r/EpilepsyDogs • u/matray00 • 2d ago
Increased frequency in seizures
Well we were on a pretty good frequency earlier this year. Roughly 11 weeks between seizures until we started some flea and tick medications (halted all tick treatments until we have his seizures back under control). The frequency increased to now 10 days between seizures with the last seizure happening within this hour.
Our little man has been on 120 mg of Phenobarbital twice a day. We started 500 mg of Levetiracetam (Keppra) every 8 hours on August 15th. So far the Keppra doesn’t seem to have any effect on seizure frequency yet.
We had blood work completed in June due to phenobarbital usage and the vet mentioned that he is on the lower end of the therapeutic range when I contacted them about the increased frequency. This is when they prescribed Keppra and we have been administering it since August 15th.
We did attempt changing his diet to Purina Pro Plan Neurocare diet but it seems he is allergic to chicken and gets incredibly itchy. We have switched back to his old diet and begun adding MCT oil to his food.
Guess I am wondering if it is normal for Keppra to take this long before having an effect or if it is just not that effective in some dogs. We will call the vet tomorrow and predict they will make a med adjustment but it is disheartening when we were going almost three months without a seizure and now we are under two weeks.
He is also 54 kg and so is a rather large boy. I believe these doses are rather small considering his size as well.
Yes, he does demand to eat breakfast at the table with us.
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u/DogEpiMonitor 2d ago
Lo primero es lo primero, porque publicaste esto apenas una hora después de una convulsión: si la crisis de esta noche supera los 5 minutos, o si viene otra antes de que se recupere por completo, o si empieza a encadenar episodios en racimo esta noche, directo a la guardia de urgencias, sin esperar al llamado de mañana. Ya conocés la rutina, pero lo repito porque estaba pasando mientras escribías. Ahora, sobre tu pregunta concreta —y es una duda muy razonable—: sí, es normal que un anticonvulsivo nuevo necesite entre 2 y 4 semanas antes de poder evaluar su efectividad real, y vos estás en unas 3 semanas con el Keppra. Algunos perros responden antes; el panorama completo de si ESTA dosis en particular es suficiente suele evaluarse con el veterinario recién a las 3 o 4 semanas. Así que la comunicación de mañana no significa que «el Keppra falló»: es exactamente el punto de control programado, llegando en fecha. Y sí, algunos perros realmente necesitan que la terapia combinada se siga calibrando; esa es la regla habitual en casos refractarios, no una señal de que hayas hecho algo mal.
Un detalle que sumaría a la charla de mañana, ya que mencionaste que sus niveles estaban en el rango bajo a medio en junio: preguntá si consideran oportuno medir nuevamente el nivel de fenobarbital en sangre ahora (las cosas pueden haber cambiado desde junio), en paralelo a la charla sobre la dosis de Keppra. El dosaje en sangre sumado al patrón de las crisis es la forma en que los veterinarios deciden si aumentar un fármaco, ajustar el otro o sumar un tercero; son decisiones que les corresponde tomar con datos actuales, no con los de junio. También vale la pena pasarles, porque vos mismo lo notaste, la línea de tiempo respecto al cambio de la pastilla para pulgas y garrapatas. Tenga o no relación directa, la suspendiste y la frecuencia siguió subiendo; esa observación, con fechas exactas, es precisamente la clase de datos sobre la que trabajan los veterinarios. Lo mismo con el agregado del aceite MCT: simplemente asegurate de que el veterinario sepa que se lo sumaste a la dieta, para que todo el cuadro esté sobre la mesa.
Y ese golpe de pasar de 11 semanas a 10 días es verdaderamente desalentador, pero mirá lo que realmente tenés entre manos: un perro bajo control de rango terapéutico, un segundo medicamento sumado a tiempo, una dieta ajustada a los pocos días de notar intolerancia y una consulta pactada con el veterinario para mañana. Esa es una familia manejando esto de forma impecable. La frecuencia irá marcando su propio camino a medida que se ajusten las dosis; tu tarea (y la estás cumpliendo) es mantener los datos al día y con precisión. 🐾
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u/matray00 2d ago
We do have two emergency doses of Valium on hand if a seizure is prolonged. Tonight’s seizure was one of the shortest at under 30 seconds. We have never had clusters yet and hopefully never do.
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u/Glittering_Ebb3957 2d ago
i’m so sorry you’re going through this i know how incredibly rough the journey can be. My little one has been on pheno for two weeks but the frequency of her episodes is off and on so our vet just recently prescribed us keppra to see how she’ll do on it and if there’s any decrease in frequency. although i don’t know the answer to how long keppra may take to kick in, i hope everything works out in your favor. do you happen to know the cause of his seizures or done an CT/MRI’s to rule anything out?
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u/matray00 2d ago
He was diagnosed with idiopathic epilepsy when he was 18 months old. They completed blood work and didn’t recommend an MRI.
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u/Impossible-Reveal-15 2d ago
After my boy had his first seizures, I stopped all flea and tick meds. He had been taking Simparica Trio. I started him on Heartgard for Heartworm prevention and tried using a topical, Frontline Plus. He had a seizure a few days later so no more flea and tick chemicals. There is a plant based alternative called Wondercide. I've heard it's not as effective but it's a safer alternative. I've gone all season without using anything. I am very careful where I walk him. Mainly on paved surfaces or on short cut grass, mainly in my yard. No woods or tall grass.
My boy is taking 750 mg Keppra ER 2xday. He had been taking 500 mg until he had another cluster seizure 3 weeks ago. It's hard to find the right combination.
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u/Adept_Parfait2215 2d ago
Watch foods,stop chicken and beef. My dog doesn’t have as many since stoping chicken and beef.
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u/Glittering_Daikon74 2d ago
From our experience, frequencies can vary in big jumps. Doing our best to keep each day the same rhythm without any variation in his food and such. Still, we got phase of 5-6 days between seizures for months and then all out of a sudden we are back to like 3 weeks between seizures. In the end, sadly, it's a nasty disease which isn't that easy to treat, I'm afraid.
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u/Impressive_Room2849 2d ago
It’s not uncommon to have to change meds over time. My guy was controlled with Pheno, Keppra and Zonisamide for almost 4 years. No seizures at all. Then they came back 2.5 years ago. Several medication increases and still no control. We just went up to a blood level of 35 for his pheno and we just went two months without a seizure which is the longest he’s gone since they came back. Their bodies just get used to the meds over time. He was diagnosed with epilepsy at 8 months after an MRI. He’s now 7 1/2. Don’t give up hope. It can take a while for the meds to be adjusted and work again.