Refractory epilepsy

Re: Refractory epilepsy

warwickshire vet — Tue, 16 Feb 2010 00:16:39 GMT

I have had some success with using epitaur (taurine supplement) and sculcap/vallerian (dorwest herbs) - this has been on top of using phenobarb/kbr +/- keppra in refractory dogs - dogs that seizured every day improve to every 2 weeks. I know its a bit off 'alternative medicine' but its quite cheap..

There was a paper published in a medical journal recently where they looked at the times of the month people were admitted for epileptic seizures and found there were significantly more admissions on a full moon. Getting my clients to note their pet's seizures revealed about 6 or 7 had cluster fits around full moons (over 8-9 months). So we inc phenobarb dose or add in diazepam during these 'risk' periods - it seems to work for them.

One of my colleagues has been using acupuncture as well, which has had some success. I guess its what the client/vet is happy using.

Re: Refractory epilepsy

Utlendigur — Mon, 15 Feb 2010 21:49:35 GMT

There's a pre-BSAVA satellite meeting on 7th April (Small animal medicine society) the first topic of which is "Epilepsy: when the (usual) drugs don't work..."

Re: Refractory epilepsy

Charlie Lyon — Wed, 10 Feb 2010 13:33:49 GMT

We have given the owner some diazepam rectal tubes to see if that will help, going to try gabapentin like we've been using keppra to see if a change of drug will make any difference. We've been using the Keppra for a year so really he's done well regarding becoming tolerant to it til now.

Unfortuantely he's not insured so the more expensive drugs aren't an option, will have a look into Chlorazepate if gabapentin doesn't do anything. Thanks for the help.

Re: Refractory epilepsy

Caren Stubbington — Tue, 09 Feb 2010 18:48:54 GMT

I went to a CPD lecture last year with Katia Marioni-Henry from SCVS referrals. She talked about using Chlorazepate 0.5-1.0 mg/kg PO TID for treating dogs at home with cluster seizures. This had been mentioned to me before by Simon Platt when I approached him for advice on a case that sounds very similar to yours. Unfortunately at the time I was unable to source the drug. The owners used rectal diazepam when he had a seizure but unfortunately he remained poorly controlled and they opted for euthanasia. He was on Keppra and phenobarb but was insured (still only just covered the Keppra though at 50 kgs!) She talked about a 'honeymoon' effect with both Keppra and Gabapentin helping intially in some cases, but then wearing off. Zonisamide was mentioned as being very good but very expensive! She estimated monthly costs of about £235 for a 10 kg dog. They apparently have increased clearance if on phenobarb and so require a higher dose. Not sure any of that helps much...sorry!

Re: Refractory epilepsy

Utlendigur — Tue, 09 Feb 2010 18:20:04 GMT

Is it blood in the urine or is it myoglobinuria/haemoglobinuria due to seizures being particularly violent or prolonged? - may be worth centrifuging a sample to check

We had one 40kg dog not controlled on epiphen and epilease, which settled when gabapentin was added in - but that was insured. (Is it just me or are poorly controlled epileptics usually large dogs...)

We've also had some dogs with cluster seizures and sensible owners where we've dispensed diazepam rectubes for the owner to administer at home if the dog starts fitting - worked for some

Re: Refractory epilepsy

Mike Martin — Tue, 09 Feb 2010 14:25:38 GMT

I've no ideas for you. But, I think this forum provides a great opportunity to show movies of various conditions. This does not apply to your case, but as a cardiologist, opisthotonus is common with cardigenic syncope and often misdiagnosed as seizures. I've love to be able to show owners a selection of collapse/seizure dogs and ask, which one best fits your dog? It would be great tool for us all.

Any chance you could ask your owner to take a movie - best using a digital camera (not phone) in movie mode. And get her permission to put it on the internet, so that it will benefit many many other dogs (and owners, and vets)?

And on the topic. If any one out there has a collapsing dog from which they can get a movie - I'll give an opinion FOC - in return for the owner giving permission to publish this on the web, or for use in lectures.