104 | Everything the vet nurse needs to know about caring for seizure patients (ft Zoe Hatfield, VTS-Neurology)
Want to know how to manage seizures confidently as a veterinary nurse? Today we’re doing exactly that.
You’re listening to episode 104 of the Medical Nursing Podcast, and the final episode in our neurology mini-series! Today I’m delighted to welcome back Zoe Hatfield, a RVN and veterinary technician specialist in neurology, who is helping us understand common neurological conditions and how to manage them as vet nurses.
In this episode we’re chatting about one of the most common neurological issues we run into in practice - and probably one we aren’t super confident about managing as nurses - and that’s seizures. We’ll look at what seizures are, some of the common causes, and how our nursing skills can really benefit these patients.
So Zoe, perhaps you could start us off with what a seizure is, and why they happen?
A seizure is a sudden, transient episode of abnormal motor, sensory, or autonomic activity caused by temporary dysfunction in part or all of the brain.
There are lots of possible underlying causes, and treatment is aimed at reducing frequency, not curing the patient. Successful treatment should hopefully see a 50% reduction in seizure activity (so 10 seizures a month down to 5 would be considered a success).
Idiopathic epilepsy is one of the most common neurological conditions in dogs in the UK (around 1–2%). In these patients, quality of life matters just as much as seizure control, for both the patient and the caregiver, and as nurses we can have a huge role in ensuring this is the case.
So why do seizures happen?
Seizures happen due to a sudden, involuntary, hypersynchronous discharge of neurons in the brain. How the seizure manifests is dependent on which area of the brain it originates in or spreads to.
What we need to know (and should be asking our clients about):
Muscle tone: flaccid or rigid
Any involuntary facial movements?
Head tilt or head tremors?
Mental status: conscious or unconscious
Is one side worse than the other?
Autonomic signs: salivation, urination, defecation
Duration of the episode
Recovery: quick vs slow, and any post-ictal signs?
What might cause a seizure?
There are many causes, and we can divide these into intracranial (within the brain), or extracranial (outside the brain). If neither of these fit, the seizure cause would be classed as idiopathic.
Common intracranial causes include meningoencephalitis, brain tumours, and congenital malformations (such as hydrocephalus), and extracranial causes include hypoglycaemia, toxins and electrolyte imbalances. Idiopathic epilepsy is diagnosed by exclusion, with preed predispositions seen in Pugs, Border Terriers and Border Collies.
Let’s take a quick look at seizure terminology.
Before we move on and look at seizures in more detail, it’s worth explaining the common seizure terminology as there are many terms used to describe seizures:
Seizure: sudden onset event representing abnormal forebrain function
Generalised seizures: whole-body involvement
Convulsive: collapse, convulsions, loss of consciousness/awareness
Non-convulsive (atonic): sudden generalised loss of tone → collapse
Focal seizures: affect one area and may stay focal or generalise
Motor: e.g., facial twitching, repeated jerking head movement
Autonomic: e.g., hypersalivation
Behavioural: e.g., anxiousness, attention seeking
Epilepsy: recurrent seizures
Idiopathic epilepsy: recurrent seizures in young dogs (typically 1–6 years), diagnosis of exclusion
Cryptogenic epilepsy: recurrent seizures in older dogs (>6 years) with unremarkable work-up, presumed microscopic disease process
Structural epilepsy: seizures due to brain abnormality (tumours, trauma, infections)
Reactive seizures: seizures triggered by transient external disturbance (toxins, metabolic imbalance) with otherwise normal neuronal function. If we treat the cause, the seizures should cease
Cluster seizures: two or more seizures in up to 24 hours, patient normal in between. Higher risk of progressing to status epilepticus and often unlikely to stop without rescue medication. These patients need to be seen.
Status epilepticus (SE): seizure lasting >5 minutes, or multiple seizures without return to normal consciousness between episodes. These patients are at the highest risk for neuronal damage.
Tonic seizure: generalised rigidity
Clonic seizure: paddling/rhythmical convulsing
Tonic-clonic seizure: rigidity followed by paddling/jerking
Myoclonic seizure: brief muscle contractions (these can be generalised or focal)
Ok, so that’s why seizures happen and how we describe them. But how do we manage a seizure in an emergency?
The priority is stopping seizure activity quickly. The longer a patient is actively seizuring, the higher the risk of irreversible brain damage and systemic complications. Cluster seizures and SE are common neurological emergencies, with increased morbidity and mortality rates; the reported mortality rate for SE is 25.3-38.5%.
Seizures are an emergency when they’re prolonged and not self-limiting, or when they happen repeatedly close together. Traditionally, seizures are described as:
Brief: <5 minutes
Prolonged: 5–30 minutes
Historically, SE was described as >30 minutes, but because seizures lasting >5 minutes are more likely to continue and become non-self-limiting, a 5-minute cut-off time is now widely accepted. The goal of that 5-minute cut-off time is to minimise systemic and brain complications before prolonged activity develops, reduce worsening prognosis and drug resistance as uncontrolled seizure duration increases, and avoid repeated or prolonged intervention (including anaesthetic drugs) in patients with brief or self-limiting seizures.
These patients require rapid assessment and stabilisation.
Given the urgency to prevent systemic and neuronal damage, emergency treatment should be aimed at ceasing seizure activity. Veterinary nurses play a key role in this process, working under veterinary direction to rapidly stabilise these patients.
This involves a rapid triage assessment, and administration of (usually intravenous) antiepileptic drugs under veterinary direction. If IV access isn’t possible, rectal or intranasal benzodiazepines (usually midazolam or diazepam) can be administered.
Patients should also be handled in a calm manner throughout stabilisation, to avoid overstimulating them which may perhaps cause seizure activity to become prolonged.
Flow-by oxygen should also be provided if possible, since seizures increase metabolic demand and oxygen utilisation.
As the patient recovers they require careful handling, since unexpected aggression may be seen in the post-ictal phase.
As soon as the seizures stops, an IV catheter should be placed. Bloods should also be collected at that time, and as a minimum, blood glucose may be checked to exclude hypoglycaemia requiring urgent treatment. If point-of-care analysers are available, lactate and ammonia levels may also be assessed at this time. Remember, though, that the main purpose of IV access to facilitate the ongoing delivery of antiepileptic drugs, so further diagnostics need to wait until the patient is more stable..
Hyperthermia is common in seizuring patients due to increased muscle activity. If the patient’s rectal temperature exceeds 40oC we need to begin active cooling. This cooling should stop when they reach 39°C, because rebound hypothermia is common, particularly in sedated patients. Once temperature normalises, this should be monitored regularly.
Ideally, throughout this period another team member will be supporting the client and taking a thorough history. This is an incredibly stressful and emotive time, so ensuring they are supported as well as their pet is vital.
And once our patient is stable, it’s time to think about diagnostics.
Before we jump into a big seizure work-up, it’s really important that we make sure this was a true seizure and not a ‘seizure-like’ event.
If the client calls during an event, asking them to video it can be really helpful. This is particularly useful as many patients arrive with a normal neuro exam, meaning we have to rely on history and signalment to guide diagnostics. A video of the episode is therefore really helpful - and it gives the client something practical to do during what is a very stressful time.
When is further work-up needed?
If the patient has neurological deficits after the post-ictal period, such as behavioural changes, including post-seizure aggression, or if the patient is <1 year or >6 years old, diagnostics will be required.
These include bloodwork, urine analysis and advanced imaging. Additional tests such as EEG or CSF analysis may also be needed.
Let’s start by looking at the common blood tests we perform.
Bloods include basic haematology, biochemistry, and electrolytes to rule in or out metabolic causes for the seizure. Liver function tests such as a bile acid stimulation test and ammonia levels may be indicated to diagnose a portosystemic shunt causing hepatic encephalopathy.
In some cases, infectious disease testing (such as toxoplasma and neospora) may be required, depending on the patient’s clinical signs and imaging findings.
Genetic testing may also be indicated in some cases; this could include testing for tests such as CKCS episodic falling or Lafora disease. These tests are more likely in cases that do not fit the typical seizure presentation.
Patients diagnosed with epilepsy and started on anti-epileptic medications are likely to require regular blood testing, checking drug doses are within the therapeutic ranges, and ensuring there are no adverse effects (such as hepatotoxicity).
Then we have urine analysis.
Urinalysis may be performed to exclude systemic causes for the seizures. Additionally, quantitative urine organic acids may be requested to screen for organic acid accumulation suggesting metabolic defects.
And after this, our patient will need diagnostic imaging, and possibly CSF analysis.
MRI is usually the imaging modality of choice with these cases as it provides the highest quality images of the brain. It can show the presence of oedema, neoplasia, anomalous defects or inflammation which could cause the patient to present with seizures, and permits visual assessment of intracranial pressure.
Though it doesn’t provide as much detail as MRI, CT can also be useful, especially if there is a history of trauma for example.
After the MRI, CSF analysis is often indicated. The MRI images should be assessed to determine whether sample collection is safe before it is attempted. If appropriate, CSF will be collected to assess inflammation (e.g., MUO), support lymphoma investigation (including PARR testing), and infectious testing where indicated.
We may also perform other diagnostic tests where appropriate.
These include EEG and extracranial imaging.
EEG
EEG records brain electrical activity. It’s widely used in human medicine but isn’t as readily available in veterinary medicine, largely due to the higher risks of movement artefact and patient interference, and the need for specialist training and equipment. Even when EEG is performed, it may not capture seizure activity, or activity may be hard to differentiate from background interference.
Extracranial imaging
Depending on the individual patient, other imaging such as cardiac or abdominal ultrasound may be required. This allows us to investigate systemic causes, and to assess potential cardiac or renal damage after seizures.
After our patient’s diagnostics, we need to plan their ongoing treatment and nursing care.
And the first thing to mention is emergency seizure control.
Emergency treatment focuses on rapidly stopping convulsions by using either intravenous, rectal or intranasal benzodiazapines. Typically, Diazepam and Midazolam are considered the most appropriate first-line, fast-acting choices. If these are not enough then IV phenobarbital or levetiracetam are usually the next choice. If the patient still continues to seizure propofol may be considered, although we must remember we are inducing anaesthesia at this point.
Ketamine may also be given in those patients who continue to seizure, this is given in an attempt to stop the ‘snowball effect’ and hopefully allow for the seizures to become controlled.
Regardless of the drug protocol the vet selects, all members of the clinical team need to know where these drugs are, and how to access them quickly in an emergency.
Then we need to think about ongoing management.
The first thing we need to consider here is when is the appropriate time to start anti-epileptic medications?
It’s not recommended to start anti-epileptic drugs until there’s proof the seizures are recurrent. There are no set recommendations,, but treatment is often considered when:
One or more seizures occur every 6–8 weeks
Seizures are increasing in frequency or duration
Seizures are long or occur in clusters
Post-ictal signs are severe/dangerous (e.g., aggression)
A structural cause has been diagnosed
The veterinary surgeon will also consider any comorbidities the patient may have, and whether the episodes are truly seizures or not. And then, once these factors have all been considered, they’ll move on to which medication to choose. This depends on several factors, including:
Medication related factors, such as tolerability, efficacy, formulation, dose, expense and safety;
Patient related factors, such as the type, frequency and cause of the seizures, as well as comorbidities and concurrent medications;
Client related factors, such as lifestyle, finances, and their ability to cope with side-effects.
There are several anti-epileptic medications available - and we’re going to spend the next few minutes looking at the ones we use most commonly.
First, we have phenobarbital.
This is a first line antiepileptic drug which provides good control of seizures in 60-80% of cases.
It is viewed as the most powerful and most effective anticonvulsant, taking 10-14 days to reach peak blood concentration levels.
Serum phenobarbitone levels should be monitored regularly; this is usually done at 2 weeks, 6 weeks and then every 6 months if doing well. It is important to note that phenobarbital can induce its own metabolism, sometimes referred to autoinduction, and this is why bloods are advisable at the 6 week mark. If a patient presents with increased seizure activity, clusters or status it is also advisable to recheck blood serum levels. Phenobarbital undergoes hepatic metabolism, so additional bloods are advisable to ensure drug is not causing issues with the liver.
Expected side effects include sedation, ataxia, polydipsia, and polyphagia - these may improve with time but may be permanent. Hepatotoxicity, neutropenia, thrombocytopenia and/or anaemia, as well as skin changes, may be seen in rare cases.
Then we have potassium bromide.
This can be used as monotherapy or as an adjuvant therapy.
It has a long elimination half-life, meaning it allows for once-daily dosing. This may be beneficial for clients who struggle to give medications multiple times a day, however, this long half-life also means that it takes up to 3 months to reach steady concentrations in the body.
Like phenobarbital, regular bloods are required, to monitor serum concentration levels.
Common side effects include PUPD, polyphagia, ataxia, Behavioural abnormalities, and sedation. If the patient is on both phenobarbital and bromide, pancreatitis may be seen. Megaoesophagus may also occur, which can lead to aspiration pneumonia if not diagnosed quickly.
Diet is also very important in patients treated with bromide. Potassium bromide is excreted in the urine, which means the bromide competes with chloride for renal tubular reabsorption. This means that alterations in chloride intake can affect serum bromide concentrations. Changes in salt intake can therefore affect blood concentration levels, and clients should be told not to switch their pet’s diet, and to monitor their treat intake carefully. Care should also be taken if the patient is playing or swimming in the sea, due to the high concentrations of chloride in salt water.
In cats, potassium bromide should be avoided as it can cause lower airway disease and severe respiratory signs which may be fatal.
And then we have levetiracetam.
Levetiracetam is an effective, off-label anticonvulsant used to treat seizures and epilepsy in cats and dogs, often when other medications like phenobarbital are insufficient.
It’s also used to manage hepatic encephalopathy, since the drug is primarily metabolized through the kidneys, and therefore relies less on the liver for excretion. If antiepileptic drugs that undergo hepatic metabolism are given to patients with liver disease, they’ll remain in the body for longer periods and should be avoided for this reason.
Levetiracetam is also used as a ‘pulse therapy’ in times where patients experience cluster seizures, status epilepticus or need additional therapy until their first line antiepileptic drug reaches a steady state. It is the treatment of choice for cats with Feline Audiogenic Reflex Seizures (FARS).
Currently there is no established reference level for levetiracetam in cats and dogs, so serum concentrations are not routinely monitored.
Levetiracetam is well tolerated in dogs and cats, even at high doses. However, some clients may report sedation, ataxia, gastrointestinal signs, and behavioural changes.
Then we move on to our newer treatments: zonisamide and pexion.
Zonisamide is a newer generation antiseizure medication. A reference interval for zonisamide has not yet been established.
It appears to be well tolerated in both dogs and cats, and side effects appear to be less common with this medication. Where seen, they can include sedation, ataxia, and inappetence. More rare and serious side effects reported include renal tubular acidosis and hepatotoxicity.
Pexion (or imepitoin) is recommended for the reduction of frequency of generalised seizures caused due to idiopathic epilepsy in patients who have not presented with cluster seizures. As a side note it can also be used in the reduction of anxiety and fear related to noise phobia in dogs. Imepitoin is excreted faecally and does not require therapeutic monitoring. Reported side effects include ataxia, hyperactivity, anorexia,, PUPD, and diarrhoea, but generally the drug is well tolerated.
And CBD may also have a place in seizure management.
Studies indicate that CBD oil can help reduce seizure frequency in dogs with drug-resistant epilepsy when used as an adjunct to conventional medications, but it is not a cure.
Clinical trials have shown that dogs receiving CBD oil experienced a significant reduction in seizure frequency and seizure days compared to those on a placebo.
CBD is generally considered most effective when used in combination with existing antiepileptic drugs rather than as a sole treatment, and many clients report a perceived improvement in their dog's overall quality of life and a reduction in seizure severity when using it.
This is an area where we are likely to see more research in the future, it is worthwhile being aware of CBD as an add-on treatment in case clients ask us about this as an option.
Adjunctive therapies
There are several other treatment options available and being aware that owners can go and do their own research means as nurses we should also be aware of what is available.
Other treatment options include;
Acupuncture
Vagal nerve stimulation
Homeopathy
Diet
The impact of diet is being researched and shows some promise but care needs to be taken to ensure we do not cause pets harm by providing a unbalanced diet. Hypoallergenic diets, neurocare diets aimed at supporting brain health, and essential fatty acids are all being investigated.
Most areas for adjunctive therapies require significantly more research (at least in the veterinary field) to prove a link between therapy and seizure reduction.
There’s also the possibility of surgery, though it’s more commonly performed in humans.
Corpus callosotomy (CC) surgery interrupts the spread of seizure activity from one hemisphere to the other, thereby preventing focal seizures from evolving to generalized seizures.
It is a highly specialised and rare neurosurgery reserved for dogs with severe, drug-resistant epilepsy.
A small study on three Cavalier King Charles Spaniels reported an average of over 80% reduction in seizure frequency and improved, more active, and mentally alert behaviour in surviving dogs. This surgery is highly specialised and generally considered only when all other options for treating epilepsy have failed.
Regardless of the treatment used, client support is vital.
With any therapy choice the client needs to be fully on board when it comes to committing to treatment, timing and follow-up diagnostics to ensure the patient receives the appropriate level of care.
Depending on the family situation this could be a significant commitment and should not be overlooked, and as veterinary nurses we play an essential role in supporting with this process.
Just like many of our other medical patients, feeding an appropriate diet and maintaining gastrointestinal health is essential, particularly, especially for patients receiving antiepileptic drugs.
Good overall health will help maintain balance, other illnesses may increase patient’s frequency of seizures, and some antiepileptics increase appetite. All of this means nursing support is vital, including regular weight checks, taking bloods under veterinary direction, and reviewing seizure diaries.
And now we’ve discussed treatment, we need to think about nursing care.
When we are planning our nursing care it is a good idea to take a step back and ask ourselves what is the seizure doing to the body, and what systems are at risk?.
Let’s start by looking at the respiratory effects.
Status epilepticus can cause severe respiratory compromise including hypoxia, hypercapnia, and neurogenic pulmonary oedema.
Seizure activity disrupts the respiratory centre, causing respiratory muscles to fatigue. Aspiration risk also increases (especially with hypersalivation or vomiting), and suction may be needed in these cases.
Patients with very severe respiratory compromise and significant hypoxaemia may require mechanical support. Oxygen should always be part of first-line emergency care.
We also need to consider the cardiac effects.
SE triggers massive sympathetic activation and autonomic dysfunction, leading to hypertension, tachycardia, and possible catecholamine toxicity with decreased contractility.
Risks include severe arrhythmias, myocardial damage (which worsens cardiac contractility), and even cardiac arrest. In addition to direct cardiac damage, secondary hypoxia and acidosis (from apnoea or muscle activity with high lactate) add further strain, and severe repeated seizures can contribute to organ damage and risk for DIC.
And there are also renal effects to consider.
Prolonged seizures with hyperthermia and muscle activity can cause rhabdomyolysis, leading to myoglobin release and myoglobinuria (red-brown urine). This is filtered by the kidneys which are damaged as they try to reabsorb it, leading to acute kidney injury. Poor perfusion, hypovolaemia, and hypotension where present contribute to this AKI by limiting renal blood flow and causing pre-renal azotaemia. Cats can also develop transient neurogenic urinary retention after severe episodes.
Lastly, we need to consider the neuronal effects.
Prolonged seizure activity can lead to neuronal damage via excitotoxicity, excessive glutamate release, and increased intracellular calcium.
Hypoxia, hyperthermia and metabolic strain caused by seizure activity can also result in irreversible brain injury.
Excessive energy consumption (due to the excessive neuron activity) can deplete glucose resources, starving the brain of vital nutrients, and inadequate oxygen delivery to the brain during seizure activity causes ischemic injury.
Ongoing seizure activity causes increased blood-brain barrier permeability, oedema and reduced cerebral blood flow, and creates further ischemia.
Post-ictal patients may experience temporary mentation changes, ataxia and behavioural changes. They may also suffer visual abnormalities and can be blind post seizure. If signs are shown after a week, they are likely to be permanent. This is something clients need to be made aware of and may require additional support with, and veterinary nurses are ideally placed to provide that support.
Now we can start planning our nursing care - and this begins during stabilisation.
The first goal during this period is to stop the seizure. This may happen quickly, or patients may require full anaesthesia to do this - and if this is the case, they need monitoring like any anaesthetised patient.
Respiratory care
These patients should ideally be administered flow-by oxygen (via face mask or nasal prongs if tolerated). SpO2 or blood gas analysis can be used to monitor oxygenation. Respiratory rate and effort should be monitored closely and any changes, particularly irregular breathing patterns should be highlighted promptly.
Renal care
The renal system is perhaps the area most overlooked initially but it is important that we monitor the patient closely for signs of renal damage. This includes monitoring serum creatinine and performing urine analysis regularly.
By providing intravenous fluids to promote renal blood flow, reduce myoglobin levels, and manage potential kidney failure, we can hopefully support the renal system.
Post-seizure inpatient care
Many patients are hospitalised for monitoring until they’re seizure-free (often 24 hours). Some will not need much inpatient care except for seizure monitoring, whereas others will need monitoring and diagnostics such as MRI.
Housing these patients in an appropriate kennel is really important. They need to be housed in an area where they can be monitored easily, but in a quiet area with minimal stimulation. The kennel should be of an appropriate size, and padded to minimise the risk of injury.
It’s important to remember that stress and anxiety can trigger seizures, and hospitalisation is often stressful - so being hospitalised itself can trigger seizure activity. Minimising stress - and being prepared for any potential seizures - is therefore vital.
Ideally, every hospitalised seizure patient should have a seizure plan kept with them at all times. This allows antiepileptic drugs to be administered quickly, even when the veterinary surgeon is not directly present. The plan is created on admission and includes the drug, dose, and calculated volume pre-prescribed by the veterinary surgeon. This means that the right drug can be given promptly without scrambling to find the vet mid-seizure. Everyone should know where emergency drugs are stored, and how to access them quickly.
Nursing care for patients who are stable is usually straightforward and involves constant monitoring for seizure activity, administering medications appropriately and ensuring they receive the correct nutrition while hospitalised.
However some comparison can be made between ADHD in humans and idiopathic epilepsy, so these patients can frequently exhibit behavioural comorbidities that mirror human ADHD, including hyperactivity, impulsivity, inattention, and increased anxiety. Knowing this we can understand why being stuck in a kennel may be difficult for these patients and result in them being noisy for example.
Patients with cluster seizures or SE often need more frequent vitals and BP monitoring if possible. Once they have recovered and are seizure-free for at least 24 hours, they can often go home. More severely affected patients who are obtunded or comatose after status may need ongoing oxygen, turning and pressure sore care, bladder management, cleanliness, eye lubrication, mucous membrane care, and gentle passive physio. As patients recover they may be non-ambulatory or weak initially, so supporting mobility with things like slings and harnesses can be helpful.
Client support and follow-up care
Watching your pet have a seizure (no matter the reason) can be extremely stressful.
As veterinary nurses we can support clients to deal with these seizure episodes, in a way that minimises the level of stress they experience.
Epilepsy (whether idiopathic or secondary) will require long term treatment, so on top of their pets experiencing these seizure episodes and needing investigations, clients will also have to deal with the introduction of daily medications, likely several times daily and at carefully managed times, as well as likely requiring regular blood monitoring.
All this can be incredibly stressful, and support via nurse clinics may help our clients deal with this. Clinics provide an opportunity for them to go over seizure diaries and share their thoughts or struggles, while we assess the patient and do things like collect bloods to measure therapeutic AED levels.
Successful nurse clinics are important for ensuring clients feel supported and can have a good quality of life along with their pets.
In conclusion, nursing seizure patients can be a challenging experience, especially when the patient has refractory epilepsy, cluster seizures or presents in status epilepticus.
However, they can be extremely rewarding to nurse, especially as patients recover and go on to achieve a good quality of life. As veterinary nurses we can play a key role in this process, even providing nurse clinics for these patients.
Seizures will often require lifelong treatment, meaning we have a good chance to bond with the client as well as their pet and seal a strong relationship between them and the practice.
Did you enjoy this episode? If so, I’d love to hear what you think. Take a screenshot and tag me on Instagram (@vetinternalmedicinenursing) so I can give you a shout-out and share it with a colleague who’d find it helpful!
Thanks for learning with me this week, and I’ll see you next time!
References and Further Reading
Garcia, G.A., Kube, S., Carrera-Justiz, S., Tittle, D. & Wakshlag, J.J. 2022, "Safety and efficacy of cannabidiol-cannabidiolic acid rich hemp extract in the treatment of refractory epileptic seizures in dogs", Frontiers in veterinary science, vol. 9, pp. 939966.
Hooper, E. 2021, "Nursing the seizure patient", The veterinary nurse, vol. 12, no. 6, pp. 280-285
Charalambous, M., Muñana, K., Patterson, E.E., Platt, S.R. & Volk, H.A. 2024, "ACVIM Consensus Statement on the management of status epilepticus and cluster seizures in dogs and cats", Journal of veterinary internal medicine, vol. 38, no. 1, pp. 19-40.
Roynard, P., Bilderback, A. & Dewey, C.W. 2021, "Intravenous Ketamine Bolus(es) for the Treatment of Status Epilepticus, Refractory Status Epilepticus, and Cluster Seizures: A Retrospective Study of 15 Dogs", Frontiers in veterinary science, vol. 8, pp. 547279.
Munguia, G.G., Brooks, A.C., Thomovsky, S.A., Thomovsky, E.J., Rincon, A. & Johnson, P.A. 2024, "Emergency Approach to Acute Seizures in Dogs and Cats", Veterinary sciences, vol. 11, no. 6, pp. 277.
https://todaysveterinarypractice.com/pharmacology/antiseizure-medications-for-dogs-and-cats/
About Zoe Hatfield, RVN, VTS(IM-Neurology)
Zoe qualified as a registered veterinary nurse in 2012. After spending her first year as a RVN working in first opinion practice, she moved to referral joining the University of Glasgow Small Animal Hospital nursing team in 2013.
Since joining the nursing team, Zoe has developed her passion for neurology and in 2019 gained the VTS certificate in Neurology.
Working within the vet school she enjoys using her extensive experience in neurology to teach and educate students and newer members of staff.
She also presents CPD on a wide variety of neurological topics, including at BSAVA Alba, ExcelCPD, VetTrust, AIMVT and BVA Live.
