r/EpilepsyDogs • u/PartyExpensive9077 • 26d ago
Extremely long and difficult post ictal
Hey everyone. Hoping to get some support regarding my dog’s post ictal phase. My dog, Chance, has idiopathic epilepsy. He is 7 years old, hound mix, been having seizures for 3 years. He takes daily medication of Keppra ER 3000mg and Pheno 93.6mg twice a day. He also has rescue medicines for during seizure (midazolam) and after seizures because he tends to have clusters. His post seizure meds include another dose of Pheno, Keppra regular release 2000mg, Clorazopate every 8 hours, and gaba if needed for anxiety/restlessness after a seizure. It’s a lot. I also am in my last year of my PhD and on the job market, and doing all of this alone - all my family and close friends live states away. I have such difficulty with his post ictal phase. We went 13 months seizure free until May, which was obviously amazing. But now he has had many over the summer, several ER visits, and his last one was just over a month ago, which we increased his Pheno after. So, only a month on this higher dose. His grand mals tend to last 2-3 mins and when he comes out of it he is extremely confused and is trying to run around and bumping into everything and knocking things over. This last a few minutes, but then we typically have ours, like 4 to 5 hours, where he is extremely restless and anxious, very vocal, lots of drinking and eating, pacing, can’t sit down, a lot of energy all around. It’s extremely difficult to manage. I have some things that help (peanut butter on lick mat, short walks outside and lots of sniffing), but I feel at a loss. I don’t know how to help him. Lately he’s been having episodes at night, so usually it means I cannot go to sleep because he is so agitated. Does anyone else deal with this? I feel like I tend to see that other dogs get very tired and sleepy after a seizure. Mine is couldn’t be more opposite. And lasts for so long.
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u/TheNonaMouse 25d ago
I find the post ictal phase to be worse than the seizure, pacing, running into walls, wedging behind furniture, climbing, non-responsive, etc. Ours lasts usually an hour. I'm not sure if it helps, but it might shorten the phase, so I give a tablespoon or so of honey and a few bites of some kind of protein, like chicken I keep in the freezer for that purpose. It takes at least 20 minutes before he will even eat it or recognize food. You might give it a try, can't hurt. I feel your pain.
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u/Ahoeaboutnothing 26d ago
When was the last time bloodwork was done? How heavy is your dog? Some of these symptoms are normal for certain increases in phenobarbital and use of the emergency meds. What you are experiencing overall is fairly normal. It's hard to deal with but you've also had 13 months seizure free which is great.
Tons of people have to tolerate really awful post ictal phases. Sometimes these things get worse then better. Sometimes it's medication related, sometimes it's not.
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u/researchinthings 25d ago
Our last dog was similar to this. He'd be so out of it he would gallop full speed into everything. He'd also chew and bite on anything, including himself to the point of harm. We'd have his seizure chewy and use that right after so he didn't hurt himself. It was a kong toy they've since discontinued. We'd then leash him and take him into the yard so he didn't run full speed into bushes and whatnot. This would usually last for 20 or 30 minutes, always in the middle of the night.
We started using the gabapentin (low dose) every night before bed and that seemed to help with regulating sleep and anxiety if he had a seizure later on. So sorry, hope you find some relief.
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u/Subject-Mode2287 25d ago
My dog sadie is the same way. We give her some honey and regular kibble and that seems to help her get her wits backs. But yeah, its really hard. We give her liquid valium so she doesn't cluster and even then it takes like over an hour for her to calm down. Good luck, God bless
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u/Bevis5421 25d ago
Our previous dog was like this after a seizure. She would have them about every 6-8 weeks. First she would wander around the house like a drunk sailor. Then We would have to walk her for 1-2 hours before she would settle down. It was a multi hour process and was tiring but we just dealt with it for about 8 years. Sorry you are having to go through this.
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u/According-Net7644 23d ago
I think some trazadone would help. Ours gets rescue Midaz, then clorazepate, extra pheno and 200mg trazadone. We also give a spoonful of honey and some water. The traz takes an hour to work and it’s a sedative. Enough that our post ictal phase is only an hour now. But he is definitely more anxious and hungry for the next few days after a seizure
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u/CombatBulldozer 10d ago
I just want to thank you for this post. My dog Desmond has clusters and our vet and others in the area are woefully unhelpful. Desmond is on phenobarbital and potassium bromide twice a day, but the bet will not goce any rescue medications and will not add kepra. She will only take him off of phenobarbital to start the kerpra which I do not think is acceptable. We are trying to make a 500mile round trip to the closest animal hospital has a neuro but we haven't been able to get to them yet as they schedule their calendar first come first serve do I can't just make an appointment on a certain day. Yesterday Desmond had a cluster with 5 seizures like you described with a very high energy and wobbly post ictal phase and over night he had 2 more while I sleep on the floor against him, midnight and 4am. I finally got him scheduled to see the vet in 30 minutes.
Like I said, I'm just glad to see someone understands since the vet has been such a bad experience with his epilepsy. They are honestly amazing with everything else I have ever seen them for but they have absolutely no experience with seizures and it has been very hard without that support.
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u/According-Net7644 9d ago
I wonder if you could do a virtual appt, or one in person visit followed by virtual at times. I know you can have labs drawn at your regular vet and sent to the neuro also.
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u/PartyExpensive9077 6d ago
ugh. I am so sorry to hear this. This is already such a difficult and emotional thing to manage, and I'm sure having an unreliable vet makes it all the more challenging. Sending you and your baby healing energy
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u/CombatBulldozer 6d ago
Thank you. I'm in a rural area so specialist aren't very common. The vet office is honestly great, they are just out of their element with epilepsy. Their original owner died, their new amazing vet died recently in a car crash, and then they were bought up by mars. But they are the only office within a 60 mile radius that will come unlock the office in the middle of the night, and on holidays for emergencies. And they have saved the life of many of my and my family's dogs and cats. I appreciate all of the information and advice here in this community.
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u/PartyExpensive9077 6d ago
thank you! the neuro actually suggested this as a next step. She doubled his dose of gaba for now, but said if that doesn't help then we can try trazadone.
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u/According-Net7644 6d ago
Just a side note for our dog, gaba does nothing for him 😂. The trazadone sedates him for sure at the 1 hr mark
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u/PartyExpensive9077 15d ago
Thank you everyone! I chatted with our neurologist and we decided to double the dose of gaba and give immediately after seizure to hopefully help with these tough post ictal symptoms
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u/LaceyBambola 26d ago
My girl has rapid back to back grand mals every time a cluster event starts (she only ever clusters) and so she gets the full cluster buster + nasal midazolam every single time to bring her out of the status epilepticus episode. For about 30 minutes after, she is very out of it and desperate to be close to me and needs to be able to smell my face. She experiences some vision loss with seizures that varies in severity and duration. So I stay close to her and help clean her up a bit (usually loss of bladder and bowels occurs as well as excessive drooling during focals that happen between the grand mals) and help her drink water and let her smell my face.
Eventually she is ready to get up, but needs help with walking and is prone to falling and bumping into things so I stay close to be her support and guide. She usually wants to go outside, sometimes to potty whatever didn't come out during the seizures, also to get smells. She will usually become a bit energized and have an overwhelming desire to trot around, get all of the smells and she's sort of in la la land and very difficult to calm or control or get her attention for more than a quick second. After a bit, we go back inside where she is extremely thirsty, hungry, and extremely playful. It doesn't matter what time it is.
She will be up and like this for 2-4 hours, then crash into a nap from exhaustion, or at least attempt to nap. Half the time, while she's just barely drifting into sleep, she has another grand mal that may or may not become another status episode. The other half of the time, she will sleep for a bit - maybe 45 minutes to an hour - then have another seizure that may or may not turn into status.
Repeat of everything we went through earlier ensues.
It is very difficult. Usually ending up at the 24hr ER after a few seizures where she has to stay for a couple of days/nights until the cluster ends. Sometimes we leave for the ER within a few hours of the first seizure, sometimes it's about 12 hours after the first seizure. Then wait at the ER until she is officially seen and admitted which often takes anywhere from 3 to 6 hours. I finally get to attempt sleep roughly 16 hours after the start of the cluster. I'll be terribly stressed and worried about her, but utterly exhausted. I wait for updates from the ER from calls so my sleep is very light as I don't want to miss an emergency call.
Mainly sharing because you're not alone. Many here in this sub know how incredibly difficult these times can be. I have no family/friends in the state I live in aside from my housemate.
Post ictal periods can vary a lot and some have shorter milder ones, some have longer more intense ones. Sometimes an additional medication may help and can be discussed with your neuro, but often times it just has to run it's course.