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Phenobarbital and Zonisamide.

Species: Dog
Breed: miniature poodle
Age: 5-8 years
Ziggy had cluster seizures as a puppy and we have been controlling them (averages 1/month) with a combination of Phenobarbital and Potassium Bromide. His latest Bile Acid level was 45.1, up from 27.6 six months ago. His ALP and GGT levels have always been high according to my vet because of the phen barb.
He has recommended we transition him off the phen barb and on to 100 mg Zonisamide taking them both as we taper off the phen barb slowly.
Does this sound like a good idea to you or should we have further tests done to verify the most recent Bile Acid test and/or liver damage? He has a bad tooth to deal with at the same time. Can a decaying tooth effect the Bile Acid level?
We are planning on taking care of the tooth first then dealing with the medication transition. The last time he had a tooth removed he had his worst seizure to date.
Would love your opinion on this. Thank you.


Online vet, Dr. Marie

Dr. Marie replied:

I'm sorry to hear about Ziggy's recent problems. Seizures can be very frustrating to deal with. A bile acid level of 45.1 does indeed sound high. High bile acids can often be a sign that the liver function is impaired, and as we know that phenobarbital can be hard on the liver, it's not wise to stay on it if there is risk of liver damage. There is certainly no harm in asking your vet to repeat the bile acids test as occasionally we can get misleading results.

But, it does sound like your vet is doing the same things that I would do.

It's unlikely that a dental issue would affect the bile acids, so I wouldn't think that this is the problem.

If you do transition the medications (which sounds like the wise things to do) I hope things go well.

Dr. Marie.


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Dr. MarieDr. Marie is a veterinarian who practices in a busy animal hospital in Ottawa, Ontario. She created Ask A Vet Question as a resource for good, accurate veterinary advice online. Dr. Marie treats dogs, cats, hamsters, guinea pigs, and rats. She has been a vet since 1999.

Is an online vet visit just as good as a trip to your veterinarian? No! But, many times, asking an online veterinarian a question can help save you money. While Dr. Marie can't officially diagnose your pet or prescribe medications, she can often advise you on whether a vet visit is necessary. You can also ask Dr. Marie for a second opinion on your pet's condition.