International veterinary epilepsy task force consensus proposal: outcome of therapeutic interventions in canine and feline epilepsy

Abstract

Common criteria for the diagnosis of drug resistance and the assessment of outcome are needed urgently as a prerequisite for standardized evaluation and reporting of individual therapeutic responses in canine epilepsy. Thus, we provide a proposal for the definition of drug resistance and partial therapeutic success in canine patients with epilepsy. This consensus statement also suggests a list of factors and aspects of outcome, which should be considered in addition to the impact on seizures. Moreover, these expert recommendations discuss criteria which determine the validity and informative value of a therapeutic trial in an individual patient and also suggest the application of individual outcome criteria. Agreement on common guidelines does not only render a basis for future optimization of individual patient management, but is also a presupposition for the design and implementation of clinical studies with highly standardized inclusion and exclusion criteria. Respective standardization will improve the comparability of findings from different studies and renders an improved basis for multicenter studies. Therefore, this proposal provides an in-depth discussion of the implications of outcome criteria for clinical studies. In particular ethical aspects and the different options for study design and application of individual patient-centered outcome criteria are considered.

Fig. 1

Categorization of seizure control. Seizure freedom is the primary treatment goal in the therapeutic management of canine and feline epilepsy patients. The additional category of partial therapeutic success takes into account that the prevention of seizure clusters or status epilepticus, and a reduction in seizure frequency or seizure severity can be of significant clinical relevance in veterinary patients