Seizure Meds Questions

[giadog]

Regarding the liver enzymes, the way our doctor described it was that the Pheno is not actually DAMAGING the liver...the liver enzymes ARE elevated while he's on the pheno, but that's just their reaction to the pheno. If/when we're able to wean him off the pheno, his liver levels will return to normal. So it's not lasting damage you should worry about, just a natural reaction.

[LBass]

So it's not lasting damage you should worry about, just a natural reaction.

 

Unfortunately, for some dogs (though not the majority) Phenobarbital can cause lasting liver damage. The good news is that, if it is caught early, medications can be changed and the liver is wonderfully able to heal itself. That is why the regular testing of liver function is regarded as a wise precaution for dogs on Pb. Piper has had several years with no issues so I am likely going to switch from testing every 6 months to testing every 12 months with my vet's blessing.

 

http://www.canine-epilepsy.com/liver.html Here is a good article written by a veterinarian discussing anti-epileptic drugs and the liver. It in fact supports both what giadog's vet said--that not all elevated liver enzymes mean there is danger of liver damage--and what I have said--that there is, unfortunately, a small but real risk of serious liver damage from anti-epileptic drugs.

 

--Lucy

[Guest LindsaySF]

Thanks guys. I don't want to start her on any supplements if she doesn't need them. Looks like regular testing is the way to go.

 

 

[giadog]

So it's not lasting damage you should worry about, just a natural reaction.

 

Unfortunately, for some dogs (though not the majority) Phenobarbital can cause lasting liver damage. The good news is that, if it is caught early, medications can be changed and the liver is wonderfully able to heal itself. That is why the regular testing of liver function is regarded as a wise precaution for dogs on Pb. Piper has had several years with no issues so I am likely going to switch from testing every 6 months to testing every 12 months with my vet's blessing.

 

http://www.canine-epilepsy.com/liver.html Here is a good article written by a veterinarian discussing anti-epileptic drugs and the liver. It in fact supports both what giadog's vet said--that not all elevated liver enzymes mean there is danger of liver damage--and what I have said--that there is, unfortunately, a small but real risk of serious liver damage from anti-epileptic drugs.

 

--Lucy

 

 

Good to know, Lucy! Thanks for the further info.

[Guest MZH]

A vet told me to give Cullen milk thistle to protect the liver. His alk phos levels were way too high, over 1000. Darned if it didn't get the numbers down by at least 50%. It took maybe a month.

 

I also gave him taurine. He had far fewer seizures when on taurine.

 

Before giving any supplement you might want to wait until the therapeutic med levels are established and then add one thing at a time. If the alk phos levels are OK, I'd start with taurine and add the milk thistle only if the liver values are off.

 

There are two holistic vets in CT who'd likely be able to help you with the supplements. I know them b/c we've used them. One is Julia Carter in Branford, last I knew, and one named Emily and whose last name escapes me at the moment -- she's in Bristol and Avon. They're both good. Julia does acupuncture and holistic meds and Emily does chiropractic and holistic meds. Julia was our regular vet for quite a while and was excellent. She had a pet greyhound too so she knows the breed well

[Guest LindsaySF]

As I said in Sophie's other thread, she moved to a foster home in MA at the end of November. They haven't failed fostering yet. She had one seizure since then, but has been doing fine. She likes their 2 Greys and seems happy.

 

Her foster mom called me today to say that Sophie had a seizure yesterday and three seizures this morning. I'm waiting to hear back from the vet. Should her pheno dosage be increased? It was on the low side when we did a blood test in November, so it has room to go up.

 

The only pattern we have seen with the latest seizures is that they seem related to being home alone, or being in her crate. Do you guys think crate anxiety or separation anxiety could cause enough stress to induce a seizure? Or am I looking for patterns where they don't exist? Does this mean the routine should be changed, or it's a medication issue?

 

 

 

~Lindsay~

Edited December 16, 2009 by LindsaySF

[TheFullHouse]

Stress can bring on seizures so if she's stressing big time over being alone or crated, I'm not surprised she's seizing. If her phenobarbital level was on the low side, I would suggest raising her dose of medication to get it a bit higher. This is what we did with Saint until he reached the maximum phenobarbital he could have and that's when we added the potassium bromide. I'm so sorry to hear she's having seizures again.

[Anne]

My Frasier was on phenobarb for over a year for his seizures. It did control them very well. But the hunger was always there, he was ravenous at every meal and he got a little bit chubby. We worked out a fine balance between it all, but it did take some working on since I also have 6 other dogs. I had to contain him alone for food or else he'd wolf his food down and move on to the next dogs's bowl! He was also on prednisone for SLO so he was always thirsty as well and he was ALWAYS thristy, and I cannot tell you how often he drank my soda or iced tea or coffee! Gosh I miss him so much!

[Guest LindsaySF]

Sophie had 5 seizures today. The vet gave the ok to double up her pheno dose tonight and tomorrow morning, hopefully this stops her clusters. Please keep her in your thoughts.

[Guest MyBoys]

I have had a number of seizure dogs and they have always done very well on phenobarb alone, I have never had to use potassium bromide along with the phenobarb. As for side effects, after about 2 weeks I saw none. If you decide to go with phenobarb there will be a need for blood work every 6 months to check liver levels. Like I said, we have had very good results with phenobarb, as a matter of fact our senior boy who came to us last Oct. having seizures, at least one a day, has been seizure free since Nov. of last year. Also, it may take a few dosage adjustments to get it right so don't get discouraged, one good thing is that phenobarb is very inexpensive.

[Devotion]

Stress can bring on seizures so if she's stressing big time over being alone or crated, I'm not surprised she's seizing. If her phenobarbital level was on the low side, I would suggest raising her dose of medication to get it a bit higher. This is what we did with Saint until he reached the maximum phenobarbital he could have and that's when we added the potassium bromide. I'm so sorry to hear she's having seizures again.

 

 

 

 

 

 

I was going to say the same thing. With Hans stress did increase seizure activity. I also read your vet said the Foster family could increase Pheno. Hopefully, this will control it. She could have an infection. uti or something which could increase seizure activity. best of luck for Sophia.

[TheFullHouse]

Poor Sophie. I hope the increase in pheno helps.

[Guest LindsaySF]

Sophie spent 2 days at the vet on a valium drip getting stabilized. She's home now. (Her other thread is here).

 

The neurologist increased her meds from 1 pheno tab 2X day to 2 pheno tabs 2X day, and her KBr from once a day to twice a day. Basically both medications have been doubled. That seems a little much to me?

 

She is showing symptoms of ataxia, incoordination, stumbling, weakness, etc. Is that something that will pass? Or a sign that her meds are too strong? I thought it was residual from the valium drip, but now I'm not so sure.

 

 

 

~Lindsay~

[Guest LindsaySF]

She could have an infection. uti or something which could increase seizure activity.

The vet suspected this too. We did MRI, spinal tap, urinalysis, etc, and all looks good. Either it was stress-induced, or her little brain got used to the meds and a higher dose (or different combo) is needed.

 

 

 

~Lindsay~

 

 

 

 

[Guest gretzky]

Lindsay, the tech today did say that she could be "out of it" for up to 2 weeks until she adjusts. Not sure what degree of out of it is acceptable but they expected her to be "off".

 

She had a big day today, hoping things look a little better tomorrow.

[Guest LindsaySF]

Lindsay, the tech today did say that she could be "out of it" for up to 2 weeks until she adjusts.

Two more weeks of this?! Oy.

 

I didn't get much sleep last night. Someone was restless and wanted to go out every hour.

 

Well the good news is that she was perky this morning (probably her meds had worn off a bit overnight, she gets her meds every 12 hours), and she did lots of snow zoomies! I'll post pics and video later. She got her meds this morning and she seems sleepy again now.

 

 

 

~Lindsay~

[TheFullHouse]

The side effects of the increase of medication should wear off in a couple of weeks. Saint spent about 3 weeks walking around like a drunken sailor. One of the side effects that may stay with her is the ataxia. Saint always has rear end weakness and probably always will. It doesn't stop him from running and jumping and acting like the other dogs though. Sophie's body has to adjust to the increase of medication. This will happen every time you increase her dosage. She'll adjust though and be just fine.

 

Forgot to add, every time they increase the phenobarbital, she'll have to use the bathroom more often until her body adjusts.