In the Literature
Pergande AE, Belshaw Z, Volk HA, Packer RMA. Owner perspectives on the impact of veterinary surgeons upon their decision making in the management of dogs with idiopathic epilepsy. Vet Rec. 2023;193(1):e2482. doi:10.1002/vetr.2482
The Research …
Epilepsy, a disorder of the brain characterized by an ongoing predisposition to epileptic seizures, is the most common chronic neurologic disorder in dogs.1 Idiopathic epilepsy refers to seizures of unknown cause.2 Long-term administration of anticonvulsants is the mainstay of therapy, and treatment goals include extending the interictal period and reducing seizure severity.3
Idiopathic epilepsy is a diagnosis of exclusion.4 Frequent clinic visits and laboratory diagnostics are often necessary for treatment, medication adjustments, and monitoring. Management of epilepsy in dogs is complex, and effective communication and trust are essential for pet owner satisfaction and compliance.
In this study, 21 owners of dogs with idiopathic epilepsy were interviewed regarding their perspective on the impact of clinicians on decision-making and condition management. All owners consulted with a clinician after their dog’s first seizure. Strong emotions, including fear and distress, were reported, and clear explanations from the clinician were considered very important. Owners reported appreciating advice from veterinary staff and information regarding after-hours emergency options.
Some owners indicated the information provided by the clinician did not set correct expectations, as they assumed seizures would stop after anticonvulsant medication was administered. Owner priorities during the early seizure management period were discussions about expected seizure frequency (particularly a specific goal for seizure intervals) and likely response to treatment.
Owners valued clinicians who demonstrated strong clinical competency, experience managing patients with epilepsy, and openness to bidirectional communication. Many owners searched for information from other sources (eg, internet, online support groups) and occasionally sought the opinion of a second clinician. More than half of owners were referred for neurology consultation and/or additional diagnostic testing. Owners who reported negative experiences with the primary care clinician were more likely to conduct internet research.
Findings of this study suggest additional communication training in veterinary school may be beneficial for managing difficult and emotional cases. Providing informational handouts and reliable, evidence-based online support to owners may also be helpful.
… The Takeaways
Key pearls to put into practice:
Appropriate expectations for seizure management should be set during the initial examination. This author typically counsels that seizures will likely recur, even following administration of anticonvulsant medication. Providing detailed and realistic expectations early in the management process may help build a stronger clinician–owner relationship.
Scheduling an additional consultation to further discuss owner concerns soon after the initial visit may be helpful. Emotions are often high during the initial visit and can influence the owner’s ability to retain information. A phone call from a veterinary technician may also be helpful.
A team approach involving the primary care clinician, neurology specialist, and owner should be emphasized and implemented.
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