EPILEPSY

More than any health issue covered on this web site, I truly want to shine a light on epilepsy.  Why?  Because too often it is hidden, swept under the carpet, not discussed openly and honestly by anyone other than the pet owners of those dogs affected by this tragic disease.  It's no coincidence that this page on epilepsy gets five times more traffic than any other health issue covered on this site.   This does not mean that epilepsy is more common than those other problems, but it is generally less discussed, and clearly there is a thirst for knowledge and honest information about epilepsy and its effect on Greater Swiss Mountain Dogs.

Sadly, in this breed there is often a rush to breed very young dogs, and sometimes breed them too often right out of the gate, which may not allow adequate time to get a handle on what that dog is producing.  Reproductive technology has enabled us to freeze semen successfully on these stud dogs, so there really should be no rush to use under age dogs or over breed those who are just beginning their breeding careers.  Some "breeders" are knowingly breeding the offspring of dogs who have suffered or even died from seizures.  Those dogs are at real risk of suffering seizures themselves, and it one can never assume that a dog who hasn't started seizing by the time it's 3 or 4 is somehow safe.  It seems it's just as common or Swissies to start seizing between the ages of 4 and 6.  I believe that this breed is in real jeopardy and unfortunately it is up to the puppy-buying public to help keep breeders honest.

I have learned what it means to live with an epileptic dog (see Axel's Diary of Epilepsy). Though this was not a total surprise for my Axel, whose pedigree might be called "risky" at best with numerous epileptic relatives, including his father and numerous aunts/uncles, it is still a blow to your heart when you see your dog seize for the first time. I had such hopes for this dog, who finished his championship with ease, had all his health clearances, and was a beautiful, typey, and very sound Greater Swiss Mountain Dog.  My plans to special him and one day hopefully pass on the genes that made him so beautiful were set aside. In fact, I had decided not to breed him before he started seizing, before his father started seizing, before his sister started seizing...all based on the incidence of epilepsy on his mother's side of the pedigree. Pretty ironic, huh? My hope then became merely that he would just live...and that he did, until the very day he turned six years of age, when he had the most severe episode of seizing a dog can have...status epilepticus. The resultant onset of hyperthermia (a temp of 106.9) and damage that did to his organs (basically liquefying his brain and causing disseminated intravascular coagulation or DIC) was too much for him to battle this time. He stopped breathing twelve hours after being admitted to the emergency hospital. CPR and attempts to intubate were unsuccessful due to all the blood in his lungs.  He expired at 9:30am on February 2nd, 2010 after battling the demon epilepsy for not even 2 years. 

​Even more than my fears attached to my own dogs, I dread nothing more than receiving a phone call from a terrified puppy buyer who is watching their dog have a seizure for the first time.  I don't want to have to take that call.  But of course I will.  The other thing I will do is accept the diagnosis of epilepsy and not blame the seizures on the puppy buyer for giving the dog that dose of Frontline or that rabies vaccine.  Or for not feeding him a raw diet.  Or for letting him watch too much television. 

While I cannot eliminate epilepsy from this breed, or from my own breeding program for that matter (until we know more about how it is inherited and can test for carriers), I can own up to it when it occurs, share that information with others, and apply some meaningful standards -- like removing affected dogs and any of their offspring from my breeding program.  These are not always easy things to do -- what might be considered "throwing away" a perfectly beautiful dog because his father started having seizures?  But being a breeder isn't supposed to be easy.  We have to make compromises all the time.  So do we breed to this dog who's a bit straight and high in the rear, or do we breed to that beautiful dog who has the epileptic parent?  I know what my answer would be, but it may be different from others'.

As you can see, I am not afraid to talk about epilepsy.  I am afraid of what happens when we don't talk about it.  Trust me when I say it has not made me very popular with many GSMD breeders.  Some think I must have some political agenda for being outspoken about epilepsy.  Others merely think I have no business speaking out about it when they claim that epilepsy was their battle, long before I came onto the scene.  Of course, some of those breeders don't even mention the word on their websites.  As far as I'm concerned, Axel gave me every right to speak out about this disease.  And I am NOT the only Swissy fancier who is deeply concerned and vocal about epilepsy and the tragic impact it has on these dogs and their families.  Far from it.

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​What can you do to help?

The University of Minnesota is actively recruiting Swissies who have suffered from seizures (one of 5 breeds with high incidence of epilepsy included in this study).  If your dog has experienced seizures, please participate!  
You can do your part by submitting blood and filling out their survey HERE.

Hopefully, with our help, the Univ. of Minnesota can one day find the genetic markers and establish a mode of inheritance.  This may enable us to screen for epilepsy in breeding stock.

​Epilepsy and Breeding

- A True Story -
I have often dreaded the day that will come when I'd have to deal with the heartbreak of producing a Swissy with epilepsy, the burden of knowing what that dog's owners were going through and feeling absolutely helpless.

 But I had never really contemplated the predicament I'd find myself in recently...

-Read more below

What is Epilepsy and what causes it? 
While epilepsy refers to any seizure disorder, there are actually two kinds of epilepsy.  Symptomatic epilepsy, which is also called "secondary" epilepsy, is the diagnosis for seizures that are a symptom of another identifiable health problem, like a brain tumor or a stroke.  Then there is idiopathic epilepsy, which is also called "primary" epilepsy and describes seizures with no known cause (the definition of idiopathic).  Idiopathic epilepsy, the type we are truly concerned about here, has been called a disease without a diagnosis.  Brain tumors may cause seizures.  A poisoned dog may have seizures.  But if a dog is having seizures, and the vet can find no reason for those seizures, that dog will be diagnosed with idiopathic epilepsy.  A dog may have five seizures per year, five per month or five per week -- if there is no identifiable cause for those seizures, then we should consider that dog to have idiopathic epilepsy.
Is Idiopathic Epilepsy inherited?  
Hereditary idiopathic epilepsy has already been proven in some breeds of dogs, but it is suspected that ideopathic epilepsy is hereditary in most breeds.  Much research is ongoing at The Canine Epilepsy Project, with the hope of identifying the genes that carry epilepsy, and that some day a test will be developed to identify those dogs predisposed to epilepsy and those carrying the genes.  It is very frustrating to know that this is a hereditary disease and yet not understand how it is inherited.  

Until such time that we have identified the genetic mutations that cause this disease and are able to utilize a DNA test to screen dogs, it is up to the breeder community to be as cautious as possible.  What does that mean?  It means not repeating breedings that have produced epilepsy.  It means not breeding dogs who are affected with epilepsy, or the offspring of any affected dogs.  It means openly sharing information about our dogs and what they have produced, so that other breeders may make smarter, more informed decisions.  Unfortunately, that level of cooperation does not seem to exist in the Swissy breeder community as a whole.  Very often I hear about dogs producing epilepsy for the first time from potential puppy buyers who have had epileptic Swissies in the past, or from people who post innocent questions about their dog's epilepsy and treatment on various public forums.  And I am so thankful that these owners are willing to talk about their dogs, as they not only provide a resource and support to other people just like them, but they actually provide a service to breeders who want to know more about where epilepsy exists in our bloodlines.

When does Idiopathic Epilepsy strike?  
While the average age for the onset of epilepsy is between one and four years, a dog can begin having seizures before its first birthday.  I personally know of one who started when she was seven or eight months old.  It can happen when a dog is 5, 6 or even 8 years of age.  If the dog is otherwise healthy and no causes can be identified, that is idiopathic epilepsy.  I recently learned that the father of one of my own dogs had his first seizure at nearly six years of age.  Needless to say, my dog will NOT be bred, and I am especially relieved that I made the decision long ago, because of some "epilepsy red flags" in his pedigree, not to rush into breeding him.  

I know of Swissies who had early onset epilepsy and managed well, yet others I've known have been lucky to survive a year or two.  Likewise, I have heard of dogs with late onset epilepsy who only had sporadic seizures, yet other did not do so well.  There seems to be no rhyme or reason, or any correlation between age of onset and how severely the dog will be affected.  And the bottom line is this -- whether a dog starts having seizures at 8 months or 8 years of age, if no cause can be diagnosed other than Idiopathic Epilepsy, then those two dogs should be viewed the same way.  It is naive to think that the dog with late onset epilepsy is safe to breed because it didn't start seizing until it's life was 2/3 over.  Perhaps it's just the case that the older dog was not exposed to the right triggers and that in another household or environment, those seizures may have started much younger.  The same "what ifs" apply to the younger dog -- if only we hadn't given her that vaccine (the one we hypothesize MIGHT have triggered her seizure) maybe she wouldn't have had a seizure...until she was done having her fourth litter!  With the younger dog, we have the opportunity -- or rather, the DUTY -- to make sure that dog is never bred.  In the case of the older-onset dog, whose breeding days may be over by the time it has a seizure, for the sake of damage control we must give the same consideration to the offspring produced by that affected dog.  As far as I am concerned, no dog who has had seizures of an unknown cause should be bred.  And neither should their offspring.

Can Epilepsy be treated?  
There is no cure for idiopathic epilepsy, but seizure activity can often be controlled through drug therapy.  Epilepsy may be managed through the use of anti-epileptic drugs, such as phenobarbital, potassium bromide, and diazepam.  It can be very tricky to find the right drug, or the right combination of drugs, as every dog/case is different.  And even once that perfect balance is achieved, it may change over time as the disease progresses.  Some dogs may just not respond well to drug therapy.  But patience is a must.   And for those who do, the high degree of toxicity and the side effects that come with these drugs present yet other challenges to the Swissy and owner managing this disease.  These are decisions that a pet owner with an epileptic pet must make with their veterinarian, as they weigh the frequency and severity of the seizures against possible side effects of the drugs.  The age of the dog must also enter the equation as once a dog is reliant on anti-seizure medications, it is difficult to wean them off.  Dogs being treated for epilepsy should be visit their veterinarian on a very regular basis to determine what toll, if any, drug therapy is taking on their bodies.

EPILEPSY & BREEDING

I always dreaded the day that would come when I'd have to deal with the heartbreak of producing a Swissy with epilepsy, the burden of knowing what that dog's owners were going through and feeling absolutely helpless.  But I had never really contemplated the predicament I'd find myself in recently, this Winter of 2010/11.
On December 8th, 2010, I bred my Moxie, who was fast approaching 5 1/2 years of age, for what was to be the third and final time.  She was the picture of health and had rested 18 months since her previous litter.  I chose the sire for this litter earlier in the year but put off breeding due to the demands of my job during the summer.  But now everything was set and I was so excited by the prospect of another Moxie litter.  
Because Moxie has not been the easiest girl to get pregnant or carry to term, my repro vet counseled me that I should do everything as we did the previous litter (8 live puppies).  This involved 4-6 weeks of Baytril prior to breeding ($500 - $750), and doing a natural breeding.  Therefore, I was more limited as to choice of stud dog, being restricted to fairly young dogs who were within driving distance.  The dog I selected to sire this litter was 3 years and 8 months of age, not exceptionally young by Swissy standards but not terribly old either and it would be his first breeding.  Although he had no track record as a stud dog, he did come from a litter of 11, with exceptional depth and breadth of health clearances, and most importantly no seizures in any of the dogs from his litter.
We only got one "tie" but it could not have been more perfectly timed and within a couple weeks Moxie was not only acting but actually looking pregnant.  Finally, after about 3 and 1/2 weeks I called the sire owner to let them know that in all likelihood she was pregnant.  They couldn't have been more thrilled as they were looking forward to a female puppy from this litter.
AND THEN, at 5:30 the next morning (1/3/11), the world pretty much spun off its axis. I received a call from the sire owner -- the dog had just had a seizure!   Half asleep still, my heart started pounding as I thought about these poor folks and what it was like the first time I saw Axel have a seizure. And then about thirty seconds later, I thought about Moxie, most probably full of puppies out of this dog who had just had a seizure. Oh my God, I thought! What can I do? One thing I did know, immediately and without hesitation, there was no way I could ever place these puppies.  But what were my options?
Even before contacting the vet that morning, I hopped on the computer to explore options for terminating the pregnancy.  When I finally did speak to the vet, she told me to breathe and said "First, there still is a possibility that she is not pregnant."  But if she was, there were a couple options available. One, of course, was to immediately spay her. But if I wanted to breed her again, then I could have Moxie undergo prostaglandin treatment.  After weighing the options for a day, I decided to go with the latter.  And because Moxie did have a history of miscarriage (resorbing puppies), we elected to put off the ultrasound until the end of the week, when she would be about 30 days or so into gestation, an optimal time to begin the prostaglandin treatment.  
On January 7th, I took Moxie for her ultrasound, and within a matter of seconds they determined that she was indeed full of puppies.  And so, with a heavy heart, I checked her into the vet to begin the treatment.  Due to the sensitive nature of handling prostaglandins as well as the side effects, plus the fact that the injections must be administered 2-3 times per day, this treatment really must be done under a vet's care.  While I anticipated that Moxie would have to stay at the vet for 7-10 days, she wound up staying at the vet for 14 days.  As it turns out, Moxie is just as difficult to get "un-pregnant" as it is to get her pregnant.
Although I don't believe I had any other choice, terminating this pregnancy was not easy to do.  Rationally, I know there is still a possibility Moxie may not be a carrier (none of her puppies to date had had seizures, though they were still all under three years of age), in which case the puppies may have been just fine.  I know of a such a litter, sired by Axel's epileptic father, and as far as we know, the puppies in that litter are still okay.  On the flip side, there is also a possibility that Moxie could even HAVE epilepsy herself.  Yes, she is 5 1/2 years old and, so far, healthy.  But I have known of other Swissies who did not start having seizures until they were 6 or 7 years old (Axel's father, for one).  More likely though, Moxie may well be a carrier for epilepsy and that is the assumption I have always made when breeding her.   
The bottom line is these were not puppies who needed to be born.  Because I only breed for myself and to improve the breed (which includes health!), there is no way a puppy from this litter would be part of my breeding program.  So why not place them all as pets?  Well, ask yourself -- who in their right mind would knowingly purchase a puppy sired by a dog who had seizure?  Emphasis on KNOWINGLY, because I would have told potential puppy buyers about the sire, and about what it means to own an epileptic Swissy.  That if their puppy started having seizures, they might be looking at emergency room visits that could run thousands of dollars each time the dog had a cluster.  And in the worst case, they could very well watch their dog die an early death from this horrible disease.
Yes, this was a very difficult experience for all concerned.  But it could have been so much worse.  What if I had bred Moxie six months earlier, something I would have done were it not for work obligations?  I'd be living on egg shells for the years to come, waiting for that first puppy buyer to call.  Or worse still, what if the sire didn't have his first seizure until two months later, and I'd be looking at a whelping box full of adorable puppies who would never find homes?  All scenarios that make me cringe and reconsider why even breed dogs at all.  The reason that I do, and will ultimately breed again, is that I hope that I can make a difference.  I do now lie in bed and wonder how many other breeders have found themselves in the same nightmare I faced?  What did they do?