Making the Most of your Teleconsultation- It All Starts with the History!

Patients experiencing seizures can often benefit from a neurologist's guidance, whether remotely or in person. As a neurologist, I like to gather key information from my history to help guide my treatment of the case. In general, the goals of your history taking for a patient experiencing seizures or "seizure like episodes" should include:

1. Establishing (to the best of your ability) whether the pet is truly having seizures

2. Determining when it is appropriate to start seizure medication

3. Establishing an appropriate diagnostic and treatment plan for your patient

In this article, we will delve into the essential aspects of gathering a thorough medical history for dogs or cats experiencing seizures.

1. General Information: Start with a general health and lifestyle history for your patient.
2. Seizure Description:

• Encourage the pet owner to describe the seizures in detail. Try to determine whether the pet experienced loss of consciousness, drooling, vocalization, or loss of bladder/bowel control. This can help you determine whether the event they describe is a true seizure. Remember, lots of other events (syncope, vestibular episodes, etc) can look like a seizure. Always ask the owners if they have a video of the event!
• Inquire about the pet's behavior before, during, and after a seizure episode.
• Request specifics such as the duration and frequency of the events. Have they experienced any other unusual behaviors outside of the seizure itself?

1. Possible Triggers: Identifying potential triggers is vital in managing seizures. Ask the pet owner about any recent changes in diet, medications, or exposure to toxins, such as cleaning products or plants. Inquire about the pet's reaction to loud noises, bright lights, or stressful situations.
2. Medical Background: A pet's medical history holds valuable clues regarding their seizure episodes. Inquire about any pre-existing conditions, previous injuries, or surgeries. Discuss the pet's vaccination history, parasite control, travel history, and any known allergies. Also, ask if there is a family history of seizures or any neurological disorders among the pet's siblings or parents.
3. Medications and Supplements: Document all medications, including dosages and frequencies, currently administered to the pet. Inquire about any recent changes in medications or the addition of supplements.?
4. Additional Clinical Signs: Seizures can be a result of an underlying medical condition. Probe for other associated clinical signs, such as changes in appetite, weight loss, excessive thirst or urination, weakness, disorientation, or abnormal behavior. These signs may help in identifying possible causes or comorbidities.
5. Diagnostic Tests and Treatments: Ask the pet owner about any previous diagnostic tests or treatments related to the seizures. Inquire about the results of blood work, imaging studies, or neurological evaluations. Understanding the previous diagnostic and treatment approaches can help guide the current assessment and avoid unnecessary repetition.

Training your staff to take a thorough history can save you time in the exam room and can help you provide the best care for your patients. When you schedule a consultation with a neurologist on Stratocyte for your seizure patient, providing all of this information to the neurologist will help save you time during your consultation. The neurologist will be prepared ahead of time, and they can focus on providing treatment recommendations instead of going over history questions!