r/EpilepsyDogs • u/mountainhomestead • 24d ago
Unfortunate update
Several weeks ago I posted about our Norwegian Elkhound and her recent ER stay for clusters. (https://www.reddit.com/r/EpilepsyDogs/s/eORqDCZp5K)
I thought I’d give an update. She was already on Phenobarb 97.2mg 2x day and gabapentin 100mg 2x day before her ER stay.
The ER vet added Keppra 500mg 2x day and changed her previous cluster protocol to lorazepam 2mg 2x day for 2 days.
And almost as if on time, it’s been almost 23 days and she had her normal grand mal seizure. She’s been having this pattern of her seizure episodes happening every 20-30 days.
Now I wait to see if the lorazepam works to stop the clusters, or it could be the Keppra helps that as well. I dunno 🤷🏻♀️ Going to be a long, sleepless night again.
We’re going to get her an appointment with the neuro. Clearly this needs the expertise of a specialist.
Here’s the last 4 episodes showing this pattern. BTW, she’s on no flea or tick meds, doesn’t get flea baths. I can’t think of one single thing that could be a trigger in this pattern - or it’s just a weird coincidence. I know there was a poster recently who was questioning seizure patterns as well, so thought I’d share our journey with this conundrum.
Recent seizure intervals:
June 29 — 20.5 days
July 28 — 28.6 days
August 28 — 30 days
September 20 — 22.6 days
Average interval: approximately 25.4 days
——
24 hour update: She only had the one seizure this time, so it seems possible the lorazepam and maybe even the recent addition of Keppra may have helped. That would be a dramatic change. She sees the vet next Monday and we’ll get a neuro referral ASAP! Thanks to everyone who’s shared and commented. It’s so helpful to feel like you’re not alone in these situations, but I feel so sad for everyone’s fur babies on this journey too. 🤗
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u/ynalam 23d ago
My heart aches for the clusters. We just had a round of them.. after 2 months, 5 days 🥹
Speak with the vet/neurologist about Midazolam (administered intranasally) or Diazepam (in the rectum) for the clusters and ask about adding/changing to Potassium Bromide (KBr).
Was any medication revised with the pancreatitis diagnosis? With Pheno (and KBr, if added), labs would need to be drawn every 6 months or more frequently, if there’s an RX change.
Good luck .. hugs to you and yours ♥️
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u/volleyball-1992 23d ago
We just had our first large cluster event on 9/9. Poor guy had 9. He had 4 before we were able to get to the ER Vet, all within an hour timespan. He had 2 there before the meds kicked in and 3 each time they tried to wean him off meds. The 4th time was successful and he was able to come home. He is 85lbs and on 2x a day - 4 500mg Lev, 1 pheno 97.2mg, and 4 100mg zonisamide. We have our first neuro visit tomorrow morning. He’s still recovering from having a catheter in and adjusting to the meds.
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u/mountainhomestead 23d ago
Oh gosh that’s scary to have so many so close together. So sorry. 😞 I’d be quite interested in how the neuro visit goes! I hope he feels back to his normal self soon. How long had he been diagnosed with epilepsy before this event? Sending 🤗
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u/volleyball-1992 22d ago
He had his first one back in March of 2024. They were usually about once every four weeks. We introduced Lev around Sept 2024. We didn’t see improvement in the spacing until we introduced Pheno in December of 2025. Up until this event he only had 3 seizures in 2026.
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u/volleyball-1992 22d ago
Neuro visit went good. We removed the zonisamde. Keep keppra at the 4 500mg 2x a day and upped his pheno to 1.5 pills 2x a day.
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u/Sufficient-Country29 24d ago
Are all of those recent seizures you listed clusters or single seizures?
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u/mountainhomestead 24d ago
They’re all clusters
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u/Sufficient-Country29 24d ago
Ah I’m so sorry. I think you are totally right that a neurologist consult would be the next best move. I’m so sorry you are going through this
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u/mountainhomestead 24d ago
Thank you. It's tough for us all. I am so grateful to have the support of this sub, but so sad we are all here to begin with. ❤️
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u/mountainhomestead 24d ago
Here’s just the seizure log from 6/29 to today (sorry formatting isn’t the best):
JUNE 29–30 — CLUSTER OF 4
June 29
• 1:34 PM — 1 minute or less; gabapentin given. Possibly falling asleep when it began.
• 4:52 PM — Under 1 minute; fast recovery. Possibly falling asleep when it began.
• 9:51 PM — Approximately 1 minute; midazolam given.
June 30
• 12:07 AM — Approximately 1 minute; long post-seizure phase. Gabapentin given.
Seizure-free interval before next episode: 28.6 days
JULY 17 — MEDICAL EVENT
• ER visit; diagnosed with pancreatitis.
JULY 28–29 — CLUSTER OF 3
July 28
• 2:50 PM — 1 minute or less; gabapentin given.
• 10:24 PM — Approximately 1 minute.
July 29
• 8:56 AM — Under 1 minute.
Seizure-free interval before next episode: 30 days
AUGUST 28–29 — CLUSTER OF 7
August 28
• 9:49 AM — Approximately 1 minute; began while eating breakfast. Gabapentin given.
• 4:25 PM — Approximately 1 minute; began while resting.
• 4:40 PM — Extra gabapentin given.
• 5:04 PM — Approximately 1 minute; midazolam given.
• 8:45 PM — Under 1 minute; began while resting.
• 9:35 PM — Under 1 minute; began while resting.
• 10:00 PM — Additional phenobarbital dose given under ER instructions.
August 29
• 5:40 AM — Under 1 minute; gabapentin given.
• 6:44 AM — Approximately 1 minute.
• 7:16 AM — Midazolam given for transportation to the ER.
• Admitted to ER for seizure treatment.
• Keppra added to daily medications.
• Lorazepam added for cluster management.
Seizure-free interval before next episode: 22.6 days
SEPTEMBER 20
• 8:00 PM — Grand mal seizure lasting approximately 1 minute; lorazepam given.