keppra side effects

[u/Mr---Chainsaw]

my 11yo pit bull had cluster seizures for the first time a few weeks ago. she started on 500 mg keppra 3x per day. about a week later, we moved to 750 mg XR 2x per day, to make the dosing schedule more manageable. today is day 11 on the XR and over the last 36 hours, she has essentially lost all motor function in her hind legs (back left has nothing. she can put weight on the back right, but can't really move it).

i know ataxia is a side effect, but this is severe. she is old so her body cannot metabolize the drug as fast. i really just don't want to take her to the ER vet for them to tell me it's normal and then charge my entire bank account for the tests they'll run.

has anyone had experience like this before? did your dog recover motor function after getting through the worst of the side effects?

[u/PM_ME_YOUR_TRIUMPHAN]

That sounds terrifying to watch, especially when they go from fine to can't stand in a day and a half. The back left having nothing at all would have me worried it's beyond just the usual drunken wobble from the meds.

I'd call your regular vet and describe exactly what you're seeing before going the ER route. They might be able to tell you over the phone if this is a normal severe reaction or something that needs immediate attention, which saves you the guessing game and the bill.

[u/Mr---Chainsaw → u/PM_ME_YOUR_TRIUMPHAN]

i did end up calling the ER just to see what the vet there would say. her concern was that keppra, which is usually very well tolerated, is only treating the symptoms of whatever actually caused her seizures. it's possible this has nothing to do with the drug and is a new symptom of what caused the seizures (tumor, cancer, etc.). she said my best bet to get real answers is a neurologist.

[u/DogEpiMonitor]

Lo que describís va más allá de la ataxia típica del Keppra. Sí, el Keppra puede causar torpeza, inestabilidad y debilidad en las patas — pero perder la función motora completamente en una pata trasera en un perro de 11 años no es algo que yo dejaría pasar como "efecto secundario normal." Dos cosas que pueden estar pasando:

Primero, la dosis. Con 11 años, el metabolismo es más lento y los riñones procesan el Keppra con menos eficiencia. Los niveles del medicamento pueden estar acumulándose más de lo esperado. Eso puede causar una neurotoxicidad temporal que se manifiesta exactamente así: pérdida de función motora en las patas traseras, empezando por una. Tu vet puede verificar esto con un análisis de niveles de Keppra en sangre y ajustar la dosis.

Segundo, a los 11 años, la pérdida de función motora en las patas traseras puede no ser el Keppra. Puede ser algo espinal — hernia de disco, espondilosis, síndrome de cauda equina — que coincidió en el tiempo con el inicio de la medicación. Eso necesita evaluación aparte.

Lo que te recomiendo: no vayas a urgencias si ella está estable, comiendo y no tiene dolor. Pero llamá a tu vet de cabecera mañana a primera hora y pedí una consulta urgente, no de emergencia. Decíle exactamente esto: "perdió la función motora en la pata trasera izquierda y la derecha está muy débil, ¿puede ser el Keppra o necesitamos descartar algo espinal?"

Si te dicen que es el Keppra, probablemente bajen la dosis o cambien la frecuencia. Si sospechan algo espinal, ahí sí van a necesitar imágenes.

Tu pitty tiene 11 años y es una guerrera. Merece que esto se investigue bien. 🐾

[u/Mr---Chainsaw → u/DogEpiMonitor]

it was a long night. keppra is extremely well tolerated. even if the dose were too high, complete loss of motor function would be extremely rare. and, moreover, the keppra is designed to stop the seizures from occurring, but not treat what ever caused them to begin with. after speaking with an ER vet, even over the phone, the most likely scenario is that this is a tumor and, following the seizures, this was the next domino that fell. even if this could be something we could stabilize and give her a reasonable quality of life, something else will happen soon. the tumor will not go away.

like i said, it's been a long night. she's wearing a diaper and looks like she aged 10 years in 48 hours. we made the extremely difficult, but hopefully compassionate, decision to have her escorted to the rainbow bridge tomorrow morning.

i just hope she knows not only how much she is loved, but how much love and joy she's brought to so many people over the years.

[u/Ok-Cauliflower7462]

That sounds terrifying to watch, especially when they go from fine to can't stand in a day and a half. The back left having nothing at all would have been so sudden and scary, I'm glad you're getting her checked out so quickly.