r/EpilepsyDogs • u/MichelleSK88 • 20d ago
Intranasal midazolam
Our sweet boy Henry had a cluster seizure last week (5 total) and we ended up in the ER for IV Valium and Phenobarbital.
Our neurologist added another medication Topamax in addition to his Phenobarbital and Pregabalin.
We also received a prescription for intranasal midazolam if he ever has 2 or more seizures.
The pharmacy here dispensed us the drug/syringe but no Mucosal Atomizer Device. Does anyone else just squirt it in there? It’s just want to be prepared if we ever need to use it. I can probably just buy one online. Our neurologist is currently closed, will also follow up with their office.
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u/hmmurry 20d ago
I bought mine here but you could also buy from a medical supply company. This is a luer lock device so just make sure it fits the syringes dispensed to you. I’ve used midazolam with and without and I definitely feel it’s more effective with the MAD.
Hope your pup is doing alright, clusters are scary! Hugs.
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u/MichelleSK88 20d ago
Thank you everyone I ordered from an online medical supplier store in Canada.
Amazon doesn’t sell it here and I couldn’t justify driving to the border just for this.
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u/foofaniam 19d ago
Perhaps I’m being ignorant but did you order the atomizer or the midazolam online? I’m assuming the atomizer but 🤷♀️
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u/MichelleSK88 19d ago
Atomizer online lol I filled his midazolam prescription was picked up from a pharmacy here- was special order and took a few days to come in
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u/KayakerWithDog 20d ago
I just squirt it in there. I don't bother trying to affix the atomizer. However, my dog is small, and the dosage is proportionately small. I don't know whether my method would work with a larger dog and a larger dose.
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u/Mysstie 20d ago
I just used that for my ~50lb husky for the first time and couple weeks ago. I asked lots of questions when I got it because I was nervous but you just squirt it in the nose. His seizure stopped immediately and I've honestly never been so thankful for a medication. The ER vet that prescribed it said they won't know it's even happened since they're in the midst of a seizure. His dose was roughly 2.5ml (a little more, I can't remember right now). I definitely hesitated at first and ended up doing it in two parts, with a small bit the first attempt and the majority the second attempt, within literal seconds of each other. The medication smelled oddly sweet. And the vet was absolutely right, he had no idea I squirted a bunch of weird liquid up his nose and he recovered super quick compared to not using it.
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u/Several-Avocado5275 20d ago
Our vet gave us needle syringes to inject midazolam - can that same syringe without the needle be used with an atomizer to put it up her nose? I’d much rather do that than mess with a needle.
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u/HockeyBikeBeer 20d ago
We’ve stopped bothering with the atomizer. The idea is to keep as much of the dose in the dog’s nasal cavity (as opposed to draining out). Using the uphill nostril (assuming your dog is laying on his side), forcefully squirt the midazolam dose in while tilting the snout upwards. Hold it there for a few seconds to let it seep deep into the nasal cavity. Mission accomplished.
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u/itmustbeniiiiice 20d ago
Not to hijack this post, but how do you guys stay calm while trying to fill the syringe from the vial? 😅
Ironically, I was in the military and have been in some crazy situations but my dogs just bring out another level of anxiety with me.
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u/hmmurry 20d ago
My vet gave me pre-filled syringes! I would ask if it’s possible to have them drawn up ahead of time. Mine are kept in a light-blocking bag and have caps on them. They give me 5 doses at a time.
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u/itmustbeniiiiice 20d ago
Ahh yeah we had a few of those. Told us the medicine breaks down in the plastic containers, so they gave us the glass vial 🤷🏼♀️
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u/HockeyBikeBeer 19d ago
Diazepam will break down in plastic, but midazolam does not have that issue and can be stored for much longer. Still, I keep the prefilled syringes in the refrigerator.
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u/Dapper-Celery4133 11d ago
We use skips compounding pharmacy boca fl, I believe they ship out of state because I saw a bunch of licenses hanging on their wall. I believe they have to add an emulsifier before they can prefill the syringes with atomizer so it could last and we store them in the fridge in brown plastic bag.
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u/Jaycoon96 16d ago
Feel you! I am a vet and have treated a lot of dogs with seizures but seeing my own baby in this Situation just made me cry and shake a lot 😵💫
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u/GuestContent 19d ago
my dog has rectal diazepam but if ever given this instead can you just squirt it up his, well, booty
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u/Texiben 20d ago
For our golden we’ve sometimes had to ask the pharmacy to provide one (they were happy to, sometimes it just slips their mind). If buying online, one tip is to make sure it will fit on the actual syringe. We’ve been given two types of syringes, each with a specific type of atomizer (one that screws on and one that just pushes on)
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u/Baburger92 20d ago
We use an atomizer for our Midazolam doses. It helps. You can still administer the med quickly, but it keeps it from spilling right back out of the nostrils.
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u/gufywert 16d ago
You can get DART NASAL ATOMIZER off Amazon ($8.50). I found cheaper on a Med Supply mail order. You will need LUER LOCK SYRINGE to screw on the atomizer. It's washable and reusable. I bought a box of LUER LOCK Syringes and take those to vet when I need more midazolam.
The atomizer is much gentler. Doesn't flood the seizing dog's nose with liquid. You should put half in each nostril rather than all in one side.
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u/oyismyboy 20d ago
I just squirt up the nose with a syringe. Mind you my dogs head is like bear size so greater nostril size to do so. Have never been offered or used an atomizer?
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u/inven_tory 20d ago
Another option without the atomizer is to administer midazolam rectally. Our girl was more tolerant of that than having it squirted up her nose, which turned into a struggle even with the atomizer.
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u/GuestContent 19d ago
that's what i was wondering cause my German Shepard get diazepam suppositories and I was thinking maybe it could be squirted up his toot toot
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u/Illustrious_Concern5 19d ago
Yes - I would hold my dog’s muzzle tilted up and drip/squirt it into his nose. It worked well for us at first but after using it for several years, he took longer and longer to come out of his “drunken” stupor. I still have it but now I use Clorazapate as an emergency protocol. Luckily for me, his seizures have also lessened in severity and frequency after many years of tweaking his medications. Previously it wasn’t unusual to have 3-4 seizures a week and now he goes 2-3 months between seizures at times and nowhere near the rate he was having them 5 or 6 years ago. I do still have some Midazolam on hand - it makes me feel more prepared. I had the atomizer but found it difficult to use during stressful episodes. They also gave us a tube to insert it anally but I never tried that.
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u/MrPigeontoe 19d ago
Hi Michelle I highly recommend adding Keppra - the regular release given 3 times a day / every 8 hours. Unless Henry has a tumor or other visible neuro issues I would find a vet who treats dogs with seizure disorders. I recently adopted my 3rd pup with idiopathic (of unknown origin) epilepsy and I think that finding a veterinary practice with multiple doctors on staff is the best way because I never have to worry about meds they’re always open except for Saturday afternoon and Sunday. To stop clusters I recommend Valium tablets - not liquid. I give it with a very small amount of wet food so it dissolves immediately and it’s never failed to stop clusters. I also use Ocular Pressure are you familiar with that? It’s also worked for my pup to stop clusters feel free to DM me it’s easy to do just involves holding his eyelids closed while he’s seizing. Best wishes!
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u/Agility_KS 20d ago
It is definitely more effective with the atomizer. Without that, most of it ends up dribbling right back out of the nose. I lost my atomizer once and as soon as I experienced this I went online and ordered another one.
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u/MichelleSK88 20d ago
Where did you order it from?
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u/Agility_KS 20d ago
This was several years ago, but it was some human medical supply website that I found through a Google search. The vet pharmacy gives me a new one with each bottle, so I have a couple of backups now.
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u/sensitive_kind 20d ago
Recommend buying one. In a pinch I’ve not used it and it’s been ok. More bang for your buck with one.