Steak's Seizures

[kamsmom]

WARNING! This video is not pretty, not funny, not for everyone. But, I thought just maybe it might be educational.

 

Steak has been having seizures every two weeks since December 2010. We started off the traditional route with phenobarb and progressively increased the dosage until we could no longer increase it. We then tried potassium bromide with the pheno and it also did not stave off the seizures. Most recently we did switch to zonisamide at the urging of members here. That was three weeks ago. Today, Steak seized at 5am and 10am. During the second one was when I was able to video. At that time I loaded him up and we went to the vet. We sat at the vet all day long. He seized again at 2pm and again at 4pm. We then came home as the vet does not have overnight care and he again seized at 7:30pm. I can't remember the name of the med that he was given at the vet but I also called again this evening and if he seizes again tonight I am to take him to the ER. The vet mentioned that if he was to go in he would be placed on an IV but I can't remember the name of the med that he said it would be.

 

My brain is mush right now. I'm tired, frustrated, sad... I'm just trying to do what's best for him but I keep thinking I am doing something wrong. My vet and the neuro vet spoke a few times today. He reviewed the MRI that we had done several months ago and now wants to do another one, but the treatment won't change, it would just give us a better understanding of what is going on... I just don't know what to do. I don't want to sound as if his care is dependant on cost but it is coming to that since each vet visit has averaged about $200- $300. Then add on the cost of meds and the cost of another MRI is just scaring the crud out of me .

 

Anyway, I don't really know what I am wanting to do or what I should be doing but for some reason I just thought maybe the video may help others or maybe help someone to help me.

 

Edited August 25, 2011 by kamsmom

[Guest PiagetsMom]

Beth, I didn't watch the video because I have no experience with seizures......and selfishly, I'd rather not be upset. But, I'm sorry that you and Steak are having such a time with this and I can understand your worry and frustration. I wish I had some advice and I do hope someone else does have some for you.

[Hollis]

Beth I'm sorry. I have no experience. I've read about seizures but just had no idea what they were like. My heart breaks for him. And for you. And for every other pup and family that goes through this. I pray someone sees something here that can help.

[kamsmom]

The only thing I keep thinking about today is that for the last couple of months the weather has been very hot, 100 degrees hot. Then today it started out hot, got very windy and looked and smelled like it was going to rain but then never did. The temp did drop almost 15 degrees in about 10 minutes time. I know that weather has affected him before but nothing this bad.

 

Just thinking and trying to make sense of it.

[maggiespet]

Oh dear God - poor Steak, poor you. Oh I hope your girls didn't see this - or maybe they've been educated better about seizures than I. It takes a lot to move me to tears - but I'm moved.

 

If the treatment is the same whether or not the additional tests are administered and whether or not the results show something different/better/worse - I personally wouldn't run them. You'll do what's best for Steak and your family.

 

I'm so very sorry you all are going through this. Prayers coming for sweet Steak.

[SkipSailors]

I had a collie-spaniel mix who had seizures when I was young. No fun. I'm sorry for the both of you.

[kamsmom]

The girls have seen the seizures. They have all been as violent as the one shown in the video. The girls are really good about it and know the routine now. They know to just wait and make sure the other dogs are ok and that to just let Steak wake up on his own and then take him outside. They then give him a spoonful of peanut butter.

 

It used to really shake me up when he seized and now I know what to expect with it. When it is just one than I do ok, but today has really got me down. I've cried a few times. The vet is a really great guy and he knows how much I love Steak. He is always just so nice and comforting. He likes Steak. (at least he makes me think so )

He got a bit choked up when I cried at the office today. I don't know... I just don't know if I am doing the right thing anymore. The one thing that the vet keeps reminding me is that Steak has no neuro deficits after these seizures. His personality has become more subdued but all his neuro senses are still intact.

[Devotion]

I've had seizure dogs before and treated for that. but after what I'm going through now with Avril I have a bit of a different feeling. Have you talked about adding antibiotics in case there is an underlying infection. for example, some can harbor for months before being noticed. Baytril crosses the brain barrior in case you are dealing with abscesses etc. also tbd can cause this. my dog has been to so many vets and it's unimaginable what can cause these seizures however, it possibly could be epilepsy and you have not found the right keppra, zonisamide etc dosage. it is definitley like walking a tight rope.

I could go on and on but it's a real touchy subject for me please pm me if you need any more info.

 

edited to add. also MRI and cat scans unfortunately can miss things just like in people. i know some will say no but i do work in the health field and yes.

also this a little extreme comparison but treating a seizure with seizure meds if there is a cause like a tbd etc is like giving a kid meds for a fever. it's treating the symptom. I'm not saying do or don't do the MRI. you may or may not get different info but if it were me I'd be pressing to try other things like antibiotics. it could be a tbd that needs doxy or you need baytril to cross the brain barrior. and yes, in my case this has helped.

Edited August 25, 2011 by Devotion

[kamsmom]

Keppra, that is another that we have tried and even tried to increase the dosage.

 

I did ask about infection today and the vet did run a urine cs but said he was fine. I was thinking his urine seems too concentrated but the vet feels that Steak is a bit dehydrated so has me adding some water to his food and also just being sure that the kids are checking the water bowls more often when I am not home.

 

I may re ask about antibiotics again tomorrow.

[Remolacha]

I am so sorry to see this, I didn't know Steak was having seizures! I wish I had some answers for you

[JJNg]

Sorry you are going through this with Steak. I have a couple patients with difficult to control seizures, and I can see what a struggle and frustration it is for the owners.

 

I have more questions than answers at this point... How old is Steak? Did the pheno and bromide help at all to decrease the frequency of seizures, or was he having them every 2 weeks on the dot, regardless of those meds? Does he always have clusters of multiple seizures, or have they just been single seizures every 2 weeks in the past? Do you keep any rectal Valium on hand to give when he has seizures at home?

 

Most recently we did switch to zonisamide at the urging of members here. That was three weeks ago.

Up until today, had he had any seizures since starting the zonisamde? I'm surprised your neuro vet didn't suggest zonisamide sooner when his seizures weren't improving with the pheno and bromide. It seems that zonisamide is increasingly becoming a first choice for seizures among veterinary neurologists.

 

When you say you 'switched to zonisamide' did you stop/wean down the pheno and/or bromide? When our neurologist has recommended adding zonisamide for my difficult cases, it has been on top of the other meds, and we don't even talk about trying to decrease the others until seizures were under much better control.

 

The vet mentioned that if he was to go in he would be placed on an IV but I can't remember the name of the med that he said it would be.

Standard treatment is usually IV Valium boluses given to stop seizures. When one of my patients had a difficult to control cluster, the neurologist recommended doing a continuous drip of Valium, gradually weaned over 24 hours.

 

He reviewed the MRI that we had done several months ago and now wants to do another one, but the treatment won't change, it would just give us a better understanding of what is going on...

Did the neurologist find anything on the MRI to explain the seizures, or was the diagnosis idiopathic epilepsy? If the MRI was normal last time, do they have any reason to expect to find anything different if you repeat it? Especially if cost is a concern, I personally don't recommend doing any testing that won't change the treatment plan.

 

Our neurologist seems to be pretty conservative about recommending MRIs in seizure cases. I referred one of my difficult cases (an IG) to him when we weren't able to make much progress with pheno and bromide. Both the owner and I were expecting them to do an MRI, but he said it wasn't necessary because the dog fit all the criteria for idiopathic epilepsy. Instead, he's mostly just consulted over the phone to help us add and adjust medications. This particular dog is now on pheno, bromide, zonisamide, and generic Keppra, and we've gotten his clusters spaced out to every 7-8 weeks. Even with the improvement, though, his last cluster was the one where we had to use the continuous Valium drip to get it under control. And after that, the neuro recommended upping his Keppra dose. Each time we've added a new med or increased doses, we haven't changed any of the other meds.

 

My other difficult case is one that initially responded well to pheno, then had to add bromide. Did well for a few more months, then started having clusters every 2 weeks despite increasing the dose of both. Tried adding gabapentin because it was easily available, fairly inexpensive, and there are some reports of it helping, but saw no improvement after a month. Cost was a huge issue and owners were considering euthanasia at that point (dog is a 90# mastiff mix with very violent seizures - ie. flips all over the room and sprays urine everywhere). We've seen this dog's seizures while he's boarded at the clinic, and I honestly don't know how the owners are able to deal with them at home. Decided to try zonisamide as a last ditch effort, and he's now gone 5 weeks with no seizures since starting it. <knock on wood>

 

Not sure if these accounts will help you at all, but each case is different and just wanted to share examples of what we've tried with other dogs. I am certainly no expert in this area and rely heavily on our neurologist's recommendations.

 

I do think Pam has a good point about the possibility of infection or other TBD. Had Steak had any TBD testing done? Did they do a CSF tap when they did his MRI?

 

Best wishes for Steak and hoping you're able to find a combo that works better for him.

[kamsmom]

Steak is 6 years old.

 

He has had the seizures every two weeks on the dot for the last 6 months regardless of meds. This is the first clustering though. Only one other time did he have two in one day but they were about 12 hours apart. At that time was when we weaned the pheno and started Keppra.

We had stopped the bromide before the Keppra as well. The only thing he is on is the Keppra and I was told to stop the Keppra at the time we started the Zonisamide. He has had one other seizure after the Zonisamide which was two weeks ago. I knew and was expecting a seizure this week but never thought there would be more than one.

 

Valium, that is the stuff. Yes, we do have a script for rectal valium and he did get a shot of valium in the office today. That is the med he mentioned on the phone as well.

 

The MRI showed nothing abnormal. We have been going with the thinking that it is epilepsy. But then today my vet started to wonder aloud if we weren't dealing with a tumor or lesion that may have been missed. In talking to the neuro vet they decided that the treatment was going to be the same regardless of the diagnosis. I guess I was just thinking maybe I "needed" the diagnosis.

 

We have tested for TBD in February and it was negative. I am totally open to going an antibiotic route. At this point I am willing to try anything. The only thing I miss the most is that "fun" dog he used to be. The meds or seizures have zapped his personality. He is still a very affectionate dog but he is scared all the time. It's as if he is waiting for the seizures to happen again.

 

The image you give of the mastiff is what we sometimes see with Steak. Urine usually goes everywhere and he will at times flip over. He has had seizures on the couch and falled off of it onto the floor. I am in constant worry mode that he will hurt himself badly during a seizure when I am not home. This morning he was near the entertainment center and caught his foot, tearing the webbing on one of his front paws.

 

Thank you for chiming in. I am more than willing to try anything for him. We are on Zonisamide, 3 pills per day, can't remember the dosage right at this moment. We were just doing two pills per day and the vet said that we "could" go up to 4 pills per day if needed. He wants to give the dosage a solid two weeks to see if there is any change...

[September]

It was heartbreaking to watch the video- so very sorry for you and your family, and Steak.

 

We had a seizure dog when I was growing up. She eventually died from one such episode. We had her on different meds. I think though, her issues were genetic.

 

Good luck to you in trying to figure out a way to help Steak.

[greypuppyluv]

Steak's seizure looks just like Phaelin's seizures. They feel like they go on forever and you just want them to stop.

 

Only one other time did he have two in one day but they were about 12 hours apart. At that time was when we weaned the pheno and started Keppra.

We had stopped the bromide before the Keppra as well.

 

Maybe Lindsay could correct me, but I thought Keppra was used more as an add-on drug, not a stand-alone drug (Phaelin hasn't been on it, so I'm not that familiar with it). As for the Zoni, I'm wondering if you may need to give it more time to see if it works. Some AE drugs can take 2-3 months to be effective in some epi dogs. I know it's hard to wait (believe me, I know), but sometimes that's what it takes.

 

When the vet or neuro is having Steak start out on new drugs, are they doing a loading dose?

 

Are you keeping a log/diary of Steak's seizures and med changes? I know it sounds cumbersome, but it really can help in looking back to see when drugs were changed, what time of day seizures happened....I even make notes of weather issues or if we walked when it was too warm and Phaelin seizes. It kills me, but I can't let Phaelin exercise if the weather is higher than 70 degrees or he will seize the next day.

 

It's a reach, but one thing that will cause seizures are lesions from Valley Fever. You mention that Steak was tested for TBD, but was he tested for VF? It's a different test. I wouldn't get my hopes up that VF is the culprit and if you don't want to keep throwing good money after bad as far as testing goes, you may not want to do the VF test, but I wanted to mention it. I knew a dog years ago that had around 15 seizures in one day because he had advanced VF. If Steak wasn't raced in states where he could be exposed to VF, his chances are pretty low he has it.

 

I was reading an old post on the EPIL-K9 list the other night and the following was posted regarding valium protocol immediately after a seizure. I wanted to post it in case you might like to talk to Steak's neuro to see if this is something he should have you do with Steak since he now seems to be clustering:

 

I am fairly new to the seizure world - Zeke has had two rounds of seizures

since he has been with us, but each time they were cluster seizures. The

neuro we consulted after his second round put us on a protocol for the

rectal valium. We are to give it to him as soon as we can once the first

seizure has started. Then, after 20 minutes, we give him another dose (even

though he will hopefully not be seizing at this point) then, 20 minutes later

another dose, and 20 minutes after that another dose.

 

One more thing I wanted to add.....hang in there.

[Batmom]

No advice, just lots of hugs for yourself and gentle scritchies for your handsome boy.

[FiveRoooooers]

No advice, Beth, just a for Steak and one for you. .

[BootsyCollins]

[Guest zombrie]

I'm so sorry you are going through all of this. I know how hard it is for both you and Steak. Unfortunately I know all to well what it is like

 

Manny clustered every two weeks. We tried pheno barb and potassium bromide and it didn't seem to work one bit. Then we switched him to Keppra and he start clustering once a month. Then we added potassium bromide to the Keppra and he went seizure free five months.

 

It's so frustrating, I know. Sending all my good thoughts and strength to you.

 

ETA I don't know what you do when you are sleeping/go out, but we put Manny in a padded x-pen (with pee pads underneath) Keeping him safe is unfortunately all you can really do for him while he is having seizures. Before Manny came to our house, he broke his leg twice while having seizures in two different episodes

Edited August 25, 2011 by zombrie

[galgrey]

No experience with seizures here, but I'm sending good thoughts to all of you. :group

[MTFSTHNDS]

Poor Steakers. I have no advice just a for Steak and a for you Beth.

[Charlies_Dad]

Beth, I have no advice and dearly hope you can find a drug combo that will help Steak. Now that I have seen Steak's seizures, I don't know anyone can go through this with their pup.

[kamsmom]

He just had another one We will be going back in to the vets office this morning. That will be #6 in 24 hours time.

 

I am keeping a log. The seizures are all different times. They last about the same amount of time but the only thing I have been able to narrow down is that it is every two weeks.

 

It stormed this morning and so Steak did his usual hiding in the bathroom. I checked in on him at 6am and he was good. I still keep wondering if the sudden and drastic weather change is what has thrown him into this.

[racindog]

I'm so sorry you and Steak have had such a terrible time. I watched the video because I was wondering how they compared to Minny's siezure(s) since Minny's was caused by brain cancer. I am a layman and of course each dog is different but it looked a lot different than Minny's. Minny's was more like he was "all there" , and his body just wan't working right but Steak looked out of it. Minnys also wasn't violent-more that his body just twisted up and wouldn't work etc. I am praying for the great physicain to lay His healing hand on Steak and praying for strength for you to endure what you must. God bless both of you.

[Guest vahoundlover]

I'm sorry this is happening, Beth. It took a L O N G time to get Busters down to 1 every couple of months. He was on Phen and Kbr, we just kept adjusting the dosages. One of his triggers was a lot going on in the house, ie company or a lot of excitement. The others I never figured out. I'm not familiar with the other drugs you have mentioned and mixing them. If I had a seizure dog now, I'd talk to a holistic vet to see what they could offer, perhaps accupuncture ???? to aid the meds. There is a *seizure pinch* with the ear ours taught us to stop a seizure. We never got a chance to use it. I'll see if I can find a picture.

 

Again, I am so sorry Steak is going through this. Makes me really sad for you guys.

[Devotion]

oh darn i'm terribly sorry he's having more seizures this am. i'm sure your vet/neuro will recommend valium iv drip to pull him through the clustering.

 

i think steak needs more than 3 zonisamides a day. i would say he needs 500-600mg per day which would be 5-6 pills.and he possibly will need more. please talk to the neuro vet about this and also keeping him on something else as well like keppra.

some dogs will have a tbd even if the test said negative. again it could be a hidden infection that just isn't showing up.

 

you will both get through this. good thoughts coming for you two....