Any Hounds On Keppra?

[Wonder]

Thunder had 11 seizures over the weekend (started 1:30 am Friday until 5am Sunday).

 

After spending the night at the evet and getting an iv drip, 2.5 hours after coming home sat night, he had a grand mal and another grand mal Sunday morning.

 

I took him back to the evet Sunday morning and got a weeks worth of keppra extended release. The evet did not know how quickly it starts working. Anyone know?

She said there would be minimal side effects. His neuro was out of town until this morning. My primary vet does not use keppra.

 

 

He is now on:

zoni 250 mg bid

pheno 100 mg bid

keppra 750 mg bid

 

He hasn't had a seizure since starting keppra.

[Guest Clawsandpaws]

No experience with seizure dogs, but I am SO SO SO sorry you are going through this. It must have been so horrifying for you and your baby

[kamsmom]

I don't know how fast, but I remember thinking that once Steak was on Zoni and Keppra things were better. It's hard for me to see your updates as they remind me of Steaks so much.

[Wonder]

I just talked to his neuro vet and she said 2-4 days and it's fully working in his system.

 

 

Beth- I'm sorry Put me on ignore so you don't see the updates

[a_daerr]

I am so sorry you're going through this. Poor Thunder. :(

 

To my knowledge, Keppra's half life is shorter than the other seizure meds so it has to be dosed more frequently. I'm gone from home for 9-10 hours a day because of my work schedule, so that one wasn't ever a consideration for us. But from my copious amounts of research on seizure meds, I have read that Keppra is a better alternative to Pheno for certain dogs because it has less side effects and liver scarring. It's primarily an anti-convulsent for humans, but they've had success using it on dogs (I think within the last 10-15 years). I've never heard of Pheno, Zoni, and Keppra all three used in combination... but who knows. With seizures, the medication is mostly trial and error. Oh, another thing I do know about Keppra- it's quite expensive. If Thunder stays on it, I'd recommend going through Costco or Sams Club as their prescription prices are significantly lower.

 

Just curious, has his neurologist ever suggested Pheno in combination with Potassium or Sodium Bromide? That's usually the first thing they change if the seizures aren't controlled on Pheno alone. From my experience with Henry, regular vets and e-vets don't have a lot of knowledge about epilepsy pharmacology other than Pheno and Keppra. So it might be worth having a conversation with the neurologist when you take him back in.

 

I'm keeping Thunder in my thoughts. Poor guy.

[Wonder]

He's on the extended release keppra so it's given every 12 hours. No way I could do the reg keppra.

I suggested Potassium Bromide (which is what my primary vet suggested). Neuro didn't want to add since it's an older drug and keppra is newer. Trust me, I fought for it but in the end went with keppra since it works quicker than PB. That can take 2-3 weeks to be up to full strength.

 

It was the neuro that suggested the keppra Evet looked at the notes from the neuro (they are in the same clinic).

Edited June 18, 2013 by Wonder

[Wonder]

I've never heard of Pheno, Zoni, and Keppra all three used in combination... but who knows. With seizures, the medication is mostly trial and error. Oh, another thing I do know about Keppra- it's quite expensive. If Thunder stays on it, I'd recommend going through Costco or Sams Club as their prescription prices are significantly lower.

I can't take him off the other drugs because he will have more seizures so that's why he's on all 3. We tried in May and within a few days, he had a grand mal.

 

It's $109 a month for the keppra.

[a_daerr]

Extended release Keppra!? Wow! Is that something new? When we were looking at meds for Henry, that wasn't mentioned. They said it 100% had to be dosed every eight hours. Hen's doing fine on the Zoni (we are going on seven months seizure-free). But that's good info to know if we ever need to change anything.

 

Did your neurologist say anything about reducing or withdrawing the Zoni on Thunder if he does okay on the Keppra/Pheno combination? Three different meds just seems like a little much, not to mention making things more expensive and difficult to dose. But in the end, hey, whatever works. Also, it's nice that your e-vet and neuro are all in the same practice. That really streamlines things for everybody when they're able to review each others' notes and files.

 

ETA: You answered my question in your second post. I was thinking maybe they'd eventually reduce or withdraw the Zoni. But since he's 11 and has a history of grand mals, this is probably the best option. My guy is only 5, so I'd go broke/crazy if I had to indefinitely pay for him to be on three separate meds.

Edited June 18, 2013 by a_daerr

[Wonder]

Extended release Keppra!? Wow! Is that something new? When we were looking at meds for Henry, that wasn't mentioned. They said it 100% had to be dosed every eight hours. Hen's doing fine on the Zoni (we are going on seven months seizure-free). But that's good info to know if we ever need to change anything.

 

Did your neurologist say anything about reducing or withdrawing the Zoni on Thunder if he does okay on the Keppra/Pheno combination? Three different meds just seems like a little much, not to mention making things more expensive and difficult to dose. But in the end, hey, whatever works. Also, it's nice that your e-vet and neuro are all in the same practice. That really streamlines things for everybody when they're able to review each others' notes and files.

We already tried to reduce the zoni and he had a grand mal. That's a side effect for zoni that I didn't know about when I started him on it.

I take that back- the neuro did tell me before I started the zoni that I prob can't take him off it. I forgot about that.

Edited June 18, 2013 by Wonder

[Guest Fasave]

I've had very limited exposure to seizures so I can't help with medications. However, when I was at GIG, I heard a woman speak about a diet developed by Jean Dodds for seizures dogs. Not sure if you're doing anything with diet but thought I would share this link. The speaker actually recommended that you feed this diet to all dogs for a couple weeks a couple times a year just to cleanse the liver. She also recommended it for all dogs that have been recently retired.

 

 

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

[Wonder]

I've had very limited exposure to seizures so I can't help with medications. However, when I was at GIG, I heard a woman speak about a diet developed by Jean Dodds for seizures dogs. Not sure if you're doing anything with diet but thought I would share this link. The speaker actually recommended that you feed this diet to all dogs for a couple weeks a couple times a year just to cleanse the liver. She also recommended it for all dogs that have been recently retired.

 

 

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

 

Thanks, I will check it out.

I've had him on grain free for a few months.

I am switching him to raw this week.

[Charlies_Dad]

Good thoughts for Thunder and you. I hope you are able to get his seizures under control.

[carronstar]

Keeping you and Thunder in my thoughts and prayers.

[MaryJane]

I'm so sorry to hear about Thunder -- seizures are tough on our pups but, this must have been a really bad weekend for you. Lucy has gone through clusters like what you describe and I was a wreck afterward. Usually, the neurologist would either increase the pills or if we were at the limit, add another. We are now at the point where she still has a seizure about once a month and this pattern has developed after a few months. The neurologist and I agreed that we are going to wait and see if the pattern stays the same over the next few months and then decide what we will do (maybe nothing). I am also using rectal valium ever since she started clustering to make sure that the one seizure does not turn into multiple and so far (cross my fingers) it has been working.

 

1. If you are not already using a neurologist, it is time to get one. Your regular vet is not going to be of use with all the different seizure meds.

2. You may not get to the point where Thunder is seizure-free, you may have to settle for a seizure a month, or every 5 weeks, or every three weeks - have a heart-to-heart talk with the neurologist about this (NOT the regular vet).

3. The neurologist should show you how to use the rectal valium. The rectal valium will help prevent the clusters. It lasts a few hours but, during that time, it helps to keep the dog from seizing. Otherwise, you will end up at the ER. Lucy tolerates the procedure for the rectal valium pretty well. After a seizure, she gets her vanilla ice cream and then she gets her rectal valium. They should set you up with the glass bottles, syringes, catheters, and ... the neurologist should show you how to do it. My neurologist was great -- he made me do it after him to make sure that I felt "capable" of doing it.

 

Lucy is on 300mg Zonsiamide bid - after her seizures moved to every three weeks, we went from 200 to 300 and the neurologist does not want to increase the zonisamide at this point. Zonisamide has a "grace period" of a little less than a year and after that, a small percentage start to seize again and have to have another medicine added. Lucy, was not one of the lucky ones.

 

After cluster, we added the 750mg KeppraER bid (a bit over 100$ for 1 month) which went well for about 3 months and I decided to switch to Costco (note, you don't have to be a member for their prescriptions) and the cost there was about $50 for 1 month. It turns out, different manufacturers use different enteric coatings and it looked like the one from Costco had a coating that Lucy couldn't absorb so the pills were not likely getting into her system. After starting the Costco pills, she has a seizure the next day ...

 

Ok, then we went back to the hospital for their version of Keppra pills but, they no longer had the KeppraER (out of stock) so Lucy went on the regular Keppra ($100) and things went well for about 6 weeks and then another seizure. Since she was on the regular Keppra, I am able to cut the pill and give her 1 1/4 pills tid.

 

As I noted, she's been having a seizure about every month (she had one on Friday too) but, we are watching and waiting.

 

It gets expensive but, someone on the epi-list mentioned that Sam's Club has an even better deal on Keppra (I vaguely remember about $50 for three months - WOW) but, Sam's club does not ship, so you have to go the store.

 

I just recently am trying to move Lucy to the Costco Keppra again, since this is not the ER pill, maybe she can use those.

 

There is also a foundation -- Wally Foundation which helps adoption groups with the costs associated with epileptic dogs.

 

 

 

 

 

 

[Wonder]

I do use a neuro and just started using my primary vet for bloodwork every 6 months. Before that, I was using my adoption groups vet. Plus I can text, call, email my primary vet any time of the day and he gets back to me right away. The neuro isn't that easy to reach.

 

The neuro won't give me rectal Valium (claims it won't work on him). I've asked my reg vet for some.

[MaryJane]

The regular vet probably won't know the right dosage for a rectal dose. When Lucy's vet prescribed the rectal valium for the interim time until we could get in to see the neurologist, she prescribed 5 ml as the dose ... once we got in to see him, the neurologist prescribed 16 ml (yikes .... big difference). Don't get me wrong, I love Lucy's regular vet, just not for the seizure treatment.

 

If he is going into the ER, they are likely doing a drip that has the valium - bring that up to the neurologist or if you are having a hard time dealing with that particular neurologist, switch to another one. Lucy's neurologist wants to know whenever she has a seizure - I email him and ... usually I get an answer back within an hour or two ... even on weekends. We were lucky to get someone so caring and so intelligent - he is a wealth of information on not just seizures, but everything else.

 

You might also want to join the epi-list. There are tons of really caring people on the list that can provide support and suggestions (sometimes at all hours of the night). Some have had luck with occular compressions, others with going to grainfree diets .... just tons of other things that you can try.

 

I didn't have a chance to add some links (cable guy was here and pulled my connection as I was typing last reply ..)

 

http://thewallyfoundation.com/

 

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

 

There are mentions of Dr. Dodds ... please be forewarned, she is on the fringes of the established medical community. While it's good to read her materials, they have not been peer-reviewed and thus, may make conclusions that others would not.

 

For others that may be reading this -- send the Wally Foundation link to the adoption group that you dealt with - again, they will help to pay for seizure drugs for dogs in adoption shelters.

Edited June 18, 2013 by MaryJane

[RaineysMom]

Rainey was on all 3 too -- the Keppra and Zoni seemed to make her wonky when we started and any time the dosage was adjusted (always up). GO TO COSTCO to get the meds (and the generic of the keppra, levetiracetam) -- WAY cheaper.

 

when she was just on the zoni and keppra, she continued to have seizures. Only after we bit the bullet and added the pheno back (it made her impossible to live with, many side effects) did she finally stop seizing, for 2 months, until we tried to back down on the Zoni. We let her go shortly after.

 

ETA: keep an ice pack in the freezer and when he starts to seize, place it on his back, just a bit past midway down, right on the spine. I swear by it, it lessens the severity and several other folks that have tried this said the same thing.

 

ETA again: didn't know they now have an extended release -- that's great. Rainey was on the regular and got pills at 5:30am, 1:30pm and 9:30pm. Thankfully I was already down to part time so I got home by 1pm to pill her.

Edited June 18, 2013 by RaineysMom

[a_daerr]

 

There are mentions of Dr. Dodds ... please be forewarned, she is on the fringes of the established medical community. While it's good to read her materials, they have not been peer-reviewed and thus, may make conclusions that others would not.

 

Agree... and the epi-list really is a great resource.

[Wonder]

I'm trying to find a large ice pack. The problem is, he has the seizures in my room which is in the attic. There's no way I can leave him to run to the kitchen to get the ice pack.

[MaryJane]

One last thing, if you are using the KeppraER, some dogs have trouble metabolizing the enteric shell and as a result it just gets excreted whole. I mentioned that this happened to Lucy ... what you probably want to do is check the poop for a few days and make sure that the pill is not getting excreted whole and in that case, it's not getting into the system. From what some people have said, sometimes just the outer shell gets excreted and if that is the case -- that's OK.

 

Probably just what you wanted to hear ... having to dig through ** ...

[hikinghounds]

Sorry to hear Thunder had more seizures! Zephyr takes 500mg of Keppra, actually the generic. I didn't know there was an extended release Keppra. I'm going to look in to it. That sure would make things easier. I hope Thunder does well with the addition of Keppra.

[Wonder]

One last thing, if you are using the KeppraER, some dogs have trouble metabolizing the enteric shell and as a result it just gets excreted whole. I mentioned that this happened to Lucy ... what you probably want to do is check the poop for a few days and make sure that the pill is not getting excreted whole and in that case, it's not getting into the system. From what some people have said, sometimes just the outer shell gets excreted and if that is the case -- that's OK.

 

Probably just what you wanted to hear ... having to dig through ** ...

Can't the pill be mashed up and mixed into kibble?

[JJNg]

I've never heard of Pheno, Zoni, and Keppra all three used in combination...

 

It's actually pretty standard to use combo meds for difficult to control seizures. I have a case I'm managing with the help of a neurologist who is on 5 different anti-seizure meds - pheno, bromide, zoni, keppra, and now Topamax. Before trying the Topamax, we added Lyrica, but stopped that and tried Topamax instead when it didn't help. Unfortunately, he's still seizing every couple weeks. They're now trying an experimental vagal nerve stimulator. And I've also talked to the owners about considering acupuncture.

 

Can't the pill be mashed up and mixed into kibble?

 

If it's mashed up, it won't be 'extended release' anymore. The ER relies on the intact pill and coating being digested and absorbed slowly.

[Wonder]

I picked up the keppra last night. It was $60 for a months worth. If you do use Costco, sign up for their discount drug program, it saved me a few bucks.

I'm looking into acupunture as well.

[a_daerr]

 

It's actually pretty standard to use combo meds for difficult to control seizures. I have a case I'm managing with the help of a neurologist who is on 5 different anti-seizure meds - pheno, bromide, zoni, keppra, and now Topamax. Before trying the Topamax, we added Lyrica, but stopped that and tried Topamax instead when it didn't help. Unfortunately, he's still seizing every couple weeks. They're now trying an experimental vagal nerve stimulator. And I've also talked to the owners about considering acupuncture.

 

Poor thing. I've heard of two different combo meds being used, but never three. Thanks for clarifying.

Do they have any idea what's causing the seizures for the doggie you mentioned? MRI?