Which Anti Epileptic drug or drug combo is the most successful for our doodles?

[Kirsy & Jasper]

I was wondering which medication/s work for most of your dogs and which ones don't?

We so far have tried Keppra (Levetiracetam). It works very well in combination with Pheno and/ or Potassium Bromide for many dogs in my seizure groups. But it didn't work as SOLE AED for our Jasper.

We have now weaned him off it and are trying Pheno instead. 

I know of a Labradoodle who tried Zonisamide as SOLE AED without success, but now on Pb he is already more then 5 months seizure free.

Looking forward to feedback from others.

[Amanda and Quinn]

I'm sorry to hear it too, Kirsy. I hope it hasn't brought you down too much, and I hope it is an isolated event. Quinn has breakthrough seizures here, and there, too--usually one or two a year--despite his levels being in the therapeutic range. It's never easy, but it is manageable, and sometimes I think it makes us appreciate him even more.

[LG & Sadie]

Hi Kirsy, sorry to hear about Jasper's seizure 5 months was a good seizure free period. Sadie has what our Vet calls "breakthrough" seizures 2 to 3 a year despite being in the therapeutic range for her phenobarbital. There doesn't seem to be a rhyme or reason for these-we have had theory upon theory and each one has been disproved. We wish many, many more seizure free days ahead! Please keep us updated on how you guys are doing. Hang in there! Leane & Sadie

[Kirsy & Jasper]

Thank you guys for all your nice messages. I just keep looking at other dog breeds in my EPILgroup and k9epilepsygroup@yahoo how many drugs some of those poor dogs are on and they still have seizures. So 5 months and just a mild one is pretty good. I guess I felt bad because nobody was home and how frightened he must have been afterwards. Waiting for Mom to come home and clean him up. That loss of anal gland control is worst the the bladder or bowel!

Best wishes to all your pups

Kirsy & supercuteness Jasper

[Amanda and Quinn]

I agree! Quinn's second seizure was at Thanksgiving with relatives visiting. Everyone was terrified by the experience and then kindly trying not to pretend the smell afterwards wasn't THAT bad. It was that bad. :) My dad was quick to offer a trip to the store for more carpet cleaner.

[Kirsy & Jasper]

Update - Jasper & Kirsy (Australia):

I haven't posted for a long time. Things are good for my boy. Jasper had a second mild breakthrough seizure in May 2013 while we were on holidays in Europe. That was a 9 months break. I am happy with that. He is still on the same very low dosage of Pb. Not rocking the boat. There is a new safer AED PEXION out in Europe and a few members in my other epi groups are trying it right now. How are all the other dogs doing?

[Karen, Jasper and Jackdoodle]

So glad to hear Jasper is doing well. 

[Kirsy & Jasper]

How is Jackdoodle Karen?

[Karen, Jasper and Jackdoodle]

Right now he's doing well, but we are about to enter the time of year when his immune system gets hit the hardest. Hoping this year there won't be any Atopy or IBD flares. Thanks for asking about him. :)

[Gayle,Sophee & Baylee]

Sophee is on Potassium Bromide and  Phenobarbital and it seems to work pretty good for her last night was her first seizure in almost 4 months~

[Ellen]

Really late for the discussion, but wanted to add my two cents.   For Riley, phenobarbital has been the key.

 

At the neurologist's recommendation, when the seizures began, Riley first started with zonisamide (200 mg BID) because of its low incidence of side effects.  This seemed to work for about 6 months, but then Riley started having seizures more often (every 3 months and then every month).  Neurologist then added Keppra (500 mg TID), but the combination didn't work.   We also tried adding gabapentin (100 mg TID), but it didn't seem to have any effect.  Eventually, we turned to phenobarbital.

 

Like others, I was hesitant about phenobarbital because of its associated side effects, but when Riley started seizures every 10 days, the neurologist said that we should give it a try.   The phenobarbital (60 mg BID for 50 lb dog) hit Riley instantly.  Within 6 hours, he was experiencing ataxia.  He had trouble walking (esp on marble and hardwood floors) and sometimes bumped into glass doors.  He looked drunk (or stoned according to my boyfriend).   He was like a different dog -- very sleepy and none of the usual playfulness.  Neurologist said that this side effect is typical and said that it should improve in two weeks or less (which it did). 

 

In short, Riley is 100% back to normal  (and actually more playful and mischievous than ever).  The ataxia completely disappeared, but he tends to drink more water than pre-phenobarbital (one of the side effects of the drug).   Riley has been seizure-free since phenobarbital was added in mid-December 2012.   He's still taking zonisamide and Keppra, but at the neurologist's recommendation, I'm slowing reducing the amount of Keppra that Riley gets since we don't think this drug really adds any therapeutic effect.    So, the only downside is that I'm continuing to pay for two drugs that may not do much for controlling the seizures.  Luckily, I don't have budgetary constraints, so I am happy to continue paying for these drugs as long as Riley doesn't have seizures. 

[AndySharon BoomerShaynaMariner]

Good to hear that Riley is doing well.   Sometimes it takes time to get the right combination.

[Kirsy & Jasper]

Hi Ellen,

Thanks for adding your 2 cents! Glad Riley is doing well.

I am surprised your neuro kept him on Keppra and Zoni once he introduced Pb. What if Pb on its own does the job, which in most cases it does? When we had no success with Keppra ONLY our vet slowly weaned Jasper off Keppra while putting him onto Pb. We started and still are on the lowest dosage of 45 mg BID for 40 lb. IF we didn't have success we could have done 2 things: A up the Pb or B add another drug like Keppra, Zoni or Kbr. As they all have some sort of side effects (organs etc.)....the less the better.

Jasper had no ataxia, when we started Pb and he was still on the full dosage of Keppra at 750 mg TID then. I freaked out every time we had to lower the Keppra by another 25%...thinking ..NOW he is going to have a seizure, but he didn't. 

Do all of you do 6 monthly Pb level and liver bile acid blood tests? I got Jasper on Milk Thistle twice a day religiously. Need to keep that liver safe. LOL

Glad Jackdoodle and Sophee are doing well.

How are Quinn and Sadi going?