Doses of epiphen/pexion/keppra, post statushttps://www.vetsurgeon.org/f/clinical-questions/23051/doses-of-epiphen-pexion-keppra-post-status I had a dog in a few days ago that was reasonably well controlled with Epiphen and Libromide, but needed a day on fluids and phenobarbitone to control a 24 bout of fits (brought in twitching having had several one minute episodes the previous night.en-USTelligent Community 10RE: Doses of epiphen/pexion/keppra, post statushttps://www.vetsurgeon.org/thread/139748?ContentTypeID=1Tue, 07 Jul 2015 14:38:49 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:272211f5-4de6-4e64-bd01-e8f52f0d5f3aThomas Johnson<p>[quote user=&quot;Anthony Dennison&quot;] <p>Other potential is owner compliance - did they miss a dose?</p> <div style="clear:both;"></div> </p> <p>[/quote]</p> <p>And following on from that, was there anything else that could have made a seizure more likely such as infection, dehydration, etc?</p><div style="clear:both;"></div>RE: Doses of epiphen/pexion/keppra, post statushttps://www.vetsurgeon.org/thread/139716?ContentTypeID=1Tue, 07 Jul 2015 09:47:51 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:4114734a-e734-4b76-8cfb-b3bbdb962432Anthony Dennison<p>[quote user=&quot;Neil Wheadon&quot;]It was on 60mg BID and I gave 300mg in an emergency setting IV that controlled it[/quote]</p> <p>Thanks Neil, what was the dose per weight (mg/kg)? A lot depends on whether the theoretical dog was on the lower or upper end of the dose range.&nbsp;</p> <p>[quote user=&quot;Neil Wheadon&quot;]I had a dog in a few days ago that was reasonably well controlled with Epiphen and Libromide[/quote]</p> <p>How long have seizure been well controlled for? Having the phenobarb loading dose will mean the steady state has been reached quicker so serum levels could be checked pretty quickly I guess. If this dog did have breakout seizures timing of sampling is essential; accurately get the nadir 6-8 hours after the tablet.</p> <p>Other potential is owner compliance - did they miss a dose?</p><div style="clear:both;"></div>RE: Doses of epiphen/pexion/keppra, post statushttps://www.vetsurgeon.org/thread/139715?ContentTypeID=1Tue, 07 Jul 2015 09:28:49 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:24a68eb4-9399-48db-915f-d90434ac7498Neil Wheadon<p>Hi Anthony</p> <p>It was on 60mg BID and I gave 300mg in an emergency setting IV that controlled it</p> <p>Unfortunately it had never had a phenobarbitone level taken </p> <p>This question is partly theoretical as I have dealt with Emergency Medicine for so many years, passing these cases on, once the emergency issue was over.</p> <p>For the sake of this discussion, can we assume the dog had therapeutic levels within the normal range, as it&#39;s a point I&#39;m interested in for other cases that will come, (mine and everyones)</p> <p>&nbsp;Thanks for the reply</p> <p>&nbsp;&nbsp;&nbsp;&nbsp; Neil</p><div style="clear:both;"></div>RE: Doses of epiphen/pexion/keppra, post statushttps://www.vetsurgeon.org/thread/139713?ContentTypeID=1Tue, 07 Jul 2015 09:15:35 GMT146601cc-3922-4be7-9974-7e1d4e45a66b:9d7c6acc-8556-42a6-b656-83d7791ccbbeAnthony Dennison<p>What dose is the dog on currently, and what was the last phenobarbitone serum levels?</p><div style="clear:both;"></div>