Overweight, itchy, epileptic JRT!

Re: Overweight, itchy, epileptic JRT!

Bob Russell — Mon, 18 Jul 2011 13:44:56 GMT

I have spoken to the neurologist and she is recommending Keppra as the fits are only just 'under control'. Also lower dose Atopica as the phenobarbitone can potentiate its effects.

We will see how it goes!

Re: Overweight, itchy, epileptic JRT!

SteveOwen — Sat, 16 Jul 2011 18:41:23 GMT

ps Bob - I'd go with Cortavance for this case too :)

Re: Overweight, itchy, epileptic JRT!

SteveOwen — Sat, 16 Jul 2011 18:40:10 GMT

[quote user="Kate Richardson"]

I think it was mentioned on another thread that anti-histamines are possibly more effective when given in combination with EFAs?

[/quote]

I have asked a few dermatologists at different CPD events about antihistamines and not found one yet who uses them, as they all say there is no evidence and not even found one yet who suspects they work in dogs or cats.

Re: Overweight, itchy, epileptic JRT!

SteveOwen — Sat, 16 Jul 2011 18:38:18 GMT

[quote user="sarah mason"]

Cortavance spray and more frequent malaseb for the atopy?

[/quote]

Malaseb for atopy?! Presumably with informed consent as off-license, but why? It contains chlorhexidine for pyoderma and miconazole for Malassezia or ringworm in cats. Something like Episoothe, Allermyl or Coatex appropriate for managing pruritus in dog without pyoderma or Malassezia.

Re: Overweight, itchy, epileptic JRT!

Martin Atkinson — Sat, 09 Jul 2011 09:31:48 GMT

[quote user="Michael Woodhouse"]

Which miserable bugger has been dishing out red starts on this thread without at least trying to put another viewpoint across?

[/quote]

Yeah, how come I got a red star for suggesting very standard treatment when I've written a load of bovine dung in the past and its been ignored? I've never had the temerity to rate anyone else's post yet, perhaps I'll start now!

Re: Overweight, itchy, epileptic JRT!

Kate Richardson — Fri, 08 Jul 2011 18:16:37 GMT

I think it was mentioned on another thread that anti-histamines are possibly more effective when given in combination with EFAs?

Re: Overweight, itchy, epileptic JRT!

Bob Russell — Fri, 08 Jul 2011 18:05:08 GMT

[quote user="Michael Woodhouse"]

Which miserable bugger has been dishing out red starts on this thread without at least trying to put another viewpoint across?

[/quote]

Don't know but if they have a better idea then I would like to hear it. Why 2 stars for asking a clinical question? These are 'bread and butter' cases for general practices. Sorry if they seem too humdrum for some.

He is on Aller-G3 already. I will talk to Novartis about Atopica but funds are limited and this has limited this option in the past!

Thanks for the ideas. His pruritus is moderate only and this was why I wanted to try antihistamines. In the formulary all those I could find had the caution about lowering the seizure threshold. As his seizures are only just controlled this worries me!!!

Re: Overweight, itchy, epileptic JRT!

Michael Woodhouse — Fri, 08 Jul 2011 17:46:21 GMT

Which miserable bugger has been dishing out red starts on this thread without at least trying to put another viewpoint across?

Re: Overweight, itchy, epileptic JRT!

Martin Atkinson — Fri, 08 Jul 2011 14:36:37 GMT

EFA supplementation and a pro-ceramide shampoo/spray eg Douxo

Re: Overweight, itchy, epileptic JRT!

sarah mason — Fri, 08 Jul 2011 13:58:55 GMT

Cortavance spray and more frequent malaseb for the atopy?

Re: Overweight, itchy, epileptic JRT!

Clive Ansell — Fri, 08 Jul 2011 11:34:37 GMT

Would it be worth trying one of the newer non sedating antihistamines, such as Cetirizine, as it is my understanding that they enter the CNS less than the older sedating ones do?

Atopica?

From BNF

Non-sedating antihistamines such as acrivastine, cetirizine, desloratadine (an active metabolite of loratadine), fexofenadine (an active metabolite of terfenadine), levocetirizine (an isomer of cetirizine), loratadine, mizolastine, and rupatadine cause less sedation and psychomotor impairment than the older antihistamines because they penetrate the blood brain barrier only to a slight extent.