Epilepsy in dogs
Dogs on Diazepam, Phenobarbital, KBr and Prednisolone
Clorazepate dipotassium (Tranxene:Abbott) is a benzodiazepine pro-drug
FORRESTER, S. DRU, D.V.M., M.S., DIP ACVIM ET AL
KBr 15mg/lb – 25mg/lb and even 45mg/lb
Loading – rapid control: A loading dose of 450-600 mg/kg, usually divided over 5 days,
If the patient appears obtunded prior to a dose, skip it and resume when the patient seems more normal.
Serum bromide level is checked. The therapeutic range for dogs is 0.7-3.5 mg/ml.
But decrease PBarb dose while going higher and higher.
the phenobarbital dosage should be no higher than 1-2 mg/lb/day or severe sedation
SISSON, ALLEN, D.V.M., M.S.
Monotherapy with oral KBr (administered without a loading dose) is recommended at 50-80 mg/kg/day as a starting dose may have to increase to 120 mg/kg/day in some dogs. The dosage is administered once a day, but the total dosage can be divided to avoid GI upset.
DEWEY, C.W., DVM, MS, DIP ACVIM ET AL.
Loading: the loading dose is 400-600 mg/kg total dose divided into equal treatments overthe next 36-48 hours. The loading dose is mixed in food to minimize vomiting/diarrhea.
HOSKINS, JOHNNY D., D.V.M., PH.D., DIP ACVIM
Sudden discontinuation of anticonvulsant medication can produce status epilepticus.
PBarb levels should be: are maintained between 15-45 micrograms/ml.
Consider measuring triglycerides: Hypertriglyceridemia should be considered in dogs with a history of seizures.
dietary therapy has been successful in reducing triglyceride concentrations and eliminating seizures
FORD, RICHARD B., D.V.M., M.S., DIP ACVIM
felbamate (Felbatol:Wallace Labs) 10kg animal is $22/month
45 mg/kg/day, PO, divided TID. The drug is well absorbed and the plasma elimination half-life is approximately 13 hours.
KORTZ, GREGG D., DVM, DIP ACVIM
Ketogenic diet: Protein and fat ONLY
Dr. John Freeman of Johns Hopkins
If neither phenobarbital or bromide are effective in treating seizures in the dog, mephenytoin (Mesantoin:Sandoz) – WITH the other drugs.
10 mg/kg, TID may be used with the dosage increased as needed to achieve a therapeutic blood level of nirvanol of 25-40 5g/ml. Steady state blood levels should be achieved in 6 days.
SISSON, ALLEN, D.V.M., M.S.
This clinical study found that ocular compression (OC) may be a useful aid for stimulating the vagus nerve to control seizures in dogs. The globe was intermittently compressed into the orbit, using digital pressure superior eyelid of one or both eyes for 10-60 seconds. Ocular compression was prescribed at 5 minute intervals,
SPECIALE, JOHN, DVM & JODY E., STAHLBRTODT, BS
Sodium valproate has recently shown some promise in the control of canine epilepsy. Its current recommended use is in combination with phenobarbital for resistant seizure dis- orders. The recommended dose of sodium valproate in the dog is 15 mg/kg/day. If the total dose exceeds 150 mg, it should be divided BID to avoid GI disturbance. The dose can be increased if necessary by 5 mg/kg/week to a maximum dose of 60 mg/kg/day.
SCOTT-MONCRIEFF, CATHARINE, VET MB & PETE BILL,DVM
DIAZEPAM AND SIEZURES:
For dogs and cats, diazepam has been recommended at a dose of 0.5-1.0 mg/kg, IV, up to a maximum dose of 20 mg
PLATT, SIMON R., BVM&S & JOHN J. MCDONNELL, DVM