Phenobarbital not being effective

[Madhura Khedkar]

Hi All - A not so very good Einstein update: 

Einstein (1 year 9 months) had been diagnosed with idiopathic epilepsy (MRI, spinal tap, liver tests, thyroid all normal)  in February this year. He was initially started off on Keppra which was not effective after which the vet started him on Phenobarbital 64.8 mg. Pheno was very effective and he was seizure free for 6 months. We recently moved from New York to San Francisco for work the move has not gone down well with our baby. A week after we moved, he had his first seizure in 6 months. 2 days later, he had another seizure. We didn't have a new neuro in the city (appointments are out for a month), so we consulted with our NYC neuro who suggested increasing pheno dosage by 25%. That was 12 days ago. Last night he had another seizure (which makes it 3 seizures in 2 weeks). His previous two seizures in SF were around high levels of activity (a day after walking around the city OR day after hiking). We finally met with a neuro in SF who suggested we let it be and not exercise him as much(keep the same medication dosage and let the seizures be). That seems to be conflicting with the advice we got from our NYC neuro who always advocated decent seizure control through meds since he is a young puppy and should be able to enjoy the outdoors (so that seizures are kept at 3-4 per year). We are consulting another neurologist on Saturday but I would love to get some insights on these medications:

1. Zonasimide: Has anyone used it? I have read mixed reviews on this medication but the side effects seem to be less (slightly) than Pottassium Bromide

2. If my puppy is on phenobarbital, could environment changes affect him so much that his seizure cycle resumes? Or does this indicate lack of good seizure control?

3. Any other new anti-epileptic anyone has used which has proven to be effective? OR any alternative med for that matter?

4. He seems to recover quickly from his seizures and they have been luckily under a minute but I still want the frequency to be much less than this. In Feb, his seizure frequency grew shorter and shorter till he had a cluster seizure (which left him temporarily blind for 15 days). Given all this (and the fact that both my husband and I work and some day cares rejected him due to epilepsy), do you think it is wrong to opt for additional medication? We love him and want to do whats best for him. 

Any other advice / thoughts are very welcome!

[Madhura Khedkar]

I just requested to join the private facebook group (I love bragging about Einstein so this is going to be my favorite facebook zone). We decided to go with Potassium Bromide and will start with it as soon as the neuro provides us with the prescription. Fingers, Toes, Paws crossed that we enjoy a long streak of well controlled epilepsy time with our little boy. PB used to make Einstein thirsty and hungry. The former faded off over time but he is still always very hungry and I expect that will only increase with KBr added to his regime. But a small price to pay for a better quality of life. 

[Kathy Sheehan]

You will love being a member of the Doodle Family! It is by far my favorite thing to look at on FB!

Good luck on the PB...I have had great results with Cooper! For the most part Cooper leads a normal doodle life...he does get tired out easier, so he just lays down and takes a nap! 

[Madhura Khedkar]

One last question to the group: Our neurologist wrote that we need to control the salt content in his treats and food now that we are starting him on Potassium Bromide (food is easy). But, I was going through his treat bags and none of them display exact salt content. I also went on the website for Pure Bites and Himalayan chew. One of them lists salt as an ingredient but I do not know the exact amount. Any suggestions on how I can keep tabs on salt content in treats? 

[Karen, Jasper and Jackdoodle]

I'm not sure which Pure Bites treats you're using, but if there's salt in them, I'm guessing it's cheese. JD gets the chicken Pure Bites, and there's no salt in them at all, nothing but dehydrated chicken. The turkey Pure Bites are the same. So I'd suggest switching. Use treats that are 100% meat or poultry, or something like Sam's Yams sweet potato treats that are 100% sweet potato with no other ingredients. That way, you know there's no salt added.

The Himalayan Chews do contain salt, I'd call the company and ask for the amount. 

[AndySharon BoomerShaynaMariner]

The point is that the salt intake should stay relatively constant.  The amount of salt in your dogs system affect the absorbtion of the Potassium Bromide.

Our only concern was when we were switching food.  The occasional treat should not have a significant effect.  Remember this medication has a half life of 24 to 46 days.