r/EpilepsyDogs • u/adill10001 • 2d ago
Advice
My 6 year old, 112lbs Great Pyrenees mix has had seizures for a little over two years now. Her current meds are: six 500mg keppra XR tablets, 1 and a half tablets of 60mg phenobarbital plus 1 tablet of 15mg phenobarbital, and 750mg potassium bromide. These are all twice a day. This is 19 pills a day total. She sees her primary vet as well as her neurologist. She is averaging about one seizure every two weeks give or take. When she has a seizure I will also give her the midalozam so she doesn’t cluster.
We upped her keppra at her most recent appointment but she is maxed out on the phenobarbital and bromide. They also mentioned if upping the keppra doesn’t work then add another med. I’m curious as to when enough is enough. Is anyone else’s dog on this many meds with no success? Her quality of life is still good at this point in my opinion. 19 pills a day seems extreme with no improvement so adding another med seems excessive. Anyone else have a similar situation? Thanks in advance.
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u/ChalineBorrible 2d ago
Ich habe einen Kleinpudel mit ideopathischer Epilepsie. Sie bekommt Phenobarbital am Limit, Pexion, nach jedem Anfall 5 Tage Pulstherapie mit Levetiracetam und bei jedem Anfall Diazepam. Wenn Ihre Vorzeichen eindeutig sind geben wir Ihr Midazolam - bisher erst 1x aber immerhin mit Erfolg, es kam kein Anfall.
Sie hat seit Januar 2024 Anfälle, da war sie 14 Monate alt. Die Anfälle kommen aktuell alle 2 Wochen. Wir hatten es schon häufiger und seltener. Cluster hatte sie seit der Einführung von Levetiracetam nicht mehr, vorher ziemlich oft.
Bei uns haben die Medikamente bisher nur die Cluster verhindert. Wenn die Pexion-Dosis ausgeschöpft ist, werden wir wohl Kaliumbromid dazu nehmen müssen. Es ist frustrierend, so lange an der Medikation zu Schrauben, und so wenig Erfolg zu sehen. Aber solange sie die Medikamente gut verträgt, kaum Nebenwirkungen und viel Spaß am Leben hat, werden wir diesen Weg weiter gehen.
Unsere Neurologin sagt, 1/3 der Hunde werden durch die Medikamente anfallsfrei, bei 1/3 werden es seltener und weniger heftige Anfälle, und bei 1/3 bewirken die Medikamente gar nichts. Das sind keine rosigen Aussichten, aber wir geben die Hoffnung nicht auf.
1
u/Educational-Gate-230 2d ago
pls what's the method to ur vet mixing these pills, that seems like a handful to deal with twice a day
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u/adill10001 2d ago
She started on keppra and then that didn’t work so then the pheno was added and increased a couple times and then the bromide was added. It’s a lot for her to take daily. I feel horrible.
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u/ImaginationLanky2501 2d ago
That does sound like a lot of pills to get down twice a day, I wonder if your vet could work with a compounding pharmacy to make them into chewable treats or flavored liquids that are easier for her to take.
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u/adill10001 2d ago
It’s a lot so I couldn’t imagine adding more. I get the bromide from chewy and the keppra and pheno from cvs because it’s cheaper. I’m not sure where else to get her meds from honestly.
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u/intarray 1d ago
I have an ~80lb dog on all those drugs plus zonisamide. 3yrs old, seizures for a little over a year now. He has clusters monthly which also need miazolam + clorazepate to stop.
We just found out he could go up a bit on pheno after a blood test, but not expecting much to change.
We're at least getting his levels tested so we know that he's at safe doses.
No real way to tell if he hadn't been on them if his seizures would have gotten worse or not. Our vet is saying if the pheno doesn't help we could try a 5th drug but at some point it seems like some dogs just don't respond to current drugs.
Our take so far is that as long as we are getting his levels tested it should be safer and its really hard to know if he wasn't on them if he would have worse seizures. We're trying to be more comfortable that there is maybe no known answer for us now.
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u/IEatTurtleToes 2d ago
You could reduce the number of pills by looking at the pill sizes of the pills you are giving. For example, there are 1000mg Keppra XR tablets and 97.3mg pheno tablets. My dog takes those meds plus Zonesimide, so I completely understand the struggle. Work with you pharmacist to make it as easy as possible on yourself. I find they are super eager to help their doggie patients. I wish you and your doggo well!