We apologize for the delay in responding and understand your concern with Mr Boots seizure illness. I will try to answer your questions.
First, without a complete diagnosis treatment remains empiric, essentially an educated guess, made based on liklihoods, but without an expectation of accuracy. Mr. Boots could have a kidney tumor which metastasized to the brain, however, he could also have a second completely unrelated problem and the enlarged kidney has been an incidental finding. His history of kidney disease is likely associated with the abnormally sized and shaped kidney, but we really dont know what is happening in the brain. An MRI does require anesthesia, but would also tell us if there is tumor in the brain or whether there is no structural abnormality at all and Mr Boots has developed an acquired epilepsy. Additionally, an ultrasound exam of the kidneys would provide information as to whether the enlarged kidney is more likely to be a tumor or another problem, such as enlargement due to chronic obstruction or infection.
If your plan is to avoid further diganostics and attempt to suppress seizures with medication, you should know that seizure-suppressing medications are incmpletey effective and Mr Boots is likely to continue having some seizures, but hopefully fewer, shorter ones. Phenobarbital requires 10-14 days to reach a steady state in the blood and doses may need modification or progressive increases to maintain a relatively seizure free condition. Sometimes the side effects (sedation) of the medications become as objectionable and worrisome as the seizures themselves, but only ypu can judge that.
Once recovered from a seizure there is no reason Mr. Boots could not eat if desired.
As far as unobserved seizures, they may well have been going on occasionally for a long time before you became aware of it. Certainly preventing Mr Boots from being on high surfaces at the onset of a seizure is a good idea and perhaps caging him when you are not observing him is reasonable. He will get used to it. He is less likely to get hurt in confined space with a litter pan and water than in the house loose.
Finally, seizure recovery is unrelated to actions you may take such as holding or stroking. If you feel it comforts him, and you to do so, that makes sense but you shouldnt feel guilt for not being there to do so after unobserved seizures. As I said, they likely were happening unobserved before and Mr. Boots was as you said, he is back to almost normal fairly quickly.
I hope this is helpful. I reiterate that completing the diagnostic process may give information that could alter the treatment protocol or at least offer a prognosis. You need a name on the condition to get that information. The imaging studies are the way to get that. Good luck with Mr. Boots and please keep us informed. Thank you.
Arnold L. Goldman DVM, MS
and on behalf of the MedHelp veterinary crew