Dr. Marie replied:

Poor little Trinket. I'm sorry to hear that she is not doing well.

I did some researching for you as I also did not know what HCM was on bloodwork. I looks like it is the equivalent of the mean copuscular hemoglobin concentration. If this is the only thing that is elevated I really don't pay any attention to it. (If it is elevated and the dog is also anemic then this value can tell us something about what type of anemia the dog has.)

Did Trinket ever have respiratory symptoms? i.e. has she ever had an extremely runny nose, sneezing and coughing? When dogs get distemper, yes, they can have seizures, but the seizures always come after the respiratory symptoms. My guess is that this is not distemper.

When I see seizures in a young dog with normal labwork then I usually call it epilepsy. There is no test for epilepsy, but if we have ruled other things out then this is the most likely reason. If I think a dog has epilepsy and if the seizures are frequent (i.e. a few times per week) then I will usually put them on a medication such as phenobarbitol which helps control seizures. If she has epilepsy then this would likely be a lifelong medication.

In some areas, there are some parasites that can cause seizures. In my area I don't see this often, but it's possible that she has something like toxoplasmosis or neospora. Likely, if this is my case I would try her on an antibiotic called clindamycin for a while. This treats these parasites.

Again, my guess is that this is epilepsy. Unfortunately though when I see a dog who is diagnosed with epilepsy at a young age they often are difficult to control with medications. You may find that her seizures get worse or more frequent.

I wish I had some better advice for you. I hope she does ok.

Dr. Marie.

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Dr. Marie replied:

Oh dear...I'm sorry to hear that she is having seizures like this constantly. It sounds like the phenitoin is the same thing as phenobarbitol. This is good for seizures, but will take a few days to build up to a level where it is most effective.

Unfortunately I can't legally advise you on dosages online. You can talk to your vet though and ask if neospora or toxoplasmosis are conditions that you would see in your area. If so, they can advise you on medication.

I really don't like the fact that she is seizing like this continually. If this were my case I would likely be advising keeping her in the hospital and keeping her on intravenous medication to help stop seizuring. But even then, there is a possibility that we may not be able to cure her.


I just have a couple of other thoughts (that are a bit of a long shot). Does she eat or drink from ceramic dishes at all? There have been some cases of ceramic dishes made in Mexico that contain lead and can cause lead poisoning. However, her red blood cell count would probably be affected if this was the case.

Also, I know you mentioned that she had never had respiratory signs. Do you know her entire history from birth? It is possible that she had a mild case of distemper when she was extremely young and this could cause some scarring in the brain. Unfortunately though it is difficult to test for this...and there would be no treatment. She would continue to get worse until she died.

I have one other thing that I am going to mention. I am usually very reluctant to contradict a vet's choice of medications (as I don't know the entire case). But, I am questioning why chloramphenicol is used. In dogs with seizures, this drug can sometimes make seizures worse. Also, it can cause phenobarbitol to not be absorbed properly.

It is possible that you may have to be making some hard decisions about her quality of life soon.