands. P.J.J.Mandigers@uu.nl.
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authors: Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany. matiasek@patho.vetmed.uni-muenchen.de.
authors: Kaspar
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authors: Matiasek
authors: Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL9 7TA, Hertfordshire, UK. rpacker@rvc.ac.uk.
authors: Rowena M A
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authors: Clinical Unit of Internal Medicine Small Animals, University of Veterinary Medicine, Veterinärplatz 1, 1210, Vienna, Austria. akos.pakozdy@vetmeduni.ac.at.
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authors: Pakozdy
authors: University of Minnesota College of Veterinary Medicine, D426 Veterinary Medical Center, 1352 Boyd Avenue, St. Paul, MN, 55108, USA. patte037@umn.edu.
authors: Ned
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authors: College of Veterinary Medicine, University of Georgia, 501 DW Brooks Drive, Athens, GA, 30602, USA. srplatt@uga.edu.
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authors: Platt
authors: Chicago Veterinary Neurology and Neurosurgery, 3123 N. Clybourn Avenue, Chicago, IL, 60618, USA. mpodell@comcast.net.
authors: Michael
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authors: Podell
authors: Department of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximillians-University, Königinstr. 16, 80539, Munich, Germany. potschka@pharmtox.vetmed.uni-muenchen.de.
authors: Heidrun
authors: H
authors: Potschka
authors: Department of Animal Medicine and Surgery, Veterinary Faculty, Universitat Autònoma de Barcelona, Campus UAB, Bellaterra, 08193, Barcelona, Spain. marti.pumarola@uab.cat.
authors: Martí Pumarola
authors: MP
authors: Batlle
authors: Fitzpatrick Referrals, Halfway Lane, Eashing, Godalming, GU7 2QQ, Surrey, UK. ClareR@fitzpatrickreferrals.co.uk.|School of Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, GU2 7TE, Surrey, UK. ClareR@fitzpatrickreferrals.co.uk.
authors: Clare
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authors: Rusbridge
authors: Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL9 7TA, Hertfordshire, UK. hvolk@rvc.ac.uk.
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mesh_terms: D000818:Animals; D004283:Dog Diseases / Q000175:diagnosis*; D004285:Dogs; D004827:Epilepsy / Q000175:diagnosis / Q000662:veterinary*; D020022:Genetic Predisposition to Disease; D038622:Internationality; D017410:Practice Guidelines as Topic; D014730:Veterinary Medicine / Q000458:organization & administration*