Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Jan-Feb;38(1):19-40.
doi: 10.1111/jvim.16928. Epub 2023 Nov 3.

ACVIM Consensus Statement on the management of status epilepticus and cluster seizures in dogs and cats

Marios Charalambous  1 , Karen Muñana  2 , Edward E Patterson  3 , Simon R Platt  4 , Holger A Volk  1
Affiliations

ACVIM Consensus Statement on the management of status epilepticus and cluster seizures in dogs and cats

Marios Charalambous et al. J Vet Intern Med. 2024 Jan-Feb.

Abstract

Background: Seizure emergencies (ie, status epilepticus [SE] and cluster seizures [CS]), are common challenging disorders with complex pathophysiology, rapidly progressive drug-resistant and self-sustaining character, and high morbidity and mortality. Current treatment approaches are characterized by considerable variations, but official guidelines are lacking.

Objectives: To establish evidence-based guidelines and an agreement among board-certified specialists for the appropriate management of SE and CS in dogs and cats.

Animals: None.

Materials and methods: A panel of 5 specialists was formed to assess and summarize evidence in the peer-reviewed literature with the aim to establish consensus clinical recommendations. Evidence from veterinary pharmacokinetic studies, basic research, and human medicine also was used to support the panel's recommendations, especially for the interventions where veterinary clinical evidence was lacking.

Results: The majority of the evidence was on the first-line management (ie, benzodiazepines and their various administration routes) in both species. Overall, there was less evidence available on the management of emergency seizure disorders in cats in contrast to dogs. Most recommendations made by the panel were supported by a combination of a moderate level of veterinary clinical evidence and pharmacokinetic data as well as studies in humans and basic research studies.

Conclusions and clinical relevance: Successful management of seizure emergencies should include an early, rapid, and stage-based treatment approach consisting of interventions with moderate to preferably high ACVIM recommendations; management of complications and underlying causes related to seizure emergencies should accompany antiseizure medications.

Keywords: cat; dog; emergency seizure disorders; treatment.

PubMed Disclaimer

Conflict of interest statement

Karen Muñana consults for MesaGreen Pharmaceuticals and Teliatry Inc, and Holger Volk for Purina and DomesPharma. No other authors declare a conflict of interest.

Figures

FIGURE 1
FIGURE 1
Illustration of the SE stages and their differences regarding underlying pathophysiological processes involved and sensitivity to the drugs used.
FIGURE 2
FIGURE 2
Pyramid of hierarchy regarding antiseizure therapy recommendations for SE in dogs.
FIGURE 3
FIGURE 3
Pyramid of hierarchy regarding antiseizure therapy recommendations for SE in cats.
FIGURE 4
FIGURE 4
Pyramid of hierarchy regarding antiseizure therapy recommendations for CS in dogs.
FIGURE 5
FIGURE 5
Pyramid of hierarchy regarding antiseizure therapy recommendations for CS in cats.
FIGURE 6
FIGURE 6
The long‐ and short‐term plan for the management of CS in dogs and cats.
FIGURE 7
FIGURE 7
ACVIM therapeutic approach proposal in SE according to the stage.
See this image and copyright information in PMC

References

    1. Bateman SW, Parent JM. Clinical findings, treatment, and outcome of dogs with status epilepticus or cluster seizures: 156 cases (1990‐1995). J Am Vet Med Assoc. 1999;215:1463‐1468. - PubMed
    1. Fentem R, de Stefani A, Quintana RG, et al. Risk factors associated with short‐term mortality and recurrence of status epilepticus in dogs. J Vet Intern Med. 2022;36:656‐662. - PMC - PubMed
    1. Zimmermann R, Hulsmeyer V, Sauter‐Louis C, et al. Status epilepticus and epileptic seizures in dogs. J Vet Intern Med. 2009;23:970‐976. - PubMed
    1. Charalambous M. Management of cluster seizures and status epilepticus in dogs and cats. In: de Risio L, Munana K, eds. A practical guide to seizure disorders in dogs and cats. USA: In, Edra; 2022.
    1. Charalambous M, Bhatti SFM, Volk HA, Platt S. Defining and overcoming the therapeutic obstacles in canine refractory status epilepticus. Vet J. 2022;283‐284:105828. - PubMed

Publication types

Substances