Veterinary neurology experts collaborate for first ever global consensus on pets with epilepsy

• International Veterinary Epilepsy Task Force (IVETF) develops common language to be used in the ‘chain of care’ of canine and feline epilepsy
• IVETF establishes guidelines to improve care for veterinary patients with epilepsy
• IVETF establishes a framework and standards for future trials

An international body of vets and scientists have come together to set out unified and standardised guidelines for the research, diagnosis and treatment of canine and feline epilepsy for the first time ever in veterinary medicine.

 Made up of 26 veterinary practitioner, neuropharmacology, neuropathology and neurology experts from around the world, the IVETF has produced seven ‘consensus statements’ that outline a number of recommendations and classifications on all aspects of the condition. It is the first time this many veterinary neurology clinicians and neuroscientists have formally agreed on the key aspects of canine and feline epilepsy.

 Epilepsy is one of the most common diseases encountered in veterinary practice. The prevalence of the illness means there have been numerous research studies carried out over the years. But, despite a frequency in the research work carried out, there remains a lack of consistency throughout these studies.

 This lack of cohesion has made it difficult for owners and professionals to communicate adequately on the issue of pet epilepsy. This is because classifications, definitions, therapeutic outcome measures, neuroimaging and neuropathological standards have differed between many of these studies, making it difficult to draw comparisons and significantly limiting their scientific impact.

 This also affects the ongoing understanding of epilepsy in relation to professional guidelines which, in turn, affects clinicians when diagnosing and advising treatment options for the condition.

Professor Holger Volk, is Clinical Director of the Royal Veterinary College (RVC) small animal referral clinic and a specialist in Neurology and Neurosurgery. He established and chaired the IVETF in 2014: “Looking back over last year’s journey and finally seeing the end product of having multiple consensus statements is one of the most exciting things I have been involved with in my career” he says.

“I feel very privileged, humbled and honoured to have worked and learned from all these highly skilled, knowledgeable and prestigious colleagues. Going forward, we are looking forward to continuing the journey we have started so successfully. I have no doubt that this work will have the impact we hope and will lead to better care for our patients with epilepsy.”

The IVETF’s collaborative approach has identified a ‘chain of care’, from the animal’s breeder and owner through the first opinion practitioner to the neurology specialist and neuroscientist. Each statement aims to be a ‘user friendly’, pragmatic, reliable and valid tool that benefits all these groups. The IVETF is also building a scientific and clinical framework to manage and research epilepsy appropriately. This work will provide the foundation for an agreed common language in the area of companion pet epilepsy.

The working group was made up of veterinary and human neurologists and neuroscientists, practitioners, neuropharmacologists and neuropathologists. Professor Andrea Fischer from LMU Munich was one of those involved and is excited about the IVETF making a difference, she said: “The future of veterinary neurology lies in conducting multicenter studies throughout the world focusing on investigation of genetics, pathophysiology and treatment of epilepsy. Thus a common language and clear description of breed-specific epilepsy syndromes is urgently needed”.

Dr. Bhatti, Head of the Clinical Neurology Department at Ghent University, added: "For the medical treatment of canine epilepsy, the question ‘to treat or not’ has been mainly replaced by when to start, which drug or drugs should be used, and when treatment changes should occur. This consensus proposal aims to provide a common language in treatment planning which is essential for comparing future study results."

Reader Dr. Rusbridge at University of Surrey and Fitzpatrick Referrals said: “Magnetic resonance imaging (MRI) is regarded as an important diagnostic test to reach the diagnosis of idiopathic epilepsy and there is a need for a standardized veterinary epilepsy-specific MRI protocol which will facilitate more detailed examination of areas susceptible to generating and perpetuating seizures, is cost efficient, simple to perform and can be adapted for both low and high field scanners.”

The IVETF has agreed on the following consensus statements involving more than 25 co-authors (Berendt M1; Bhatti SFM2; De Risio L3; Farquhar RG4; Fernández-Flores F5; Fischer A6, Hülsmeyer VI6; Jovanovik E7; Löscher W8, Long S9; Mandigers PJJ10; Matiasek K11; Milne M9; Muñana K12; Packer, RMA13; Pakozdy A14; Patterson EE15; Penderis J16; Platt S17; Podell M18; Potschka H19; Pumarola MB5; Rosati M11; Rusbridge C7,20; Stein VM21; Tipold A21; Volk HA13; Wagner E11). The IVETF hopes that each statement will help advance the field of canine and feline epilepsy and ultimately lead to better care for our patients:

1. International Veterinary Epilepsy Task Force consensus report on epilepsy definition, classification and terminology in companion animals (chaired by Prof. Mette Berendt)
   http://doi.org/1186/s12917-015-0461-2
2. International Veterinary Epilepsy Task Force Consensus Proposal: Diagnostic approach to epilepsy in dogs (Chaired by Drs. Luisa De Risio and Sofie Bhatti)
   http://doi.org/10.1186/s12917-015-0462-1
3. International Veterinary Epilepsy Task Force current understanding of idiopathic epilepsy of genetic or suspected genetic origin in purebred dogs (Chaired by Dr. Velia-Isabel Hülsmeyer)
   http://doi.org/10.1186/s12917-015-0463-0
4. International Veterinary Epilepsy Task Force consensus proposal: Medical treatment of canine epilepsy in Europe (Chaired by Drs. Sofie Bhatti and Luisa De Risio)
   http://doi.org/1186/s12917-015-0464-z
5. International Veterinary Epilepsy Task Force Consensus Proposal: Outcome of therapeutic interventions in canine and feline epilepsy (Chaired by Profs. Heidrun Potschka and Andrea Fischer)
   http://doi.org/1186/s12917-015-0465-y
6. International Veterinary Epilepsy Task Force recommendations for a veterinary epilepsy-specific MRI protocol (Chaired by Drs. Clare Rusbridge and Sam Long)
   http://doi.org/10.1186/s12917-015-0466-x
7. International Veterinary Epilepsy Task Force recommendations for systematic sampling and processing of brains from epileptic dogs and cats (Chaired by Profs. Kaspar Matiasek and Martí Pumarola Batlle).
   http://doi.org/1186/s12917-015-0467-9

The research paper has been published in the academic journal, BMC Veterinary Research

The International Veterinary Epilepsy Task Force (IVETF) was set up in 2014 by a group of Veterinary Neurology Specialists and non-specialists. It is an independent organisation and its main aim is to provide the veterinary community, breeders and pet owners with key advice on the key areas in the field of epilepsy.

Centres which have been involved in the development of these consensus statements.

• 1Department of Veterinary and Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark (Mette Berendt)
• 2Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke 9820, Belgium (Sofie Bhatti)
• 3Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, Suffolk, United Kingdom (Luisa De Risio)
• 4Fernside Veterinary Centre, 205 Shenley Road, Borehamwood, SG9 0TH, Hertfordshire, United Kingdom (Robyn Farqhuar)
• 5Department of Animal Medicine and Surgery, Veterinary Faculty, Universitat Autònoma de Barcelona, Campus UAB, Bellaterra, 08193 Barcelona, Spain (Fernandez-Flroes; Martí Pumarola Batlle)
• 6Clinic of Small Animal Medicine, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539 Munich, Germany (Velia-Isabel Hülsmeyer, Andrea Fischer)
• 7Fitzpatrick Referrals, Halfway Lane, Eashing, Godalming, GU7 2QQ, Surrey, United Kingdom (Eli Jovanovik, Clare Rusbridge)
• 8Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Bünteweg 17, 30559 Hannover, Germany (Wolfgang Löscher)
• 9University of Melbourne, 250 Princes Highway, Weibee 3015, Victoria, Australia (Sam Long, M Milne)
• 10Department of Clinical Sciences of Companion Animals, Utrecht University, Yalelaan 108, 3583 CM, Utrecht, The Netherlands (Paul Mandigers)
• 11Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539 Munich, Germany (Marco Rosati, E Wagner, Kaspar Matiasek)
• 12Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC 27607, USA (Karen Muñana)
• 13Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL9 7TA, Hertfordshire, UK (Rowena MA Packer, Holger A Volk)
• 14University Clinic for Small Animals, Clinical Department for Companion Animals and Horses, University of Veterinary Medicine, Veterinärplatz 1, 1210 Vienna, Austria (Akos Pakozdy)
• 15University of Minnesota College of Veterinary Medicine, D426 Veterinary Medical Center, 1352 Boyd Avenue, St. Paul, MN 55108, USA (Edward E Patterson)
• 16Vet Extra Neurology, Broadleys Veterinary Hospital, Craig Leith Road, Stirling, FK7 7LE, Stirlingshire, United Kingdom (Jacques Penderis)
• 17College of Veterinary Medicine, University of Georgia, 501 DW Brooks Drive, Athens, GA 30602, USA (Simon Platt)
• 18Chicago Veterinary Neurology and Neurosurgery, 3123 N. Clybourn Avenue, Chicago, IL 60618, USA (Michael Podell)
• 19Department of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximillians-University, Königinstr. 16, 80539 Munich, Germany (Heidrun Potschka)
• 20School of Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, GU2 7TE, Surrey, United Kingdom (Clare Rusbridge)
• 21Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559 Hannover, Germany (Veronika Stein and Andrea Tipold)