Older dog having seizures.

Dr. Marie replied:

Aw, I'm sorry to hear that you and Cooper are going through this. Seizures can be a scary thing to deal with because we often don't know what is causing them.

The symptoms that you are describing certainly could be a side effect of the phenobarbital. Has he had his blood level of phenobarb checked throughout these dose changes? There is a particular blood level of phenobarb that we know works well for seizures. If the level is too low then it is not going to be effective. If it is too high then we know that we can expect some side effects.

However, it's also possible that the symptoms are a sign of something more serious, such as a brain tumor. Unfortunately this is probably what you are fearing.

Any time I see an older dog who has no history of seizures start to have seizures then I get really worried about a brain tumor, especially if his blood work is normal. (If there was some type of problem evident on bloodwork such as a kidney or liver problem then we could blame the seizures on that.) It is uncommon for a dog to suddenly develop epilepsy at 10.5 years of age.

Unfortunately though, the only way to accurately diagnose a brain tumor would be to have an MRI or CT scan of the brain done. And these are quite expensive (usually well over $1000.00).

If this were my case, my plan of action would be this:

1. Do a blood test to determine if the phenobarb level is within the required range. If I find that the level is too high then I would lower the dose. This may help to reduce the hyperactivity symptoms you are seeing.

2. I think it's a good idea to add potassium bromide. It has very few side effects and sometimes when we combine it with phenobarbital it does a good job at decreasing the amount of seizures that we see. It often can help to reduce the amount of phenobarb that needs to be given.

3. If the medicines are not working well, you could ask your vet about the possibility of using a drug called Keppra. It is more expensive than phenobarbital but I have had it work well for dogs whose seizures we can't control well with other drugs.

I think it's also important to note that the goal of seizure medications is to reduce the frequency of seizures, and not necessarily to completely get rid of them. I know it is hard to watch a dog have a seizure, but it is important to know that a seizure is usually not hard on the dog. Dogs will often feel a little off for a few hours before and after a seizure, but they are no consciously aware of what is going on.

So, at this point, if we are seeing a seizure once a month or so, I would likely see if we need to lower the phenobarbital and take things a day at a time.

If we start seeing that there are more and more seizures, or if he is having long seizures (like 5-10 minutes or more) then you may have some hard decisions to make about his quality of life.

I hope this helps. Let me kno w if you have more questions.

Dr. Marie.



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