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My boy, BJ, was diagnosed with epilepsy last April. He has been on phenobarbital ever since. He started at 1- 60mg pill 2x daily, then was upped over the summer to 1 1/2 twice a day. He did good for a while them in october they became more frequent and he was upped to 2 pills 2x a day. Each time, having his blood drawn and sent out to check his levels.
2 weeks ago, he began clustering (had 7 seizures in les then 24 hours)to the poist that it seemed like he had some neurological problems after (his back end was rounded, and his back feet turned in and his tail was droopy) and was then upped to 2 1/2.
Yesterday he began clustering again, he went to the vet and got blood drawn. The levels came back lower then they were before. He hasnt missed any doses. I'm not sure why this is happening to my baby. The vet wants me to up him to 3 twice a day now.
I'm leary in doing so. Each and every time he has been upped, he goes through this period where he doesnt eat, he drinks gallons of waters at a time, constantly urinates, and he just mopes around.
The vet had mentioned before about adding in Potassium Bromide, but doesnt want to do that yet.
I know he will never be cured and he will always have seizures, but my only fear is that this coupled with the fact that he has a sever aggression issue that there maybe something more serious going on in his poor little head.
Should i get a second oppinion? Or seek out a specialist? Or just continue doing what the vet says?
I want to do whats right by my boy. He is my heart, but I'm just not real sure what to do at this point.
Any advice would be appreciated.

Ashley
(formerly ashers4142 for those who may remember me)
 

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You don't have anything to lose with a second opinion from a specialist. Are you near the University of Pennsylvania vet school- I know they have helped others in situations that seem impossible-
 

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Discussion Starter #3
Actually, yes i am. I live about an hour away from there. I never even thought to try them.
I just dont want to hurt my vets feelings if i take him elsewhere (she happens to be my boss as well :/)

Thanks, i will most deffinately look into it.

Ashley and BJ (why are you looking at me like that mom??)
 

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Have had a basset die at 2 1/2 year of age from a status siezure and diagnosed with idopathic epilepsy at 1 1/2 year of age that was never controled she averaged 1 siezure every 2 weeks.

Some thing I have Learned.

1. Potassium Bromide s hould be the First drug used to attempt siezure control. It is as effective in most dogs as phenobarbitol without the nasty side effect. The only draw back is it takes time to build up to cinical levels in the blood stream.

2. Any Dog on Phenobarbital Need frequent liver tests and Testing level of Phenobarbitol in the blood steam. and a bile acid test. Just month before She died her liver was almost completely destroyed by Phenobarbitol. and was hospitilize for nearly 2 weeks.
REDUCING THE RISK OF DRUG INDUCED LIVER DISEASE

URINE BILE ACID TESTING
"We all know how important pre- and post- bile acid testing is for dogs on phenobarbital. Since about 20% of the dogs on Pb develop liver disease, bile acid testing should be done every 3 to 4 months to make sure that your dog is not developing liver dysfunction."

REDUCING PHENOBARBITAL DOSAGES

Potassium Bromide Used Alone and as an Adjunct to Phenobarbital

"potassium bromide is becoming more popular today to treat canine epilepsy and has been shown to be effective especially in dogs with seizures that are resistant to standard therapies including phenobarbital (Pb).

...Here is what Lauren Trepanier, DVM, Ph.D. of Cornell University has to say about this:

“The relative efficacy of bromide alone compared to phenobarbital alone is still not clear. In the handful of epileptic dogs that we have treated with bromide from the time of initial diagnosis, bromide appears to be quite
effective as a single agent. Because of the risk of hepatotoxicity with phenobarbital, bromide may be preferable as a first line agent, with smaller doses of phenobarbital added later if additional seizure control is needed.
Only further experience with clarify this issue.”"


3. Was a full Thyroid panel done on the dog. Low thyroid can cause siezures even if there are no other clinical signs of hypothyrodism and just notice in your post FWIW Aggression is another side effect of hypothyrodism. In younger dogs this cause is often over looked.


COMMENTS ON THYROID DISEASE

". Thyroid testing should be considered in any dog with recurrent seizures. Although the relationship between hypothyroidism and recurrent seizures is unclear, thyroid testing is relatively inexpensive and carries little risk to the patient.

Only one symptom may be present to suspect low thyroid function. Seizures can be a symptom of thyroid imbalance, which warrants performing a full thyroid panel. "

BEHAVIORAL CHANGES ASSOCIATED WITH THYROID DYSFUNCTION IN DOGS
"*Thyroid dysfunction was found in 62% of the aggressive dogs, 77% of seizuring dogs, 47% of fearful dogs, and 31% of hyperactive dogs.

*Outcomes of treatment intervention with standard twice daily doses of thyroid replacement were evaluated in 95 cases. Of these, 58 dogs had greater than 50% improvement in their behavior as judged by a predefined 6-point subjective scale (34 were improved >75%), and another 23 dogs had >25 but <50% improvement. Only 10 dogs experienced no appreciable change, and 2 dogs had a worsening of their behavior. When compared to 20 cases of dominance aggression treated with conventional behavioral or other habit modification over the same time period, only 11 dogs improved >25% and of the remaining 9 cases, 3 failed to improve and 3 were euthanized or placed in another home. These initial results are so promising that complete thyroid diagnostic profiling and treatment with thyroid supplement, where indicated, is warranted for all cases presenting with aberrant behavior."


4. Considering the life threatening situation Cluster seizure can be You need a prescription for Liquid Valium and a syringe to administer it rectally to the dog.
See: TREATING CLUSTER SEIZURES WITH THE RECTAL AND ORAL VALIUM PROTOCOL"

HOME TREATMENT WITH RECTAL DIAZEPAM FOR CLUSTER SEIZURES IN DOGSBy W.B. Thomas DVM, MS, Dipl. ACVIM (Neurology)

"While a single seizure of short duration is rarely life-threatening, status epilepticus is a medical emergency requiring prompt treatment. Continuous seizure activity lasting 30 to 60 minutes can lead to profound, life-threatening abnormalities and brain damage. 2 Although cluster seizures do not fulfill the definition of continuous seizure activity, they nevertheless represent a serious condition that can progress to status epilepticus. The goal of treatment is to quickly stop the seizure and provide support for the patient. Typically, this involves urgent veterinary care, including administering anti-seizure medication by vein. The financial and emotional distress of repeated emergency treatment is a common reason for a client to have an epileptic pet euthanized.

...This treatment uses commercially available diazepam injectable solution. Although this solution is intended for injection by vein, studies have shown that this product is absorbed well when given rectally. The syringe is filled with the appropriate dose of diazepam and then attached to a 1-inch teat cannula or similar device. This is inserted approximately one inch (2 cm) into the dog's rectum and the syringe's plunger is pushed, delivering the diazepam. The first treatment is given as soon as possible after the onset of a seizure. The same dose can be repeated for a total of 3 times within a 24-hour period.

...Each patient is different, so specific recommendations can only be made by the attending veterinarian. A dose of 2 mg per kg of body weight is usually recommended for dogs taking Phenobarbital (Phenobarbital is known to increase the dose requirement for diazepam).5 In dogs not taking Phenobarbital, the dose is usually 0.5 to 1 mg per kg.


The rectal dose is higher than the intravenous dose in order to obtain adequate blood levels. Also, as mentioned above, long-term treatment of Phenobarbital increases the dose requirement as well. These doses have been found to be quite safe in experimental studies in dogs.5"

[ February 03, 2006, 08:40 PM: Message edited by: Mikey T ]
 

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Very sorry to hear about BJ. :( Unfortunately, no one at CyberHound is qualified to assess BJ or make treatment recommendations. A second opinion, especially from a specialist or veterinary school is an excellent suggestion.

In the meantime, here is Purdue University's Canine Epilepsy Network. The content is provided by veterinarians with a research interest in canine epilepsy. Canine Epilepsy Basics provides a good overview, with discussion of common-used meds and mention of some newer ones. You might also find their Canine Epilepsy Network Discussion Forum useful and supportive.

Wishing you the best of luck with getting BJ's seizures under control.
 

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Lisa,

I remember you-Welcome back to Cyberhound. I'm pretty sure your vet wouldn't mind you seeing a specialist. What if one of your clients called and asked you if you thought it would be ok for him to ask your vet if he can bring his dog to a specialist? What would you say?

Sorry to hear about BJ's seizures. I would think an appointment with a neurologist would be just as helpful to you as it would for BJ. Another opinion doesn't hurt. U Penn sounds like a good place to start.

Please Keep us posted.
 

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Discussion Starter #7
Thank you for your help and kind words. I have been doing tons of research in the past 24 hours to see if there was anything else i could do for him. I have found some good ideas that i will be trying out as soon as the stores open this morning.
I will be calling U Penn on monday. And will be talking to my vet again about the Potassium Bromide. If she wont prescibe it, i will be calling other local vets for a second opinion.

Mikey, Thank you for all that info! I will be reading it shortly.
He has had his tyroid checked too many times to count. He was about 1 when the aggression started and was tested then, and then again every 6 months- he almost 6 now. He also has some very nasty food allergies to boot so he has become my problem child.

Thank you all again and i will keep you posted.

Ashley and BJ-the problem child.
 

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I also have an epileptic dog. Not exactly the same case as you described, Kit's were much less frequent. They started getting bad when I brought Lea home to stay with us and that's when I decided to go for medication. The vet also gave me potassium bromide and we are going on 24 weeks fit-free. The potassium is supposed to be much less hard on the system than phenobarbital (so the vet says). I would get a 2nd opinion and see why your dog was put on phenobarbital. Maybe there's a reason us non-vets no nothing about?

I'm glad Mike posted because I didn't know about the frequency of blood tests needed. Kit's only had one so far.

Good luck I know what you are going through and it is most awful and scary.

Lou
 

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Hi,we met at one of the dog shows I have Vinny and we did really bad in the ring. I'm sorry to hear about BJ.Is he the one related with some of my dog's pedigree? If so I would like to know what the other part of his pedigree is,please feel free to e-mail me privetly. I hope you find something that works.Take Care
 

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Discussion Starter #10
Thank you all for your responses. He seems to be ok for now. So far, until i can get a hold of a specialist, i am following what the vet said, though instead of 3 twice a day we are doing 2 three times a day in hopes of keeping his levels at a more constant levels so as not to have those peaks and vallies in between doses. I read that a higher protien diet can help also, so we are switching his diet to one of the prescription allergy foods (because he also has severe food allergies).
I will be calling U Penn and a local specialist tomorrow to see what they say.
I read that dogs can safely be given phenobarb up to 8mg per pound of body weight(He could, in theory, go up 2 1/2 more pills). She said to recheck his levels in 2 weeks and if they are no better then we will add in the Potassium Bromide (he will also have a complete blood panel done, including thyroid, just to be on the safe side. He hasnt had his thyroid checked since September)

Bubbad, yes i remember you and Mr Vinny! And you didnt do too bad- no worse then Bella did lol.
I dont think BJ is directly related to your dogs, but he does come from a breeder that i know you have dealt with in the past. I will email you privately about his pedigree shortly.

Thanks again. And i will keep you posted.
Ashley and BJ

[ February 05, 2006, 06:03 PM: Message edited by: Lisnagear ]
 
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