Controlling Seizures

[CaseyKay]

I am wondering if anyone has a dog that has seizures and uses something other than phenobarbitone (Pb) to control them.

Background:

My girl KC (that cute bc in my avatar) has seizures caused by (we think) a head trauma as a puppy. Her skull is flatter on one side. The vet said possibly not trauma, possibly it just grew like that. She has had x-rays and MRI etc. Which don't seem to show anything.

She is blind on the right side and circles/spins a lot towards the left which I think is more a visual thing than a neurological thing.

When she was 20 months old, in early 2004, she began having seizures very suddenly and it became a cluster with seizures about every 30 minutes, and she had a lot of blood tests and then given valium and she was put on Pb 30 mg twice a day, she weighs 11-12kg. I did not like the dog she became on the Pb. She used to be happy, bouncy go-go-go little dog. On the drugs she became very lethargic and woozy, had some weakness in her hind end and generally slept a lot. After 8 months on the drugs, Dec 2004 she had not had any more seizures and we weaned her off. Her personality returned and we were happy to have her back.

Fast forward 2 years to last week. She had not had any seizures since that cluster. Then she had one last Tuesday night, then Thursday afternoon, Thursday 3am and Thursday 6am so I took her to the vet and she had another two there (stress?). So she was given IV valium to stop the seizures. Which worked and then she was started back on Pb that night, same dose as last time.

She was okay for a few days but yesterday she seems to be slipping back into the way she was last time, she is very clingy but doesn't do much but sleep and she looks a bit out of it. She is also starting to get wobbly.

At the moment I am thinking I will take her off Pb after a month. I don't know what caused the last cluster and I don't know what caused this one. What I do know is I don't like her being on Pb. The vet said the other drug I can put her on is Potassium Bromide (KBr) but seems to have similar side effects.

My plan is to keep valium supposatories at home after she goes off Pb and if she has another cluster in the future to use that and if that doesn't work to go to vet for IV valium. The vet said this is "risking it" as she is obviously prone to seizures. But she had two years no drugs/no seizures?? It seems to me to be cruel to put her on what my husband calls the "zombie dog" drugs if most of the time she is fine.

If she had another cluster I am thinking that I would go with the valium and then NOT put her on the Pb and see if the valium alone stops them.

If there is anyone out there that does this I would like to hear from them, or if you use other drugs, etc. Her blood levels of Pb when on it are not "therapeutic" which is another thing that makes me wonder if the Pb is really doing anything.

[~Anne~]

There are a few of us on DOL that have dogs that suffer from epilepsy.

I have a 4 year old Pug, Monte, who is an epilpetic and also suffers clusters. Monte has on average around 5 seizures within 60 minutes. I usually manage to get valium into him after the first seizure and this seems to slow him down.

Monte is on Pb and Kbr and has been for more then 2 1/2 years. He started on Pb only but he was still having regular clusters of up to 10 and an obvious death sentence and so Kbr was introduced around 2 years ago.

He currently has 45mg Pb twice a day and 175mg Kbr twice a day.

Although he suffers ataxia, some lethargy and an increased appetite (amongst other things) but I would never consider ceasing his medication. It would be a death sentence for him to do this. Dogs that suffer from epilepsy, and in particular, cluster seizures have an increased chance of dying form the seizures. Cluster dogs have a much higher chance of going into status then other epis and valium will not always stop the clusters or prevent status even in dogs on both Pb and Kbr.

The Pb will take up to 3 months to settle in her system. If her levels were not in therapeutic range then you will have the opportunity for movement and increase if she continues to have seizures. The addition of Kbr will increase the ataxia for some time and lethargy. She will also experience an increase in thirst.

I can highly recommend a few websites and epi lists that may be of help to you if.

My advice is to consult with your vet and continue with the Pb and, if needed, the introduction of Bromide. A third drug, known as Keppra, is also used but this has its limitations in dosage and is not commonly used in Australia. Without the drugs you may be risking the death of your dog.

Edited to add: forget the valium suppositries. It is proven they are not as effective as injectable valium given anally.

Edited November 30, 2006 by Puggles

[Erny]

There's a couple of things (that I know of) that you can do:

1. Increase PB doseage.
   
2. Use "Bromapex" (Potassium Bromide)
   

As I recall (and my memory could now be deceiving me) the information I learnt about it at the time:-

1. The problem with PB is that it tends to "dope" your dog up. So, whilst it stops the seizures (which IS important), it can also slow the dog right down.
   
2. Bromapex doesn't have as much a tendancy to "dope" the dog up (as much, anyway), however I understand the dog's body can tend to become "used" to the doseage to the point it no longer has effect.
   

You can, however, use both the PB and the Bromapex in conjunction with each other. Of course, doseages and any proposed change to medications should ALWAYS be discussed with your Vet first.

Unfortunately, Bromapex didn't 'sit' well with my girl and caused her to vomit and gave her diarrhea. My darlin's condition was complex and related to adrenal tumour as well as brain tumour. She was not on the meds for a great length of time before I could not help but give her the greatest gift I could manage ........ her 'wings'. So I'm afraid I can't give you much more first hand information than that.

If you google for Phenobarbitone as well as for Potassium Bromide you should come up with a list of the possible adverse reactions, which, whilst not necessarily going to occur with your dog, are worth noting.

I was going through a bad and emotional time with my girl's condition/illness at the time of giving her these meds, so I find my memory of the details of the meds quite hazy (even though, at the time, I researched and understood them very thoroughly).

Edited November 30, 2006 by Erny

[Staffy-Lover]

My staff is on both pb and kbr. I believe the kbr does not effect some dogs as much as the pb.. i know the pb makes my boy wacky but the kbr doesn't as much.

If your pup only has seizures a long time apart without using any medication then talk to your vet about only keeping pb and valium to use at the time of seizure (pb as it works fast in the system).

But the problem is that you don't always see the seizures so pup could be having more then you think.

Otherwise i would definately recommend adding kbr and then trying to slowly reduce the pb until you find the right level that works.

If u r using drugs to medicate you need to remember to do regular 6 monthly blood tests to ensure they don't go to poison level in the system and to keep an eye on the liver.

I can highly recommend a neuro called Dr Childs at the vet specialist at nth ryde in sydney. Until we saw her our boy had seizures every fortnight in clusters very very severely.

No two dogs are the same so you need to consider your bub and what you think is best for him with advice from your vet. You can always try one way and then change.

Just remember that when taking a dog off pb or kbr you have to do it slowly or you can cause death.

Best wishes as those of us that own an epi dog know the stress that the seizures can cause... keep my info and give me a yell if you ever need help.

Edited November 30, 2006 by Staffy-Lover

[CaseyKay]

Great, I just wrote this long reply and it went and disappeared on me.

I really hate this seizure thing, so many unknowns. So scary, the 3 vets at my clinic seem to disagree on what to do. And if they can't agree...no specialist neurologists in NZ to help me either

After 2.5 years reading and learning as much as I could, just last month I signed off an epi-dog email list because I figured we were "safe" now. I guess I thought no seizures for 2 1/2 years they must be gone, right? WRONG. I feel cheated! Hey, this wasn't to happen again!

But yes, Staffy-lover what you said about not using any medication but having Pb and Valium (which is the injectable stuff in a syringe with the end cut off to be given rectally) on hand in case of future seizures is what I have been wondering. Because we have done it before (under veterinary advice and weaned off slowly).

So now I don't know what to do but we have blood tests in a month and go from there I guess.

She has never had a grand mal. She shakes, snaps and foams, and loses bladder control but she doesn't fall down or lose consciousness. The foaming is a LOT and dries all over her face and head and she is, umm, very fluffy underneath and needs a wash after she has one! So I am pretty sure she wouldn't have a seizure I don't know about.

Right now she is snoozing beside the computer and she looks so normal sleeping, it is when she wakes up I wonder where my best mate went and got replaced with this dog that only looks like mine. I know people with dogs of a similar size on twice the dose of Pb/weight and you would never know they were on it. I wonder if this sub-theraputic thing is not a constant for all dogs and she could be on a lower dose.

Anyway thanks for your suggestions etc, and I hope your dogs are currently doing well Staffy-lover and Puggles. Interesting to see both your dogs on Pb and KBr. Did they start on only Pb? Was KBr added on top or with the Pb lowered a bit?

[~Anne~]

Hi Staffy-lover, I didn't realise you got over to see Georgina. She's great isn't she!

Personally I find the Kbr more of a problem than the Pb. Bromapex is only a branding name for the drug and the active ingredient is still Potassium Bromide.

Erny, Staffy-lover - have you used only tablet forms or liquid of the Kbr?

I have returned to the liquid as I find this is absorbed easier by his system and works more effectively. Have you ever found any difference in seizure activity and reactions in the different forms of Kbr?

[~Anne~]

Did they start on only Pb? Was KBr added on top or with the Pb lowered a bit?

We started only on Pb but the seizures were not under control. So about 6 months later he was started on Kbr. Originally the Pb was halved when they added Kbr but, again, his seizures (clusters) continued so the Pb was upped again.

Apart from a focal last week we are now 10-11 weeks seizure free and counting (touching wood).

[Erny]

Erny, Staffy-lover - have you used only tablet forms or liquid of the Kbr?

Used the liquid.

I have returned to the liquid as I find this is absorbed easier by his system and works more effectively. Have you ever found any difference in seizure activity and reactions in the different forms of Kbr?

Due to Kal's reaction (vomiting/diarreha) to the Kbr, we returned to PB only (under Vet supervision) and upped the PB. This made her somewhat slower, but the illness subsided. Seizures were at first controlled by PB alone (Kal was having GM's) and reason for adding Kbr was that after a short period of no seizures, mini-seizures began to occur on a frequent basis (mainly "head-tapping"). I did not find Kbr made a difference, but I didn't keep her on it for a very long period of time due to her not coping with that medication.

Sadly, Kal's condition took over her quality of life fairly quickly which is why I sent her with her wings. So in fairness to either medication, I have to say she wasn't on it for a great deal of time to properly determine success levels as far as seizures over a long time are concerned.

Edited November 30, 2006 by Erny

[Staffy-Lover]

yep started on pb then added kbr when i didn't get control... are just thinking about reducing pb now. it takes a while to work everything out.

well u sound like you know all the options and i know u will choose the right one... so dont' stress just make a decision give it a little while to work itself out and then make decisions from there..... it's pretty much what the rest of us do aswell.

good luck and i hope your bub remains seizure free

[CaseyKay]

We decided to reduce KC's Pb to 15 mg twice a day (half dose), although the vet said if I was going to do this I may as well take her off it completely. Although she did say KC is more sedated and lethargic than what she would expect on what is really not a "high" dose of Pb. So we finally decided between vet and me she will get 15mg for now and if she seizes again we will try adding KBr instead of more Pb and see how we go with that. She has been on 15mg for a few days now and is pretty much back to her normal self which I am very happy with.

I think you are right Staffy-lover, and we will tweak the meds etc as we go and made further decisions as we need to. That is I guess all anyone can do.

[~Anne~]

We tweak Monte's constantly.

Poor bugger had a focal the other week and then a tonic clonic on Sunday night. The unusual thing is he only had one? I drew up the valium and didn't end up using it. This has never happened before so I am a little wary about what will be next.

He didn't seem to experience the full clonic side to it either and was up in half the time he normally would be. He was a little hyper for the first few minutes after it but calmed very quickly. I gave him a little jam on bread and then 30mg valium orally and he settled (sort of - he paced on and off) for the remainder for the night.

Every time you think you have it down pat the rules are changed.

[cav_mad]

Has anyone here tried fish oil? I have an epileptic child (lots of partial seizures but no grand mals) whose seizures were resistant to all the medications. We were desperate- we were prepared to try anything and then I read on the net about fish oil having some benefit for epileptics.

The fish oil has been of great benefit to my child- the seizures are no longer the problem they were and life has returned pretty much to normal. However- if we get slack and go a few days without giving the fish oil capsules the seizures return so there is no doubt in my mind that it is the fish oil that is controlling them.

Maybe worth a try on epileptic dogs? One capsule should be enough for an average sized dog- my child gets two capsules and is around 50 kg. Those epileptic drugs have such nasty side effects- it must be terrible for dogs who have to endure them.

[Staffy-Lover]

cav mad yes i use fish oil every night, the neuro recommended it for general health and said that research suggests it COULD make a difference but nothing tight.... so what the hell if it might work i'm using it heheheheheh

Puggles - yes i did get into see Dr Childs... she is fantastic.... she only had to do a few tests with making max walk and turn certain ways to tell us that it wasn't a tumour or anything and that all neuro was fine and so epilepsy it is.

She also gave us a wealth of info that has been sooooooo useful

re the kbr - i only use the tablet form...and seems to work well... do u know if the liquid is any better re digestion etc?

After xmas i am going to see if i can reduce the pb a little with maxi to see if i can get control on less meds... but u know how it is.. if its working it is a bit scary to make any changes !!!!

What i did find out from Dr Childs is that KBR is not absorbed very well if you don't give it with a substantial amount of food. We now give ours with weetbix or porridge in the morning and then normal dinner at night and it has made a HUGE difference.

Hope Monte is doing well !!

[~Anne~]

What i did find out from Dr Childs is that KBR is not absorbed very well if you don't give it with a substantial amount of food. We now give ours with weetbix or porridge in the morning and then normal dinner at night and it has made a HUGE difference.

Hope Monte is doing well !!

I wasn't aware of this actually but I have always fed him twice a day anyway and his meds are put in his food so I guess this is why she didn't say anything.

[loony888]

hello all,

we have a 3 year old staff male and he had his first seizure in april. since then we have been struggling to get his seizures under control, he is currently on 150mg of phenobarbitone twice a day and from previous increases in medication he seems to grow accustomed to it rather quickly. usually about 2 weeks seize free then back to having them.(mainly in the small hours ) our vet has prescribed "epibrom" but doesn't keep it in stock,???. can anyone tell me a reputable on line supply of this bromide drug for my boy?

thanks in advance, and i must say, until we discovered our boy had epilepsy i had no idea just how common it is, and i'm sure it's just as gut wrenching to see for every owner as it is for us.

cheers,

paul.

[~Anne~]

hello all,

we have a 3 year old staff male and he had his first seizure in april. since then we have been struggling to get his seizures under control, he is currently on 150mg of phenobarbitone twice a day and from previous increases in medication he seems to grow accustomed to it rather quickly. usually about 2 weeks seize free then back to having them.(mainly in the small hours ) our vet has prescribed "epibrom" but doesn't keep it in stock,???. can anyone tell me a reputable on line supply of this bromide drug for my boy?

thanks in advance, and i must say, until we discovered our boy had epilepsy i had no idea just how common it is, and i'm sure it's just as gut wrenching to see for every owner as it is for us.

cheers,

paul.

Hi Paul,

I have used use Epibrom in the past but am currently using Bromapex liquid. My vets don't keep this sort of drug in stock usually either and I usually always pre-warn them. It only takes a few days and they have it in.