Why Is My Cat Having Seizures? Causes, Treatment and Emergency Signs

By Dr Duncan Houston

Watching a cat have a seizure is frightening. One moment they may appear completely normal, then suddenly fall over, stiffen, paddle their legs, drool or lose awareness.

Not every feline seizure looks dramatic. Some cats remain standing but stare, twitch one side of the face, snap at invisible objects, run uncontrollably or make repetitive chewing movements.

A seizure is a clinical sign, not a final diagnosis. The real concern is whether it was triggered by a reversible metabolic or toxic problem, an underlying brain disorder, or epilepsy with no identifiable cause.

Quick Answer

A seizure is a sudden episode of abnormal electrical activity in the brain. Cats may experience focal seizures affecting one part of the body, generalised seizures involving the whole body, or subtle episodes involving facial twitching, drooling, staring, abnormal behaviour or uncontrolled running.

A seizure lasting more than five minutes, repeated seizures without full recovery, or multiple seizures within 24 hours is an emergency. A first seizure in a cat also deserves prompt veterinary investigation because metabolic, toxic and structural brain diseases must be actively ruled out. (Improve Veterinary Education España)

Cat Seizures at a Glance

Finding	What it may mean	What to do
One seizure lasting under one to two minutes with complete recovery	Self-limiting seizure, but the cause remains unknown	Contact your veterinarian promptly
Recurrent facial twitching, chewing or drooling	Possible focal seizure	Record a video and arrange veterinary assessment
A second seizure during the same day	High risk of further clustering	Contact an emergency clinic rather than waiting
More than two self-limiting seizures within 24 hours	Cluster seizures	Treat as an emergency
Seizure lasting more than five minutes	Status epilepticus	Emergency treatment immediately
Repeated seizures without normal awareness between them	Status epilepticus	Emergency treatment immediately
Prolonged confusion, blindness, weakness or aggression afterwards	Significant postictal effects or ongoing brain disease	Urgent veterinary assessment
Known exposure to dog flea treatment, toxins or human medication	Possible reactive seizure	Emergency veterinary care

The 2024 ACVIM consensus defines status epilepticus as seizure activity continuing beyond five minutes, or repeated seizures without recovery of consciousness. Cluster seizures are more than two self-limiting seizures within 24 hours. Both can become self-sustaining and resistant to treatment if intervention is delayed. (OUP Academic)

What Is a Seizure?

A seizure is a temporary clinical manifestation of excessive, abnormally synchronised electrical activity within the forebrain.

The signs depend on which parts of the brain are involved. A seizure may affect movement, awareness, sensation, behaviour or automatic functions such as salivation, urination and defecation. (Sage Journals)

Is One Seizure the Same as Epilepsy?

No.

A cat can have one seizure because of:

• Low blood glucose

• A toxin

• An electrolyte disturbance

• Head trauma

• Severe liver or kidney dysfunction

• A temporary brain insult

Epilepsy describes an ongoing predisposition to recurrent unprovoked seizures. It is commonly defined as at least two unprovoked seizures occurring more than 24 hours apart. (Merck Veterinary Manual)

How Are Feline Seizures Classified?

Veterinarians broadly classify seizure disorders into three groups:

Reactive Seizures

The brain itself may be structurally normal, but reacts to a problem elsewhere in the body.

Examples include:

• Hypoglycaemia

• Electrolyte abnormalities

• Liver encephalopathy

• Kidney-related encephalopathy

• Severe hypertension

• Thiamine deficiency

• Toxin exposure

Correcting the underlying abnormality may stop the seizures completely. (Sage Journals)

Structural Epilepsy

An abnormality within the brain creates the seizures.

Possible causes include:

• Brain tumour

• Inflammation or encephalitis

• Infection

• Stroke or vascular injury

• Previous head trauma

• Brain malformation

• Degenerative disease

• Hippocampal injury or necrosis

Structural disease becomes more concerning when seizures begin before one year of age or after approximately seven years, when the neurological examination remains abnormal between episodes, or when behavioural changes occur outside the immediate postictal period. A normal neurological examination does not completely rule it out. (Sage Journals)

Epilepsy of Unknown Origin

This is sometimes called idiopathic epilepsy or presumed genetic epilepsy.

No metabolic, toxic or structural cause is identified after an appropriate diagnostic investigation. Unlike in many dogs, this diagnosis should not be assumed purely because a young adult cat has recurrent seizures. It remains a diagnosis of exclusion. (PubMed Central (PMC))

What Do Seizures Look Like in Cats?

Cats have a remarkably wide range of seizure presentations. A full-body convulsion is only one possibility.

Focal Seizures

Focal seizures begin in one region of the brain.

Possible signs include:

• Twitching of one ear, eyelid or side of the face

• Repetitive chewing or chomping

• Excessive salivation

• Dilated pupils

• Head turning

• Twitching of one limb

• Sudden aggression or fear

• Repeated swallowing

• Running uncontrollably

• Urination

• Sudden unusual vocalisation

• Staring or reduced responsiveness

The cat may remain partly aware, lose awareness, or progress into a generalised seizure. Focal seizures with salivation, facial movement and repetitive chewing are particularly well recognised in feline temporal-lobe and limbic seizure disorders. (Sage Journals)

Generalised Tonic-Clonic Seizures

A generalised seizure involves both sides of the brain and body.

The cat may:

• Fall onto one side

• Become rigid

• Paddle or jerk the limbs

• Clamp or chatter the jaw

• Drool or foam

• Vocalise

• Urinate or defecate

• Lose awareness

• Breathe irregularly

The tonic phase describes stiffness. The clonic phase describes repeated jerking or paddling.

Myoclonic Seizures

Myoclonic seizures cause very brief, shock-like muscle contractions.

The cat may appear to:

• Jerk suddenly

• Flick the head

• Contract the shoulders

• Drop an object

• Momentarily lose balance

• Have repeated brief body spasms

These may be mistaken for startling, dreaming or muscle fasciculations.

Feline Audiogenic Reflex Seizures

Some older cats develop seizures triggered by particular high-frequency sounds.

Reported triggers include:

• Crinkling foil

• Metal striking ceramic

• Key jangling

• Clicking computer equipment

• Crinkling paper or plastic

• Hammering a nail

• Certain household alarms

Brief myoclonic jerks are particularly common, although generalised seizures may also occur. Levetiracetam has shown good efficacy for this specific syndrome. (International Cat Care)

Absence or Nonconvulsive Seizures

A cat may have a brief interruption in awareness without collapsing.

Possible signs include:

• Sudden staring

• Failure to respond

• Small facial movements

• Eyelid twitching

• Brief behavioural arrest

These episodes are difficult to distinguish from ordinary staring, sleepiness or other behavioural events without electroencephalography.

Nonconvulsive seizure activity can also continue after visible convulsions stop. A cat that remains profoundly unresponsive, continues subtle facial twitching or fails to regain awareness needs emergency evaluation. (PubMed Central (PMC))

What Happens Before, During and After a Seizure?

Preictal Period

Some cats show behavioural changes before the seizure, including:

• Restlessness

• Hiding

• Increased vocalisation

• Clinginess

• Pacing

• Anxiety

• Seeking the owner

• Sudden withdrawal

These signs are variable and may not occur before every seizure.

The term aura refers to the subjective sensation experienced by a person before a seizure. Because a cat cannot report that sensation, a true aura cannot be reliably separated from other preictal behaviour without EEG information. (Today's Veterinary Practice)

Ictal Period

This is the seizure itself.

Most self-limiting feline seizures stop within approximately one to three minutes. Owners commonly overestimate the duration because even 30 seconds can feel like several minutes during a frightening event. Use the timer on your phone rather than estimating. (International Cat Care)

Postictal Period

Afterwards, the cat may experience:

• Confusion

• Restlessness

• Temporary blindness

• Poor coordination

• Increased hunger or thirst

• Hiding

• Vocalisation

• Aggression

• Exhaustion

• Deep sleep

• Pacing

• Temporary hearing impairment

Recovery may take minutes to several hours. Some cats remain altered for longer after a severe or prolonged seizure. Persistent deficits, worsening disorientation or failure to return towards normal should not simply be attributed to an ordinary postictal phase. (Today's Veterinary Practice)

How Worried Should You Be?

Lower Immediate Risk

Your cat has:

• One brief seizure

• A duration under approximately one to two minutes

• Normal breathing afterwards

• Complete or near-complete recovery

• No suspected toxin exposure

• No other neurological abnormalities

What it may mean: The seizure has stopped, but its underlying cause remains unknown.

What to do: Contact your veterinarian promptly and arrange an examination. A first feline seizure should not be ignored simply because the cat now looks normal.

Moderate Concern

Your cat has:

• Repeated focal episodes

• Prolonged postictal confusion

• A first seizure before one year or after seven years

• Changes in personality between seizures

• Weight loss, increased thirst or appetite changes

• Head pressing or circling outside the recovery period

• A seizure while receiving antiseizure medication

What it may mean: Structural brain disease, metabolic illness or incomplete seizure control is more concerning.

What to do: Arrange same-day veterinary assessment where possible.

High Concern

Your cat has:

• A second seizure during the same 24-hour period

• Seizure duration approaching five minutes

• Incomplete recovery after several hours

• Marked weakness or blindness

• A suspected toxin exposure

• Recent head trauma

• Fever or systemic illness

• Repeated vomiting or inability to eat

What it may mean: Further clustering, status epilepticus, toxic disease or significant intracranial disease may be developing.

What to do: Contact an emergency veterinary hospital. I would not wait for a third seizure in a cat without an established rescue plan.

Critical

Your cat has:

• A seizure lasting more than five minutes

• More than two seizures within 24 hours

• Repeated seizures without regaining awareness

• Severe breathing difficulty

• Blue, grey or very pale gums

• Severe overheating

• Collapse

• Uncontrolled bleeding or major injury

• Minimal responsiveness

• Suspected permethrin or other toxin poisoning

What it means: Status epilepticus, cluster seizures or another life-threatening emergency is present.

What to do: Attend an emergency veterinary hospital immediately. (OUP Academic)

When Is a Cat Seizure an Emergency?

Treat the following as emergencies:

• Seizure activity continuing for five minutes

• Repeated seizures without full recovery

• More than two seizures within 24 hours

• A second seizure in one day when no rescue plan exists

• Suspected toxin exposure

• Severe head trauma

• Open-mouth or laboured breathing

• Blue, grey or white gums

• Severe hyperthermia

• Collapse

• Seizures during pregnancy or shortly after giving birth

• A diabetic cat having a seizure

• A kitten with hypoglycaemia risk

• Severe weakness or persistent neurological abnormalities

Prolonged seizure activity can cause hyperthermia, low oxygen levels, cardiovascular instability, aspiration, metabolic disturbances, muscle injury and irreversible brain damage. Treatment becomes more difficult as seizure activity continues. (OUP Academic)

What To Do During a Cat’s Seizure

1. Start Timing It

Use your phone timer immediately.

Record:

• Time seizure started

• Time visible seizure activity stopped

• Time the cat began recognising the environment again

• Whether another seizure occurred

The seizure duration and recovery time can substantially change the emergency plan.

2. Clear the Area

Move away:

• Furniture with sharp corners

• Glass objects

• Other pets

• Children

• Water bowls

• Objects the cat could become trapped beneath

Block access to stairs, balconies or open windows.

Do not drag the cat unless there is an immediate danger such as water, fire or a high edge.

3. Reduce Stimulation

Dim the lights and reduce:

• Loud voices

• Television

• Music

• Touching

• Crowding

• Flash photography

Keep the room calm and cool.

4. Keep Your Hands Away From the Mouth

Do not attempt to:

• Hold the tongue

• Pull the mouth open

• Place an object between the teeth

• Give oral medication

• Offer food or water

Cats do not swallow their tongues during seizures. Jaw movement is involuntary, and a bite can be severe.

5. Do Not Restrain the Cat

Holding the body down can cause injury to both the cat and handler.

Allow the seizure to run its course while preventing environmental injury.

6. Record a Video When Safe

A video can be invaluable because many seizure mimics have stopped by the time the cat reaches the clinic.

Capture:

• The face

• The whole body

• Eye movement

• Limb movement

• Responsiveness

• The beginning of recovery

Safety comes before filming.

7. Use Prescribed Rescue Medication

Some cats with known epilepsy are sent home with a veterinarian-designed rescue plan, potentially including intranasal midazolam or another short-acting antiseizure medication.

Use it only:

• For the cat for whom it was prescribed

• At the prescribed time

• By the demonstrated route

• At the prescribed dose

Intranasal benzodiazepine treatment is favoured for out-of-hospital seizure emergencies because it can be given without intravenous access, although feline-specific evidence remains more limited than canine evidence. (Veterinary neurology consultation)

8. Prepare for Safe Transport

Once active convulsions have stopped enough for safe handling:

• Place the cat in a secure carrier

• Line it with towels

• Keep the carrier level

• Maintain ventilation

• Keep the environment quiet

• Call the hospital while travelling

A postictal cat may be blind, frightened or aggressive. Use a towel to guide the cat only if needed and avoid placing your face near the mouth.

What Should You Not Do?

Do not:

• Put fingers near the mouth

• Restrain the body tightly

• Shake the cat

• Pour water onto the face

• Give food or water before full recovery

• Give human medication

• Give another animal’s seizure medication

• Repeat a rescue dose without following the prescribed plan

• Delay emergency care while waiting for another seizure

• Assume a seizure is harmless because it stopped

• Allow the cat outside immediately afterwards

The mistake I see most often is concentrating solely on stopping the visible movement while forgetting that the underlying toxin, metabolic disease or brain disorder may still be progressing.

What Causes Seizures in Cats?

Metabolic and Systemic Causes

Reactive seizures may occur with:

• Hypoglycaemia

• Severe hyperglycaemia

• Low calcium

• Low magnesium

• Sodium abnormalities

• Severe liver disease

• Portosystemic shunt

• Kidney-related encephalopathy

• Severe hypertension

• Hyperthyroidism

• Hypoxia

• Severe anaemia

• Thiamine deficiency

A diet history matters because thiamine deficiency can occur with improperly formulated diets, sulphite-preserved pet meats, or diets containing high amounts of thiaminase, including inappropriate raw-fish diets. (Sage Journals)

Toxins

Important feline seizure toxins include:

• Permethrin-containing dog flea and tick products

• Organophosphates

• Pyrethroids

• Lead

• Ethylene glycol

• Metaldehyde slug bait

• Human medications

• Recreational drugs

• Essential oils and concentrated chemicals

• Toxic plants or moulds in selected cases

Permethrin is highly toxic to cats and remains a major cause of feline poisoning. Exposure can occur when a dog product is applied directly to a cat or when a cat has close contact with a recently treated dog. Tremors, twitching, hypersensitivity, poor coordination and seizures require immediate care. (International Cat Care)

Infectious and Inflammatory Brain Disease

Possible causes include:

• Feline infectious peritonitis

• Toxoplasmosis

• Cryptococcosis

• Bacterial meningitis or abscess

• Immune-mediated encephalitis

• Limbic encephalitis

• Parasitic migration

• Rabies in relevant exposure situations

The specific infectious tests depend on geography, travel, age, immune status, lifestyle and MRI findings. (Sage Journals)

Brain Tumours

Possible tumours include:

• Meningioma

• Lymphoma

• Glioma

• Choroid plexus tumour

• Metastatic cancer

• Nasal, skull or pituitary tumours extending towards the brain

A new seizure in a senior cat deserves particular attention even when the cat appears normal between episodes.

Vascular Disease

Seizures can occur with:

• Ischaemic stroke

• Haemorrhage

• Severe hypertension

• Thromboembolic disease

• Coagulation disorders

• Hyperviscosity syndromes

Trauma

Head trauma may cause immediate seizures or create scar tissue that produces seizures later.

Any cat that develops seizures after a fall, road accident or significant blow to the head needs emergency assessment.

Developmental and Degenerative Disorders

Young cats may be affected by:

• Hydrocephalus

• Lissencephaly

• Porencephaly

• Storage diseases

• Other inherited or congenital brain abnormalities

Genetic testing is available for certain storage disorders in particular breeds. (Sage Journals)

What Can Be Mistaken for a Seizure?

Syncope

Syncope is temporary loss of consciousness caused by reduced blood flow to the brain.

It may involve:

• Sudden collapse

• Limpness

• Brief stiffening or paddling

• Very rapid recovery

• Exercise or excitement as a trigger

The postictal period is usually absent or extremely short. Heart disease, abnormal rhythm and low blood pressure must be considered.

Vestibular Disease

A cat with vestibular disease may:

• Fall

• Roll

• Develop a head tilt

• Have nystagmus

• Become nauseous

• Struggle to stand

Awareness is generally maintained, even though the cat looks profoundly disoriented.

Paroxysmal Dyskinesia

These episodic movement disorders may cause abnormal posturing or muscle movement while consciousness remains intact.

They are uncommon and may be difficult to distinguish from focal seizures without video and specialist assessment.

Dreaming and REM Sleep

Cats may twitch, paddle or vocalise during sleep.

The movement usually stops when the cat wakes, and there is no postictal disorientation.

Feline Hyperesthesia

Hyperesthesia may cause:

• Skin rippling

• Sudden running

• Tail chasing

• Vocalisation

• Back sensitivity

• Biting at the body

• Dilated pupils

Some cases may have a neurological component, but pain, itch, stress and skin disease must also be investigated.

Pain or Behavioural Events

Dental pain, ear disease, nausea, reflux, compulsive behaviours and fear can cause chewing, licking, vocalisation or abnormal movement.

Orofacial movements should not automatically be diagnosed as epilepsy, but recurrent stereotyped episodes involving impaired awareness, drooling and postictal changes make seizure activity more likely. (Sage Journals)

How Do Veterinarians Diagnose the Cause?

Detailed History and Video

The veterinarian will ask:

• What the cat was doing beforehand

• Whether the cat was awake or asleep

• How the episode began

• Which body parts were affected first

• Whether awareness was lost

• Whether there was drooling, urination or defecation

• How long it lasted

• What recovery looked like

• Whether medication or toxins were accessible

• Whether appetite, weight, thirst or behaviour changed

• Whether trauma occurred

• Whether similar episodes happened previously

Videos are considered invaluable when distinguishing seizures from syncope, vestibular disease, dyskinesia and behavioural events. (Sage Journals)

Physical and Neurological Examination

Every seizuring cat should receive a complete physical and neurological assessment.

The veterinarian evaluates:

• Mental status

• Behaviour

• Gait

• Posture

• Vision

• Pupil responses

• Facial symmetry

• Cranial nerves

• Limb position and strength

• Neck or spinal pain

• Cardiovascular function

• Signs of systemic disease

Postictal blindness, ataxia or behaviour changes may temporarily make the examination abnormal. Repeating the neurological examination after recovery can help distinguish transient postictal effects from ongoing structural disease. (Sage Journals)

Baseline Laboratory Testing

Testing may include:

• Complete blood count

• Serum biochemistry

• Blood glucose

• Electrolytes

• Calcium and magnesium

• Kidney and liver values

• Urinalysis

• Urine culture

• Blood pressure

• Total thyroxine in appropriate cats

• Bile acids when liver dysfunction is suspected

• FeLV and FIV testing when indicated

• Infectious disease testing based on risk

A postictal increase in ammonia can occur even without underlying liver disease, so results must be interpreted with the timing of the seizure and may need to be repeated. (Today's Veterinary Practice)

MRI

MRI is the preferred advanced test for identifying many structural brain abnormalities.

It may reveal:

• Tumours

• Inflammation

• Infection

• Stroke

• Malformation

• Hippocampal disease

• Previous trauma

• Degenerative change

MRI is especially important in cats because structural brain disease cannot be ruled out by a normal examination alone. Once extracranial causes have been excluded, advanced imaging is generally recommended for cats with recurrent seizures. (Sage Journals)

Cerebrospinal Fluid Analysis

CSF may be collected after imaging when it can be performed safely.

It can help investigate:

• Encephalitis

• Infection

• Inflammatory disease

• Some cancers

Imaging usually comes first because raised intracranial pressure or a mass can make CSF collection dangerous.

Electroencephalography

EEG records electrical activity from the brain.

It may be useful for:

• Subtle nonconvulsive episodes

• Suspected absence seizures

• Ongoing altered awareness after visible convulsions

• Distinguishing seizures from movement disorders

Availability is limited, and sedation can affect interpretation.

How Are Emergency Seizures Treated?

First-Line Treatment

Benzodiazepines are the first-line emergency antiseizure drugs because they act rapidly.

Veterinarians may use:

• Midazolam

• Diazepam

• Lorazepam in selected settings

Intravenous administration is preferred when access is available. Intranasal midazolam can be used when intravenous access is not immediately possible. (Merck Veterinary Manual)

Longer-Acting Seizure Control

Because benzodiazepines act briefly, an additional longer-acting medication is often needed.

Possible drugs include:

• Phenobarbital

• Levetiracetam

The cat is also monitored and treated for:

• Hyperthermia

• Low oxygen

• Low blood glucose

• Electrolyte disturbances

• Aspiration

• Blood-pressure abnormalities

• Underlying toxins or metabolic disease

Refractory Status Epilepticus

When seizures continue despite initial medication, treatment may require:

• Continuous midazolam infusion

• Additional phenobarbital or levetiracetam

• Propofol or another anaesthetic infusion

• Intubation

• Mechanical ventilation

• Continuous cardiovascular monitoring

• EEG monitoring where available

This level of treatment requires intensive hospital care. (PubMed Central (PMC))

When Should Long-Term Seizure Medication Begin?

Maintenance treatment is generally considered when a cat has:

• Status epilepticus

• Cluster seizures

• Structural epilepsy

• Increasing seizure frequency or severity

• Prolonged or severe postictal effects

• Seizures occurring more often than approximately once every 12 to 16 weeks

• A condition where another seizure would present an unacceptable risk

• Recurrent seizures that significantly reduce quality of life

The decision should consider seizure burden, underlying diagnosis, medication safety, owner capacity and the cat’s quality of life. (Today's Veterinary Practice)

Which Medications Are Used Long Term?

Phenobarbital

Phenobarbital remains a common first-line maintenance medication for feline epilepsy.

Advantages include:

• Established efficacy

• Relatively predictable absorption

• Twice-daily dosing in most cats

• Ability to measure serum concentrations

• Availability in oral and injectable forms

Possible adverse effects include:

• Sedation

• Poor coordination

• Increased appetite

• Increased thirst or urination

• Behavioural change

• Blood-cell abnormalities in uncommon cases

Sedation and wobbliness are often most noticeable during the first one to two weeks and may improve as the cat adapts.

Phenobarbital blood concentrations are generally checked approximately two weeks after starting or changing the dose, then periodically together with complete blood count and biochemistry. (Today's Veterinary Practice)

Levetiracetam

Levetiracetam is widely used because it has:

• A favourable safety profile

• Minimal liver metabolism

• Relatively few drug interactions

• Rapid onset

• Particular efficacy in feline audiogenic reflex seizures

Possible adverse effects include:

• Sleepiness

• Reduced appetite

• Mild poor coordination

Immediate-release formulations usually require frequent administration because the drug has a comparatively short half-life in cats. Missed doses can therefore create gaps in seizure protection. (Today's Veterinary Practice)

Zonisamide

Zonisamide can be used as a first-line or additional medication when phenobarbital is ineffective or poorly tolerated.

Possible adverse effects include:

• Sedation

• Ataxia

• Reduced appetite

• Vomiting

• Diarrhoea

• Rare hypersensitivity reactions

Evidence in cats is more limited than for phenobarbital, but retrospective studies support its potential effectiveness. (Today's Veterinary Practice)

Medications To Avoid or Use With Particular Caution

Potassium Bromide

Potassium bromide is generally not recommended in cats because it can cause severe lower-airway inflammation and respiratory disease. (PubMed Central (PMC))

Long-Term Oral Diazepam

Repeated oral diazepam administration has been associated with idiosyncratic, potentially fatal acute liver necrosis in cats.

Diazepam may still be used by veterinarians as an emergency injectable antiseizure drug, but it should not be casually prescribed or administered orally as routine long-term feline seizure control. (PubMed)

Never Stop Medication Abruptly

Suddenly stopping an antiseizure medication can cause severe rebound seizures, clusters or status epilepticus.

Medication changes should be gradual and directed by the veterinarian, even when the cat has been seizure-free for a long period.

What Side Effects Should Owners Monitor?

Contact your veterinarian if your cat develops:

• Excessive sedation that does not improve

• Severe wobbliness

• Loss of appetite

• Vomiting

• Jaundice

• Persistent fever

• Skin eruptions

• Enlarged lymph nodes

• Marked behavioural change

• Breathing difficulty

• Increasing seizure frequency

Do not independently reduce or skip doses because the cat appears sleepy. The veterinarian may alter the dose, change the schedule or choose another medication safely.

What Should a Home Seizure Plan Include?

Every household caring for a cat with recurrent seizures should have a written plan covering:

1. What counts as an ordinary self-limiting seizure

2. When to administer prescribed rescue medication

3. How many rescue doses may be given

4. When to leave immediately for the emergency clinic

5. Which hospital is open overnight

6. The cat’s current medication and dose

7. The date and time of the last medication

8. What to do after a missed dose

9. What to do if the cat vomits medication

10. How to transport the cat safely

Keep the rescue medication somewhere accessible and check its expiry date regularly.

How Do You Keep a Seizure Log?

Record:

• Date

• Exact start and finish time

• Focal or generalised signs

• Behaviour before the seizure

• Recovery time

• Possible trigger

• Medication timing

• Missed doses

• Appetite

• Vomiting or diarrhoea

• Video availability

• Rescue medication used

• Veterinary treatment required

A log helps distinguish genuine improvement from memory bias and guides medication adjustments.

What Is the Prognosis?

The outlook depends far more on the cause than on how dramatic the seizure looked.

Epilepsy of Unknown Origin

Cats with no identifiable structural or metabolic cause and normal MRI findings often have a favourable long-term outlook.

Some become seizure-free, while others achieve a meaningful reduction in frequency and severity with medication. (PubMed Central (PMC))

Reactive Seizures

The prognosis may be excellent when the cause is identified quickly and completely reversed, such as uncomplicated hypoglycaemia or a correctable electrolyte problem.

The outlook becomes guarded when the toxin or metabolic disease has caused permanent organ or brain injury.

Structural Epilepsy

The prognosis varies substantially.

A surgically removable meningioma may have a very different outlook from diffuse encephalitis, metastatic cancer or progressive degenerative disease.

Seizure control may still improve quality of life even when the underlying condition cannot be cured.

Quality of Life

The goal is not always complete seizure freedom.

A clinically meaningful response may involve:

• At least 50% reduction in seizure frequency

• Shorter seizures

• No clusters

• No status epilepticus

• Milder postictal signs

• Minimal medication adverse effects

• Preserved normal behaviour between seizures

Cats with well-controlled seizures and few medication effects can maintain a good quality of life. Owner support and a realistic medication plan also reduce the burden of long-term care. (Today's Veterinary Practice)

How Can You Reduce Future Seizure Risk?

Not every seizure can be prevented, but several risks can be reduced.

Prevent Toxin Exposure

Never apply a dog flea or tick product containing permethrin to a cat.

Also secure:

• Human medication

• Insecticides

• Slug bait

• Antifreeze

• Essential oils

• Cannabis and recreational drugs

• Cleaning chemicals

• Toxic plants

Give Medication Consistently

Administer antiseizure medication:

• At the same times each day

• At the prescribed dose

• Without abrupt discontinuation

• Using reminders or timed alarms

• With early prescription refills

Maintain Routine Health Monitoring

Regular examinations may identify:

• Diabetes

• Kidney disease

• Hyperthyroidism

• Hypertension

• Liver disease

• Weight loss

• Neurological changes

Senior cats deserve particular attention because a new seizure may be the first sign of a structural or systemic disorder.

Create a Safer Home

For cats with uncontrolled seizures:

• Restrict access to balconies

• Secure windows

• Block steep stairways where practical

• Avoid unsupervised outdoor access

• Keep the cat away from open water

• Provide low resting areas

• Use padded, stable furniture arrangements

Manage Known Sound Triggers

Cats with suspected audiogenic reflex seizures may benefit from reducing avoidable high-frequency sounds.

Do not deliberately reproduce the trigger to confirm the diagnosis.

Common Cat-Seizure Mistakes

Waiting for a Third Seizure

The formal cluster definition may require more than two seizures within 24 hours, but a second seizure already signals a high risk of further activity. Contact an emergency clinic rather than waiting for the situation to meet a textbook threshold.

Putting a Hand in the Cat’s Mouth

This does not protect the tongue and creates a serious bite risk.

Assuming Every Seizure Means Idiopathic Epilepsy

Reactive and structural causes must be investigated, particularly in kittens, seniors and cats with abnormalities between episodes.

Assuming Every Strange Movement Is a Seizure

Syncope, vestibular disease, pain, hyperesthesia and movement disorders can look similar.

Skipping MRI Because the Examination Is Normal

Cats with structural brain disease may have a normal interictal neurological examination.

Giving Potassium Bromide

This medication can produce severe respiratory disease in cats.

Using Oral Diazepam Long Term

Cats have developed fatal acute liver failure after repeated oral diazepam treatment.

Stopping Medication After a Seizure-Free Period

Abrupt withdrawal can trigger a serious recurrence.

Failing To Record Episodes

Accurate timing and video often provide more diagnostic information than a description given from memory several days later.

Frequently Asked Questions

Can a cat have one seizure and never have another?

Yes. A single reactive seizure may not recur once its cause is corrected. However, a first seizure still warrants investigation because toxin exposure, metabolic disease and structural brain disorders may initially produce only one visible event.

How long does it take a cat to recover after a seizure?

Many cats begin recovering within minutes and return towards normal over several hours. Temporary blindness, wobbliness, hunger, thirst or confusion may occur. Failure to improve, worsening signs or profound alteration lasting many hours requires veterinary reassessment. (International Cat Care)

Can stress cause seizures in cats?

Stress may lower the seizure threshold in a predisposed cat, but it should not be accepted as the sole diagnosis without investigating metabolic, toxic and structural causes.

Can cats live normal lives with epilepsy?

Many can. Cats with epilepsy of unknown origin frequently respond well to medication and may live for years with good quality of life. Prognosis is more variable when seizures are caused by progressive brain disease. (PubMed Central (PMC))

Should every cat be placed on medication after one seizure?

Not necessarily. A single short seizure may be monitored while the cause is investigated. Long-term treatment becomes more strongly indicated after status epilepticus, cluster seizures, structural epilepsy, increasing frequency or severe postictal effects. (Today's Veterinary Practice)

Final Thoughts

A seizure in a cat should never be dismissed, but it also does not automatically mean your cat has an untreatable brain disorder.

The most important points are:

1. A seizure is a sign, not a diagnosis.

2. Feline seizures can be focal, generalised or extremely subtle.

3. Facial twitching, drooling and repetitive chewing may be focal seizure signs.

4. A seizure lasting more than five minutes is an emergency.

5. Repeated seizures without recovery are status epilepticus.

6. More than two seizures within 24 hours are cluster seizures.

7. A second seizure in the same day deserves urgent contact with an emergency clinic.

8. Never restrain the cat or place anything in the mouth.

9. Time and video the episode whenever it is safe.

10. Metabolic and toxic causes must be ruled out before diagnosing epilepsy.

11. A normal neurological examination does not exclude structural brain disease.

12. MRI and CSF testing may be needed in recurrent cases.

13. Phenobarbital, levetiracetam and zonisamide are commonly used maintenance options.

14. Potassium bromide is not recommended for cats.

15. Repeated oral diazepam can cause fatal liver injury in cats.

16. Never stop antiseizure medication abruptly.

17. Many cats achieve good seizure control and retain an excellent quality of life.

The mistake that causes the greatest harm is focusing only on the seizure that has stopped. What matters next is whether another one is coming, whether the cat has fully recovered and what caused the brain to seize in the first place.

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ASK A VET™ can help you organise seizure videos, episode timing, medication records and changes in your cat’s behaviour while you arrange direct care with your veterinarian or veterinary neurologist. A cat with a seizure lasting five minutes, repeated seizures, breathing difficulty, collapse or suspected toxin exposure still requires immediate hands-on emergency treatment.