Ocular compression for seizures in dogs - all you need to know

Canine idiopathic epilepsy is the most common neurological disorder in dogs. It is a chronic disease with no known cure. Seizures are the main symptom of canine idiopathic epilepsy and can vary in severity and frequency. Vagal nerve stimulation has been investigated for the control of seizures in dogs for many years. There are a variety of ways that vagal nerve stimulation can be achieved. In this blog, we look at the evidence behind ocular compression for seizure control in dogs and give tips on how and when to perform it for your dog.

Ocular compressions refers to an owner or vet applying pressure over the eyes either before or during a seizure. It can be easily incorporated into a dog's seizure plan and does not require any special equipment. The dog does not need to be sedated or anesthetized for ocular compressions to be performed. Ocular compressions can be done by owners at home or in the veterinary clinic.

How do ocular compression work?

Ocular compression stimulats the vagus nerve, which then leads to an inhibitory effect on the brain and seizure control.

What is the vagus nerve?

The vagus nerve is the longest cranial nerve and extends from the brainstem to the abdomen. It plays a vital role in autonomic (involuntary) functions such as heart rate, gastrointestinal motility, and sweating. The vagus nerve also innervates the pharynx, larynx, and bronchi. In people, the vagus nerve has been shown to be important in seizure control.

How do you perform ocular compressions?

Ocular compression is performed by gently pushing on the eyeball (closed eye) into the orbit with your thumbs. Pressure can be applied to one or both eyes for about 10-60 seconds and may be repeated at 5-minute intervals.

When should you start ocular compressins?

Ocular compression or pressure can be applied during a series of seizures or when pre-ictal aura or prodromal phases are suspected or recognized.

What are the side effects of applying ocular compressions?

Several minor side effects of ocular compression have been reported, including a decreased heart rate and facial twitching. In addition, minor adverse side effects such as limb twitching were also reported in a study of non-invasive vagal nerve stimulation in dogs (Robinson et al, 2020).

What is the efficacy of ocular compressions in dogs for seizure control?

A small case report in 1999 looked at the use of ocular compression in dogs with IE and found that it was effective in preventing the onset of seizures in 28% of dogs and was effective in aborting seizures in 42% of dogs (Speciale et al). Although this was a very small population of dogs that were examined, ocular compressions have minimal side effects, are free, and may be beneficial for a population of dogs in part of their seizure control, thus it seems logical that it should be considered as part of a pet's seizure plan.

If you think ocular compression may be an option for your dog, talk to your veterinarian about incorporating it into your dog's seizure plan.

References:

Ramani A. (2008). "Efficacy of vagal nerve stimulation in refractory epilepsy." Epilepsy & Behavior 13(Suppl): S37-S41.

Robinson, S., Platt, S., Soares Magalhaes RJ, et al. (2020). "Pilot study of noninvasive vagus nerve stimulation in dogs with seizures." Journal of Veterinary Internal Medicine 34(Suppl): 1846-1852.

Speciale JL, Mathews KA, Smeak DD. (1999). "Use of ocular compression in dogs with idiopathic epilepsy." Journal of the American Veterinary Medical Association 215(Suppl): 1731-1733.