Wednesday, 25 August 2010
The Further Adventures of Frodo the Faller - update
If you're familiar with tales about Frodo the Faller you will know that he acquired his name from his habit of collapsing without warning (usually) and dancing while unconscious. The first time he did this his female servant, who was alone in the house at the time, apart from two other Dalmatians, was quite frightened. She had seen humans experiencing this but now here was her gentle, loving, devoted dog turned into a snarling, uncommunicative beast – the snapping jaws, the frothing mouth, the unseeing eyes, the frantic paddling paws were unrecognisable - but in the back of her mind she understood what was happening. After that first episode she took Frodo to see Nadia-the-Vet. By the time Nadia saw him he was completely recovered and wondering what all the fuss was about. Further episodes occurred and he started a mild drug régime for he was now officially diagnosed as idiopathically epileptic, undergoing tonic-clonic seizures.
For eleven months Frodo was free of seizures and then they recurred; they happened every three to five weeks and he would have clusters of two to three in a 24 to 48-hour period. They were not prolonged – about one and a half minutes – and his recovery was swift but gradually his medication was increased to try and control them.
Eventually, we decided to try and find out if there was an underlying cause and took him to the Royal Veterinary College for tests. He had to stay overnight – that was a shock for the poor boy! Thankfully there was no evidence of anything untoward though they discovered a cyst, which might have been present from birth and not have caused any problems, and so we continued with the treatment. However, we were advised to have another MRI scan to see if the cyst had changed in any way so we travelled to Potter's Bar once more, this time taking Jenna along for company for the lad. Again, he stayed overnight and though the scan showed no change in the cyst, poor Frodo went into status epilepticus, a potentially fatal condition when fits either do not cease or follow each other in such rapid succession that the brain cannot cope and the individual dies. The mortality rate is high, around 20%. It happens to humans too. A seizure of longer than five minutes is considered an emergency. We are sure it was stress that caused this.
The neuro-surgeons were able to help Frodo and added another drug, so thereafter he was taking three drugs. We brought him home and drugged him as prescribed. He slept like a puppy or an old dog – that is, very soundly. During the intervening years Frodo has balanced so that he can go three to five weeks between seizures, occasionally as long as eight weeks. His fits are short, increasingly singular rather than clustering.
What causes a seizure? Frodo is fortunate in that there are no food or drug-related triggers. Some dogs, and cats, have seizures triggered by delays in drug administration or food to which they are intolerant. Others are affected by perfumes in hair spray or carpet shampoo, deodorant or soap. Yet more react to sudden changes in weather or the phases of the moon. Frodo reacts to stress. Now this is a problem when so many things in the course of a day can excite him. Breakfast! Walk! Doorbell! Janice moving out of eyesight! Car! Janice returning! Telephone! Supper! Visitors! Vet!
When he first started having fits, just before his third birthday, he was so aware that something unpleasant had happened that he was reluctant to return to the scene of the disturbance. This meant that I had to accompany him out to the garden and reassure him if one had occurred out there. If he had a seizure as he was getting into the car the next couple of occasions with the car would be cause for anxiety – for all of us! Fortunately, he seems less anxious these days, or perhaps better able to deal with stressful situations.
Seizures can occur at any time of day or night, and an animal may be awake and active or asleep. Many animals display particular behaviours before and after a seizure (pre-ictal and post-ictal) Pre-ictal conduct may involve restlessness, trembling, unresponsiveness to commands, biting or snapping at objects or persistent gnawing at paws. Post-ictal behaviour can include pacing, excessive thirst and/or hunger, confusion, ataxia, temporary loss of sight and hearing, when they may crash into walls or down stairs. These behaviours can continue for hours and are very distressing. Frodo tends to become very clinging when he's about to have a seizure. He also becomes rather clumsy. During the ictal (fit) stage he loses consciousness, thrashes his limbs, his neck and spine arch, his jaws open wide, he growls and salivates and urinates. Afterwards, he is dazed and then stumbles around for about twenty minutes. If it's daytime he'll have a long drink. At night he goes back to (a clean) bed.
A dog in a multi-dog household is potentially at great danger from his housemates. There are many instances of dogs being attacked and severely injured while they are having a fit. In Frodo's case each of the dogs reacts differently. Before he lost most of his sight and some of his hearing, Buddy showed every sign that he would attack if we were not there to check him. The late, great Dominie was concerned, gentle girl that she was. Jenna is usually frightened and wants to get away. Gus thinks he's playing and wants to join in but I have a feeling he may also be inclined to assault when he's a little older. A dog in the throes of a seizure looks aggressive but is unconscious and therefore unresponsive to the subtle dog language of his canine companions. Thus, if he continues to show apparent aggression he is likely to be set upon.
We rarely leave the dogs alone but have to be careful who goes where
Recently Frodo's pattern seems to be changing again. He has had two short fits a week apart and we expect another one imminently. At night I sleep with one ear open, ready to leap out of bed as soon as I hear the tell-tale scrabbling in Frodo's basket. I support his head and talk to him although I know he is lost to the world and cannot hear me. When he comes round I change his bedding and reassure him. Eventually, we all go back to sleep, thankful it was not worse and hoping there won't be more in the next couple of days.