This chapter reviews decision making strategy in the management of canine epilepsy. Because of the greater accessibility and wider use of MRI in the diagnosis of epilepsy and the fast growth in the number of anti epileptic drugs (AED) available, veterinary surgeons are faced with the dilemma of when is the optimal time to commence treatment, which is the best initial therapy to use and when should changes in therapy be considered. This chapter therefore reviews decision-making strategies for AED therapy, provides a summary of the current AED available, and discusses therapeutic advances in the management of canine epilepsy.