Neurologic Emergency Care | Seizures, Collapse

Signs that require immediate evaluation

Seek emergency care immediately for

A seizure lasting more than 5 minutes (status epilepticus)
Multiple seizures within a 24-hour period (cluster seizures)
First-ever seizure in an older pet (higher concern for underlying disease)
Sudden collapse or inability to stand
Sudden paralysis or weakness in the hind limbs
Loss of consciousness, even briefly
Severe disorientation, circling, or head pressing
Sudden blindness

Seizures

A seizure is caused by abnormal electrical activity in the brain. During a generalized seizure, a dog or cat may fall on their side, paddle their legs, become stiff, urinate or defecate, chomp their jaw, and lose consciousness. The post-ictal phase that follows — confusion, temporary blindness, restlessness, or deep sleep — can last minutes to hours and is not a second seizure.

What to do during a seizure

Stay calm. Your pet cannot swallow their tongue — this is a myth.
Do not restrain your pet or put your hands near their mouth.
Remove nearby furniture or objects that could cause injury.
Time the seizure from start to finish.
Keep the room dark and quiet to reduce stimulation.
If the seizure lasts more than 5 minutes, this is an emergency — call us on the way.

Spinal cord emergencies

Sudden hind limb weakness or paralysis is often caused by intervertebral disc disease (IVDD) — a herniated disc pressing on the spinal cord. This is most common in breeds with long spines and short legs (Dachshunds, Basset Hounds, Corgis, Shih Tzus) but can occur in any breed. The speed of deterioration matters — a dog that loses the ability to walk requires prompt evaluation, as surgical decompression is more effective when performed early.

Signs of a spinal emergency include sudden weakness or dragging of one or both hind legs, crying out when touched along the spine, reluctance to move, and loss of bladder or bowel control.

Vestibular disease

Vestibular disease affects the balance system and can look alarmingly like a stroke. Signs include sudden head tilt, falling, rolling, walking in circles, and rapid involuntary eye movement (nystagmus). Pets are often extremely nauseated. The most common form — idiopathic vestibular disease — is not life-threatening and often resolves within days to weeks. However, central vestibular disease (caused by a brain lesion) looks similar and is far more serious. An examination is needed to distinguish between the two.

Toxins and neurologic symptoms

Some toxins cause neurologic symptoms — tremors, seizures, ataxia (wobbling), and altered mental status. If your pet is showing neurologic signs and there is any chance of toxin exposure, please tell us immediately. This changes both the urgency and the treatment approach significantly.

Frequently asked questions

My dog just had its first seizure. What should I do?

Stay calm and keep your dog safe. Do not put your hands near their mouth — a seizing dog can bite reflexively. Move furniture away to prevent injury. Time the seizure. Most last 1–3 minutes. A seizure lasting more than 5 minutes is a medical emergency — call us immediately. After the seizure ends, your dog will likely be disoriented (the post-ictal phase) — keep them calm, quiet, and away from stairs. A first-time seizure always warrants a vet evaluation, even if the dog recovers fully.

What is the difference between a seizure and a fainting episode?

This is an important distinction. Seizures typically involve uncontrolled muscle activity (paddling, stiffening, chomping), altered consciousness, and a recovery period of confusion afterward. Fainting (syncope) usually involves sudden collapse with brief unconsciousness, often with rapid recovery and no post-ictal confusion. Both are serious and warrant evaluation, but they often have different underlying causes.

My cat has a sudden head tilt and is falling over. Is this an emergency?

This sounds like vestibular disease, which affects the balance system. It can look dramatic — severe head tilt, falling, rolling, rapid eye movement (nystagmus), and extreme nausea. It can be caused by inner ear infection, which is treatable, or by central (brain) causes which are more serious. Evaluation is needed to distinguish the two. While idiopathic vestibular disease often improves on its own within days, you should not assume that is the cause without an exam.

How are seizures treated in emergency settings?

Active or cluster seizures are treated with IV anticonvulsant medications to stop the seizure activity. Once stable, we assess for underlying causes with bloodwork, urinalysis, and sometimes imaging. Depending on the cause, long-term anti-epileptic medication may be recommended — that conversation typically happens with your regular vet after the emergency is resolved.

Neurologic emergencies