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rec.pets.dogs: Canine Epilepsy FAQ



 
 
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Default rec.pets.dogs: Canine Epilepsy FAQ

Archive-name: dogs-faq/medical-info/epilepsy
URL: http://www.k9web.com/dog-faqs/medical/epilepsy.html
Last-modified: 10 Nov 1997

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Canine Epilepsy

Author

Alicia Wiersma-Aylward )
Copyright 1995.

Table of Contents

* Introduction
* Types of Epilepsy
* Types of Seizures
* What is a "seizure threshold"?
* Stages of a Seizure
* Diagnosing Epilepsy
* Treatment
* Monitoring Drug Treatment
* Why Treatment Fails
* Alternative Therapies
* Parting Considerations
* References
* Acknowledgements

__________________________________________________ _______________

Introduction

It happened without warning. One moment my young male Belgian
Tervueren was snuggling against me as I sat on the couch; the next
moment he lost control of his hindquarters and fell onto his side,
unconscious. His lips writhed back over his teeth; his legs stretched
out, then became rigid; and his head twisted up and back as if an
unseen hand was trying to raise his chin to an impossible height. It
seemed like an eternity, but actually only two minutes passed before
his body relaxed and consciousness slowly ebbed back. For an hour
afterward he seemed exhausted and disoriented. I was shaken too, never
having witnessed such a seizure before. Yet later that day the dog was
romping about as if nothing out of the ordinary had occurred.

My dog is lucky. His seizures have been few and far between. We now
believe they are caused by hypothyroidism. Other dogs are not so
lucky. Seizures can be severe and frequent. They may occur in
"clusters" (several in one day), or progress to the life-threatening
state of status epilepticus. In extreme cases where seizures cannot be
controlled, a veterinarian may advise euthanasia.

Epilepsy is found in all breeds and mixed breeds of dogs. Belgian
Tervueren are listed among the breeds for which a genetic factor is
either proved or highly suspected. Other breeds so listed include the
Beagle, Dachshund, German Shepherd Dog, (Alsatian), and Keeshond. A
high incidence of seizure disorders is also found in Boxers, Cocker
Spaniels, Collies, Golden Retrievers, Irish Setters, Labrador
Retrievers, Miniature Schnauzers, Poodles, Saint Bernards, Siberian
Huskies, and Wire-Haired Terriers. (Oliver, Seizures). The prevalence
of epilepsy in the general dog population has been estimated at .5 to
5.7%. (Koestner, Cunningham).

A progress report on the epilepsy survey conducted by the American
Belgian Tervuren Club in cooperation with John Oliver, Jr., DVM in
1983 found that 57 (21%) of the 268 Tervueren studied had suffered
more than one seizure. The authors of that report concluded, "At this
time, we believe there is sufficient evidence for the probable genetic
basis of seizures in Tervuren to warrant concern on the part of
breeders". (Mahaffey). Unfortunately, this survey was discontinued.

The term "epilepsy" can be confusing because some authors use it to
describe recurrent seizures of any etiology (cause), while others use
it to specify recurrent seizures unrelated to brain disorders or
underlying disease processes. (Shell, Understanding). The definitions
below are helpful in distinguishing types of epilepsy.

Types of Epilepsy

Primary epilepsy: also known as idiopathic, genetic, inherited, or
true epilepsy. There are no positive diagnostic findings that will
substantiate the diagnosis. It is a case of ruling out every other
possibility. The first seizure in a dog with primary epilepsy usually
occurs between the ages of 6 months and 5 years. (Oliver, Seizures).
However, a diagnosis of primary epilepsy is not proof of a genetic
defect; only careful breeding studies could prove that. The breed, the
age, and the history may suggest a genetic basis for primary epilepsy
if there is a familial history of seizures.

Secondary epilepsy refers to seizures for which a cause can be
determined, and there are many. In dogs less than one year of age, the
most commonly-found causes of seizures can be broken down into the
following classes: degenerative (storage diseases); developmental
(hydrocephalus); toxic (lead, arsenic, organophosphates, chlorinated
hydrocarbons, strychnine, tetanus); infectious (distemper,
encephalitis, and others); metabolic (such as transient hypoglycemia,
enzyme deficiency, liver or kidney failure); nutritional (thiamine,
parasitism); and traumatic (acute injury). In dogs 1-3 years of age, a
genetic factor is most highly suspected. In dogs 4 years of age and
older, seizures are commonly found in the metabolic (hypoglycemia,
cardiovascular arrhythmia, hypocalcemia, cirrhosis) and neoplastic
(brain tumor) classes. (Oliver, Seizure). Dr. Jean Dodds has mentioned
that seizures are also associated with hypothyroidism, which is a
familial (inherited) autoimmune disease of purebred dogs.

Types of Seizures

The types of seizures most commonly reported are listed below. If you
believe your dog is having a seizure, it is important to note all the
details so that you may accurately describe it to your veterinarian.
Types of seizures include:

Generalized Seizu Tonic-clonic (may be Grand Mal or Mild): In the
grand mal seizure, the tonic phase occurs as the animal falls, loses
consciousness, and extends its limbs rigidly. Respiration also stops
(apnea). This phase usually lasts 10-30 seconds before the clonic
phase begins. Clonic movements include paddling of the limbs and/or
chewing. Other signs that appear during the tonic or clonic phase are
dilation of the pupils, salivation, urination, and defecation. The
mild seizure involves little or no paddling or extension of limbs, and
usually no loss of consciousness. Generalized seizures are usually
associated with primary epilepsy.

Petit Mal Seizure (aka Absence Seizure): Depending on the authority
quoted, petit mals are described as either very rare or usually
unrecognized in animals. Signs are brief (seconds) duration of
unconsciousness, loss of muscle tone, blank stare, and possibly upward
rotation of eyes. According to one authority (Kay), the term petit mal
is misused by veterinarians and should only be accorded to cases
manifesting very specific clinical signs and EEG abnormalities.

Partial Seizures: Movements are restricted to one area of the body,
such as muscle jerking, movement of one limb, turning the head or
bending the trunk to one side, or facial twitches. A partial seizure
can progress to (and be mistaken for) a generalized tonic-clonic
seizure, but the difference can be established by noting whether or
not a seizure starts with one specific area of the body. Partial
seizures are usually associated with secondary epilepsy.

Complex Partial Seizures (aka Psychomotor or Behavioral) Seizures: are
associated with bizarre or complex behaviors that are repeated during
each seizure. People with complex partial seizures experience
distortions of thought, perception or emotion (usually fear),
sometimes with unusual visual, olfactory, auditory and gustatory
sensations. If dogs experience the same things, it may explain the
lip-smacking, chewing, fly biting, aggression, vocalization,
hysterical running, cowering or hiding in otherwise normal animals.
Vomiting, diarrhea, abdominal distress, salivation, blindness, unusual
thirst or appetite, and flank biting are other signs. There is an
obvious lack of awareness though usually not lack of consciousness.
Abnormal behaviors may last minutes or hours and can be followed by a
generalized seizure. Complex partial seizures are usually associated
with secondary epilepsy.

Cluster Seizures: Multiple seizures within a short period of time with
only brief periods of consciousness in between. May be confused with
status epilepticus.

Status Epilepticus: Status can occur as one continuous seizure lasting
30 minutes or more, or a series of multiple seizures in a short time
with no periods of normal consciousness. It can be difficult to tell
status epilepticus from frequent cluster seizures; but both are
considered life-threatening emergencies. Most status patients usually
suffer from generalized tonic-clonic seizures. Though status
epilepticus can occur with either primary or secondary epilepsy, it
may also suddenly arise in dogs with no previous history of seizures
(traumatic brain injury, toxins, or disease). (Dyer & Shell,
Managing).

What is a "seizure threshold"?

Dr. Alexander de Lahunta of Cornell University and others suggest that
each animal inherits a "genetically determined predisposition to
seizures", and that seizures occur when this threshold is exceeded.
(Cunningham, Inherited). In other words, a physical condition (see
examples under section on secondary epilepsy above) which may cause
seizures in a low-threshold animal may not cause seizures in a
"normal" animal.

The seizure threshold is apparently exceptionally low in animals that
suffer from idiopathic (primary) epilepsy. (de Lahunta). An animal's
threshold can also be altered by other means. Certain types of
tranquilizers (e.g. acepromazine) may induce seizures in animal with a
low threshold. The medical condition of alkalosis is reported to
decrease the threshold. (Shell, Differential)

Karen R. Dyer, DVM, PH.D, and Linda G. Shell, DVM, Dilp. ACVIM, note
that there is "convincing experimental evidence" that repetitive
seizures can "irreversibly lower the seizure threshold" in a process
called kindling. William Fenner, DVM and Julie Haas, DVM, describe
kindling as a mechanism in which epileptic neurons in the brain
"recruit" normal neurons into the original seizure focus, enlarging
the area of the brain that can produce seizures. Linda Shell, DVM
describes kindling as the "increased excitability of neurons", and
notes that normal neurons, sufficiently stimulated, become
increasingly able to cause seizures independent of outside
stimulation.

The mirror focus phenomenon also deserves mention. Each hemisphere of
the brain is a "mirror image" of the other. A seizure focus on one
side of the brain will show itself as abnormal wave forms on EEG
recordings. Within a period of weeks, the "normal" side of the brain
will start to show similar EEG abnormalities. In time, the mirror
focus becomes capable of causing seizure activity on its own. Thus,
repetitive, uncontrolled seizures also lower the seizure threshold in
any given animal. That is why early intervention is so important in
the control of seizures.

Stages of a Seizure

There are 4 basic stages to a seizu 1) the prodome, 2) the aura or
preictus, 3) the ictus or seizure stage, and 4) the postictus.

1) The prodome may precede the actual seizure by hours or days. It is
characterized by a change in mood or behavior. Human epileptics
experience mood changes, headaches, insomnia or feelings about the
impending seizure. It is not known whether animals experience a
prodome except for any behavioral changes observed by their owners.

2) The aura signals the start of the seizure. Signs include
restlessness, nervousness, whining, trembling, salivation, affection,
wandering, hiding, hysterical running, and apprehension.

3) The ictus is the actual seizure, characterized by sudden increase
in tone of all muscle groups. The ictus is either tonic or
tonic-clonic, generally lasting from 1-3 minutes.

4) The postictus may be the only sign of epilepsy the owner sees,
particularly since many seizures occur at night or early in the
morning. For minutes to days after the seizure, the dog may be
confused, disoriented, restless, or unresponsive, or may wander or
suffer from transient blindness. At this stage the animal is conscious
but not functional. (Shell, Understanding; Kay; Oliver, Seizures).

What can you do when your dog seizures? Note the time to determine how
long the seizure lasts. Keep the dog as quiet as possible. Loud or
sharp noises may prolong the seizure or make it worse. Other dogs
should be removed from the area, as they may disturb or attack the
seizuring dog. Should you attempt to comfort the animal? Opinions on
this vary. My own dog is comforted by my presence and looks for me as
he returns to consciousness. I make a point of calmly maintaining
physical and voice contact with him throughout the seizure and during
recovery.

Diagnosing Epilepsy

What do you do if you think your dog has had a seizure? Veterinarians
have a number of diagnostic tools at their disposal.

For dogs who have had only one isolated seizure, a complete physical
and neurological examination is in order. Owners will be advised to
watch for further seizures if no abnormalities are found. Medical
treatment will not be instituted until future activity can be noted.

For every patient having more than one seizure, a minimum data base
should be developed. The data base contains the patient's profile,
history, results of complete physical and neurological examinations,
and basic tests. The profile consists of the dog's breed, age, and
sex. Pertinent history includes vaccinations, potential exposure to
toxins, diet, any illnesses or injuries, behavioral changes, and
whether seizures occurred in any animal related to the dog.

Owners are also asked to give a complete description of the seizures:
frequency, duration, and severity, as well as any behavioral
abnormalities associated with them. An accurate description is
important because there are other conditions with symptoms that mimic
seizures, such as cardiac and/or pulmonary disease, narcolepsy,
cataplexy, myasthenia gravis, and metabolic disturbances.

Among the recommended tests a CBC, urinalysis, BUN, ALT, ALP,
calcium, fasting blood glucose level, serum glucose level, serum lead
level, fecal parasite or ova examination, and others if indicated.
When the results of the examinations and tests have been analyzed, one
of three conclusions will be drawn: a definitive diagnosis, a
potential cause of seizures requiring further tests to confirm, or no
suggestion of a cause.

When further tests are required a complete date base should be done.
This may include computed tomography or magnetic resonance imaging;
CSF analysis (cell count, protein levels, pressure), skull
radiographs, and an EEG.

Treatment

Medical treatment is generally advised for animals who have one or
more seizures per month. Animals who have cluster seizures or go into
status epilepticus may be treated even though the rate of incidence is
greater than once per month. Successful drug therapy depends upon the
owner's dedication to delivering the drug exactly as prescribed, with
absolutely NO changes in the dose or type of medication without
veterinary consultation. Haphazard drug administration or abrupt
changes in medication is worse than no treatment at all, and may cause
status epilepticus.

William Thomas, DVM, MS feels it important to remember that the goal
of treatment is to decrease the frequency and severity of seizures and
avoid unacceptable side effects. It may not be possible to stop the
seizures altogether. A number of drugs and some alternative therapies
may be used to control epilepsy. Phenobarbitol and primidone are the
most widely used anticonvulsant drugs, but others have their place in
treatment as well.

Phenobarbitol is one of the most commonly prescribed drugs. Frey
reports that while dogs rapidly develop tolerance to the sedative and
hypnotic effects of phenobarbitol, at high concentrations tolerance
may be lost and persistent depressive side effects may appear. Dogs
may eat or drink more than their usual amounts. Liver function can be
impaired. When use of the drug is terminated, signs of physical
dependence (tremors, incoordination, restlessness, seizures) may
develop. There is danger of triggering status epilepticus during
withdrawal. To avoid this, dosages should be gradually reduced in
small steps over a prolonged period.

Primidone's side effects include sedation when treatment is initiated,
and eating or drinking more than usual. High concentrations of liver
enzymes have been reported with prolonged treatment at high dosages.

Diazepam (Valium) is used for treatment of status epilepticus.
Phenytoin (Dilantin), carbamazine, and valproic acid are not currently
recommended for use.

Potassium bromide (KBr) is gaining new recognition for use in
refractory (difficult to control) canine epilepsy, though used to
treat human epileptics as early as 1857. It is the anticonvulsant of
choice for dogs with liver disease. Sodium bromide is preferred for
dogs with kidney problems. Combining potassium bromide or sodium
bromide and phenobarbitol may be useful for patients who do not
respond well to phenobarbital or primidone alone.

One recent study (Pearce) reported that 10 dogs who had uncontrolled
seizures with phenobarbitol alone had improved control with the
addition of potassium bromide to their drug regimen. The severity of
the seizures and the tendency to cluster were significantly decreased.
An earlier study by Professor Dorothea Schwartz-Porsche
(Sisson/LeCouteur) reported that 5 of 9 epileptics uncontrolled by
phenobarbitol responded to the addition of potassium bromide to either
phenobarbitol or primidone. Podell and Fenner reported that bromide
therapy improved seizure control in 83% of dogs previously unimproved
by phenobarbitol; 26% of the 83% dogs became totally seizure free.

Bromide is not approved for use in dogs, nor is it commercially
available at this time. Veterinarians can obtain it from chemical
supply houses as an American Chemical Society reagent, which dissolves
in water and is added to the dog's food. Dog owners are asked to sign
release forms and are advised to handle the drug with gloves. Thomas
notes that some custom pharmacies will now formulate bromide in
capsules or suspension so the veterinarian doesn't have to.

Side effects of bromide toxicity (bromism) can include incoordination,
depression, muscle pain, and stupor. There are no dermatologic or
gastrointestinal signs as seen in humans taking KBr.

Monitoring Drug Treatment

In order for any drug therapy to be effective, the amount of drug
found in the body (serum concentration) must be consistently
monitored. No two animals may react to the same dose in the same way.
Farnbach reports a sixfold variation in the ratio between daily dosage
and serum concentration was demonstrated in a large population of
epileptic dogs. In 3 dogs given roughly the same dose of
phenobarbitol, one dog's condition did not change, the second dog
achieved seizure control, and the third dog experienced toxicosis. The
amount of drug found in the body correlates much better with seizure
control than daily dosage.

If your dog is on medication, work with your veterinarian in observing
your dog and testing his/her serum levels to ensure he/she is
receiving the appropriate amount of drug to achieve control and avoid
side effects.

Why Treatment Fails

There are many reasons why medical treatments can fail. The biggest
reason is the owner's lack of proper administration of the prescribed
drug. The progression of an underlying disease (such as brain tumor)
may resist treatment. Also, gastrointestinal disorders can affect drug
absorption, and tranquilizers may stimulate seizures. Drug
interactions can occur and adversely affect the level of
anticonvulsant drug in the dog's system. And it just might be that a
particular drug may not work for that animal. (LeCouteur).

Alternative Therapies

These range from acupuncture to vitamin therapy. Traditional
acupuncture therapy for epileptic dogs involves the placement of
needles in up to 10 areas of the body. Needles can be left in place
from 20 minutes to over a month.

Acupuncture is not usually considered a substitute for drug therapy,
but is used in conjunction with them. Of 5 dogs with intractable
epilepsy, followed after gold bead implants in acupuncture points, 2
dogs relapsed after five months. Two reports of epileptic dogs given
acupuncture in the ear (Shen-men point) are more positive. One dog
enjoyed a six-fold increase in time between seizures; the other was
seizure-free for 200 days after a previous history of monthly
seizures. (Joseph, van Niekerk).

Holistic veterinarian Roger DeHaan, DVM states that some forms of
epilepsy respond to supplementation of vitamin B6, magnesium, and
manganese. Drs. Wendell Belfield and Martin Zucker stated that "It has
long been known that a deficiency of vitamin B6 or any interference
with its function can cause seizures in any mammalian species,
including man and dog".

Parting Considerations

If your dog is experiencing either mild or severe seizures, there is
help for both of you. Work with a veterinary professional with whom
you feel a good rapport, and educate yourself on seizures and their
treatment. Follow the vet's instructions, never change medication or
dosages without a consultation, be observant, monitor serum levels as
recommended, have patience and be willing to try another form of
treatment if that seems indicated. Above all, if your breed club
sponsors a health registry or research project on seizures or epilepsy
in your breed, participate fully in it. New research on epilepsy is
being done each year in an effort to determine how it's inherited and
ultimately, to design a test that will allow breeders to select
against this health defect.

References

Bell, DVM, Jerold: Telephone conversation, December 1993.

Bielfelt, S.W. MS, H.C. Redman DVM, and R.O. McClellan DVM: Sire-and
Sex-Related Differences in Rates of Epileptiform Seizures in a
Purebred Beagle Dog Colony. American Journal Veterinary Research,
32:2039-2048, 1971.

Cunningham, James G. DVM Ph.D. and George C. Farnbach VMD Ph.D.:
Inheritance and Idiopathic Canine Epilepsy. Journal of the American
Animal Hospital Association, February 1987, pp. 421-424.

DeHaan, Roger L. DVM MTS: Natural Care of Pets. Articles published
by Dr. DeHaan, Holistic Veterinary Services, Haverill, Massachusetts.

de Lahunta, Alexander DVM Ph.D: Special Report - Seizures: How They
Happen and What You Can Do. (Handout).

Dodds, W. Jean DVM: Letter to the Editor, Pointer Points, Spring
1992.

Dyer, Karen R. DVM Ph.D and Linda G. Shell DVM Dipl. ACVIM:
Anticonvulsant Therapy: A practical guide to medical management of
epilepsy in pets. In Symposium on Seizure Disorders, Veterinary
Medicine, July 1993, pp. 647-653.

Dyer, Karen R. DVM Ph.D. and Linda G. Shell DVM Dipl. ACVIM.
Managing Patients with Status Epilepticus. Veterinary Medicine, July
1993, pp. 654-659.

Falco, Marsha J., John Barker, and Margaret E. Wallace: The Genetics
of Epilepsy in the British Alsatian. Journal Small Animal Practice,
15:685-692, 1974.

Farnbach, George C. VMD Ph.D.: Seizures in the Dog. Part I. Basis,
Classification, and Predilection. The Compendium of Continuing
Education, Cont. Ed. Article #6, 6:6, 569-574, 1984.

Farnbach, George C. VMD Ph.D.: Seizures in the Dog. Part II.
Control. The Compendium of Continuing Education, Cont. Ed. Article #5,
7:6, 505-510, 1985.

Fenner, William R. DVM and Julie A. Haas DVM: Mechanisms of Seizure
Disorders. Problems in Veterinary Medicine, 1:4, 501- 516, 1989.

Frey, H.H. DMV: Anticonvulsant Drugs Used in the Treatment of
Epilepsy. Problems in Veterinary Medicine, 1:4, 558-577, 1989.

Hendricks, Jan: Epilepsy in the Belgian Tervueren. In Tervueren News
Tales, newsletter of the American Belgian Tervueren Club, March 1987,
pp. 19-21.

Joseph, Richard DVM: Neurologic Evaluation and its Relation to
Acupuncture. Problems in Veterinary Medicine, 4:1, 98-206, 1992.

Kay, William J. DVM: What is Epilepsy? Problems in Veterinary
Medicine, 1:4, 495-500, 1989.

Koestner, Adalbert DVM Ph.D.: Neuropathology of Canine Epilepsy.
Problems in Veterinary Medicine, 1:4, 516-534, 1989.

Kornegay, Joe N. and Stephen B. Lane: Seizures. Chapter 15 in
Textbook of Veterinary Internal Medicine, 3rd edition.

LeCouteur, Richard A. BVSc Ph.D., and Georgina Child, BVSc: Clinical
Management of Epilepsy of Dogs and Cats. Problems in Veterinary
Medicine, 1:4, 578-595, 1989.

Mahaffey, Mary DVM: Epilepsy in the Tervueren. In Tervueren News
Tales, newsletter of the American Belgian Tervueren Club. Fall 1980,
pp. 9-10.

Miller, Libbye DVM: Epilepsy. Parts I and II. Pointer Points, Spring
1992.

Oliver, John E. Jr., Kevin McElfresh, Mary Mahaffey: Epilepsy in the
Tervueren: Progress Report. In Tervueren News Tales, newsletter of the
American Belgian Tervueren Club, April, 1983, p. 2.

Oliver John E. Jr., Michael D. Lorenz: Chapter 14, Seizures and
Narcolepsy. Handbook of Veterinary Neurology, 2nd edition, W.B.
Saunders, Philadelphia, PA, 1993.

Parent, Joanne M., BSc, DVM, MVSc: Clinical Management of Canine
Seizures. Veterinary Clinics of North America: Small Animal Practice,
18:4, 947-964, 1988. (Note: Joanne Parent is now conducting a EEG
study of epilepsy in Belgians at the University of Guelph, Canada).

Pearce, Laurie, DVM: Potassium Bromide as an Adjunct to
Phenobarbitol for the Management of Uncontrolled Seizures in the Dog.
Progress in Veterinary Neurology, 1:1, 95-101, 1990.

Podell, M., and Fenner, W.R. Bromide Therapy in Refractory Canine
Epilepsy. Journal of Veterinary Internal Medicine, 7:318- 327, 1993.

Shell, Linda G., DVM Dipl. ACVIM: The Diagnostic Approach to
Seizures. In Symposium on Seizure Disorders, Veterinary Medicine, July
1993, pp. 641-646.

Shell, Linda, G., DVM Dipl. ACVIM: The Differential Diagnosis of
Seizures. In Symposium on Seizure Disorders, Veterinary Medicine, July
1993, pp. 629-640.

Shell, Linda G., DVM Dipl. ACVIM: Understanding the Fundamentals of
Seizures. in Symposium on Seizure Disorders, Veterinary Medicine, July
1993, pp. 622-628.

Sisson, Allen, DVM MS and Richard A. LeCouteur BVSc Ph.D. Letter to
the Editor Potassium Bromide as an Adjunct to Phenobarbitol for
the Management of Uncontrolled Seizures in the Dog by Progress in
Veterinary Neurology, 1:2, 114-116, 1990.

Thomas, William B, DVM, MS. Email correspondence of 1/10/95.

Valrie, Gerard Ph.D. and Cliff Conarck DVM: Identifying the Cause of
an Early onset of Seizures in Puppies with Epileptic Parents.
Veterinary Medicine, November 1991, pp. 1060-1061.

Van der Velden, N.A: Fits in Tervueren Shepherd Dogs: a Presumed
Hereditary Trait. J. Small Anim. Practice 9:63-70, 1968.

van Niekerk, J. and GN Eckersley: The Use of Acupuncture in Canine
Epilepsy. Journal of the South African Vet Association, 59:1, 5, 1988.

Wallace, Margaret E.: Keeshonds: A Genetic Study of Epilepsy and EEG
Readings. J. Small Animal Practice, 16:1-10, 1975.

Wilcock, Brian DVM: Genetic Diseases of the Belgian Shepherd Dogs.
In Tervueren News Tales, newsletter of the American Belgian Tervueren
Club. April 1990, pp. 14-16 (reprinted from Belgian Sheepdog Club of
American newsletter, Summer 1989).

Yohn, Susan E. DVM MS, Wallace B. Morrison DVM MS, and Patrick E.
Sharp DVM: Bromide Toxicosis (bromism) in a dog treated with potassium
bromide for refractory seizures. JAVMA, 201:3, 468-470, 1992.

Acknowledgements

Without the encouragement, support, and wisdom of the following people
and organizations, this article would not have been possible.
* Debbie Eldredge, DVM, Vernon, New York
* JoAnne LaFear, University of Maine-Augusta
* Barbara Licht, Ph.D., Florida State University
* Libbye Miller, DVM, Elizabethtown, Kentucky
* Alan Pothoff, DVM, Portland, Maine
* Jerold Bell, DVM, Enfield, Connecticut
* Alexander de Lahunta, DVM, Ph.D., Cornell University
* Paul R. Lennard, Ph.D., Emory University
* Kansas State University Information & Documentation Services
* United Belgian Shepherd Dog Association (UBSDA)/UKC
* University of Southern Maine

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Alicia Wiersma-Aylward )

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