Potassium Bromide Questions

[greypuppyluv]

For anyone who has a dog on potassium bromide, would you mind sharing the dosage, concentration and weight of the dog? Also, I'd be interested in hearing about if you ever did a loading dose of the bromide and how much the dosage was and for how long you did the loading dose for.

 

I'm asking because a friend who is not on GT is currently having some major issues with her sighthound that was recently introduced to KBr. My friend is in contact with her vet but it's me who would like to hear some experiences from other people about their dogs and dosages. I have experience with Phaelin's seizures but he's on sodium bromide (and pheno) and I don't know that the sodium bromide can be compared equally to the potassium bromide.

 

Thanks.

[MaryJane]

My Lucy was on Potassium Bromide - she was weighing about 70 pounds and she was on 1.5 ml bid of a 250 mg/ml solution (375mg). She did not have a loading dose. She was also on 2 other seizure meds (Zoni & Keppra) and also thyroid.

 

She started Kbr back in August of 2013. We recently had to switch to Sodium Bromide as it appears she has IBD and the concern was that the Kbr was a factor in that.

[greysmom]

Hopper is on 2.4ml bid. He weighs about 77 lbs. I don't know what the concentration is, but it is a liquid compounded specifically for his weight. He's on liquid rather than pills due to a malabsorption issue. He wasn't with us when he started his medication so I also don't know about any loading dose.

[greypuppyluv]

Thanks. When I said concentration, I probably should have said strength as that's what it says on Phaelin's bottle of sodium bromide.

[Saffron]

What are the major issues your friend's dog is having?

 

We had Caesar on Kbr liquid for only a few weeks and the poor guy gradually went psychotic. Whining, pacing, barking at nothing, not sleeping, etc. His anxiety (and he is always a little anxious) went through the roof! The longer he was on it the worse it became and we were afraid he had a brain tumor! It turns out that this is a rare side effect of Kbr and he is hypersensitive to a lot of drugs. As soon as we took him off it (substituting Keppra, not cold turkey) he was miraculously better.

 

I wrote about it here:

http://forum.greytalk.com/index.php/topic/97439-greyhound-epilepsy-study/page-6

 

Sorry, I can't remember the exact dosage of Kbr he was on and don't have his log with me. He did not have a loading dose, and I'm sure the dose was standard for his weight.

Edited March 11, 2014 by Saffron

[greypuppyluv]

Well, it's sort of a long story, but here goes (I have a migraine so my details might be a little sketchy and probably a little wrong ).

 

A few weeks ago my friend's dog had a grand-mal/tonic-clonic seizure and went into status. She was seizing for approx 30-40 minutes by the time my friend was able to get her out of the house and seen by the ER vet. She made it through the seizure and went home the next day with instructions to see the family vet for follow up. My friend's normal vet wasn't in so she saw another vet at the practice who prescribed a loading dose of 15 ml twice a day of potassium bromide for 7 days as a loading dose for a 40 lb whippet/saluki mix. Yes, you read that right. 15 ml twice a day. When my friend told me this, I was having more migraines than usual so with the pain and the difference between sodium bromide and potassium bromide, I didn't know know how to tell if this vet knew what she was doing. Turns out it appears she didn't since my friend's dog is having major issues with bromism. Looking back, we're both wondering if she meant to prescribe 1.5 ml twice a day. After approx 5 days (I think....this is where my details get sketchy), my friend talked to her usual vet about her dog's issues so he reduced the bromide to 3 ml (don't know if it was once or twice a day) because the dog could not walk, use her tongue to drink water, would constantly pace at all hours of the day and night and would whine a high pitched whine. After a day or two more, I think my friend took her off the bromide completely and the dog is now on pheno in case she has another seizure. She is still recovering from the bromism and it's been a very slow recovery. I've seen her dog and it was really hard to see her stumble around so much and have to pick her up.

 

We had both tried looking up online for potassium dosages but couldn't find a whole lot of information that was easy to understand without a physics degree. My friend is now adding a little salt to the dog's food and water (per our online research) to hopefully move the bromide out of her system quicker, but she knows it will still be a slow process.

[Saffron]

I am so not a vet, but that sounds like a massive overdose not a loading dose. I thought bromism only happened with longterm use as it builds up in the system! I hope the dog recovers well because that is awful!

 

Looking at Caesar's log now: 75 lbs and started on 2 ml 2x a day of 250 mg/ml solution. Within a week he started to lose weight and started to get agitated. My vet consulted with the neurologist by phone, and we lowered the dose to 1.75 ml BID, next week and then to 1.5 ml. BID the following week. He got worse not better, but both my vet and the neuro thought he'd improve as he got used to it - and perhaps the neuro thought I was exaggerating the symptoms. I wasn't and my regular vet knew that.

 

He was on it for just over 3 weeks before we could get an appt. with the neurologist, brain scan etc. and took him off it. But as I said, Caesar gets weird reactions to many drugs. Valium makes him hyper as well.

[greypuppyluv]

Thanks for the info. In looking at one of the two potassium bromide bottles when I was there, the strength wasn't listed so I asked her to call the vet to find out what it was. He told her 227 mg/ml. My friend has had prior experience with a dog with seizures, so this stuff isn't new to her, but bromide is and with the first seizure being so long, we both weren't sure if the symptoms were because of bromism or a brain tumor. It's looking more and more like bromism.

[Saffron]

I hope it is not a brain tumor and scans and spinal taps are $$$$. With that big of a loading dose I'm thinking its probably bromism too. I just wanted to add -- Caesar never had ataxia when on Kbr.

 

I'm sure other people will chime in here soon but it might be a good idea to ask this question on on the Yahoo or Facebook canine epi groups or on the EPIL-K9 list.

Edited March 11, 2014 by Saffron

[greypuppyluv]

Thanks for the suggestion of the Yahoo and the epi-groups. With the info given here, I pretty much already have my answer that the vet overdosed my friend's dog. There's no way a loading dose of 15 ml should ever be given to a 40 lb dog with the regular dosages given above to dogs twice her weight. And in looking at the bottle size (8 oz) and the fact that she gave my friend 2 bottles, she really did mean for the loading dose to be 15 ml. Phaelin's bottle is only 4 oz and that lasts for either a month or two. I'm friggin' pissed.

[scullysmum]

What are the major issues your friend's dog is having?

 

We had Caesar on Kbr liquid for only a few weeks and the poor guy gradually went psychotic. Whining, pacing, barking at nothing, not sleeping, etc. His anxiety (and he is always a little anxious) went through the roof! The longer he was on it the worse it became and we were afraid he had a brain tumor! It turns out that this is a rare side effect of Kbr and he is hypersensitive to a lot of drugs. As soon as we took him off it (substituting Keppra, not cold turkey) he was miraculously better.

 

I wrote about it here:

http://forum.greytalk.com/index.php/topic/97439-greyhound-epilepsy-study/page-6

 

Sorry, I can't remember the exact dosage of Kbr he was on and don't have his log with me. He did not have a loading dose, and I'm sure the dose was standard for his weight.

Interestingly Kbr was one of the earliest drugs used to treat seizures in humans but it was quickly replaced as it caused psychosis in many patients.

 

My bridgekid Scully was on a combinatio of Pheno and Kbr which completely controlled his seizures, but despite looking I cant find any note of his dosage so can't really help.

[Saffron]

Thanks for the suggestion of the Yahoo and the epi-groups. With the info given here, I pretty much already have my answer that the vet overdosed my friend's dog. There's no way a loading dose of 15 ml should ever be given to a 40 lb dog with the regular dosages given above to dogs twice her weight. And in looking at the bottle size (8 oz) and the fact that she gave my friend 2 bottles, she really did mean for the loading dose to be 15 ml. Phaelin's bottle is only 4 oz and that lasts for either a month or two. I'm friggin' pissed.

 

I would be pissed too and hope that your friend brings it to the attention of the prescribing vet. It definitely looks like a misplaced decimal point! I guess the poor dog can make a full recovery from Bomide toxicity but I'd be really angry with the vet. An acknowledgement and apology is the least the vet can offer.

 

 

scullysmum: Yes, you are quite right, Kbr does cause psychosis in humans but rarely in dogs. When I did a search I only found a couple of footnotes about Kbr psychosis in dogs on what I think of as the usual Canine-Epi support websites. Also, one article on a poodle site and one on a Westie site, IIRC. Even veterinary articles say that only a handful of dogs go psychotic on Kbr.

 

Trust Caesar, he always likes to be different!

 

I'd use certainly use Kbr again on other seizure dogs, but I hope Caesar's experience now comes up on searches. I would have pressured to take him off it faster had I known, and I don't want other people and dogs to go through what we did.