Diving Deeper into Epilepsy

The ultimate goal for any dog with epilepsy is seizure control with good quality of life. Seizure control is considered one or fewer seizures per month.  We were not achieving control on the first two anti-seizure medications, Zonisamide and Keppra.

During April, Elton’s seizures became more frequent and culminated in a series of cluster seizures and a trip to the emergency vet. Three or more seizures within 24 hours or any seizure lasting more than 5 minutes is considered an emergency situation that could lead to a life threatening seizure condition called “status.” 

Elton’s neurologist recommended further diagnostic testing to determine if there was some underlying condition other than epilepsy that was causing the seizures. The most common tests performed are Computerized Tomography (CT) scans, Magnetic Resonance Imaging (MRI), and analysis of cerebral spinal fluid. On April 25th, Elton had an MRI and spinal tap and results were completely normal. 

Our next step was to introduce a third anti-seizure medication, phenobarbital, to achieve seizure control. Phenobarbital is a barbiturate and central nervous system depressant. Common side effects of phenobarbital are increased appetite and thirst, and hind end weakness. A long term side effect of phenobarbital can be liver toxicity, so blood levels of phenobarbital and liver function must be monitored every few months.

At this point, we were willing to take the risks and deal with the side effects to help reduce Elton’s seizures but we were not prepared to deal with Elton being unable to walk. The first day on phenobarbital was terrible for Elton as he had complete hind end collapse, and we were struggling to help him walk. Our vet ended up reducing the pheno dosage and the hind end weakness improved greatly within 24 hours. So now we waited and hoped that seizure control was within reach.

Learn More about Epilepsy and Follow-up Care-Ohio State University Veterinary Medical Center

Phenobarbital by Rania Gollakner, BS, DVM