Owner reported prevalence of autonomic signs in epileptic dogs

Epilepsy is a common neurological disorder in dogs. Autonomic manifestations are commonly recognised but poorly reported in veterinary literature. This study aimed to determine owner reported prevalence and course of autonomic signs in epileptic dogs.

A survey for owners of dogs with epilepsy created with Qualtrics was circulated on Facebook between March 2025 and August 2025.

There were 1,154 responses, with 704 included in statistical analysis. The overall frequency of autonomic signs was 697/704 dogs (99.0%). When analysed by body system, gastrointestinal signs [96.9% (682/704)], and urogenital signs [91.1% (641/704)] were most common. Individually, commonly reported signs included ptyalism [87.6% (617/704)], urination [79.1% (556/703)], polydipsia [78.4% (551/703)], mydriasis [71.8% (505/703)], and owner-reported appetite changes [73.9% (520/704)]; the latter could not be confidently attributed to seizure-associated autonomic dysfunction. The least prevalent were priapism [14.6% (66/452)], apnoea [16.7% (117/701)], anisocoria [18.8% (132/702)], cyanosis [20.5% (144/702)], and abdominal pain [21.3% (150/703)]. Antiseizure drugs, defined as any medications used for epileptic seizure control for both acute and maintenance management, were significantly associated with increased prevalence of several autonomic signs. Additionally, mean course of progression (deterioration) rate (3.6%) was significantly higher than mean course of regression (improvement) rate (2.9%; p < 0.001). When analysed by body system, overall regression was most common for gastrointestinal [11.2% (79/704)] and urogenital [8.8% (62/704)] autonomic signs, and overall progression was most common for gastrointestinal [15.9% (112/704)] and cardiorespiratory [15.8% (111/704)] autonomic signs.

This study demonstrated that autonomic signs are ubiquitous in epileptic dogs, progression of autonomic signs is uncommon, and progression occurs more often than regression. The prevalence of autonomic signs in epileptic dogs appears to be significantly higher than previously reported. Additionally, changes in the course of autonomic signs indicate the need to monitor autonomic activity in individuals managed for epilepsy, due to the potential impact on quality of life (QoL).