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Log inEpilepsy free-stream of consciousness
Epilepsy free-stream of consciousness
blottogg on Tue Sep 30, 2008 10:50 pm
(Below are a couple of (slightly redacted) e-mails I sent to a greyhound owner who's pup had started having seizures. Sorry for the length of the post, but hopefully it will have some info that might be useful to others.)
We’ve got four greyhounds, and our seizure dog is named Tom. We got Tom from a rescue in the Chicago area while living there, and we knew he had epilepsy when we adopted him (we had Bow and Hoss at the time, and the rescue group wanted him to go to a family with some experience with greyhounds, or epilepsy, or both.) We had him worked up by a veterinary internist in the area, and the EEG and X-rays quickly revealed the epilepsy was due to a skull fracture. Greyhounds don’t have a genetic predisposition for epilepsy, but a cause for the seizures can’t always be pinpointed (the docs call this idiopathic epilepsy.)
Tom is currently doing well, and is being treated with a combination of phenobarbital and potassium bromide (KBr). He hasn’t had a seizure in about a year, and we’re working with our vet here to reduce his dosage of phenobarb to the low end of the therapeutic range. Our vet is Dr. Barb Teeter at The Pet Clinic here in Omaha, by the way. It would probably be a bit of a hike for you from Lincoln, but she’s good, as are all the vets at this clinic.
In no particular order, here are some things we’ve learned with Tom:
- Beware cluster seizures. When we first got Tom, we didn’t know how much phenobarb the kennel was giving him, or when. They were using leftover medicine from another of their dogs that had had seizures, but died. Working with our vet, we took him off all medicine, and kept a log of his seizures, as well as the conditions under which they occurred (time of day, weather, recent activity, etc.), trying to collect data to determine the cause of the seizures. While doing this, he would throw a seizure (or sometimes two) every two weeks or so, to the point where we almost got accustomed to this. Then he threw a seizure, and a couple hours later another, then another, etc. If they come too closely together, his body doesn’t have time to recover, and clusters can be fatal, and require immediate veterinary care. After we almost lost him, we quickly took him to the internist for a work-up, instead of just collecting data while working with our primary vet.
- Medications: We’ve got Tom on phenobarb and potassium bromide (KBr). Phenobarb is a barbiturate, and over time can be toxic to the dog’s liver, so we’re motivated to keep the dosage as low as possible. KBr doesn’t damage the liver, and can work synergistically with phenobarb, requiring a lower dose of both, versus each by itself. Phenobarb also acts as a diuretic, so when Tom first went back on it, he had to pee more often, until his body got used to the dosage. KBr can reduce coordination in their hind quarters, and Tom’s back end will sometimes slip out from under him while turning corners. We’ve also got Valium to use on Tom if he has another cluster (administered rectally, which neither Tom nor I are very thrilled about, though it is more practical than IV), and our track record is about 50-50 with that. When the Valium hasn’t worked, we’ve taken him to the emergency vet, where pentobarbital (another barbituate) has worked to break the cluster.
- Seizures: The first one you saw no doubt freaked you out (as it did us). Among the things to keep in mind are stairs (if we’re gone for more than a short errand, we kennel Tom to keep him from falling down stairs after getting up from a seizure). His coordination is off after a seizure, and he needs help getting down stairs and out into the back yard (if he didn’t have an accident during the seizure, he’ll probably still need to go shortly afterwards.) If the seizure only lasts a minute or two, it’s not necessarily an emergency. If it continues more than three or four minutes, it is an emergency, as are cluster seizures. A full gran-mal seizure contracts every muscle in their bodies, and quickly builds up body heat. You may have noticed your dog panting afterwards… seizures are hard work, and also exhaust the available glucose supply to power the muscles.
In my free-stream of consciousness above, I forgot to mention that Tom too, has memory loss after seizures/clusters. The severity of the loss seems to be directly proportional to the length/severity of the seizure. Laura and I call it “wiping his hard-drive” after a cluster seizure, since that’s essentially what seems to happen. After that, for Tom it’s a “brave new world”. You may need to re-train Benton with kennel training following one of these episodes, depending on its severity. We had to do some remedial kennel training with Tom last year. His personality seems to reset after a seizure too, and re-develops into his goofy, loveable self only after a period of being seizure free. Before this long period of stability, we’d joke that after Tom had gone a while without a seizure, we didn’t want him to have another in part because “we liked this version of Tom”.
Another side affect of phenobarb that I forgot to mention is weight gain. It’s not a concern short-term of course, but something to keep an eye on long-term. Tom is a big boy, even without the weight gain. He was underweight when we got him (as most ex-racers are) at 73 lb, and he later got as high as 102 lb. With walks, dog park visits and play days, he’s now a more comfortable 96.3 as of Friday, which is still 5-10 lb heavy (like most of us.) His phenobarb dosage was originally 60 mg 3xday, and we’ve had him on 45 mg 3xday for about three weeks now, as a point of reference for your greyhound's dosage. Not surprisingly, the lower dosage has increased his activity level (which is helping his weight), though luckily not to the point of seizure (so far).
Dr. Teeter’s office number is 402-330-3096 here in Omaha if your vet wants to compare notes.
Another therapy our vet in Chicago mentioned was SAM-e and Milk thistle. He liked putting dogs on these if they were going to be on phenobarb long-term. The theory is that these two supplements would help counter the toxic effects of phenobarb on the liver. I’m a little leery of both of these because of the lack of study data available on either. I don’t think they’re harmful (they’re both available over-the-counter at health food stores), and quite possibly could be helpful. I just wish there was some study data available on clinical uses and dosages. I’ve mentioned them to Dr. Teeter, but for now Tom isn’t taking either. He just had liver/kidney/pancreatic function blood work (a test called a SMAC) drawn, and the results were all normal (yeah!), so for now we won't be making any other changes.
I asked Dr. Hanna (another of the Pet Clinic’s Vets) about alternatives to phenobarb that didn’t affect the liver, should Tom’s lab work at some point show decreased liver function. She did some digging for me, and found Keppra, an anti-convulsant that isn’t metabolized by the liver. It’s a lot more expensive than phenobarb, but down the road may be another alternative.
Greg G.
We’ve got four greyhounds, and our seizure dog is named Tom. We got Tom from a rescue in the Chicago area while living there, and we knew he had epilepsy when we adopted him (we had Bow and Hoss at the time, and the rescue group wanted him to go to a family with some experience with greyhounds, or epilepsy, or both.) We had him worked up by a veterinary internist in the area, and the EEG and X-rays quickly revealed the epilepsy was due to a skull fracture. Greyhounds don’t have a genetic predisposition for epilepsy, but a cause for the seizures can’t always be pinpointed (the docs call this idiopathic epilepsy.)
Tom is currently doing well, and is being treated with a combination of phenobarbital and potassium bromide (KBr). He hasn’t had a seizure in about a year, and we’re working with our vet here to reduce his dosage of phenobarb to the low end of the therapeutic range. Our vet is Dr. Barb Teeter at The Pet Clinic here in Omaha, by the way. It would probably be a bit of a hike for you from Lincoln, but she’s good, as are all the vets at this clinic.
In no particular order, here are some things we’ve learned with Tom:
- Beware cluster seizures. When we first got Tom, we didn’t know how much phenobarb the kennel was giving him, or when. They were using leftover medicine from another of their dogs that had had seizures, but died. Working with our vet, we took him off all medicine, and kept a log of his seizures, as well as the conditions under which they occurred (time of day, weather, recent activity, etc.), trying to collect data to determine the cause of the seizures. While doing this, he would throw a seizure (or sometimes two) every two weeks or so, to the point where we almost got accustomed to this. Then he threw a seizure, and a couple hours later another, then another, etc. If they come too closely together, his body doesn’t have time to recover, and clusters can be fatal, and require immediate veterinary care. After we almost lost him, we quickly took him to the internist for a work-up, instead of just collecting data while working with our primary vet.
- Medications: We’ve got Tom on phenobarb and potassium bromide (KBr). Phenobarb is a barbiturate, and over time can be toxic to the dog’s liver, so we’re motivated to keep the dosage as low as possible. KBr doesn’t damage the liver, and can work synergistically with phenobarb, requiring a lower dose of both, versus each by itself. Phenobarb also acts as a diuretic, so when Tom first went back on it, he had to pee more often, until his body got used to the dosage. KBr can reduce coordination in their hind quarters, and Tom’s back end will sometimes slip out from under him while turning corners. We’ve also got Valium to use on Tom if he has another cluster (administered rectally, which neither Tom nor I are very thrilled about, though it is more practical than IV), and our track record is about 50-50 with that. When the Valium hasn’t worked, we’ve taken him to the emergency vet, where pentobarbital (another barbituate) has worked to break the cluster.
- Seizures: The first one you saw no doubt freaked you out (as it did us). Among the things to keep in mind are stairs (if we’re gone for more than a short errand, we kennel Tom to keep him from falling down stairs after getting up from a seizure). His coordination is off after a seizure, and he needs help getting down stairs and out into the back yard (if he didn’t have an accident during the seizure, he’ll probably still need to go shortly afterwards.) If the seizure only lasts a minute or two, it’s not necessarily an emergency. If it continues more than three or four minutes, it is an emergency, as are cluster seizures. A full gran-mal seizure contracts every muscle in their bodies, and quickly builds up body heat. You may have noticed your dog panting afterwards… seizures are hard work, and also exhaust the available glucose supply to power the muscles.
In my free-stream of consciousness above, I forgot to mention that Tom too, has memory loss after seizures/clusters. The severity of the loss seems to be directly proportional to the length/severity of the seizure. Laura and I call it “wiping his hard-drive” after a cluster seizure, since that’s essentially what seems to happen. After that, for Tom it’s a “brave new world”. You may need to re-train Benton with kennel training following one of these episodes, depending on its severity. We had to do some remedial kennel training with Tom last year. His personality seems to reset after a seizure too, and re-develops into his goofy, loveable self only after a period of being seizure free. Before this long period of stability, we’d joke that after Tom had gone a while without a seizure, we didn’t want him to have another in part because “we liked this version of Tom”.
Another side affect of phenobarb that I forgot to mention is weight gain. It’s not a concern short-term of course, but something to keep an eye on long-term. Tom is a big boy, even without the weight gain. He was underweight when we got him (as most ex-racers are) at 73 lb, and he later got as high as 102 lb. With walks, dog park visits and play days, he’s now a more comfortable 96.3 as of Friday, which is still 5-10 lb heavy (like most of us.) His phenobarb dosage was originally 60 mg 3xday, and we’ve had him on 45 mg 3xday for about three weeks now, as a point of reference for your greyhound's dosage. Not surprisingly, the lower dosage has increased his activity level (which is helping his weight), though luckily not to the point of seizure (so far).
Dr. Teeter’s office number is 402-330-3096 here in Omaha if your vet wants to compare notes.
Another therapy our vet in Chicago mentioned was SAM-e and Milk thistle. He liked putting dogs on these if they were going to be on phenobarb long-term. The theory is that these two supplements would help counter the toxic effects of phenobarb on the liver. I’m a little leery of both of these because of the lack of study data available on either. I don’t think they’re harmful (they’re both available over-the-counter at health food stores), and quite possibly could be helpful. I just wish there was some study data available on clinical uses and dosages. I’ve mentioned them to Dr. Teeter, but for now Tom isn’t taking either. He just had liver/kidney/pancreatic function blood work (a test called a SMAC) drawn, and the results were all normal (yeah!), so for now we won't be making any other changes.
I asked Dr. Hanna (another of the Pet Clinic’s Vets) about alternatives to phenobarb that didn’t affect the liver, should Tom’s lab work at some point show decreased liver function. She did some digging for me, and found Keppra, an anti-convulsant that isn’t metabolized by the liver. It’s a lot more expensive than phenobarb, but down the road may be another alternative.
Greg G.
blottogg- Posts: 4
Join date: 2008-10-01 
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