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Phenobarbital side effects--how long?
My dog (shepherd/husky mix, 73 pounds, 12 years old) began to have grand mal seizures last week. He had two seizures, one on Sunday and one on Monday, at almost exactly the same time in the evening. After the second seizure, the vet put him on phenobarbital (97 mg/2x per day).

He's been on it for five days now and is still pretty out of it. He is extremely lethargic (sleeps most of the day), has coordination problems, and weakness in his hind end. He walks veeery slowly. He's also extremely hungry and thirsty. I've read that all of these are possible phenobarbital side effects. How long do these usually last before the dog gets used to the medication? I'm hoping that these are not signs that something else is wrong, though I am aware of the possibilities.
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1916673 tn?1420236870
Hi. Ensure is actually okay for dogs, but there are a couple of things to bear in mind about it ... first, it contains lactose, which many dogs have a problem with (many dogs are lactose intolerant). So, although it will certainly help with getting nutrition in her, it could result in vomiting, gastric upset and/or diarrhea.

The second thing is it contains a fairly rich source of vitamins, intended for humans. Much depends on what Esther's current blood panel results say about things like calcium and phosphorus, because Vitamin D particularly can interfere with the balance.

You can afford for her not to eat for another day, if you know you can talk to your vet on Monday and then get professional advice - but it is essential she gets water, otherwise she will become dehydrated very quickly and this can have dire consequences, particularly and quickly developing into kidney crisis.

The gum ulcer is more likely to be causing the failure to eat than the kidney disease at this stage. Let's face it, when we have a gum ulcer, no one wants to chew on anything. It is also likely the uremia caused by renal disease has increased the bacteria in the mouth, hence the gum ulcer. The ulcer will almost certainly be causing some pain, which will worsen if she eats and tries chewing anything. A topical therapy, such as chlorhexidine solution or antibacterial gel may be used directly on the gums and in the mouth, and your vet may also be able to prescribe a topical pain medication that can be placed on the gums and mouth to lessen the pain.

If you can't see your own vet, it might be prudent to see an emergency vet in your area, explaining that she has kidney disease and is failing to eat/drink probably due more to the gum ulcer right now. Point out that she cannot afford to lose weight at this stage of her kidney disease management.

Hope this helps.

Tony
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1916673 tn?1420236870
Hi again. Sorry for some slightly confusing comments in my prior post ... I'm answering too many questions tonight and my thoughts are all over the place. My comment about kidney disease was meant to be about the phenobarbital side-effects (I've just replied to maybe 5 people about kidney disease, so it's on my brain). There may be some uremia, which could be producing some kidney effects - but not kidney disease, as I mentioned. The ulcer could also just be a result of her feeling very tired and out-of-sorts or due to dental disease. Your vet will need to consider these potential problems.

Sorry for any confusion. I think it's high time I went to bed and got some sleep. It's actually 1am here in the UK.

Best wishes

Tony
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Boy, can i ever relate!  No worries at all; rather, thank u for taking the time, Tony,  We will definitely put some salve on the ulcer. We're still having to use tube for water. She's just not interested in the bowl. She is insistent on walking, walking, walking - even when she's the groggiest. She tumbles a lot, so we carry pillows with us to catch her when she falls. When those little tremors come on, she wants up, even out of a sound sleep, and they usually subside quickly after she gets up.  Gonna try to keep hydrating her. So far, so good. She drank About 220ml throughout the day in her awake times and we actually managed to get 2 bites of sweet potatoes on her tongue last night. Will keep at it today and keep u posted. Hope u had a glorious night's sleep - u absolutely deserve! It!  Many thanks again, my friend ;-)
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1916673 tn?1420236870
Yes, good night's sleep ... though early start this morning. But refreshed at least. I don't know whether she'll take it, but you might try some cooled-down chicken broth (basically the watery result of boiling chicken, as if stewing it). This will certainly help get some good nutrients in her for today. If she accepts it, you could also try blending it with some boiled white rice, potato or similar foods that will help her acquire some energy. Just a thought.

You're doing great with the hydrating ... keep that going. Don't let the vet fob you off tomorrow ... she definitely needs their attention.

Tony
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Hi again, Tony. Thank you for all the help above!  We managed to get 1/4 can of Ensure down her so far and feel pretty confident we can get the rest of the can down before midnight tonight when she takes her pb.  However, when we were giving it to her, she swallowed the 1-1/4" surgical tube we were using to feed her that we had on the tip of our syringe.  She didn't choke and seems ok.  We are now using a longer tube so that we can pull it out if she bites on it. Also, it's a holiday here in the States tomorrow, so vet will not be in.  Should we be worried? Do you think she will pass it naturally? We don't get paid until Thursday and our vet requires payment the day of the visit. Is there anything we can do here at home about this?  We love Esther so much and hate that we let this happen to her :-(:-( (both of us)
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1916673 tn?1420236870
Hi. The surgical tube should pass okay, but it's worth being extra cautious, as they can obstruct or puncture the digestive tract. Look out for any blood in her stool. I think leaving things until Thursday is not great, but I understand your situation. Is there anyone you could borrow enough money from until Thursday? Family or friends maybe? It's good you got the Ensure in her, though I am a little concerned about it (see my earlier post). It would be far more preferable for her to be on a canine nutritional supplement rather than Ensure. I'm sure your vet will suggest a much more appropriate one or maybe even give her some by tube himself.

Tony
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Ok. We are definitely going to try to work something out to get to vet earlier. If you are a praying person, we would appreciate any and all, Tony.  We did get a bottle of Ensure down her and we will buy some chicken to stew.   It's been touch and go here, but she isn't giving up and neither are we.  She is getting up consistently to walk, walk, walk, and pee, and we are tube feeding and watering her regularly now. We haven't left her alone since this started and won't. Will let u know what happens with vet.  It's impossible to put into words how much you have helped us through this terrifying and painful time in Esther's life (and ours), THANK YOU just isn't enough.
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1916673 tn?1420236870
Hi again. No thanks are needed. I feel we all family here ... and we care for each other and each other's best friends as much as we are able. The reward is knowing our dogs get through the tough times life throws at them ... and to be there as a shoulder for their owners, when things don't work out as we would like.

I can tell just how much you love and care for Esther. It comes across in everything you say. Yes, please do keep me informed.

Tony
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We have a 15 year old Boston Terrier...he recently started having seizures -- 8 or more in a 24 hr period. Took him to vet, had blood tests run to check his liver etc to make sure nothing was out of whack there.  The vet put him on PB twice a day.  Took me home, gave him his first dose of PB, and had to go back to work.  When we got home, he was pacing and barking, acting disoriented and like he couldn't see and then he became very aggressive, and even bit me when was trying to help him back into the house.  He also attacked our other dog and has been acting like he is biting at flies or whatever else he thinks he sees.  This started last night and wasn't any better this morning.   I know most of these can be common in post seizure activities etc...just wondering how much time to give it before we react.  On a side note...my mother had his litter mate who started having seizures and at 84 she decided it was best for the both of them that she put him down.  Another factor to note is, my mother babysat him while we were on vacation for 10 days and the seizures started the day we brought him home.  My hope is...since it was happening in his litter mate...it is more likely to be epilepsy and not a brain tumor...and that is why we decided to give PB a chance.  Wishful thinking?  Thanks in advance for your feedback
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1916673 tn?1420236870
Hi. It is almost impossible to say whether this is genetics (epilepsy), degeneration of the neurological pathways due to age or a tumor of the brain. It would take several different tests (quite expensive, unless your dog is insured for them) to make an accurate diagnosis.

So, the second course of action is to treat the seizures. It seems the vet has discounted other potential and associated illnesses that can cause seizures, so it may be the only way forward is to treat the seizures and see what happens. The disorientation is rather more associated with the phenobarbital, rather than the seizures themselves. These symptoms should ease off gradually over the next few weeks, but it will take time. Yes, there is an associated amnesia and disorientation immediately following a seizure, but these shouldn't persist more than a few minutes. That's why I think these are more likely to be side-effects of the medication.

You clearly need to be very cautious about leaving both dogs together while unsupervised, or your dog could (unintentionally) hurt the other one. Also, it's imperative that you get your vet to check the blood levels every two weeks (ideally) until the therapeutic level of phenobarbital is found. Even after that, regular blood level checks are strongly advised, because overdosing and under-dosing is common with this drug.

Hope that helps.

Tony
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It helps...this is the second Boston that I have had that has had seizures.  My first one, his started young and I treated with acupuncture and holistic remedies and had great success until he got older and then I had to put him on PB...his were totally different than Dozer's.  I guess needed reassurance that these were a reaction to the drug...not the seizures.  I do not allow the two together at this point.  I realized what could happen.  My fear is that I will get bit also.  I want to make sure he isn't suffering...he is or was in really good health until this happened.  As with everyone, he is part of the family and I want to do every I can but I don't want him to suffer.  If you were to guess...how long would you give the symptoms from the meds to subside.  Again...thanks for your help.
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1916673 tn?1420236870
Hi. I wish I could answer your question, but no one can. It normally takes between 2 and 8 weeks for side effects to subside, so you need to prepare for it. All dogs are different and no one can predict which dog will take 2 weeks to get over the side effects or which one will take 8 weeks. It will certainly help if you can make certain your vet undertakes regular blood checks (ideally every 2 weeks), as the therapeutic dosing level will help minimise the side effects and prevent seizures all at the same time.

You should also be aware that some dogs' seizures aren't controlled by phenobarbital. While this is unusual, it does occur. So, if the phenobarbital fails to address the seizures, your vet may need to add something like potassium bromide along with the phenobarbital - or prescribe a completely different anticonvulsant drug.

When seizures occur, you can protect yourself by leaving him in a safe zone until the seizure is over. This is a difficult thing to organise, but it can help to prepare for it, particularly if you can predict the seizure coming on. Baby playpens are something I have known some owners use ... but anything similar that restricts their movement (and biting you or others) without restricting the seizure itself, can be useful.

After the seizure, wait until he recognises your voice before comforting him. It's only during the first few minutes after a seizure that amnesia and confusion tends to occur, and this is when fear and anxiety may cause an aggressive reaction.

Tony
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Hello my friend,  It is a very sorrowful time for us.  As soon as the vet opened after the holiday on Tuesday, we were there with Esther, because she began moaning at 3am Monday, increasingly more right up to the moment the vet gave her a sedative.  We cried hard when she was moaning, praying hard, and holding her, comforting her as best we could.  We basically told the vet that we weren't going away (even though we couldn't make payment until Thursday), and they obliged us.  We're still not sure what happened.  After we got the Ensure down her and water continually, we were hopeful.  But something happened that we still don't understand and she began deteriorating rapidly.  Once the moaning began, she didn't seem to know us, although she was somewhat comforted by light touch.  She kept wanting to get up, and her moaning would stop when she was up momentarily, but at the last, she couldn't stand on her legs at all.  It was heartbreaking.  The vet explained to us that she was old.  We hadn't realized that, her being only 7-8 years old, but he said that was average life for a Rottweiller.  He said her moaning could be caused by many things, one possibility being that her bones ached so much from lying so long on the floor (prior to this, she slept on bed or couch with us) and because of the continuous rain we have had here.  This has been one of the hardest losses for my husband and me.  Night before last, we just laid in the bed, holding each other, crying and remembering so many precious moments with our beloved Esther.  Don't know what we would have done without you, Tony.  May GOD bless you and yours as you bless others with His loving care and wisdom.  Kindest regards, Rick and Cris
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1916673 tn?1420236870
Hi. I am so very sorry for your loss. You certainly went the extra mile in trying your very best to help Esther, but sadly, sometimes even everything we can do isn't enough. Yes, it's true, the bigger the dog, the shorter its life expectancy - dogs just don't live nearly as long as any of us would like. My heart goes out to you both. I am so sorry the outcome wasn't as we had been hoping, but rest assured you did all you could.

Run free Esther.

Tony
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We got our 6 year old cocker spaniel from the local animal shelter 4 years ago in april.  In December same year(Christmas Eve he had his first seizure) It was not severe.  We took him to the vet on the 26th and he did and exam and blood work to see if anything was going on that would show up and the blood work was normal....He said to watch him and we would go from there it was 8 months before he had another one. back to the vet, blood work again and he said same thing.  He said that cocker spaniels were proned to have seizures.  He said as long as he was not constantly having them that he didn't need meds.  He then had one about every 4 or 5 months, and they were all mild.  He only had one grandma this entire time.  Two weeks ago he had one then a few hours later he had another then about 10 minutes later another...We took him back the vet (his office is only 2 blocks from our house) and he was put on 32.4 phen a barb 2 x a day...that was on June 2nd, yesterday he had another one.....however the last few days he has been scrathing an itch on his leg and scooting along the carpet on his tummy......Could this be a reaction to the phenabarb?
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1916673 tn?1420236870
Hi. In answer to your question, itching is not a side-effect of phenobarbital, but it is an allergic reaction - possibly to the drug and possibly due to the time of year (seasonal allergies are very common right now). I wouldn't stop the phenobarbital (seizures are more dangerous than an allergy), but I would go to the vet and point this out to him. It may be your dog needs another medication other than phenobarbital (there are several alternatives, but phenobarbital is by far the most used and generally more successful) ... or just another medication to counteract the itching. Has your dog been running/walking/playing in long grass recently? Or are there any signs of fleas or other parasites?

Tony
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My 7 yr old golden was placed on pb  to treat what the neuro is surmising is Orthostatic Tremor,(OT)The symptoms are hind leg shaking while standing to the point that he cannot stand longer than a minute, but no symptoms while running, jumping,,walking, laying, or sitting.  The OT is found in giant breeds and I have not found any cases in goldens. He goes back in 2 weeks for blood  check.  After reading the posts above and hearing how dogs' personalities,changed I wonder if it is worth the side effects.
My regular vet tried him on Previcot, Predisone, and a pain pill that I,cannot remember the name of, with no change. He was had several tests that have all come back normal to rule out other conditions.
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1916673 tn?1420236870
Hi. If the diagnosis of OT is correct (it's notoriously difficult to get a true diagnosis), then phenobarbital is certainly worth trying. The side-effects will last for between 2 to 8 weeks, then they should dissipate and your dog will return to normal. Patience is a must during this time. Also, it is very important to have regular (ideally 2 weekly) blood checks to ensure the dosage given is within a therapeutic range - and the dosing must be given at the same 12 hr period every day.

There are alternative anti-convulsant drugs suitable for OT, such as pregabalin or even gabapentin, which can be trried if the phenobarbital doesn't have the desired effect.

There is a forum dedicated to OT that I found, which you may want to consider becoming a member of. It's at:

http://www.orthostatictremor.org/

Hope this info helps.

Tony
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I want to thank everyone who have posted.  I am new to this blog.  We have been backed in a corner so to speak with Mr. Frodo- a Boston terrier who has had seizures since about 6 months old. He is now 8. Has been on Phenobarbital ever since. 10 wks ago his liver function sky rocketed 7x over normal.  the vet and i decided to try zonisamide and taper him off phenol.  8 weeks later, this past Monday we were in hospital for grand mall seizures and clusters that I could not control at home with crisis meds,  so neurologist has taken off zonisamide, and replaced with Keppra. he put him back on the full doses of pheno, a liver ultrasound guided biopsy is scheduled for Monday morning,  The neurologist along with the ER doc basically put it in light for me another way - even though he responds to phenol, it is not doing his liver any good - he is more or less addicted to it.  The pheno is not even at the blood level that it needs to be to control seizures.  so I cringe now that I give it to him( drs. orders) until Monday for his test.  so , now the reason I am on here, Keppra like all other anticonvulsants - it has really made him groggy/clumsy, I read a lot of side effects about this, but the duration of the side effects not clear, anyone know a – a few days, couple weeks or couple months? Now then like most all, I love this little guy and he is truly my little buddy – He goes everywhere with me, he knows lowes and tracker supply and gets so excited just to ride in the car – it really upsets me to see him groggy and clumsy – I know all involved in his care are doing what is right for this very moment we are in, but just heartbreaking.
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1916673 tn?1420236870
Hi. You have done amazingly well to get to this stage, after such a long time with the seizures and phenobarbital treatment. One thing you might try is some Milk Thistle supplementation with his regular diet. Milk Thistle protects the liver and can help restore it ... but talk to your vet first, because it sounds like you have a good one. As far as I know, there is no "median" time for side effects to dissipate. It really does depend on every individual dog, as to how they respond. It may take just a couple of weeks - or it could take considerably longer. Either way, please try to work through it, offering reassurance when required, but keep to the regime. You are doing everything and more to help Mr Frodo (what a great name), so just stick to it.

Regards

Tony
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I have been reading through the posts and am happy to have found a place to discuss the issues we are having with our dog. She is a 12 to 14 year-old boxer/bulldog mix (we believe - she's a pound puppy). About 5 weeks ago she began to have seizures following the removal of a mast tumor on a back leg. The vet initially thought the seizures may be due to the large amount of benadryl she was on. We started pb at 1.5 pills twice a day and she became very drunk seeming - can barely walk, very stumbly, maybe a bit confused. This went on for a couple weeks when we began to slowly ween her off the pb. When we got down to .25 pill 2/day she began to have seizures again, having about 8 in a 36 hour period, including at the vets office. The vet told us that it is very likely a brain tumor. Because of her age we are not going to treat the tumor, but want her to enjoy the rest of her days. The vet told us to up the pb dose back to 1 pill 2/day. She has not have a seizure since. That was about a week ago, but again, she can't walk well - is very stumbly, has to be carried to food, water, and outside. I'm concerned that this side effect will not wear off since it didn't wear off before and the vet has told us that we shouldn't consider a lower dose again. How long should we keep her like this? Could she still be happy? It's heartbreaking to watch, but of course I don't want to let her go if there's a chance she'll get better. Has anyone dealt with this sever side effect before? She's been such a wonderful, loving dog. It tears me up, but I want to do the best and most loving thing for her. Thanks for any thoughts.
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1916673 tn?1420236870
Hi. Side effects can last up to around 8 weeks, though most dogs respond within 4 weeks. The point is, your vet is absolutely right, do not reduce the phenobarbital and make sure you never miss a dose, and give the doses at exactly the same time every day (usually 12 hours apart). You just have to be patient. The side effects will eventually dissipate. You didn't wait long enough the prior time (2 weeks I think), and had you continued with the dosage, the side effects would have reduced and disappeared within the 8 week framework. Your vet is also right that this could be a brain tumor (most common cause in older dogs, particularly boxers). You could have tests to determine whether it is or not, but I tend to agree with you, it would be stressful to consider treatment for it and, given her age, probably not a good idea.

Tony
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PLEASE HELP!

I rescued the sweetest westie mix in December of last year. However, a few months later we found out she had renal failure, since then we have managed the problem with Royal Canine LP. Our next issue was allergies, she is now on a steroid for this. Just recently, she started having seizures.She had 3 back to back seizures so now we have her on the Phenobarbital and since she has been seizure free. She has only been on the medicine a little over a week, but I am going insane. I know most of the side effects are normal, the weak legs, thirst, excessive urination etc. HOWEVER, she is barking...NON STOP. She paces, barks/howls/whines for 2 hours, sleeps for 30 minutes, paces, barks/howls/whines for 2 hours, sleeps for 30 minutes. We have a camera on her during the day and have noticed she sleeps just fine when no one is home. It only begins once we get home and literally does not stop until we leave again the next morning regardless whether we are awake, up moving, or asleep. Anyone have any ideas on how to ease the anxious barking?!
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1916673 tn?1420236870
Hi. That is a really complex group of illnesses. The anxiety barking may of course be directly linked to the side effects of phenobarbital or indeed minor (petit mal) seizures that are making her feel insecure and/or afraid. When did she last have her bloods checked? It would certainly be worthwhile, so your vet has some idea about whether the dose is high, low or at the appropriate level.

Also, what stage is the renal disease? If it is late stage 3 or stage 4, there is going to be an impact caused by the anticonvulsant drug. This may mean the renal failure is going to deteriorate more rapidly.

As she is already on phenobarbital, it may be worth your vet prescribing a suitable "calming" medication. Ordinarily, with renal failure, this is not something advised, as it will cause more toxins to be produced - but in this case, it's unlikely to make much difference to the outcome, so something probably worth trying.

Tony
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I apologize for the delay, I reached out to so many different groups it seems i had lost track of this one.

Update - Sugar has now been on the Phenobarbital for almost a month. (We started her June 30th) She is still seizure free, however the barking has not stopped. It has gotten a little better, I suppose. She still barks continuously until we go to bed. We ignore her the best we can until she stops barking and then reward that behavior. It does stop it for a short period of time. During the night she wakes up between 2 and 3am, goes potty, has a barking fit for about 30min-1hr and goes to sleep until between 6-7 and wakes up barking again. Once I get out of bed for work, about 7:20 the barking stops. She gets up and just watches me get ready, following me around the house.

We just took her to the vet last Wednesday and said her levels are "fine" and are continuing with the same dosage of the Phenobarbital. They have tried to suggest the barking is just because shes old. However I refuse to settle for that answer as it absolutely did not start until she was on the medicine.

As far as the renal failure, i am guessing she is at stage 3 from what I have read. I read that you really cannot tell from blood work until it gets to stage 3. Again, I could be wrong, but this is from what I have read.

The vet we have been going to was great with our other dog, but I feel since Sugar needs more attention and more specific treatment they are not qualified. I have another appointment for her on Saturday with another vet.

Do you think the phenobarbital could be causing this issue at all? Again, her kidney levels are almost normal still just with the renal food. We have also as of last week discontinued the steroid for her itching and have her on Hydroxezime (antihistamine)

I guess, my point of this is to get some advice on where and how to proceed with the vet on suggestions for medicines etc. The other vet did not seem open to anything and stated she had to be very careful due to the renal failure.
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Also, I did some research on her flea/tick prevention. I feel this could have been an issue as well.

We have been taking Sugar to Banfield and they prescribed her FirstShield, which is a Banfield product. Her seizures did not begin until we began giving her First Shield. Both times the seizures happened within 2 weeks of giving her this medicine.

I am not sure if you are familiar with FirstShield but the reviews are VERY disturbing to say the least. We also noticed after reading about the medication and what to look for she had other reactions from the medications. Chemical burns and hair loss along the application site.

We have taken her off this as well. I am contemplating weaning her off the phenobarbital and seeing if it was a direct effect of the FirstShield as i read it caused seizures in many dogs.
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1916673 tn?1420236870
Hi again Well, there's a lot there to try and answer ... but I'll do my best.

It is quite wrong for the vet to say you can't tell what stage the kidney failure is at until stage 3 and beyond ... the first blood test (prior to managing the kidney failure diagnosis) is the one to look at, as it is the base result. The levels you need to diagnose the stage is BUN, creatinine and phosphorus. If you have that initial test result, let me know the levels.

The vet is right that virtually all medicines are difficult with kidney failure, because all medicines cause by-product toxins, which further stresses the limited functioning kidneys. Of course, this doesn't mean all medicines should be avoided ... but certainly those that are not crucial to your dog's well-being and good health.

Yes, avoid all flea and tick treatments, unless the risk of your dog catching fleas or ticks are high. FirstSheild is not a treatment that I am very familiar with, though I suspect it falls into the same category as many others that are chemical-pesticide based. You might want to have a read of a piece I did on this subject. You can find it here:

http://www.infobarrel.com/The_Dangers_of_Flea_and_Tick_Treatments_for_Dogs

In fact, both flea and tick treatments - and kidney failure - can cause seizures. Also, the question over the kidney disease is a fair one, because many vets misdiagnose and then treat something that may not be a problem anymore. I would strongly advise your vet undertakes a urinalysis, looking particularly for protein leakage. If there are proteins in the urine, then kidney disease is confirmed. The following article looks at the correct way to diagnose kidney failure - along with various other pieces of information you will probably find useful. That article can be found here:

http://www.infobarrel.com/My_10-Point_Plan_for_Dogs_with_Kidney_Failure

Taking your dog off phenobarbital is a risk, but maybe one worth trying. Dogs can have very serious allergic reactions and acute problems from some flea and tick treatments, and seizures are not uncommon. Taking her off the phenobarbital will test the theory that this was an acute reaction (very possible, considering the other allergic symptoms you have described). There is of course a great danger that the seizures will return, so talk to your vet about this before considering it. Also, don't just stop the drug suddenly, as it needs to be phased out slowly.

The barking remains a puzzle. I am still of the opinion this must be related to anxiety and petit-mal seizures, but it's very hard to be sure without seeing the behaviour first hand. I certainly don't believe it is "down to age", which is a strange comment from a vet. Did the vet check things like hearing and sight? Sometimes, older dogs that are starting to lose some hearing and/or sight, do get afraid or confused and bark as a consequence.

Okay. That's enough from me ... keep me informed.

Tony
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Sugars BUN level upon her first visit (12/28) was 43 and creatine level was 2.1

As of 3/20 her BUN is 23 and creatine is 2.4.

I asked for the recent panel they did, but this is the last one they sent me.

At this point, we have taken her off flea and tick medication completely. I do live in an apartment complex with a lot of dogs and have noticed fleas on her after walking her, but I have narrowed down where they are coming from and keep her from those areas. I truly feel the medicine had SOMETHING to do with her seizures. Albeit, we have only had her for 8 months and I know seizures can come without warning, I just find it odd they came on both times about 2 weeks after the application of the medicine and the reviews.

I know it can be tricky. I have made an appointment with another vet for Saturday, I am sure I already mentioned that. We were taking her to Banfield, who has been great with our other dog, but with a special needs dog I feel she needs a low volume vet that can spend time with her.

As far as hearing and sight, I am glad you brought that up. That is something else I plan to address with the new vet. I do believe her sight is normal, but the hearing is an issue. Before Sugar was on the medicine, when she was sleeping we would have to walk up to her and call her name several times before she heard us. We call her name and there is no response. If there is a loud noise in the room she looks to the total opposite direction to see where it is coming from. Not trying to dismiss any options, but again, this had been the case the whole time.

Thanks for talking through this with me and you have brought up several good points to bring to the vets attention.  I also plan on reading our articles to further educate myself on these conditions.
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1916673 tn?1420236870
Hi. My opinion, for what it's worth, is that this is kidney disease. Probably stage 3. If protein leakage is confirmed, then that's another confirmation. It would also be prudent to get your dog's blood pressure checked (more on that in my article, link given previously). The point is, at this stage, there are lots of things you can do to help prolong life and improve quality of life, but getting a confirmed diagnosis and starting the diet plan and maintaining blood pressure control are crucial.

The seizures are another matter ... it could be this was an acute episode, and a consequence of the flea and tick medication. The problem for your vet now is to find out whether it was acute (and therefore is now not a problem) or whether it is an epileptic type seizure that will get progressively worse without treatment.

Let me know what your new vet advises.

Tony
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I really liked this vet! Not just because he gave me what seems to be, for now good news, but because he spent an hour talking with me and giving me hope and options for where we could go from here. I was also 30 minutes late due to being up all night with Sugar and he didn't have a "put out" attitude about it.

He started off saying he was reading through Sugar's medical history and saw that we had a concern with her flea/tick medication and didn't think that was an issue. UNTIL, he saw the ingredients on the packaging and now thinks that it is definitely possible that that could have been the cause for seizures since permethrin is one of the main ingredients.

Secondly, he said that he did not believe we were dealing with kidney failure. He said that there maybe some other issues that could be causing stress on the kidneys, but that she does not seem to have "failure."

Due to her hair loss and discoloring of skin he did a thyroid test. He also did another blood panel and a urinalysis. Hopefully we will get those results back today.

With all of the above in mind, he thinks we have some room to play with the seizure medication. We have decided to wean her off the Phenobarbital for now. We  started yesterday with just giving her half a pill 1 time in the morning (previously it was 1/2 2 times a day) and I am happy to say we had our first full night of sleep since we started the medication. She went to bed around 11pm with no help and woke up about 8am. Hopefully this will be a pattern! He also gave us diazepam to calm her when need be or if she does have a seizure. Obviously, I am holding off on this to see if she will return to her calm nature on her own without the pheno.

The only negative out of the situation was that he thought she may have a thyroid issue and that she maybe even older than we thought. He watched her behavior (pacing with no real destination) and mentioned that we might have a "geriatric" dog on our hands, but I am ok with that as long as she is comfortable.

For now, it is a waiting game and we are praying the seizures do not return without the Phenobarbital. He said he is confident however, that if they do return we can get her back under control.
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1916673 tn?1420236870
Hi. So far so good. At least your vet is starting to tie things down more and expanding the investigations. The extra blood work and urinalysis will be interesting, so do let me know what they say. I think there is room for cautious optimism. Just one question ... did they do a blood pressure check while you were there?

Tony
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We got the results for Sugar's blood work and Urinalysis yesterday. He said everything is normal and looks good. From the results she seems to be a perfectly healthy dog, except her creatnine level is just a tad bit above the high end of normal. I did not ask him about the blood pressure. I will have to check with him on that.
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1916673 tn?1420236870
When creatinine is high but BUN is normal, there is a suggestion of dehydration and/or heart issues. There is also the possibility of obstructed urine ducts. Temporary high creatinine can also be caused by a recent meal, so it's always best to check creatinine before the dog eats anything during the day of the test.

Depending on how the test is performed, high blood glucose, vitamin C supplements and certain antibiotics (cephalsporins, particularly) can falsely raise creatinine readings.

I think it's worth keeping an eye on things and having a repeat of all tests (and blood pressure) in a couple of months time, assuming Sugar stays seemingly well during this time.

Tony
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Hi Tony,

I did speak with the Dr. about the BUN and Creatnine levels after I found her original documents. When I first adopted Sugar her BUN levels were normal. I took her to the vet 2 weeks later for a teeth cleaning. This is when they noticed her BUN levels were in the 40s, never again were they abnormal. Our new vet believes that it could have easily been a dehydration situation or maybe she did't get enough to drink that morning. We are still investigating in Sugar's case, but as of now we are still seizure free (we have not had a seizure since we were on the phenobarbital) and we are now completely off of the phenobarbital. The barking I was originally concerned about has stopped. In fact, it stopped almost completely the day we lowered the pheno dose and she slept through the night completely. Now that we are off the pheno it has stopped completely. She is a completely different dog now. We will go back in for another check up and they are supposed to check everything out again. For now, it is a waiting and prayer game, but we are definitely keep an eye on everything!
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1916673 tn?1420236870
Hi. I think there's a lot of room for optimism here, so yes, wait and see and write anything down that you think might be relevant so you have a record of what might have occurred and when. Phenobarbital does take some time to work its way out of the system, so there may still be some effects lingering, which of course could be keeping seizures at bay. If the seizures do return, at least you know what will help control them. In the meantime, I would urge you to try and get the vet to perform a blood pressure check when you go back for the next run of tests.

Tony
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I just wanted to add my experience.  Reading this thread helped me through a rather scary period.

Duncan, Our 12-year-old yellow lab mix had his first grand mal seizure in September.  A horrific experience for my wife and I, who were totally unfamiliar with it.  Next day, we took him to our vet.  His opinion was that since this was the first time, let's take a "wait and see" approach.  Bring him back in if there is another seizure. They did some blood work which showed nothing unusual.  Two weeks later, he had his second seizure at 4am.  We called the vet when they opened at 8.  They said they had an opening at 11am and bring him in then.  At 9am, he had another seizure.  We called again, and they told us to bring him in RIGHT NOW.

Our vet prescribed Phenobarbital (8 mg, twice a day).  However, he felt that if Duncan had epilepsy, it should have shown up earlier in his life, probably by time he was five years old.  It certainly wasn't unheard of for epilepsy to show up this late, but he felt that a brain tumor was probably more likely.  He wanted to know if we'd seen anything unusual about his activity, primarily in motor skills.  Was he having trouble walking in a straight line?  Was he turning his head unusually?  Balance problems?  Anything at all unsymmetrical about his actions?  We hadn't seen anything.  He told us to keep him on the Phenobarbital and bring him back in in a month.

Like everyone else has seen, he was dopey and unsteady for that first week.  After than, his perky demeanor returned, but he was still a little wobbly in the back end.

After a month (and no further seizures), we brought him back in for more blood work, which came back normal.  Our vet felt that the 8 mg dosage didn't need to be adjusted.  Keep him on it and let them know if there were any further seizures or changes.

In December, we brought our dogs in for their yearly physicals.  Our vet said that the lack of any seizures since starting the medications was VERY promising, and if Duncan could make it a few more months, he'd feel confident saying that the problem IS epilepsy and not a brain tumor.

Even now, Duncan is very slightly unsteady on the back end.  He still runs full tilt and terrorizes all the local squirrels, but he doesn't bound up the stairs like he used to, and walks up them slowly and carefully.  Is this due to the medicine?  A permanent result of the seizures?  No idea.  But overall, we're very happy with the outcome.
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1916673 tn?1420236870
Hi. I think the slower movement is probably a mixture of age and the phenobarbital. At 12, he's entered old age. But on the plus side, it seems the pheno has done the job it's designed to do, which is great. As time goes on, there may be more seizures, so just look out for them - if it happens, the dose may need adjusting or you can add something like potassium bromide which will help boostr the effects of the pheno.

Tony
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hi,  new to the page BUT please stop the Rimadyl
all of those related drugs are biggies for liver kidney fails in older arthritic dogs
the exact ones they give them to
precvicox is THE worst Ive known too many aged dogs go down within a few days of using it.
other names vary but usually an X in it = for the  coX2 inhibitors
if you really must? meloxicam liquid is far gentler and you can usually halve the dosage and still get good relief
ONLY ever use them for a few days at most.

and if theyre on the phenobarb etc its a double whammy, liver assault wise

Ive used the injectable Pentosan aka cartrophen a series of 4 injections over a month they are  close to miraculous in the results of bad arthritis or joint issues. and safe.

and I am here because my 62kg great dane/staghound had his frst  seizure while asleep next to me on 26th dec 2016
then a follow up jan 31st
both during day in what i wouldnt have thought deep sleep cycle
the first one he was going blue due to tongue in throat
my idiocy  cost me one severely damaged finger and stitches and broken bone;-(
yeah tried to move his tongue
he came round as I did and chomp!
no one else Ive noticed mentions any aggression after attacks?
my fellas off kilter disoriented as you would be...but also scared and  likely to growl/snap for a while after.
with his size and weight and 3 others in our pack...its been..hmm.."interesting" shall i say?
today we started an 100mg phenobarb   1/2 2x a day
see how we go

the newest pill on market is supposed to have near no side effects BUT at a cost in AU$ or 170  a month , opposed to 40 for PB  its an option for the well off or small dog owners only really
http://www.ncbi.nlm.nih.gov/pubmed/26330063
brand name is PEXION
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my 11 year old dog has starting taking seizces and been put on steroids and pb 1 and a half morning and night hes always hungrey and at night barks all the time pdsa said he might have a brain tumour hes went from a great dog to one a don't regonise he paces the room panting all the time a don't have the money for private vet and pdsa are limited in what they do can u give me any tips to help kenzo my dog vet wants to put him to sleep what do you advice me am at my wits end
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my 11 year old dog has starting taking seizces and been put on steroids and pb 1 and a half morning and night hes always hungrey and at night barks all the time pdsa said he might have a brain tumour hes went from a great dog to one a don't regonise he paces the room panting all the time a don't have the money for private vet and pdsa are limited in what they do can u give me any tips to help kenzo my dog vet wants to put him to sleep what do you advice me am at my wits end
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I have a hound/pointer mix.  Justice is just shy of 12 years old.  She has been having 4 to 5 seizures per year but they never put her on any medication because they didn't think they were frequent or severe enough to warrant that.  In January, she has a bad seizure and hasn't been the same since then.  Within a couple weeks, she starting pacing, panting and shaking.  I took her to the vet and they did some blood tests that all came back normal.  They gave her two shots of valium with no relief.  I gave her half of a tranquilizer when we got home and she finally calmed down.  These "episodes" continued every few days.  I took her to a neurologist and they did a liver function test and it came back normal.  That same day, she had a very, very bad seizure and I called the neurologist and he put her on phenobarbital.  Its only been a week, but I feel so bad because she is walking (tipping and falling) in a drug induced stupor all the time.  She just isn't the same dog anymore.  Will she come out of this phase?  
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1916673 tn?1420236870
Sorry I didn't get to you sooner. I am very sympathetic about your circumstances and situation. Phenobarbital is a good medicine for seizures so stick with it through the initial phase of side effects and "settling". It takes a while to get things under good control, but it's worth it. You don't know whether there's a tumour or not, though it is possible. It would be expensive to have the scans needed to find out for certain. The initial phase of phenobarbital does cause a "drunk like" state, but that will pass with time.

Tony
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1916673 tn?1420236870
Hi. Yes, she will come out of this phase. It may take several weeks, but eventually, the phenobaribital will "kick in" and the side effects will dissipate. The important thing is to make sure you give the tablets each 12 hours (presumably that's what has been prescribed) and don't miss a dose. The drunk-like state will subside, eventually. It's also important to have regular blood checks, as that's the only way of working out (by trial and error) what the correct dose needs to be. Tests should be done at least monthly for the first 6 months and then quarterly and then six monthly later on. If the phenobarbital fails to have the desired effect (after about a month or so) then there are other drugs that should be tried as an alternative.

Tony
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I'm an owner of a newly diagnosed Epileptic dog who is also Epileptic! I take Pregabalin and Keppra myself after trying several other drugs with no luck. The Gizlet is on the standard Phenobarbitol (was literally started on it yesterday) but I know how well Keppra works for me so it's in the back of my mind in case it can be used as an additional drug.

Keppra is a unique Epilepsy medication as it doesn't work like any of the other drugs used for treatment. In fact medical researchers aren't even sure how it works, but it does, especially in cases where other medicines aren't helping. This is most likely due to it's unique chemical structure and method of effect on the neurons in the brain. You're quite right, it's a drug that is well worth keeping in mind if the standard meds aren't working or aren't consistently working.

I'm so sorry to hear you lost your furbaby, it's inevitable that they will die but no less devastating when they do. The Gizlet is currently 8 years old and is a Yorkie so hopefully we have many years with him left, but I do worry about him developing a brain tumour or simply dying in his sleep, both of which we humans with Epilepsy are far more at risk for too.
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I'm an owner of a newly diagnosed Epileptic dog who is also Epileptic! I take Pregabalin and Keppra myself after trying several other drugs with no luck. The Gizlet is on the standard Phenobarbitol (was literally started on it yesterday) but I know how well Keppra works for me so it's in the back of my mind in case it can be used as an additional drug.

Keppra is a unique Epilepsy medication as it doesn't work like any of the other drugs used for treatment. In fact medical researchers aren't even sure how it works, but it does, especially in cases where other medicines aren't helping. This is most likely due to it's unique chemical structure and method of effect on the neurons in the brain. You're quite right, it's a drug that is well worth keeping in mind if the standard meds aren't working or aren't consistently working.

I'm so sorry to hear you lost your furbaby, it's inevitable that they will die but no less devastating when they do. The Gizlet is currently 8 years old and is a Yorkie so hopefully we have many years with him left, but I do worry about him developing a brain tumour or simply dying in his sleep, both of which we humans with Epilepsy are far more at risk for too.
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Hi,
My Labrador, Buddy is on phenobarbital and is due his blood tests today. His own Vet requested that we take him in starved. The plan was for him to have his blood taken, feed him and then have some more blood taken 2 hours later.
Unfortunately my husband forgot to omit feeding him this morning so it looks like we'll have to cancel his appointment.
My question is;
Is it necessary to starve dogs to have their liver function test and phenobarbital therapeutic levels checked?
It' just that when he used to see the his neurologist for check ups they never asked us to starve him before his blood tests
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At 11 my pug started having seizures in conjunction with high blood pressure and hypertension. Our vet put her on Pheno and she was completely out of it, could barely walk or do anything. So we lowered the dose but then she started with the seizures again. We had no choice but to bring dose back up. After about 2 weeks the lethargy started to wear away but she became hungry and thirsty all of the time and would bark and cry all day and all night. Also lots of Potty accidents bc of increased water and food. We contemplated taking her off bc she was unbearable to be around and not funny little self but she was seizure free. Feeding her a third meal of chicken and pumpkin helped a little but still relentless for food. Finally ... After 2 months, she is getting back to her old self. She is still hungrier and thirstier than she ever was but she's mostly back to her old self. So point of my story is... Stick with it, don't give up on your dog... They will come around, even after two months of insanity. Make sure you get blood tests though to check Pheno levels and it can be dangerous at too high of a level.
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Hello, thank you so much for posting this information. I'm glad to read that your sweet dog finally got back to normal. My dog Pearl had her initial dose of phenobarbital yesterday and spent the night at the vet. We took her home today and when she's not sleeping, she's pacing around the house and crying. We even gave her Valium (vet prescribed.) It's nice to know that one day it will stop. It's 4 in the morning, we need some sleep!
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1916673 tn?1420236870
Hi. To receive accurate results, dogs need to be starved of all food for at least 8 hours prior to a liver enzyme test. This does vary depending on the laboratory used for the testing, so always follow your vet's advice. The phenobarbital test ordinarily needs dogs to starve for at least 12 hours.

Tony
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Hello,
I have a 14 yr German shepherd mix and she has currently been suffering from seizures. Her first seizure commenced second week of June and she has had some twice a week for less than 1 minute. The recent one she had was longer about 20 min. I was not home but my mom told me it was a long one. I started her with phenobarbital just days ago and she now has problems lifting herself up from the floor and seems very clumsy. Three weeks before I took her to the vet because she had a seizure, my dog had visited the vet to get heart worm test and I wanted them to take a sample of a lump on her chest that has been growing rapidly just recently. Could the cause of the seizure be because i had her take sample of fluid from that lump on her chest? She wasnt showing any problems before that test. The test result for lump came inaccurate because they didnt get enough sample, even though they took three samples of the liquid inside the lump which had some blood. I will like to know also how long do the side effects last until she is normal again?
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Hi. I would suggest identifying the nature of the lump is the first priority and, if it is cancerous, whether it has spread to other parts of the body. Seizures can be caused by many things, including cancer, but also age is relevant too. If there is a primary condition causing the seizures, then that needs to be treated, otherwise the seizures will gradually get worse.

Phenobarbital does cause a side-effect drunk-like state in most dogs. This should disappear once the therapeutic level has been found - and that involves getting blood tests done by the vet at least once a month for the next 3 months and until the appropriate dose of phenobarbital has been identified.

Tony
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Hello my name is Richie ive had a trying few weeks I took my dog to the vet to be checked out because he was in pain and vomiting,,,they seen my dog they took blood and uranian samples they told me my dog was fine and that he was just progressively going blind well I paid them over a hundred and something dollars for these test for them to call me back 72 hours later asking for a uraine sample because someone miss placed it or threw it away now my question is with that blood test would they have know my dog was diabetic
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1916673 tn?1420236870
Smokella13 ... It depends on the type of blood test undertaken. Vets tend to complete a standard test, but that may not include the relevant checks of things like blood glucose, which is required for identifying diabetes. Tony
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Hi.  My name is Tracy and I have a 125 pound,11 year old golden retriever.  He started seizing about once a month for the last year.  We stopped using cleaning products, heart worm med, etc. to prevent triggers.  last Friday night he had 9 seizure's in a row.  He was started on 6 grain of pb twice a day. After 24 hours his hind legs were paralyzed and he hasn't been able to walk.  I've convinced the vet that he was started on too high a dosage and he is now down to 2 grain twice a day.  Shadow try's to get up but ends up dragging his hind quarters behind him.  any idea when this side affect will go away and he will walk again? He was weak in the back end anyway.  This can't be good for keeping up his muscle tone.
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