Understanding Pet Seizures: Expert Insights | SOP Ep. 120 - Missy Carpentier

Welcome to Speaking of Pet. I'm Dr. Alice Novotny-Jeroman, a board-certified veterinary dermatologist. And I'm not. I'm Janet Novotny-King, the doctor's sister, podcast co-host, pet owner, rescuer, and lover. We're here to provide pet owners with science-based information to help them be the best pet parents they can be. Here's today's episode, created just for you and your pets. Hey everyone, welcome in. What would you do if your pet had a seizure? Would you know what to do, Janet? I've got to stop saying I'm having a seizure, because I don't even know medically what a seizure is, and it's not a good thing. Well, we're going to find out. We have Dr. Missy Carpentier, our favorite veterinary neurologist and owner and founder of Minnesota Veterinary Neurology, with us today. We've got questions like, what is a seizure? What are other things that look like seizures? Is there a difference in a young dog having a seizure versus an old dog? That's what, as veterinarians, we think is going on. So, Janet, this is going to be a neurology-packed hour, talking all seizures. And my question is, a cat would never share that they're having a seizure. We will be behind the scenes having a seizure and be like, I'm fine. You know? So, Dr. Missy, Dr. Carpentier, thank you so much for taking the time today to talk all about seizures. Yeah, thank you so much. Thank you for being here. Is she a two-peater, a three-peater? What is she? Well, she's getting the green jacket. Okay. I think we need, like, a paw print jacket. Yeah, a paw print jacket. Oh, I like that. That's great. With a lot of brains and spinal cord on it, all her department. I love it. Neurons, different synapses. Oh, yeah. Astrocytes. Lucky you. Look at us. Hotting neurology. Big words, doctors. Big words for us. I know. I looked them up. I looked them up. Anyway, Dr. Carpentier, please, what is a seizure? And how can we tell if our pet is having a seizure versus something else, like fainting? Yeah. No, it's a good question. So, a seizure, regardless of the underlying cause for why it happens, is something, an abnormal activity in your brain. Okay? So, your pet is having abnormal activity in the brain that caused them to have this seizure. And with seizures, they are a wide spectrum of presentations. I mean, it can be something like a little facial twitching, which is very common in kitties. They'll have what we call oral facial seizures, where it's just one side of their face kind of grimacing at you, versus it can be more of what we call the classic tonic-clonic or also known as grand mal seizures. So, your pet loses consciousness. They will be hyper-salivating. They often will urinate or they'll defecate. And most often, what people don't realize is that it's very, very common. The most common time an animal will have a seizure is when they're sleeping or when they're resting. The best way I like to think about it is if you think about this abnormal area in the brain, right, that is having, you can think of it like the rowdy kids is the best way. The rowdy kids are kind of going, and that's what drives the seizure, while during when they're awake, the other parts of the brain can kind of dampen it down and calm down those rowdy kids. But when they're sleeping, the other parts of the brain are sleeping, then they can't calm down those rowdy kids. And so, that's what can drive those seizures to be able to occur more so at that time than other times. Oh, interesting. Interesting. So, could you miss your pet having a seizure? Like, I know, or Libby's outside all the time. How would I know? Yep, absolutely. So, you definitely, you can, especially if they're more of the focal ones, because there isn't necessarily what we call our pre- and our post-ictal time in those situations. So, when I say pre-ictal, so meaning pre-seizure, what are things that you can look for? It's very common that animals, if they're not sleeping and they are awake, that they'll feel something that's about to happen. They feel, oh, my own personal dog, she never went to my husband for anything. She had seizures. But if she went and, you know, was kind of seeking or searching for my husband, I knew she was going to be having a seizure, usually within 24 hours. So, there's little things. I'll have some owners say, yeah, they never, you know, get in. They'll jump into the shower or they'll jump to the, like, there's just weird behaviors because they're almost trying to fight because they feel off. So, that's something that you can watch. Was there anything leading up to it? And then after, I usually will say the post-ictal is honestly one of the most helpful times so that post-seizure activity because a lot of dogs or cats, they're going to be confused, right? They're going to be disoriented. You can look, is there any urination or defecation or salivation where there shouldn't be? That's a lot of times when owners have pets that they know have seizures, they'll come home and if they see urine, there's, hey, there's a urinary accident or, hey, there's a huge puddle of drool here. Oftentimes, they think that their pet had a seizure when they weren't there. So, those are things that you can look for after the fact to be able to say, okay, what's going on? A lot of animals won't be able to see appropriately after a seizure, too. It's short-lived. It can be minutes to hours to days for some, depending on the severity of how many they have. But most seizures overall should be less than two minutes. It feels like an eternity. I know when my dog had her first seizure, I swear I called, I was just a vet student at the time. I called the ER saying that my dog just had, you know, I think I probably set a 60-minute seizure. I was, you know, it's very, it's nerve-wracking. And it was only, honestly, it was only a couple of minutes, but it feels like eternity. So, it's also important to pay attention to, hey, my pet's having a seizure. How long is it lasting for? Because most seizures should be less than two minutes. Today's episode is sponsored by Dr. Tim's Pet Food. Learn more at drtims.com. What should you do? You shouldn't, should you just leave the pet alone? Yeah, do you restrain them? You shouldn't go into it and try to hug it or anything like that. No, good question. You turn them on their side, you know, that whole. Yeah, so the biggest thing to do is to make sure they're in a safe place. Because if we're sleeping, are they on the bed with you? Because if they start really having a very active seizure, I've seen dogs go flying off the bed because they're just, they're running so aggressively, they're paddling so aggressively. So, make sure they're in a safe place. Make sure they're away from stairs is also going to be the big one. So, I want to make sure that if I have a pet that has seizures, that especially if they're on or isn't there, that we know they're in a safe area. So, if they have one after the fact, we can't have them stumbling down the stairs. So, really, you want to be there. I do think they can hear you and that it's nice for them to hear your voice as they're coming back with it because they lose consciousness, right? That's one of the big things during our full tonic-clonic or grand mal is that they will completely lose consciousness. So, when they kind of get their wits about them again, I think it's reassuring that you are there. You do have to be cautious because some animals can be violent or fractious. They can be aggressive after a seizure because they don't know what just happened. They got to get, you know, they're getting back to it. So, making sure that they're in a nice safe area is going to be huge for them. And then making sure you're safe too as well though. Most animals are going to want to pace and wander, kind of figure things out again. They just used a ton of energy having a seizure. So, they usually want food or water after as well. So, I always make sure you're offering them some water. And then usually they're going to want to get outside and just kind of pace and wander a little bit. So, kind of get their legs back underneath them. Can I make a comment about you talking to them during the seizure? And I've mentioned this to you before. My friend, Joan, had a brain tumor and didn't know it. And she was unloading the dishwasher and just fell on the floor in a seizure. And her very Italian husband, Frank, "Joan, Joan, what's wrong? What are you doing?" And I said to Joan, "What did it feel like when you were having a seizure?" She said, "I didn't feel anything. All I could hear was Frank saying, 'Joan, Joan, what's happening?'" So, it isn't -- they can hear you when you're having -- so, I'm sure they don't know what's going on. But hearing your voice, I'm sure, to your pet would be reassuring. Yeah. And that's really what I think it is, you know, is it's just that, right, that concept for them. Like, "Okay. It's okay. I'm coming back to it. I hear a familiar voice. I'm okay." You know, just reassuring them. But it's also, you know, it's really important for us to -- when you witness your pet having a seizure for the first time, you're going to get nervous. You're going to get anxious. You're going to be all over them. You're not going to know what to do. But it is important for us to be able to try and stay calm, as calm as we can, because we're going to get amped up. We get anxious. It's very common then. Our pets read us, right? Like, they respond to how we're feeling. So, it's important for us to try to stay calm so that they also can read into our energy. It's okay. It's all going to be okay. We just have to get through this. Somebody keeps walking in on it. Yeah. It's almost like they're trying to act like a turtle. Yeah. It's my dachshund. Oh! Oh! I couldn't tell if it was a cat or dog. I thought it was that animal that's trying to crawl like a turtle. Okay. Yeah, I know. You know, she's just very low to the ground. No problem. She's got her legs over her normal height. So, Missy, you've always said to me, when I've asked you about neurologic diseases in pets, to have the owners take a video. Yeah. Because to you, I can imagine how helpful that is, because what other things can look like a seizure, but really aren't a seizure? Yeah. Good question. So, the biggest differential that we have any time a dog has a seizure is, was it a syncopal or a cardiac event? Do they have an abnormal rhythm, and is that what it was? And they can look very, very similar. And so, that's why I always tell, you know, we used to look for, is there what we call autonomic dysfunction, to be able to say it was seizure versus a syncopal event. So, with autonomic dysfunction, basically urination, salivation, defecation. That being said, I had a dog who was born with a congenital fart defect and he had had sinkable episodes during that episode it looked exactly like a seizure i would not know the difference and so for me a lot of it is what led up to the events and then after the events so that's where it's huge because he would have them he'd get really excited then he would pass out he would urinate he would defecate and he'd pop right back up and he would be fine versus if that was a seizure i'd expect a longer postict all that post seizure timing and i wouldn't have expected it's not common for dogs to have excitement induced seizures though they absolutely can usually excitement is more going to be related to something going on with the hearts but yeah getting a video is super helpful i'll be honest though i'll see some videos and i'll say i don't know is it a seizure is a sinkable is no movement disorder all these things can look very similar to that if it's a true tonic clonic or grand mal usually that's pretty easy to be able to say yes this is what it is hands down done there's just a big variety but a video is super helpful and i would expect it's not common for dogs to have excitement induced seizures is always going to be helpful for us thank god for videos you know i was watching a neurology webinar the other day and two vets were on it talking and one of them said that this dog was on anti-seizure meds for years when it was really a reverse sneeze the you know janet how they did that yeah we didn't have videos back then yeah right yeah so it's hard to describe oh my goodness how do you how does the veterinarian determine what kind it is oh so yeah so basically what we do is we look you know you listen to the owners if they don't have a video you're going to ask certain questions you know is there what were they doing before during after that's really going to be we're kind of being little detectives right to be able to say okay what were they doing a lot of it is if i'm having a hard time knowing it's not a classic seizure i'll say what were they doing after if there's any changes in their behavior after and it especially lasts for more than a minute or so usually they're going to be doing a lot more than a minute and they're going to have a seizure and then they're going to have a seizure and then they're going to have a seizure and then i'm thinking it's more likely going to be some sort of seizure event that happens now movement disorders that's a whole other category um those patients don't lose consciousness but they can have abnormal limb movements as well those episodes though usually last very long they're 10 to 15 minutes or so and a seizure is short a seizure should be less than two minutes longer than two minutes you start getting your pet packed up to head to the er whoa okay so can can seizures happen in a seizure event in a seizure event can seizures be i don't cure it's not the right word can they be treated yes so the biggest thing is what's causing the seizure so whenever you have a pet that has a seizure you bring them in to be evaluated and assessed first thing they're going to do is run blood work and make sure there's nothing going on systemically or metabolically that's causing a senior seizure making sure the glucose is okay electrolytes are okay there's no liver disease that's really important in our young patients that can have a liver shunt that's causing the seizure so we always do a good metabolic workup and then if that is all clear and then we're saying okay we're not finding anything there is it something going on actually specifically in the brain a pathology that's causing this whether or not it's idiopathic or genetic epilepsy they were born with a seizure disorder or is there something else is it inflammatory disease like a meningitis could there unfortunately have been a stroke or could there be a mass in the brain a lot of it will be determined too based on the neurologic evaluation because if a dog we see a lot of dogs with idiopathic or genetic epilepsy so being born with a seizure disorder especially purebred dogs and so if we see those cases they come in they're normal in between seizures they've got a normal neurologic evaluation then usually we're going to have idiopathic epilepsy high in our list versus if i have a dog that comes in and when i'm checking his ability to know where his feet are in space he has a hard time knowing where they are in the right side of his body um and he's circling to the left or something like that then i'd be worried there's something focally going on in the left part of the front part of his brain so there's a lot of questions what do you tell like your family members or like your dog sitter your pet sitter yeah you know because if you're not say you're not home and you have the pet sitter yeah you'd have to find somebody that would know what to do so what yep so a lot of times if you have a pet that has seizures and let's say they've been started on seizure medication most of the time the expectation is they're going to continue to have seizures we can't stop that but we want to decrease the frequency of the seizures and the severity of the seizures so pets if they tend to have long seizures or if they have what we call cluster seizures so one seizure then they recover and shortly after they have another they may have what we call cluster buster medications so we have these protocols that owners can have at home to be giving oral medications additional orals to try to stop another seizure from recurring or they may have medications they can shoot up the nose even i'll commonly do that so that we can stop the seizure so that we don't have to worry about it being if it does end up being too long or if it does end up being too long or if it is too long or if it is too long or if it is too long or the other thing though too a lot of the times in these cases you just let them know to just be there with the pet have them in a safe place as long as they recover okay if they have had one seizure and they're already being managed for seizures they usually don't need to bring the pet into an er if they just recover quickly and they did it it's kind of the expectation is they're going to have seizures and of course they want to try to save them the er visits as much as possible um as long as the pet's doing okay so usually after one seizure the pet recovers it's a known seizure and they're going to have seizures and of course they want to try to save them the er visits usually that you know pet sitter is going to know kind of what to do just keep them comfy give them their medications as such um but if it's one that's your you know the pet has no history of seizures first time seizure then you definitely want to get them flipped at our neighbor are their springer spaniels epileptic and we take you know we switched we take care of each other's pets yeah i'd always go over and be like listen up hunter not on my watch this better be the medicine in the cheese ball janet you better be looking for saliva and pee around the house in case he would have had one then you didn't know it yeah well hunter's no he lived to 14. oh he's no longer with us so missy i remember talking about breeds certain breeds i remember in vet school in icu we had a border collie that was just on continuous pentothal because it was so hard to control are there certain purebred dogs that are harder to control with seizures yeah border collie is definitely top of the list um and australian shepherds and labrador retrievers are very much so kind of climbing that list as well but yeah my hardest to control uh seizure pets on border collies for sure they're usually refractory can i ask you when you say labrador retrievers any color preference nope okay because because i've always thought at least in derm um yellow labs were much harder to control with their allergies when i had them on immunotherapy i would always say to the owner most breeds we tell you stay with these allergy shots for at least a year but yellow labs two years and i also thought they were more sensitive to medications interesting yeah it's kind of like the blonde haired blue-eyed child yeah are there are there any um things in veterinary medicine in the future that look really promising for our seizures seizures yeah yeah i mean we're always finding new medications you know we still have our classic medications that we're going to reach for but we do find new medications really as they're you know develops for people and then eventually when they are no longer cost prohibitive they're generic then we can pull them into vet med it's hard though because animals and people they metabolize drugs very very differently so a lot of medications that are great in people we can't use in dogs and vice versa or cats um and so doing there's definitely always something on the horizon that we can be looking at in regards to medications there are different um vagal nerve simulators too that they're looking into doing for then there are some studies ongoing i know tufts has one right now to see if we're able to help in these refractory cases um and help get seizure control they're currently studying that uh dominic feisler is doing that at tufts and so they're very early on in the stages but kind of looking into that as well to see if that's going to be helpful what are some myths about seizures myths about seizures um biggest one is that if you put in an allergy shot you're going to have a seizure and you're going to have a seizure and ice pack on their head it'll stop the seizure there's some crazy things out there wow yeah that will not stop it when they're flailing in the seizure you're supposed to yeah yeah and they're going and you're getting by the face yeah there's a lot of that um so a lot of people will say if they do this with their pet during a seizure or that it'll stop the seizure but like i said most seizures are going to be less than two minutes so regardless of what you think you're doing during that time it should stop by the time you get the ice pack and come back yeah it's done yeah so maybe just stop um so the other thing too is um oh what was i gonna say something with the tongue in people they're always like don't let them choke on their tongue well i'm not reaching in there no they're not going to swallow their tongue yep that's fine they're not going to swallow their tongue don't put your hands in their mouths just um that's another that's actually a really good one it's very uncommon for a pet to die or pass from a seizure a lot of people are very worried about that good to know um so it's very uncommon if they do it's usually the pets when we i always say a seizure should be less than two to three minutes because at that point if it starts being longer than that that's when we want to start getting to the er because that's when to get to five six minutes and they're in what we call status we can't get them out of a seizure their temperature goes up really high their lack of oxygen those are when we worry about it and they can start to have abnormal rhythms of the heart that's when they're Again, it's not common for them to pass from having a seizure. especially one but those are the instances seizures back-to-back or seizures that are prolonged here's something we love about dr. 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Tim's pet food to find the formula that fits your pet's life if you're interested in learning more about how to make your pet's life better than old changes like this exercise help the right food the right that is any of that help yeah good question so unfortunately no it's usually not I like to keep my you know my patients healthy as much as possible I tell owners that there are some pets that have excitement induced seizures so I'll have some hunting dogs that only have a seizure when they it's hunting season like they go and they just get so amped up I'll have the seizure then I have some patients that only have a seizures when they go to the vet or to the groomers they're fine every other time I used to yeah yeah so we can kind of pulse therapy for those pets how to make it so that kind of preparing them for the events they can do it so well I'll ask my owners to look for any sorts of triggers in case they they happen to have a pet that has excitement induced triggers it's not uncommon during the holiday season actually I think cuz we're more stressed right people coming to the house and everything that they'll be a big uptake I always say Christmas time is the season of seizures oh it's crazy so we'll kind of pay attention to those things as well but no well balanced diet healthy diet exercise I really don't usually change their day-to-day activities much unless if they have something that we know is a trigger we'll try to limit it hope you're enjoying today's speaking of pets podcast every week we feature a board-certified specialist dermatology oncology internal medicine orthopedic surgery ophthalmology dentistry you name it if it affects pets we're on it we're here to share some really good information for pet owners practical information that is science-based so that you can be a pet owner and have a healthier pet to learn more about your pets health check out our other episodes wherever you get your podcasts hi everyone I'm Larry some of you know me as grandpa Larry and I run Larry's Animal Safari on YouTube where we share sweet and educational videos about baby gorillas zoo animals and the amazing teams who care for them if you love animals of all kinds I'd love to have you join us you'll meet little ones like Jamila and Kyambi learn how zoo families grow and enjoy real moments that bring joy and curiosity to animal lovers everywhere just search Larry's Animal Safari on YouTube or click the link in the show notes new videos go up weekly and each one supports awareness for animal care and conservation thanks to speaking of pets podcast for all they do now let's get back to the show I have a question in when an old dog comes to see you it's normal blood work they've been healthy their whole life and now they're seizuring is the first thing you think of a brain tumor unfortunately it has to be our top differential because it's a brain tumor and it's the first thing you think of a brain tumor and it's the first thing you think of a brain tumor and it's the first thing you think of a brain tumor and it's the first thing you think of a brain tumor and it's the first thing you think of a brain tumor and it's the first thing you think of a brain tumor and it's the first thing you think of a PRESIDENT. Pittsburgh. And so he called me one day, he was just freaking out because I saw the dog for allergies, but his vet had put the dog on metronidazole for some stomach issue. And now the dog was seizuring and, and it was due to the metronidazole. Yeah. So there's definitely some medication. So metronidazole, I usually think of making them vestibular, um, but though they can definitely have seizures, um, the main ones are going to be your flea and tick preventatives, um, that can't. So what I always tell people is they're not necessarily causing the seizures themselves. Usually what they do are they're altering the seizure thresholds. So you already have a patient who was predisposed to having seizures. They maybe have a mild form of idiopathic epilepsy is the best way to think about it. They get their monthly, you know, flea and tick medication, and then they have a seizure shortly thereafter. So, um, if that's the case, then we just have to alter what, you know, flea and tick preventative they're on are heartworm preventative. So there are certain ones that can kind of, like I said, alter that seizure threshold. So they're more likely, but I don't usually think of certain medications necessarily causing a seizure unless you have some drugs, um, excuse me, some patients that have like MDR one, you know, it was just going to ask you about that. Yeah. Yeah. So it's basically a gene that they have where basically they can't metabolize certain drugs appropriately. So if you give them things like ivermectin, which is in classic, you know, flea, um, and heartworm medication or tick medication, they can end up having a seizure because of the effects that all have on their brain. Um, but most clients will know if their dog has that. And a lot of times that standard dosing is not going to cause the seizure in those breeds. Um, but if they got into higher dosing, like I'll have some hurting breeds that, Hey, the horses were just deworms and then the dogs go and they eat the feces. Um, and then they're like, Oh, I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. I don't know. Or they got into the dewormer, those things, and they'll come in having seizures. I totally forgot about that, you know, because really as specialists, we don't see a lot of farm dogs, um, sadly, because some of them are very allergic. Would you comment? Because I have to say I would get, and I still get helping these rescues get a lot of questions about idiopathic vestibular syndrome and what that is. Janet, do you know about Janet? You've had a lot of vertigo problems. So you probably would love to. I know what idiopathic means. I know vestibular has to do something. And these dogs aren't doing yoga like you were. No. Yeah. So vestibular is a problem with their balance. So similar to vertigo in people. Right. Um, and so idiopathic vestibular is usually what we see in older animals when they acutely are basically lost their balance and they're falling. They may have a head tilt, their eyes are kind of darting back and forth, what we call nystagmus. And so usually then they have really significant effects and then they improve within a couple of days. Um, sometimes the head tilt can take weeks to get better, but that's idiopathic vestibular, which sometimes we can have patients, you know, that come in and say, my dog just had a seizure because all of a sudden they came on really suddenly and they're just rolling and they can look very much so like a seizure. Um, but usually if there's a head tilt, their eyes are darting back and forth. They're not going to be able to see what's going on. So that'll be a sign of a stable disease. And usually they'll get better. Over a couple of days. It's very classically in your older dogs or we'll have that. There's many other causes for a dog to lose their balance or, you know, have vestibular size, whether it's something to do with the middle ear or something going on at the level of the brainstem itself. Um, but yes, idiopathic vestibular can look like it. And what's hard is we've actually just found there's vestibular seizures as well. So that's just thrown a whole other, a whole other kind of little chaos into this scenario. So there are dogs, um, pugs actually in particular who can have vestibular seizures. And so with these episodes, they have a vestibular episode. It's short. They kind of take a little bit to get out of it, but then they're back to normal. So when they, you have an animal that has a vestibular signs and then they quickly improve, usually we're more thinking, could that have been a some sort of seizure? Because most vestibular cases, they're not just going to have an episode and then get better. They're going to be, they're going to have signs for a while. When it comes to feeding our pets, we believe in results you can see over hype. And that's exactly why we're proud to partner with Dr. Tim's Pet Food. Dr. Tim Hunt is a practicing veterinarian who spent decades formulating nutrition for every kind of pet from the laid back lap dog to his own Iditarod sled team. Check out Dr. Tim's Pet Food and see what science-backed nutrition looks like for your pet. They'll have a shiny coat, more energy, healthy weight, and more. Because every great adventure, even a nap on the couch, starts with a healthy pet. So it's not like Janet, like what you had with, you have to correct the little crystals in the ear. It's not like that, Missy, right? No, not like that. Okay. Because I don't want people trying to turn the dog's head and putting them upside down and, you know. It's called the Epley maneuver. Thank you. Yep. And because in humans, it's like this inside. We could have your husband demonstrate how he did the Epley maneuver. No, never. Never. He's an engineer and he's like, we got to fix this. I know. No, thank you. You know, the other thing too, Missy, when I was in vet school, which was way far past when you were, but we were always like, no, dogs and cats can't have strokes, but they can, right? Yeah. Thank you. Very, very common. Yep. Very common. They'll have strokes or what we call cerebrovascular accidents. And it can be the first onset. It could be them presenting with seizures. It could be them presenting with seizures, them presenting with circling, any sorts of signs. It all depends on where it is in the brain. And they can be either what we call ischemic or hemorrhagic. So ischemic, meaning that we've blocked a blood vessel and they've lost oxygen to that area or hemorrhagic, basically meaning they've had a little brain bleed. And so we'll try to identify the underlying cause for why it happens. Most dogs and cats, though, if they have a stroke or a vascular events, they're able to get through it and do wonderfully, which is great because they are pretty remarkable. And if you think about it, too. Dogs and cats, they don't, I always say, cover their ears if they're listening. Don't let your dogs hear or cats hear this. But they don't use a large portion of their forebrain. So they can actually have quite a bit happening in their forebrain. And they are still totally normal. They are very much so brainstem or hindbrain animals. And that's what drives them to do the majority of their things. So I've had dogs that have had tumors taking up the majority of the front part of their brain. And the only sign is a seizure. And it's because they don't use that part. And so if they have a stroke or a vascular event, we can see subtle signs. Or they can be more dramatic, of course, depending on where it is. But they can do very well. Well, they have more strokes. Like, you know, in humans, once you've had a stroke, they're always worried you're going to have another one. So we don't put them on blood thinners or anything like that, right? We try to find the underlying cause. So we usually say about 50% of the time we can find an underlying cause for why they happened if it was an ischemic, if it was hemorrhagic or that bleeding. Usually. We say about 40% of the time we can find a reason for why it happens. So if we can find the reason and we are able to identify and treat that underlying reason, whether it's high blood pressure, hypothyroidism, kidney disease, liver disease, clotting abnormality, and we can treat it, then they're less likely to have another one. If it's one and I work them up and I cannot find an underlying cause for the stroke, then it's a lot less likely for them to have another one. But if I find an underlying cause. You just be treating, kind of tricky to be able to regulate and control the disease that originally caused it. So I do expect those pets to have another seizure or choose me another stroke. How do you know if like the medication you prescribed for seizures, it's working because they're not going to have seizures? I mean. So they're still going to have seizures. And so we want to decrease the frequency and the severity. So for all my patients, most, a lot of owners are great and they'll have seizure logs. But for all my patients, their pet has a seizure. They email or call us and let us know. And then we have a seizure log. And so I kind of, we're tracking everything and we're able to say, okay, if you are having, say, one seizure a week, let's see if we can get you out to one seizure a month. And then let's see, you know, every case is different. I have some dogs that will have one seizure, you know, once I have one seizure a year, I have other dogs. If I can get them to go a couple of weeks without having a seizure, it's good. It's very, very case dependent and patient specific. Wow. You have to be careful. When you have, when I'm helping out Golden Rescue, we have a Golden that has seizures and she's on, I think, zonisamide. And I've got her on something for her allergies and she was fine for the past three years. And the owner just called me the other day and she had a seizure. Actually, she was doing so well, they lowered the zonisamide dose. And I think now they just took it back up. But I'm always concerned that a drug that I may be adding, you always need to tell your veterinarian or your new veterinarian or your specialist. You're saying what drugs your dog is on or cat so that when they're prescribing another drug for a different condition, it doesn't react. Yep. Yeah, it's very important just so that we know. I mean, luckily, a lot of the seizure medications will go well with most other medications, which is great. But it is important to know to make sure mainly to monitor the side effects so that we're not having a dog. You know, we don't want the patient being a zombie. Right. We want to make sure that they're still able to live and have a good life. And so it's. That fine balance of controlling the seizures, side effects of medications, adding another medications, even if they're not for seizures, they're going to have their own side. effect so it's make sure we're balancing all of it together that goes for humans too oh yeah you know you can't prescribe the doctor can't prescribe something if it's going to interact with yeah medication or at least at least adjust the dose right are there any and this is going with myths again are there any holistic meds that you see people seeking out so that their dog doesn't have to be on anti-epileptic drugs yeah i mean there's definitely a lot out there um so i mean the list i can i mean it would be like under pages long of what you know as you try because they they want to help their pet right and it's nothing wrong yeah with doing it the hard thing that i always just say is that you never know how a pet's going to react to certain supplements or medications or anything and so if i'm starting a medication i know how it's going to affect the body but then if you're adding in other things i don't know how they're going to interact and so i try to keep things as simple as possible if i don't know that that medication is going to help or that supplement is going to help i'd rather not give it and kind of muddy the waters so to say and just keep it nice and simple so that we know exactly what we're getting you know it's the same thing with kind of looking at cbd right now there's a lot of research going into it um colorado is doing a lot it's there's many different places the hard thing is that there's so many different manufacturers out there there's so many different varieties there's so many different amounts in each medication that until we get it more structured until we know exactly how not only is it helping with seizures but also how is it interacting with all of our other medications that we're giving you know until we have all that data that's why i tell clients i can't recommend it really right because i don't know how it's going to potentially affect things because nobody is supervising it you know we had dr cooperman on janet from consumer labs and he was telling us some of the supplements that they check out some of them didn't even have any of the supplement in there for example probiotics they had no probiotic in this particular probiotic and the probiotic i was taking was like way at the bottom of their list oh is that right yeah so i switched brands the other day i had um a client asked me about mushrooms you know oh and the new the new falsehood for that is that it can help lipomas i don't know how those two got i don't know about you guys but there's like mushroom tea here oh yeah it's like ground sprinkle mushrooms and i'm like janet you didn't know this but i emailed dr cooperman and i said hey have you guys looked at any of these mushrooms he said alice we haven't looked at him because we can't even establish a standard for it so that's how that's how far-fetched it is yep wow yep yeah and that's why it's so hard to be able to there's so much out there especially like you can get it i mean anywhere and there's so many different varieties and that's why i just said until i can say hey this brand is the one that i would use this is the dosing like that i know that i just i'm not comfortable doing it it's all about the marketing it has nothing to do with what is in there it and and even if it did work you don't know if the next batch is going to have as much ingredient in it as the one you're giving yeah okay we got to wrap it up alice and i have to ask dr carpenter i want to ask dr carpenter to tell us a little bit more about what she's doing and i'm going to ask dr carpenter to tell us a little bit more about what she's doing and i'm going to ask dr carpenter to tell us a little bit more about what she's doing and i'm going to ask dr carpenter to tell us a little bit more his arm is out the horse passed gas and he just got out of the way in time because he went that's how you get freckles but doesn't the arm like reverberate in there no it's tight it actually clenches down on you remember that missy yeah like you're feeling stuff and you're like yeah so so dr carpentier i was like in the fashion business and alice was going to vet school and i remember talking on the phone one day and i'm like yeah we got a whole new line in you know like i know v-necks are in or cashmere whatever i was saying i'm like how was your day and she goes well i had this big glove on and it was inside a cow and i was like yeah but but but outside of vet school i was very well dressed because she would send me all the esprit sample sales oh yeah i used to go to all the big sample sales like in new york it was it was great oh my god and the best part was all the model shoes were size nine my size you yeah and they would put holes in the bottom so they didn't have to pay a duty on them really through oh yeah so i would just take black electrician's tape slap that on there heck yeah a couple new pairs of shoes good to go yeah i was fine it was like a little drilled hole yeah well this has been fascinating because i have i learned so much every time a seizure scares me i've never seen one i've been there post on a human i've never seen it i have seen one on anne's black lab once and it was yeah even you know missy being a neurologist and me being a vet it's still horrifying it's still scary because it's so out of control like yeah yeah exactly you just want to be there to comfort them and what i always tell people is remember they don't know what's going on during the seizure but they can hear after but that yep it's after the fact that you just want to be there for them yeah thank you thank you for the great work you do we appreciate you and um thanks for tuning in today thanks for listening don't forget to subscribe to our channel and don't forget to email us your questions at soppodcast.com yeah dot com it's on our website and don't forget it's two p's in there i know it's weird but it's the best we could get thinking of pets podcast sop yeah um but thanks for listening thanks for tuning in share us like us we love likes and hey this week we're number three in the animal and pet category so we get really excited um thank you dr carpentier and um alice anything else no just give your pets a kiss for us and tune in next week yeah thanks for listening bye bye hey thanks for watching and listening we like likes don't forget to like share and subscribe you can follow us on social media at speaking of pets and give your pets a big kiss from the novotny sisters the speaking of pets podcast is an sla video production