QUARTERLY BEAT / DECEMBER 2025
COMMON DIFFERENTIALS
OF FELINE SEIZURES
AND MANAGEMENT
Missy Carpentier, DVM, DACVIM (Neurology) Minnesota Veterinary Neurology, Columbus, MN Cats commonly present to both general practice and referral centers due to seizures. For a long time, it was thought that if a cat has a history of seizures, then they must have something sinister occurring in their brain. Luckily, we now know that this is not often the case. Though we rarely see true idiopathic or genetic epilepsy in cats due to the decreased presence of purebred cats in practice, it is important for veterinarians to know that up to 22-54% of cats presenting with seizures are secondary to epilepsy of unknown cause (EUC), and in most cases we are successfully able to manage their seizures. The clinical picture of epileptic cases varies considerably, but the ultimate goal for every patient is the same - good seizure control with a good quality of life. This discussion will summarize my general approach to the feline epileptic patient, reviewing the initial evaluation, differential diagnosis, diagnostics, and treatment. SIGNALMENT It is important to know that a complete work up should be recommended for any cat that has seizures, regardless of age. It is, however, important to pay attention to the age and breed of the cat to help you start to think about possible differentials for the seizures. Remember, until you officially neurolocalize your patient based on the neurologic examination, you cannot finalize your list of differentials! Some top differentials that you should consider for a cat less than 1 year of age with seizures would include metabolic disease (a portosystemic shunt), degenerative, developmental, toxin, or inflammatory brain disease. For an older cat (greater than 10 years of age) that is presenting for seizures, neoplasia or a cerebrovascular accident need to be high on your differential list, but these are not the only differentials! For purebred cats, you need to have developmental or degenerative high on your list. HISTORY The history that the owners provide is invaluable. One of the first obstacles that you face with a seizure patient is whether or not that patient is truly experiencing seizures. There is a wide variety of seizures, and unfortunately, many of them are not the classic tonic-clonic seizure that makes identification easy, and this is particularly true for cats. Cats can
Struggling with how to approach feline seizure management? In this VETgirl article, Dr. Missy Carpentier, DACVIM (Neurology), walks you through a step-by-step process for evaluation and treatment of feline seizures. From diagnostic workup to therapeutic options, read on for practical strategies to better diagnose and manage seizures in your feline patients.
present with any type of seizure, however, two of the most common types of seizures in cats include focal and orofacial, and these can sometimes be difficult to identify. That is why it is extremely important that the owners describe the seizure to you in detail, to identify the type of seizure they possibly are having, and to recognize any signs that may not be related to a seizure. I commonly see patients presenting with a complaint of seizures, but after gathering further information from the owners, they are diagnosed with neck pain, vestibular disease, syncope, etc. It is also important to recognize that an owner may give you a perfect description—or, even better, have a video of the episode in question—and you still are left uncertain if it truly is seizure activity or not. In these cases, often times it is best to use the clinical signs that are present before or after the suspect seizure to help you identify if the episode in question was a possible seizure.
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