Phenobarbitone for cats

Re: Phenobarbitone for cats

Martin Atkinson — Thu, 02 May 2013 18:35:27 GMT

[quote user="Christina Smith"]. cluster seizures can be brought about by routine changes/stress [/quote] Indeed we had one dog that had a fit every Monday until a Bank Holiday when it had it on Tuesday. The only thing that changed was that the bin men came on a Tuesday that week we then realised the dog got very agitated by the collection. This one was resolved by keeping the dog away from threshold when the bin men were due which was a very satisfactory solution and greatly reduced the medication needed to prevent seizures at other times.

Re: Phenobarbitone for cats

Christina Smith — Thu, 02 May 2013 17:58:17 GMT

I suppose the points I was trying to make in my nostalgic reply were ; 1 pentobarbitone iv was great in the treatment of cluster seizures 2. cluster seizures can be brought about by routine changes/stress and 3. the animals recover better in a subdued and stress free environment.

Re: Phenobarbitone for cats

Martin Atkinson — Thu, 02 May 2013 14:18:19 GMT

[quote user="Christina Smith"]

In days of old, Sagatal [pentobarbitol] was very useful for the treatment of cluster fits. One particular GSD I treated would be knocked out whenever there was a bank holiday! Home visit and left to slumber in the comfort of it's sofa. Before the days of lawyers of course.

[/quote] Yes it does have its pitfalls, we had one dog which was treated this way and was left unattended in a kennel for just a few minutes and choked on its own vomit. I guess they should be intubated and monitored continually but that would add considerably to the bill. The saving grace, although the lawyers may not agree, was that the only other alternative was euthanasia anyway as all other methods of control had failed.

Re: Phenobarbitone for cats

Christina Smith — Thu, 02 May 2013 11:27:19 GMT

Re: Phenobarbitone for cats

Martin Atkinson — Thu, 02 May 2013 10:38:59 GMT

[quote user="Mark Lowrie"]

It goes on to say “Phenobarbital has an extraordinarily long half-life, so for many cats, a daily dosage is not required.”

This isn’t true. I wonder if they have confused phenobarbital with pentobarbital? Most definitely given more commonly by injection and half-life is not an important fact as it is usually given as a one off injection

[/quote] Tongue in cheek indeed but I have in desperation in the past given dogs in intractable status-epilepticus a sub-lethal dose of pentobarbitone when all else failed. They sleep for 12 hrs and when they wake up the status has resolved. If that doesn't work the next dose is the full one!

Re: Phenobarbitone for cats

Mark Lowrie — Thu, 02 May 2013 09:43:03 GMT

[quote user="Gillian Mostyn"]

It is the vetinfo one that Anthony posted above.

[/quote]

Thanks Gillian and apologies Anthony – Missed your post on the links.

The website states “For cats, injection is the most common method of administration”

I am sure a quick poll here on Vetsurgeon would prove otherwise.

It goes on to say “Phenobarbital has an extraordinarily long half-life, so for many cats, a daily dosage is not required.”

Re: Phenobarbitone for cats

Martin Atkinson — Wed, 01 May 2013 19:02:41 GMT

[quote user="Claire Fisher"]In last week's Pexion webinar Holger Volk specifically said it should not be used in cats.[/quote] Thanks. I didn't go on it live but will try and access the archive maybe one day when I'm not spending half my time on this forum!

Re: Phenobarbitone for cats

Gillian Mostyn — Wed, 01 May 2013 16:11:39 GMT

[quote user="Anthony Dennison"]The second website (question on a cat forum) I posted, the questioner seemed to give it subcut into the scruff?[/quote]

Firstly, ouch. Secondly........

Re: Phenobarbitone for cats

Gillian Mostyn — Wed, 01 May 2013 16:10:50 GMT

[quote user="Mark Lowrie"]Hi Gillian, do you have the website address for this? [/quote]

It is the vetinfo one that Anthony posted above.

[quote user="Mark Lowrie"]As others have said this would not work[/quote]

I agree completely! Was just finding out as I promised I would.....

Re: Phenobarbitone for cats

Anthony Dennison — Wed, 01 May 2013 15:58:37 GMT

[quote user="Gillian Mostyn"]As it would need to be given iv, the cat would need to come in for its jabs.[/quote]

The second website (question on a cat forum) I posted, the questioner seemed to give it subcut into the scruff?

Re: Phenobarbitone for cats

Mark Lowrie — Wed, 01 May 2013 15:16:00 GMT

[quote user="Gillian Mostyn"]

The owner (a nurse) has googled and found that cats can be successfully treated using 'occasional' pheno injections.

[/quote]

Hi Gillian, do you have the website address for this? Was unable to find it on a quick search of my own. As others have said this would not work, for a number of reasons, but one major reason being you can never predict a seizure and for phenobarbitone to work it requires steady serum concentrations which would not be achieved by intermittent infrequent injections. None the less I'm interested in the source.

[quote user="Martin Atkinson"]

I wonder how Pexion would work although clearly there is no licence for cats.

[/quote]

Unfortunately no pharmacokinetic data is available and idiosyncratic reactions are not uncommon in cats so definitely not recommended given no trials have been performed.

Re: Phenobarbitone for cats

Gillian Mostyn — Wed, 01 May 2013 15:07:12 GMT

Thanks Anthony - I also founds those pages on google but as they are for owners I didn't know if they were 'real' cases.

[quote user="Anthony Dennison"]I'm not sure I'd be massively comfortable in prescribing phenobarb injections to clients in case of misuse.[/quote]

As it would need to be given iv, the cat would need to come in for its jabs.

As far as why, as always with these things the owner is looking for an easier option. The cat has only just gone onto its meds so the owner is struggling to administer tablets. I know phenobarb solutions are available but in my experience it if often more difficult to get a liquid into a cat reliably than a tablet!

Thanks for that - I thought it sounded odd but just thought I'd ask. I suppose we could try weekly injections if the owner can't medicate and thus there is no alternative.....

Re: Phenobarbitone for cats

Claire Fisher — Wed, 01 May 2013 14:38:27 GMT

[quote user="Martin Atkinson"]

Depends on how frequently the fits and how 'occasional' the pheno injections are I'd say, anything would appear to work if they're not very frequent! Whats wrong with giving it tablets anyway? As a side, I wonder how Pexion would work although clearly there is no licence for cats.

[/quote]

In last week's Pexion webinar Holger Volk specifically said it should not be used in cats.

Re: Phenobarbitone for cats

Rob Loxley — Wed, 01 May 2013 13:36:31 GMT

If tabletting is hard then maybe try Epiphen solution?

Re: Phenobarbitone for cats

Anthony Dennison — Wed, 01 May 2013 13:23:47 GMT

Scratch that - half life can be up to 7 days, so perhaps weekly injections? A trawl through google has brought these up:

http://www.vetinfo.com/cat-seizures-phenobarbital.html

http://www.justanswer.com/pet-cat/1gfyv-cat-epilepsy-need-give-injection.html

Whether this is a more American approach, I'm not sure I'd be massively comfortable in prescribing phenobarb injections to clients in case of misuse. I suppose it would depend on the owner?

Re: Phenobarbitone for cats

Mark Hedberg — Wed, 01 May 2013 13:12:01 GMT

Maybe the cat's a pain to pill? How frequent are the seizures?

Re: Phenobarbitone for cats

Anthony Dennison — Wed, 01 May 2013 13:03:08 GMT

Surely occasional injections wouldn't keep plasma levels up high enough? In what context was Dr. Google using it - long term refractory cases that were being weaned off phenobarb all together?

It's not like phenoleptil is expensive, why switch to something that could cause more problems and therefore further costs?

Re: Phenobarbitone for cats

Martin Atkinson — Wed, 01 May 2013 13:00:19 GMT