Clinical and Diagnostic Features of Feline Epilepsy: Distribution of Seizure Types and Associated Factors

Epilepsy is a common neurological disorder in cats, but its seizure types, etiologies, and clinical associations remain incompletely characterized compared to dogs. This retrospective study analyzed 118 feline epilepsy cases from two veterinary hospitals in Finland and Lithuania, aiming to evaluate the distribution of seizure types and their associations with demographic, clinical, neurological, diagnostic, and diagnostic test results. Seizures were classified as single generalized (SG), cluster seizures (CS), or status epilepticus (SE). SG and CS occurred with nearly equal frequency (44.9% and 45.8%, respectively), while SE was less common (9.3%). Median age at presentation was 72 months, and no significant differences were found in age, sex, reproductive status, or body weight between seizure types. Abnormal clinical findings (<i>p</i> = 0.009) and neurological abnormalities (<i>p</i> < 0.001) were significantly more frequent in cats with SE, indicating greater neurological compromise in severe seizure forms. MRI was performed in 74.6% of cases and revealed a significant difference in utilization among seizure types (<i>p</i> = 0.004), with lower imaging rates in SE, likely reflecting clinical instability at presentation. Etiology of seizure development was established in 89 cats: idiopathic epilepsy (IE) predominated (80.9%), followed by structural (15.7%) and metabolic/toxic (3.4%) causes. Seizure type and etiology were significantly associated (<i>p</i> = 0.006), with structural epilepsy most common in SE and idiopathic epilepsy prevailing in SG and CS. Among cats with known outcomes (<i>n</i> = 35), seizure control was achieved in 68.6%, while mortality and euthanasia were higher in SE. These findings provide new insight into feline epilepsy by linking seizure type to clinical and etiological profiles, emphasizing that severe presentations are more often associated with neurological abnormalities and structural causes, whereas demographic factors alone do not predict seizure severity.