The Facts About Long Term Medications

[~Anne~]

I found this while looking for soemthing else on the net and thought it might be interesting and handy for those with dogs on long term meds.

factsheet_longtermmed.pdf

[Chezy]

I found this while looking for soemthing else on the net and thought it might be interesting and handy for those with dogs on long term meds.

ty I have been searching for something like this , going for a 2nd opinion on my little girl soon , not happy that she is on cortisone long term, but atm it is stopping her fits as fit meds didn't cut it . I want to see if there is a alternative.can only hope , not impressed that all say to do bloods b4 and after, yet my vet never mentioned it

[RuralPug]

That's a handy find. I have bookmarked it.

Thanks, Anne!

[~Anne~]

I found this while looking for soemthing else on the net and thought it might be interesting and handy for those with dogs on long term meds.

ty I have been searching for something like this , going for a 2nd opinion on my little girl soon , not happy that she is on cortisone long term, but atm it is stopping her fits as fit meds didn't cut it . I want to see if there is a alternative.can only hope , not impressed that all say to do bloods b4 and after, yet my vet never mentioned it

My dog never had blood work before either. Remember, the pdf is a guide only.

I am confused as to why cortisone would stop seizures?

[stormie]

I found this while looking for soemthing else on the net and thought it might be interesting and handy for those with dogs on long term meds.

ty I have been searching for something like this , going for a 2nd opinion on my little girl soon , not happy that she is on cortisone long term, but atm it is stopping her fits as fit meds didn't cut it . I want to see if there is a alternative.can only hope , not impressed that all say to do bloods b4 and after, yet my vet never mentioned it

My dog never had blood work before either. Remember, the pdf is a guide only.

I am confused as to why cortisone would stop seizures?

It can help in a couple of situations of seizures. Firstly its anti - inflammatory action would stop seizures in cases like GME, which cause brain inflammation which can cause seizures.

Secondly it can also reduce the size of some tumours so incidents of seizures due to a tumour (or the resulting inflammation around the tumour) would be helped with cortisone.

[~Anne~]

Thanks Stormie. However.... wh would the vet firstly have put the dog on antiseizure medication if the seizures were caused by inflammation and or disease. (Sorry, not actually asking you persoanlly as you can't respond for the Vet...but asking in general).

[Chezy]

I found this while looking for soemthing else on the net and thought it might be interesting and handy for those with dogs on long term meds.

ty I have been searching for something like this , going for a 2nd opinion on my little girl soon , not happy that she is on cortisone long term, but atm it is stopping her fits as fit meds didn't cut it . I want to see if there is a alternative.can only hope , not impressed that all say to do bloods b4 and after, yet my vet never mentioned it

My dog never had blood work before either. Remember, the pdf is a guide only.

I am confused as to why cortisone would stop seizures?

my vet said when fits start in older dogs it is because of a swelling of the brain, she was put on epil drugs and cort, I reduced the cort evry month to see if she could go withouth and when we got down to twice a week she started fitting again, I slowly raised it again and she kept fitting til it got up to almost every day > so it is working, I just know that the affects cort has long term are not good, if there is no alt and it works then so be it , will make her comfy and stop fits, just means i will loose her sooner because of the cort , rock in hard place, thus I want the 2nd opinion

[stormie]

Thanks Stormie. However.... wh would the vet firstly have put the dog on antiseizure medication if the seizures were caused by inflammation and or disease. (Sorry, not actually asking you persoanlly as you can't respond for the Vet...but asking in general).

I would assume it would just be part of the diagnosis process. Rather than sending every seizuring dog for imaging or analysing cerebro-spinal fluid, they'd just be started on the more common medication. If that fails, then you pretty much rule out epilepsy and know it's something possibly more difficult, so then you could suggest the fluid analysis, or CT etc.

The only way you'd really know for sure its GME or a tumour would be imaging or analysing cerebro-spinal fluid (for GME) which would be pretty expensive to do first up.

[Rappie]

There (is usually) a decision making process before just putting a dog on medication for seizures.

We need to know things like:

- how frequent the seizures are

- details of the seizures, how long, what happens when the dog is having a seizure

- whether there are any other problems that could cause seizures

- age, medical history, concurrent diseases

If the seizures occur only occasionally, or less than once every 4-6 weeks then we may choose not to medicate at all.

If the dog (or cat) is having only partial or focal seizures, rather than grand mal this can be a diagnostic clue.

I generally recommend some basic blood work as part of the work up for seizures. 'Epilepsy' is a diagnosis of exclusion, which means (ideally) we rule out all the other other known causes of seizures before we give it that label - which can be difficult and expensive. However, things like low blood glucose, toxicities and liver disease , or inflammatory diseases (like GME) can all cause seizures and be recognised on blood tests. If we're intending to start long term medication that can have an effect on the liver, it's prudent to check liver values first. If it's a breed where a portosystemic shunt is recognised then further tests might be required. Basically the bloods are to see if there is a treatable condition that might be responsible for the seizures - not much use medicating with phenobarbitone etc if you're not treating the cause. Often there is no identifiable cause, but IMHO that doesn't mean you shouldn't look for one.

I also do a neurological exam to see if there are other clues - even if they are subtle. Abnormalities can point to structural brain disease (tumours or swellings).

The risk of a tumour causing seizures does increase with age, but it's not the only cause. If we suspect that pressure or inflammation from a tumour (as opposed to general brain swelling) is causing a seizure then steroids can be used to help.

Edit to add: With respect to the original post, I do recommend regular monitoring for patients on long term medication. Generally at least every 6 months for a check up, and depending on the medication this will also include blood tests either to check liver / kidney function, electrolytes or white cell counts, or to test drug levels (such a thyroid and seizure meds).

Edited September 15, 2010 by Rappie

[Chezy]

There (is usually) a decision making process before just putting a dog on medication for seizures.

We need to know things like:

- how frequent the seizures are

- details of the seizures, how long, what happens when the dog is having a seizure

- whether there are any other problems that could cause seizures

- age, medical history, concurrent diseases

If the seizures occur only occasionally, or less than once every 4-6 weeks then we may choose not to medicate at all.

If the dog (or cat) is having only partial or focal seizures, rather than grand mal this can be a diagnostic clue.

I generally recommend some basic blood work as part of the work up for seizures. 'Epilepsy' is a diagnosis of exclusion, which means (ideally) we rule out all the other other known causes of seizures before we give it that label - which can be difficult and expensive. However, things like low blood glucose, toxicities and liver disease , or inflammatory diseases (like GME) can all cause seizures and be recognised on blood tests. If we're intending to start long term medication that can have an effect on the liver, it's prudent to check liver values first. If it's a breed where a portosystemic shunt is recognised then further tests might be required. Basically the bloods are to see if there is a treatable condition that might be responsible for the seizures - not much use medicating with phenobarbitone etc if you're not treating the cause. Often there is no identifiable cause, but IMHO that doesn't mean you shouldn't look for one.

I also do a neurological exam to see if there are other clues - even if they are subtle. Abnormalities can point to structural brain disease (tumours or swellings).

The risk of a tumour causing seizures does increase with age, but it's not the only cause. If we suspect that pressure or inflammation from a tumour (as opposed to general brain swelling) is causing a seizure then steroids can be used to help.

TY, can getting her bloods done now be of any help to me[already on meds] , not just to check how the cort is affecting her , but incase there is another reason that was not considered

[~Anne~]

Thanks Stormie and Rappie.

I should add, Monte is regularly given check-ups and has his serum levels checked periodically also.

Edited September 15, 2010 by ~Anne~