Comorbidities, long-term outcome and poststroke epilepsy associated with ischemic stroke - A multicenter observational study of 125 dogs

Abstract

Background: Little is known regarding the comorbidities and prognostic factors associated with the long-term outcome of ischemic stroke in dogs. Although poststroke epilepsy is a well-recognized syndrome in people, it is unclear if this phenomenon also occurs in dogs.

Hypothesis/objective: Document comorbidities, long-term outcome (survival and stroke recurrence), and occurrence of epileptic seizures associated with ischemic stroke.

Animals: One hundred and twenty-five client-owned dogs.

Methods: Multicenter observational study including dogs diagnosed with ischemic stroke between 2000 and 2021. Associations between comorbidities, stroke location and extent, poststroke epileptic seizures, and long-term outcome were investigated. Referring veterinarians and owners were contacted to obtain follow-up information.

Results: Fifty-two dogs (41.6%) had a comorbidity. The most common comorbidities were hypertension (20%) and proteinuria (8%). Eight dogs (6.4%) that did not survive to discharge had a territorial ischemic stroke. Overall median survival time for dogs with a comorbidity was 482 days (range, 1-3013) and 907 days (range, 1-3027) in dogs without comorbidities (Kaplan-Meier survival analysis P = .602). Twenty-four dogs (19.2%) had a suspected stroke recurrence and a total of 8/109 dogs (7.3%) developed poststroke epilepsy. No association was found between suspected stroke recurrence or development of poststroke epilepsy and survival (P = .812, P = .487).

Conclusions and clinical importance: Despite no significant difference in survival of dogs diagnosed with ischemic stroke, with or without comorbidities, investigations for underlying causes are recommended to provide appropriate treatment. Poststroke epilepsy is uncommon.

Keywords: cerebrovascular accident; comorbidities; ischemic infarct; prognosis; seizures.

FIGURE 1

Kaplan‐Meier survival curve in dogs diagnosed with ischemic stroke, with (blue line) or without (red line) a comorbidity. Crosses represent dogs that were lost to follow‐up or were alive at the time of follow‐up, which were censored from analysis.