Several medications are available to control seizures in dogs. Most veterinarians begin by prescribing Phenobarbital. This is a drug once commonly prescribed to treat epilepsy in humans, but which has been largely replaced by more effective and safer medications in recent years. A dog's liver tends to break these new medications down too fast, which is why this medication is still used to treat seizures in canines today.
Generally, a low level of drug is given to begin with, and then increased gradually until the medication reaches a therapeutic level. If seizures continue or worsen, your veterinarian may decide to try a different medication, instead of, or in combination, with Phenobarbital.
When Phenobarbital was not successful for JoJo, our veterinarian added potassium bromide. This simple chemical salt was one of the first drugs used to control epilepsy in humans back in the late 19th century. Doctors still don't know why it works, but it has been useful for managing hard-to-control seizure activity in dogs. The combination of Phenobarbital and potassium bromide controlled JoJo's seizures very well, even in the later stages of his disease.
Keep it on schedule.
Maintaining a consistent blood level of the medication is critical to controlling seizures with Phenobarbital, as well as most other medications used to control seizures. To maintain the best control, be sure to administer the medication exactly as your veterinarian prescribes. Don't skip or skimp on dosages, because a seizure might "break through". Especially when JoJo was just ramping up to a level that would control his seizures, we found it was very important to keep to a strict schedule.
Keep it safe.
Remember that most medications used to control seizures in canines are controlled substances. They can be dangerous in the wrong hands, or when not handled safely
Store all medications in a safe, secure place, away from light or heat. Keep them out of reach of irresponsible individuals, children and pets. Teach children not to touch or play with them. It's preferable to keep medications locked away if visitors or service people are in your home.
It's important never to underestimate the ability of your pets to find and open bottles of medication. I know of at least one instance where a dog got up on a counter while its owner was away and swallowed a bottle of Phenobarbital. The dog was unable to be saved. Also, watch to make sure that your dog has actually swallowed the medicine, and that he doesn't cough it up. Almost everyone in this situation, at least once, has been "fooled" into thinking their Bubba has taken his dosage, only to later find the pill later on the living room carpet. It pays to be extra careful if you have small children in your home. Unfortunately, they might be more willing to swallow a found pill than its intended recipient.
In the case of potassium bromide, be sure to use rubber gloves and eye protection when administering the medication to your dog. Repeated contact can cause toxicity in humans.
It's sad to note this, but be careful who you talk to about your dog's medications. In today's world, it's better to be on the safe side and choose those whom you confide in with care. If and when your precious one loses her battle with meningioma, be sure to dispose of the medications promptly, or return them to your veterinarian.
Keep it monitored.
Just because you give your dog a certain amount of a medication doesn't mean that the level of the medication in the bloodstream is enough to control seizures. On the other hand, too much medication in the bloodstream can be toxic. Because each dog's liver breaks down and metabolizes medication differently, each dog will have a different response to the amount of medication he or she receives.
For example, at one time, our 13-pound JoJo was receiving enough Phenobarbital to control seizures in a 25-pound dog. Even so, he still could not maintain enough medication in his bloodstream to achieve a therapeutic level. At this point, our veterinary neurologist decided to add potassium bromide to his protocal.
Blood levels change over time, and the only way to know if your dog is receiving enough, or too much, is to have his blood levels checked from time to time. Ask your veterinarian to recommend the interval that is appropriate for your dog.
Dogs who are on Phenobarbital for a long time, or are on high dosages, can develop liver damage. Periodic blood liver panel tests can keep an eye out for this too. Liver damage due to Phenobarbital is more common with dogs who have primary epilepsy, rather than dogs who have brain tumors, due to the length of time that they must stay on medication.
However, JoJo's autopsy showed signs of liver failure, even though he had only been on medication a few months. This was due to the extreme levels of medication that had been required to control his seizures.
Watch out for drug interactions.
Chances are, you will suddenly find your counter covered with medications of all kinds. In addition to drugs to treat the cancer, and control seizures, your dog may also have medicines required to treat unrelated conditions.
If so, it doesn't hurt to keep an eye on what you're giving. Watch out for drugs that might not "get along" and potentially cause harm to your dog. This is especially important if you have several veterinarians and specialists treating your dog.
Ask a lot of questions. Look into side effects and problems with drug interaction. You can buy a veterinary medical desk reference that lists this sort of information. Here is another site you can look up online:
Animal Pharmacy Center of Mar Vista Animal Medical Center
http://www.ccweb.net/marvistavet/html/pharmacy_center.html
When seizures don't stop.
This is a situation of special concern to the family of dogs who have brain tumors. Whether it takes the form of an intense series of cluster seizures, or a minutes-long seizure that threatens to turn status, you will need to be prepared in advance to take immediate action.
Just in case, be sure to keep the number of your veterinarian and emergency clinic close at hand. Write down these numbers, and directions on how to get there. You might also want to include phone numbers where you can be reached in an emergency in case your dog needs help when you're not home.
Keep medications organized and in one place. It is often helpful to take them with you when you take your dog to the emergency clinic. A tackle box or other sectioned "organizer" box is efficient and easy to carry.
You will also want to ask your veterinarian about inter-rectal valium. Use of this medication can help stop a cluster or status seizure, but it is most effective when administered during, or just after the first seizure.
Once you've administered the valium, take your dog to your veterinarian or emergency clinic for evaluation and observation. Your vet will have additional support for your dog's condition if additional seizures or complications occur.
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