About two years after Reggie first presented with epilepsy he had another major episode of cluster seizures which required a trip to the ER. His dosage was increased. He had a seizure just two months later, and another just three months after that. That frequency was just too frequent and it was decided that a second medication needed to be added for better control. The rule of thumb is no more than one seizure every three months.
In discussing the secondary medication options, it was decided that a different approach would be taken- a traditionally human medication. It had been used in dogs with some success, and some failure. Given the other options and the possible side effects it seemed the best option and thankfully it has worked well.
So for canine control, what are your options- to be reviewed with your vet of course?
The gold standard, the go-to, the most common primary control drug. Dosage will be different for every dog because in order to reach a therapeutic level in the blood stream it is based a bit on weight. The maximum level is 30 micrograms/mL so a 100 pound dog can handle a higher dose than a 12 pound dog but still have the same level in their blood stream. Reggie takes 100 mg twice a day and is at a maximum therapeutic level of 27.2. Phenobarbital is very tough on the liver and levels are measured every six months. Side effects can be increased appetite, weight gain, sedation, increased thirst and urination.
Commonly used as a secondary control drug, not a primary drug. Diet has to be monitored closely because of the salt content of the drug. This was considered first as the secondary drug for Reggie. When I spoke with several pharmacies I found that the local pharmacy will compound and add pork or chicken flavor to it! Side effects, initially, can be behavioral changes, gait instability or muscle twitches.
This is NOT a control medication but a break-through medication. If your dog is having cluster seizures, or a particularly long seizure, Valium is used to break the seizure. The body can become resistant to Valium over time and this is not appropriate for the long term. I have read of seizure therapies that rely on Valium treatments; this seems like an incredibly bad idea if your dog has persistent and/or frequent seizures. Discuss options with your vet. When Reggie has gone to the ER he has been given Valium to break the cluster seizure cycle. If this didn’t work anymore…
This is a human drug now being used for dogs as a secondary medication. The benefit is that there is virtually no sedation side effect; however, not all dogs that take it see an effect.
This is a human drug now being used for dogs as a secondary medication. It is considered quite safe with very few (and uncommon) side effects such as an unstable gait during the acclimation period. The downside is that the best control is frequent dosing. This is ultimately what we decided to put Reggie on; he started taking 250 mg three times a day. We did have to increase his dosage to 375 mg after a couple months (it just wasn’t enough). We recently switched to an extended release tablet (500 mg twice a day) so we will see how that works!
This is another secondary medication, human drug. The benefit of this drug is that is does not cause drowsiness; however it has to be frequently dosed for ultimate effectiveness.
Another secondary medication human drug, it has few side effects but is only sometimes effective. When it is effective, the phenobarbital dosage can reportedly be drastically reduced.
Discuss all options with your vet. What works for Reggie won’t work for everyone. But be aware that there are options- and human options are becoming available to help your furry friends too!