Seizure Meds Questions

[Guest LindsaySF]

I have a few questions for anyone that has experience with seizures in dogs. My new foster Sophie (thread here) is believed to have epilepsy. She was in a home for 4 months and their vet put her on potassium bromide (2.25 mL/day, split between 2 doses). Her former owner told me that she had a seizure a few days ago, so the meds don't have them under control just yet. We will be bringing her to our vet to get their opinion.

 

From my reading online it suggests that phenobarbitol be added to potassium bromide, instead of using potassium bromide alone. Should we ask about that? Also, Sophie has some side effects from the medication (extreme hunger and thirst, and frequent urination) which is why she was returned. I have read that these side effects go away with time, but is there anything I can do to make her more comfortable? (And allow me to get some sleep at night? ) I am going to try hourly snacks per Judy's suggestion in the other thread. I considered taking up the water after a certain hour but I haven't tried that yet (it makes me nervous, Cody has Diabetes Insipidus so I'm constantly worried about dehydration).

 

Are there any forums or mailing lists for seizure dogs that I can join? I'm trying to learn as much as possible. Thanks in advance.

 

 

 

~Lindsay~

 

 

[Ullaluv]

I wonder why they started her on KBr first rather than phenobarb. KBr has a VERY long half life and you can only change blood levels very slowly. Also, when a dog is on KBr you have to be careful to keep salt intake constant, since the chloride competes with the bromide. Changes if food have to be thought out and done carefully, and treats done very carefully. In know there is some risk of liver damage with phenobarbital, but it can be minimized with monitoring and the use of milk thistle and Sam-E. And you can change blood levels pretty quickly, as well as give a little additional phenobarb if you're worried about a cluster. Can't do that at all with KBr.

[CaliforniaGreys]

Hopefully Judy will see this. I think she posted in your other thread that Pheno should be added as well

[Trudy]

PB is the normal first line of defense in seizure dogs.

How long between seizures once she was medicated? Controlled won't always mean NO seizures.

 

Until last year, controlled for Ryan meant longer amt of time between seizures and no more 2nd seizures within a week. Going 4+ months without a seizure was control for him.

We are now over a year and his levels for PB at least are below therapeutic level and I've reduced it back even more.

 

 

Ryan can drink gallons of water a day and he's been on meds since he was 4 or 5. He's 10 now. Until he got sick 2 years ago, water came up at night. Now I just leave him limited water otherwise he will drink an entire bowl at night too. He's on other meds as well and pretty much everything he takes increases his thirst.

I had to have a dog door for Ryan to keep up with how often he was needing to go out.

 

 

[Guest MyBoys]

Our senior boy has epilepsy and does quite well on phenobarb alone with no side effects what so ever. He was 9 years old when he joined our family and started having seizures the day he arrived, he has been with us a year now and seizure free since he was started on the Phenobarb. It takes a little time for it to kick in after starting and sometimes the dose needs to be adjusted so you need to be a little patient, she may have a seizure or two. This is actually our second grey with epilepsy, our other boy also did very well on the phenobarb with no side effects. I do remember my vet telling me that he might show a little sleepiness in the beginning but that will wear off when his system gets adjusted to the meds. Good luck!!!!!!!!

[TheFullHouse]

Like Trudy said, most vets will start with the phenobarbital because within two weeks it can reach therapeutic levels, where it takes Potassium Bromide about 4 to 8 weeks to reach levels where it is high enough to control the seizures. If she's not been on the PB very long, it may not be at the level to control. A blood test will tell you if it is or isn't. They can up the dose on the PB or leave it where it is and add phenobarbital.

 

You can read more about seizures Here.

[TheFullHouse]

A word of caution. If you're fostering her, I'd crate her. Unless your pack has been around a seizure dog and you know how they will react, it can be dangerous. Especially if she has her seizures at night. A pack can tear up a dog with seizures before you can get to it. Some hounds don't react some react quite a bit. My pack tried to attack Saint 3 different times.

[Saffron]

Phenobarb is usually the first drug of choice. We have had 2 dogs here that have been well controlled on pheno.

 

A word of caution. If you're fostering her, I'd crate her. Unless your pack has been around a seizure dog and you know how they will react, it can be dangerous. Especially if she has her seizures at night. A pack can tear up a dog with seizures before you can get to it. Some hounds don't react some react quite a bit. My pack tried to attack Saint 3 different times.

 

Yes, yes, and yes! I have always been careful to separate potential seizing dogs from the others.

 

There is something about seizing that can cause other dogs to attack. A Grand Mal siezure is scary, for dogs and humans.

 

Please be careful.

 

But if you are careful, it is OK to deal with. We have done it.

 

[Guest LindsaySF]

Yeah all the fosters are crated. I have heard the horror stories, so especially in this case.

 

I wonder why their vet put her on KBr instead of Pheno. I emailed her former owner to ask for more info on her seizures, how often they were, etc. We are also still waiting for them to give us her vet records, hopefully that will tell us more.

 

 

 

~Lindsay~

 

 

[TheFullHouse]

Some vets think Phenobarbital is harder on the liver so if the seizures aren't coming with great frequency they will start with Potassium Bromide. You won't know until you get her history. I can tell you that in almost 5 years, Saint's liver is still working great and his liver tests are great. I guess it just depends on the vet.

[LBass]

Here are my favorite web resources for canine seizures:

 

 

http://www.canine-epilepsy.com/Resources.html

 

http://www.canine-epilepsy-guardian-angels.com/

 

http://www.canine-epilepsy.net/

 

 

 

[Guest hlpnhounds]

I have a few questions for anyone that has experience with seizures in dogs. My new foster Sophie (thread here) is believed to have epilepsy. She was in a home for 4 months and their vet put her on potassium bromide (2.25 mL/day, split between 2 doses). Her former owner told me that she had a seizure a few days ago, so the meds don't have them under control just yet. We will be bringing her to our vet to get their opinion.

 

From my reading online it suggests that phenobarbitol be added to potassium bromide, instead of using potassium bromide alone. Should we ask about that? Also, Sophie has some side effects from the medication (extreme hunger and thirst, and frequent urination) which is why she was returned. I have read that these side effects go away with time, but is there anything I can do to make her more comfortable? (And allow me to get some sleep at night? ) I am going to try hourly snacks per Judy's suggestion in the other thread. I considered taking up the water after a certain hour but I haven't tried that yet (it makes me nervous, Cody has Diabetes Insipidus so I'm constantly worried about dehydration).

 

Are there any forums or mailing lists for seizure dogs that I can join? I'm trying to learn as much as possible. Thanks in advance.

 

 

 

~Lindsay~

It also depends on the type of seizure activity. In many of the cases we see, patients that are only experiencing focal seizures (twitching, rapid blinking, fly biting )are only on KBr. Patients experiencing full tonic/clonic seizure activity (what would be a grand mall "fit" in humans) are normally pheno loaded and then maintained on Pheno with KBr possibly added later.

Your best bet is to have her KBr levels checked with the veterinarian and follow their recommendations.

[Devotion]

I have had one seizure dog. Obviously, I don't know the full history of your foster but I find it extremely unusual that pheno wasn't added. With Hans, it took a bunch of tweaking with the meds to finally get it right. It was a long road but so worth it. He had extreme hunger and personality changes but with time this all dissipated and I got my happy, go lucky boy back. He lived a long time with epilepsy. Best of luck to you and your foster...

[Guest snakes]

I have one seizure dog. We started him on KBr due to cost of meds/blood tests. I also felt more comfortable with the long half life in the unlikely, but you never know, event that he couldn't have the medication (lost, at boarding kennel, freak spillage of medicine). One or two skipped doses of KBr won't effect the dog much at all and i understood it does with PB due to its short half life.

KBR does take up to three months to be in full concentration in their blood. My boy (75lbs) was on 5ml a day split in two doses. So if the foster was recently started it may not be in full effect yet (or at correct blood levels- a blood test), the side effects also take that long to stabilize. Every vet was also very careful to say that any anti-seizure medication does not get rid of seizures 100% (a wonderful thing if it does), they said as long as it is not more than 3 in two months and clustering doesn't occur the seizures are basically 'controlled'.

Our experience here with KBr resulted in sever increase in anxiety levels and some very significant GI upsets (both directions). We have since started a homeopathic remedy that has worked wonders and have weaned off the KBr. We currently (Still tweaking the remedy dosing) have one seizure every two months

Good luck, the links and ideas given by the above posts provided by others have a lot of good information.

[Guest LindsaySF]

Unfortunately Sophie had a grand mal seizure yesterday. Her former owners said she also had a cluster on Thursday night. I'm calling the vet now to get her seen and talk about putting her on pheno, or maybe increase her KBr dosage. I'll update everyone when I know more.

 

 

 

~Lindsay~

 

[LBass]

Piper has tonic/clonic seizures and is also prone to cluster. From everything I've read in trying to help him, the combo of KBr and Pb is a particularly good combination of drugs for dogs with cluster seizures. It certainly helped Piper--we went form weekly clusters to typically one seizure every 7-10 weeks.

 

In talking with your vet, I'd suggest that you discuss adding Pb and getting levels on KBr. You can save a considerable amount of money by sending the blood to Dr. Dodds at Hemopet to get the levels of meds checked. The forms to do so are on a couple of the web sites posted earlier. If you'd like more specifics, PM me.

 

The early days of dealing with seizures can be difficult and stressful. There tends to be a lot of time spent tweaking meds and playing with doses to get the optimal balance between decent seizure control and problem side effects. It is hard. But, there is usually light at the end of the tunnel and things settle down. The frantic eating/drinking and the endless peeing usually ends or becomes manageable.

 

--Lucy

[mom2four]

Just a suggestion. If you have a holistic vet in the area, maybe you could look into Chinese Medicine. Our Lab, Heidi, is epileptic, and was put on Chinese Herbs in December of 2003 or 2004, (can never remember), but she has not had a seizure since! There are no side effects like the ones described in your original post. Heidi is on Ban Xia Bai....(3 more names) and Si Miao San.

[Guest LindsaySF]

Thank you everyone for the advice.

 

Lucy, I saw the contact info for Dr. Dodds to check the blood levels on the canine epilepsy site. We will look into that. (On a side note, can anyone send blood there, or just rescues? Honey's thyroid test for T4, free T4, and TSH cost me over $200 at my own vet. )

 

 

Sophie is at the vet now for observation. I was able to get ahold of her medical records and it says in the notes that she was on phenobarbitol already and it was recommended to add KBr because she was still seizing. Somehow that message must have gotten messed up because Sophie was ONLY on KBr when I picked her up. No wonder her seizures aren't under control, they stopped the pheno! (Either that, or they forgot to give me the pheno and just did not mention it to me at all, which would mean she hasn't gotten it in 5 days). We are going to add the pheno back in (at the dose she was on before) and continue the KBr, see if that does the trick.

 

 

 

~Lindsay~

 

[LBass]

As I understand it, anyone can send samples to Hemopet for analysis. It is a bit of a pain to package up the serum for mailing but the saving is significant and well worth the effort.

 

My vet draws blood for whatever selection of tests we are running and the techs spin and prep it per the directions on the sheet from Hemopet. I then take the serum and package it for mailing. I've never had a problem sending it by USPS Priority Mail. Dr. Dodds sends the blood to Antec (I think) and then writes up her assessment and recommendations and faxes those, with test results, to me and to my vet.

 

--Lucy

[greypuppyluv]

In Phaelin's case, we had to add the pheno to the sodium bromide because the bromide alone wasn't even coming close to controlling his seizures. It's still a work in progress with him.

 

Here are my favorite web resources for canine seizures:

 

 

http://www.canine-epilepsy.com/Resources.html

The above website has a link: http://www.canine-epilepsy.com/subscribe.html where you can join their epilepsy list. The list is set up identical to the Greyhound-L. I'm on it and it has been extremely helpful in learning about medications, dosages and anything associated with seizures in dogs. The website says, "In addition EPIL-K9, is very fortunate to have veterinarians, including leading veterinary specialists in canine epilepsy on the list sharing their knowledge with us." So, you're getting information from really knowledgable people.

 

Also, have you talked to Johanna? I know every case is different, but she might be able to give you some advice since she's gone through so much with Owen. I know in his case, his body couldn't handle the potassium bromide.

[CaliforniaGreys]

As I understand it, anyone can send samples to Hemopet for analysis.

 

You're correct here. Be sure you're looking at current info as Hemopet is in their new facility

[Guest LindsaySF]

Paula, I just subscribed to that list. Thanks. I am going to chat with Johanna soon too.

 

Sophie is back from the vet. She is now on phenobarbital (one 64.8 mg tablet 2X/day) and we're continuing the KBr (2.3 mL/day). Cross your fingers that this combo works at controlling her seizures!

 

 

 

[Guest LindsaySF]

Ok seizure people, talk to me about supplements. I am reading about milk thistle (SAMe? Marin?), taurine, melatonin, rescue remedy, etc. Has anyone tried any of these?

 

Does Sophie need to be on a liver supplement now, or only when her liver values look off?

 

As for the melatonin, it doesn't seem like her seizures are at night, but it might help with the pacing and nighttime restlessness. I'll hold off until I see whether she settles in here, but any experiences or info is welcome.

 

 

 

[Trudy]

I've never given Ryan anything and his last labwork this month showed "kidney and liver values of a puppy" according to the vet.

He's been on PB for 5-6 years and KBr for 4-5 years

 

At his higest levels, it was 360grms of PB a day and 2000mg of KBr a day.

[LBass]

I have not given Piper supplements. I would certainly consider doing so if Piper's liver labs looked like he was in any trouble. What I do is every 6 months have his serum bile acids tested at Hemopet. This lets my vet monitor his liver function so that we catch any trouble early when we can react appropriately. Remember that the vast majority of dogs take Pb without any liver issues ever developing.

 

There is now an easier urine bile acids test that just requires that you collect pee. My vet and I discussed whether to switch from the more complicated serum bile acids test to the newer urine bile acids. We (the vet ) decided to stick to serum bile acids. We did this partly because we had several years of history with that test for comparison purposes. Also the vet explained that the urine bile acids test was statistically slightly more likely to miss a liver problem than the serum bile acids test (which was slightly more likely to give false positive readings)--I think this is what he said.

 

With the serum bile acids you have to take a fasting blood sample. Then you feed a fatty meal and take another blood sample a couple of hours later. It isn't terribly troublesome, but necessitates the dreaded skipping of a dogs rightful breakfast and 2 trips to the vets office in one morning.

 

--Lucy