Seizures

[MMA1983d]

Hi,

Our dog Numi, 50 lb Lab-Border Collie, has been on phenobarbital for 4 years. She has been taking 1.5 grains 2x per day for a year without any seizures. We increased to 1.5 grs from 1 gr. a year ago because she had 2-3 seizures in a 2 week period. Just today the vet reported her blood work came back with an elevated phenol level of 35. They are recommending action to reduce or possibly introducing another drug. Numi's quality of life seems great and we hesitate changing course because she has not had any seizures. Is 35 a level for concern and change of prescription? thanks.

[tonyb286]

Hi. Cluster seizures (multiple seizures in a single day) can be caused by a variety of things and it is often difficult to identify exactly what has brought them on. This is why at least initially, vets tend to treat the symptom (the seizure) rather than the cause. Once the seizures are under control, then it may be more likely you and your vet can start to examine and explore the reason they occurred. Stability is the priority, so the phenobarbital is the first step towards achieving that.

Poisons are certainly one of the major causes of cluster seizures, but not the only cause. Brain tumors are also a significant cause. A comprehensive list can be found at: http://healthypets.mercola.com/sites/healthypets/archive/2011/02/22/pet-seizures-and-pet-dog-cat-food-diet.aspx

I picked that particular site because I was already reading the interesting theory regarding dog collars and their potential to cause seizures.

It will take a little more time before the therapeutic phenobarbital level is found and for the medicine to take effect. Between now and then, I would keep a diary of observations - which may prove useful to the vet. I am sure your vet has already told you the importance of giving the phenobarbital at the same time each day - and never missing a dose.

Hang on in there - things will improve gradually.

Tony

[tams2]

My 7 year old Golden, Bella, had 8 seizures in less than 24 hours last Thursday/Friday.  She has been on phenobarbital since Thursday at 10am (every 12 hours).  We brought her home Friday night and she is progressively getting better. It's been great reading your posts/remarks on this topic as I feel very sad that we won't get our regular peppy Bella back to us.  However, in reading these, I see that we need to be patient and in time she will get back to herself.  Here's my question.  They have no idea why a 7 year old very fit and healthy dog would have a cluster of so many in such a short time. We know she didn't get into anything poisonous.  Should I be concerned she may have a brain tumor?

[tonyb286]

Hi. Every dog is different, which means every dog taking phenobarbital needs a different dosage - and sometimes that can change even over a few months within the same dog. So continuous blood and urine testing is essential to ensure a therapeutic level is maintained (at least every six months and more frequently if there are seizures or a changing pattern of behavior, causing dosages to be re-evaluated).

It is very important to reduce the phenobarbital level back to within a therapeutic range (under supervision of your vet). High levels of phenobarbital will cause liver damage, so the slow but gradual reduction and close monitoring of bloodwork is crucial and should not be ignored.

The recommended therapeutic range in dogs is 20 to 35 ug/ml. This means your dog is at the upper limit and it would certainly be beneficial to reduce it slightly (not much, but enough to bring the level down to a safer level). There are several other drugs that can be combined with phenobarbital if the reduced dose doesn't keep your dog seizure-free, so that would be a good option. I think your vet is following the right guidelines, so take his advice. It may be worth starting a daily diary, so you know and can record any observable changes in the dosage, time given (this is important, as it should be at exactly the same time every day), any change in your dog and any seizures (time and severity).

Tony