Canine Epilepsy & Medication

bluecherry74

My English Setter Jess has been having occasional seizures since I got her at age 6 months. She's 4 now and over the last 6 months she's been having them more often - every 3 to 4 weeks - and she's been having clusters of seizures, sometimes up to 4 in a day.

She started on Pexion in September, which is a new drug and my vet recommended it as it has fewer side effects than traditional epilepsy drugs. Unfortunately it's had no effect whatsoever on Jess's seizures, even after the dosage was increased.

I'm going back to the vet next week to review things, but last time we spoke she said she thought it might be time to try another drug, i.e. phenobarbital. From my research this has some potentially nasty side effects, the main one being liver damage. My vet says that it's highly unlikely as long as everything is monitored carefully, but another vet had previously told me that it's almost a certainty over time.

Just wondering if anyone here has any experience with canine epilepsy or with either Pexion or phenobarbital? Any general advice on dealing with epilepsy?

I really do trust my vet, but I'm getting a little scared by the idea of this medication and also the amount of seizures that Jess is having.

Nody

We have a foster cat on phenobarbital for the last two years due to seizures. It's hard to say how big effect it has had but it has worked as far as the frequency and strength of the seizures have been reduced (she used to be only able to sit around for hours after a seizure, now she's up and running within minutes, the jerks are also less severe than they used to be, how much is medicine and her growing up / getting used to it we don't know, she's usually have them in clusters as small, small, big, small with in 24h and then nothing for 2 months). The other thing is the medicine has very very short duration once eaten; you need to be serving it up every 12h pretty much on the dot because it goes through that quickly.

Due to the side effects she had some blood values raised in the last medical check and we had to lower her medication down and go on a low fat diet to help her liver; if you do put her on it you'll basically need to do blood samples at least every quarter to make sure the dosage is ok once stabilized (before that I'd recommend every month but speak with your vet on the topic) to keep a track on it and if it goes high you'll be told to scale down to let the liver recover combined with additional medication to help the liver (this is why frequent blood samples are required to spot it early enough). We're due in for a follow up check in two weeks and may go for a full brain scan as well (unlikely to find anything but we're getting to the point we're grasping for straws in finding anything to help make her life better).

On a separate note if you're not already doing it but you can also try to find out when she's likely to have a seizure. For example over time as we've recorded when seizures happen we've established a pattern that they happen when she's deep asleep which means we've prepared multiple sleeping areas she likes to sleep with additional cover to catch potential pee (loss of bladder control) and we know where she's likely to go to hide (we always to try hold her instead and get her into the bathroom to let her pee into the bathtub to avoid it getting on her if possible).

bluecherry74

Brilliant post, thanks Nody!

My vet did say that she would need regular blood tests if she goes on pheno, so I'm prepared for that. I feed raw and am hoping that won't have to change, but my vet knows this and seems open minded about it so hopefully any necessary diet adjustments cant be made to what she's currently eating.

I figured out fairly quickly that Jess only ever has seizures when she's sleeping, same as your cat. She sleeps on my bed so after numerous middle-of-the-night duvet changes, I now have a waterproof picnic blanket topped with 3 thick fleecy blankets folded in half. She's a bit like the princess and the pea (or pee! :P ) but I haven't had a wet duvet in months. (Hat tip to Muddypaws for that idea.)

Jess's current meds also require that they be given 12 hours apart and to allow a specific interval between meds and food. My schedule has more or less revolved around this since September, but we're making it work.

My big fear is that she's only 4 and if she stays healthy she'd be on these meds for a very long time.

Nody

bluecherry74 wrote: »

Brilliant post, thanks Nody!

My vet did say that she would need regular blood tests if she goes on pheno, so I'm prepared for that. I feed raw and am hoping that won't have to change, but my vet knows this and seems open minded about it so hopefully any necessary diet adjustments cant be made to what she's currently eating.

The liver damage leads towards a low fat diet; that can be managed as raw (I think DBB is currently doing it with one of her dogs as side note for another medical issue and may be able to help you on the topic).

My big fear is that she's only 4 and if she stays healthy she'd be on these meds for a very long time.

Expect lifetime; I've researched a bit into it for our foster (inc. looking in Europe for Universities and doctors to help / cure) and it's a grim story. In one research paper over half the animals (dogs & cats) had some brain damage from the seizures and even with surgery the rate of "fixes" on the animals the scan diagnosed was relatively low (and the scan only hit about 20% as identifying the brain damage to be dealt with or so). Don't want to scare you but honestly don't expect that the seizures are likely to ever stop or go away (your best bet is once she's grown up she may have grown out of them but I'd not put money on it) but rather you'll get a working regime to handle and lessen the impact of them.

Ms2011

We've a Rottie on 90mg Phenobarbitone twice a day. She started seizing at 3 years old, she coming up to 6 now so she's been on the medication for almost 3 years.
We've found it great for controling the seizures but also found her v.sensitive to any changes in the time she's given them, she has to have them at the same time everyday or she's almost certain to have a seizure, I don't see her ever coming off the medication & do feel it will eventually shorten her life expectancy but we take it year to year & for the time being she's perfectly healthy otherwise.
For us we found excitment or anxiety to be a trigger, but the medication has dramatically reduced the episodes.

ETA: It is also a relatively cheap drug, I get a 3 month supply for €35

DBB

Sorry to hear she's not in the best Bluecherry
Is she on bromine as well as the Pexion? It is meant to be super, but is most effective, I believe, when used concurrently with bromine.

tk123

Poor Jess! Bailey's liver was enlarged when he had a scan in August and values slightly raised - since then I've been giving him milk thistle to help cleanse his liver. He was in for thyroid bloods before Christmas but there was so much going on in the vets (a dog had been run over) I forgot to ask for the liver values to be done as well! So I don't know if the milk thistle is actually doing anything yet!

bluecherry74

Thanks all, for the replies. Jess was at the vet last night and we decided to start her on Phenobarbitone, I can't remember the dose but it's at the lower end. She goes back in two weeks for bloods to make sure it's at theraputic levels and I suppose get a baseline for her liver, etc.

DBB wrote: »

Sorry to hear she's not in the best Bluecherry
Is she on bromine as well as the Pexion? It is meant to be super, but is most effective, I believe, when used concurrently with bromine.

I did mention this to the vet - thanks for bringing it to my attention - but she told me it can take over 12 weeks for Bromine to reach therapeutic levels in the blood. I don't really want to wait that long since the seizures are getting closer and closer together.

tk123 wrote: »

Poor Jess! Bailey's liver was enlarged when he had a scan in August and values slightly raised - since then I've been giving him milk thistle to help cleanse his liver. He was in for thyroid bloods before Christmas but there was so much going on in the vets (a dog had been run over) I forgot to ask for the liver values to be done as well! So I don't know if the milk thistle is actually doing anything yet!

I'd be very interested to hear if this has helped - I'm all for trying natural remedies alongside the drugs. Did you adjust Bailey's diet in any other way? I know you already feed fairly low fat. Jess would be the same to be honest, so not sure what I could do to make it leaner.

bluecherry74

Ms2011 wrote: »

We've a Rottie on 90mg Phenobarbitone twice a day. She started seizing at 3 years old, she coming up to 6 now so she's been on the medication for almost 3 years.
We've found it great for controling the seizures but also found her v.sensitive to any changes in the time she's given them, she has to have them at the same time everyday or she's almost certain to have a seizure, I don't see her ever coming off the medication & do feel it will eventually shorten her life expectancy but we take it year to year & for the time being she's perfectly healthy otherwise.
For us we found excitment or anxiety to be a trigger, but the medication has dramatically reduced the episodes.

ETA: It is also a relatively cheap drug, I get a 3 month supply for €35

Thanks for this - really glad to hear it's working for your rottie. Can I ask, how much leeway do you have with the timing of the medication? Does it have to be bang on the exact time or do you have 15/30 minutes to play around with?

Ms2011

bluecherry74 wrote: »

Thanks for this - really glad to hear it's working for your rottie. Can I ask, how much leeway do you have with the timing of the medication? Does it have to be bang on the exact time or do you have 15/30 minutes to play around with?

Tbh I don't like to leave it more than an hour outside her normal time, I feel like I'm playing with fire after that.
I don't know if it's because she is on a low dose for her size that the drug has to be so accurately timed or if it's just how it effects her individually but we have found over the last few years it's best to keep to a routine time.

tk123

bluecherry74 wrote: »

I'd be very interested to hear if this has helped - I'm all for trying natural remedies alongside the drugs. Did you adjust Bailey's diet in any other way? I know you already feed fairly low fat. Jess would be the same to be honest, so not sure what I could do to make it leaner.

Like I said I stupidly forgot to ask for the liver bloods to be done too! His vein collapsed and they had to go back in etc etc I'll be getting them checked at his next thyroid bloods in 6 months and am interested to see what they say. This is the one I get - http://www.bulkpowders.ie/milk-thistle-extract-powder.html

I haven't changed that much in his diet - I switched from duck mince/necks to turkey because it's leaner and added it other lean meats/minces - rabbit, pheasant, venison and beef etc He had lost weight with his jaw and was under 29kgs but around 30-31 now but it's muscle and not fat so I'm not concerned - I weigh out the meat now and add a good big portion of veg in separate because imo he wasn't getting enough food. As it is he still get's half compared to Lucy gets and I'm not cutting it back any more.

bluecherry74

Just a little update on Jessie. She started on Phenobarbitone on January 13th and she hasn't had a seizure since. Her last one was January 8th, which makes it over 10 weeks. Prior to Phenobarbitone she was having them every 3 weeks.

She had blood tests shortly after she started on it which did show that her ALT levels were high, but not alarmingly so. My vet said it was possible that her liver would recover once it got used to the drug. I'll be taking her back for more bloods next month just to keep an eye on it.

She's still on Pexion for now - the idea is to wean her off it in a few months once we're sure things are stable. I'm expecting break-through seizures, but if she only have one every few months that would be a fantastic improvement.

Ms2011

bluecherry74 wrote: »

Her last one was January 8th, which makes it over 10 weeks. Prior to Phenobarbitone she was having them every 3 weeks.

That's my experience with this drug too, we can go almost 3 months now without a fit whereas it would have been every 2-3 weeks in the begining.
Glad to hear it's working for you.

the heathen

Ms2011 wrote: »

ETA: It is also a relatively cheap drug, I get a 3 month supply for €35

Can I ask you where you get this? Mine are costing over 20 euro a month

Bunnyslippers

Phenobarbital does work well, we had a lab x rottie years ago who started fitting at a year old, we had him on it for about four years and it did lessen the fits a bit, but he got quite dopey on it and started sitting staring at walls for hours on end and he looked like he was drugged all the time, so we stopped it. He was fine after that and we just managed his fits, ie dark quiet room for an hour after one, and avoided as much as possible situations that would trigger them which tended to be if something came towards him at speed, like one of his brothers! He managed well with only a few fits a month until he was nearly twelve when he had a massive fit and escaped, a local farmer found him in a storm drain two days later, he was fine for a few weeks after that then had another massive fit and didn't come round from that one well at all, he didn't know who were were or where he was, so we called it a day, but not a bad age for a large dog with epilepsy.
So it entirely depends on the individual dog as to how they react to different meds, some don't have any reaction others it works brilliantly so giving the phenobarbital a go is well worth it, I think my old dog just didn't get on with it and at the time there was no other meds available, but his liver was fine. I've seen a good few live long happy lives on it, they never stop fitting totally and it sometimes increases with age as as their body gets used to a drug but they can still lead perfectly normal lives, we never did anything different with Paddy he just carried on, luckily they don't know they're fitting. Good luck I hope it works out for your dog!:)

Ms2011

the heathen wrote: »

Can I ask you where you get this? Mine are costing over 20 euro a month

Castle Veterinary Clinic in Clondalkin.
My dog is on a low dose so maybe that's why it's cheaper.