Epilepsy is a chronic neurological brain disorder characterized by recurrent seizures. Since horses have a significantly higher seizure threshold than small animals or humans, for example, seizure disorders are relatively rare in horses. Seizures only occur in horses with severe brain damage. Foals, on the other hand, have a significantly lower seizure threshold and are more susceptible to seizure-triggering factors.
A seizure occurs when an imbalance between stimulation and inhibition causes abnormal electrical discharge in the nerve cells of the brain. This results in muscle spasms. If at least two seizures occur within 24 hours, the condition is referred to as epilepsy.
Provoked or reactive seizures caused by metabolic disorders or toxins must be distinguished from epilepsy. In this case, the brain is not affected and the seizures can be remedied by treating the underlying disease (e.g., liver disease, oxygen deprivation, poisoning).
Idiopathic epilepsy can be distinguished from structural epilepsy. Idiopathic refers to cases where the cause is unknown. This includes hereditary epilepsy, which is primarily observed in Arabian foals. However, structural epilepsy is much more common in horses. Its causes include inflammation, injury, malformations, circulatory disorders, and brain tumors.
The symptoms of a seizure can vary depending on the cause and location of the brain damage. Seizures can generally be divided into three phases.
Immediately before the actual seizure, many of the affected horses show noticeable changes in behavior. The horses are overly anxious and restless. This phase is known as the prodromal phase or aura.
Shortly after this stage, the actual seizure begins. This phase is called the ictus ( Latin for "stroke," "blow," or "stab"). In a focal (= locally limited) seizure, there are sudden muscle twitching, local sweating, or abnormal movements in a specific limb or part of the body. The limited seizure may end spontaneously or progress to a generalized seizure. This manifests itself in tonic-clonic muscle contractions with or without loss of consciousness. In the tonic phase, the extensor muscles stiffen, causing the body to arch backward with the head bent backward, which is called opisthotonus. The clonic phase is characterized by rapid alternating contraction and relaxation of the muscles. During a generalized seizure, the horse usually falls. Furthermore, kicking or running movements, salivation, dilated pupils, jaw locking or jaw chattering, excessive sweating, and uncontrolled urination and defecation may occur. A seizure can last between 5 and 60 seconds.
In the phase after the seizure, known as the postictal phase, affected horses often display depressive behavior, restlessness, disorientation, and blindness. The symptoms can last from a few minutes to several days. Foals may also exhibit compulsive licking or chewing movements, head twitching, and increased breathing rate.
If you notice that your horse is having a seizure, leave the stall or paddock and call a veterinarian immediately. You cannot help your animal at this point and you also run the risk of being injured yourself.
When diagnosing epileptic seizures, the patient's medical history is of immense importance. A detailed interview with the animal owner by the veterinarian can provide valuable information about the type, duration, course, and timing of the seizures, any connection to feeding, living conditions, locations (competitions, clinics, stable changes), vaccinations, previous infectious diseases, injuries, recent behavioral changes, and any history of seizures in related animals. It has proven very helpful for owners to keep a seizure diary and make video recordings of the seizures.
The veterinarian will then perform a general and complete neurological examination, which will enable them to make an initial assessment of the type of epilepsy. If no findings are made, idiopathic or hereditary epilepsy can be assumed. Depending on the neurological findings, the veterinarian may already be able to narrow down the part of the brain where the damage may be located.
X-rays, CT scans, or MRIs can be used to detect structural changes in the brain and locate them precisely. Tests of the cerebrospinal fluid (CSF) are used to detect inflammatory diseases of the central nervous system.
Further heart, blood, X-ray, or ultrasound examinations can be used to rule out other potential diseases with similar symptoms. In addition to metabolic disorders, these can include pain associated with colic, broken legs, or muscle diseases that cause seizure-like symptoms. Narcolepsy and cataplexy (see article on narcolepsy) are often confused with epilepsy.
The treatment of epilepsy depends on the frequency, severity, and duration of the seizures. Veterinarians have various antiepileptic drugs at their disposal that suppress the central nervous system and thus significantly reduce the frequency and severity of seizures. However, seizures cannot be completely prevented, which also means that these horses can no longer be ridden as the risk of injury is too great. The dose of these drugs can be slowly reduced as the duration of treatment increases to determine whether long-term treatment is necessary.
If a trigger for the epilepsy or an underlying disease has been found, this should be eliminated or the disease treated accordingly. Talk to your veterinarian about which medications are most appropriate in each individual case.
The prognosis for the hereditary form of epilepsy in Arabian foals is good. In most cases, the seizures disappear completely within the first year of life. The animals are then completely healthy. In adult horses with epileptic seizures without any apparent cause, there is little chance of a cure. The frequency and severity of the seizures can be reduced, but complete freedom from seizures cannot be achieved, which means that the affected horse can no longer be used for riding or driving. In the case of structural epilepsy, the prognosis depends on the underlying disease diagnosed and its treatability.
A must-have in every horse stable: a box containing the most important items for providing first aid or minor treatment to your horse yourself.
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