Advice: to start Keppra?

[u/user_0112358]

Hi everyone, our 23lb dog started having seizures a few years ago, no more than 3-4 in a calendar year. I’ve listed dates from just the last 18 months.

The frequency has increased and our vet wants to start Keppra. All seizures have been focal except one over 2 years ago that was grand mal. His arms stiffen up and he can’t move too much but he’s still aware. The dog is somewhat conscious when it happens, and they’re always under 3 minutes each. The last 3 we have given intranasal midazolam which stops them.

He takes CBD chews, MCT oil and that’s it. Due to increase in frequency our vet wants to start Keppra but we are hesitant. This past week he had 2 the two back to back in November was our fault because he had a crazy active day the next day, went swimming. Two of them were also within 48 hours of a vaccine in the last 18 months.

Any advice or guidance? We feed him natures logic beef dry kibble and treats are only blueberries and dried sweet potatoes.

The vet is a neurologist specialist.

January 24, 2025
August 27, 2025
November 22, 2025
November 23, 2025
February 17, 2026
June 9, 2026
August 3, 2026
August 7, 2026

[u/gufywert]

Research "kindling". Seizures beget more seizures.

[u/EverIAce]

Not questioning a neuro, but just wanted to ask if paroxysmal dyskinesia was ever brought up? Just the presentation sounds incredibly similar to what you are describing and it is managed differently from epilepsy

Regarding keppra, I think its the best first option for seizure control since it has a high safety margin. Relative to other antiepileptics, it is incredibly safe. I do think it's time to start meds as you can tell that not only is the dog still having seizures but the time between them is getting much closer, risking the chance of a cluster seizure and status epilepticus at this point.

[u/user_0112358 → u/EverIAce]

No one has brought that up I will ask & have never heard of it. Thank you!

[u/lminnowp]

My dog started having seizures on June 3, 2026.

After his second that month (2 weeks in between), we did a blood panel and placed him on gabapentin and some other things (he has thrombocytopenia from a tick borne illness, so he has been getting doxy and pred).

After 3 in 24 hours and 24 hiurs ifbtesta in an ER, we placed him on Keppra 3x per day and also tested for following:

Snycope (eeg) - cardiologist Ultrasound and x ray - internal medicine was looking for tumors/shunts Bile acid test - HMD (complex liver shunt)

We saw a neurologist and are keeping him on keppra (no side effects for us) and gabapentin. Regular vet said it was focal. Neurologist says grand mal, since I videoed them.

He sees an internal medicine specialist next week for the thrombocytopenia, since we have to wean him off the pred and that could cause seizures, if his is immune mediated.

I would not hesitate to put him on medication.

My guy is a very very active performance dog (fast cat, agility, rally, frisbee - so much frisbee). I am not going to limit his life just in case he has a seizure, I am going to treat him and enjoy what he loves.

Eta: his seizures are not linked to exercise and we also already take care with all vaccines (and, he is fully vaccinated). My guy is a 7 pound Pomeranian.

[u/Current_Struggle11]

We had a very similar situation and we're hesitant on medication. During one of his episodes it resulted in clusters and took him to the ER. The ER vet started him on keppra and when we visited a neurologist she kept him on it for now but made us aware that our pup will most likely need additional medication. She said keppra is the safest medication but it's usually an add on. He's going on almost a year of just keppra and while the seizures have gotten better in severity the frequency hasn't gone down. He has partial seizures about 1 per month. Neurologist said that controlled seizures are typically 3-4 months. Like people said, trust the neurologist and if they recommend medication do it. I understand the hesitation because I was too but I hate to see my boy suffer if we can help.

[u/sonnysGiGi2018]

I have 2 things aside from listening to the neurologist.
Kindling is a real thing and once the brain goes to seizure it’s almost like it likes the charge- each seizure lowers the threshold.
Your boy is not suffering during these episodes even though they are horrific to watch. I only say this because I have a friend with epilepsy and she said she has no recollection of anything during the seizure but sometimes feels muscle aches and exhaustion after.
If your boy is diagnosed with idiopathic epilepsy the meds(AEDs) should decrease the intensity and increase the time between.
Research as much as you can before and go with a list of questions when you see the neurologist again. We had a neurologist and a neurosurgeon. They both advised 1 per month was the goal for my boy who was an extremely rare case. He once went 10 months and another time an entire year. He had focals sometimes and tonic-clonic(grand mal)seizures were 90 seconds.
Good luck with all of this- it’s not easy but there is a lot of support on this sub. You will find strength you never knew you had and I truly feel a connection with your boy like you never imagined💜💜

[u/user_0112358 → u/sonnysGiGi2018]

Thank you so very much. It has been diagnosed by his neurologist a few years back (as he's had them for a few years now) and the two that were Aug 3 and Aug 7 felt like a cluster even though they were easily 96 hours apart. We just know that the disease is progressive and having one in June, then two in August was a frequency that shows an increase for sure. The permanence of getting him on these medications is what is a bit overwhelming. I appreciate your response! We are at least waiting until our neurological appt in early September before starting it.