Emerging Canine Drug-Resistant Epilepsy: A Review of Current State and Future Solutions

Abstract

Canine epilepsy is a disease characterized by sudden alterations in neurological behavior and involuntary muscle movements. About three-fourths of the cases are refractory to conventional anti-epileptic drugs. Drug tolerance has led to the emergence of canine drug-resistant epilepsy (CDRE) which primarily affects male dogs aged 6 months to 6 years. This review focuses on thorough knowledge about the causes, diagnosis, and mitigation strategies for CDRE, elucidating the mechanisms of drug resistance for better understanding. The estimation of CSF and plasma biomarker levels such as IL-1β, microRNAs, and high-mobility group box-1 as well as electroencephalography and MRI, could provide the promising diagnostic aid. Challenges like probable sudden unexpected death in dogs with epilepsy (pSUDEP) and sudden unexpected death in dogs with epilepsy (SUDEP) need to be addressed. Add-on doses, neurostimulation, behavioral therapy, and ketogenic diet may improve CDRE. Finally, drug repurposing, nanodrug development, and gut-brain axis modulation are the novel therapeutic approaches which could serve as the cornerstone of future CDRE treatment strategies. In-depth information regarding therapeutic strategies that can lessen the emergence and global spread of CDRE has been thoroughly covered in this article.