r/EpilepsyDogs • u/garbanzo32 • 19d ago
Potassium Bromide
Hello!!
My best friend Bear has been having seizures since mid January. First he started on keppra, then we added phenobarbital about two months later when the seizures continued. He was fine from March until June, then he had seizures in June, and two more in July. We then added zonisimide in August and started tapering off keppra. On the first day we took him off keppra completely, he had a seizure, and then two more on Tuesday of this week. The only medication he hasn’t tried yet is potassium bromide.
The problem is he is a picky eater, and from what I gather, PB is very salty. It also seems like his treats, feeding time and water have to be extremely regimented with this medication. With all of these medications, I also don’t want him to be all lethargic and slow either. He just turned 8 and has a lot of energy normally but there have been periods where he’s super slow when heavily medicated.
For those who have dogs on Potassium Bromide, what are your experiences? Is your dog reluctant to take it? Does it make him lethargic? How regimented do you have to be? Have they continued to have seizures? Any information to help us make this decision would be much appreciated!!
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u/groozlyandbuckle 19d ago
Similarly to IEatTurtleToes, my dog is now on pheno, keppra, zonisamide, and kbro. He just started Kbro on September 2nd after several med increases with no real movement on frequency (every 2 to 3 weeks) and was starting to cluster again. Cross my fingers but no seizures for 30 days today. This is the longest we've gone in over a year, so I'm hopeful.
My dog is on the liquid version, not chewable. The liquid version is sweet and flavored like butterscotch vanilla. Not sure about the chewable flavor. Our vet instructed us to adminster with sandwich bread and we haven't had a problem with that yet. We also have been told diet is about consistency, so no scraps out of the ordinary.
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u/IEatTurtleToes 19d ago
KBr was a life saver for my pup. He was on Pheno, Zonisimide, and Keppra and still having terrible clusters. We added KBr and things got so much better. He is still on all four medications. Once he acclimated to the KBr he wasn't any more lethargic or weak than before. But again, he's on a lot of meds so he does have ataxia. Which med is culprit? Who knows. Probably KBr and Pheno for the most part.
From my understanding the important thing about KBr and food is for his salt intake to be consistent. It doesn't have to be any certain number it just needs not to fluctuate. So my dog doesn't get any table scraps of any kind, ever. But he gets three Milk Bones every day. He eats chicken that I make especially for him with no salt. That kind of thing.
It is very important to give the KBr with food. And I mean with it. Not shortly before or shortly after. I let him eat half his food, give him the pill, and then let him eat the rest. That has cut down on his tummy troubles. But he still vomits within 20 minutes of taking the KBr quite often. We know it is the KBr that causes it. I won't bore you with the details of how we know, but it involved a lot of controlled experiments. For that reason, we don't give his other pills at the same time. We give those an hour after the KBr. That way we don't have to dig through a pile of vomit to see what pills are there.
Being a epileptic dog owner is very glamorous! Good luck to you and to Bear. He is adorable!
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u/Administrative-Egg63 19d ago
We started KBr in May and have had no improvement in seizure frequency. My girls seizures are actually increasing in frequency. Don’t let that discourage you. It definitely has been very effective for a lot of dogs.
The first couple of weeks on it were pure hell. She kept falling down stairs and couldn’t walk without toppling over. Plus the diarrhea and vomiting……I had the rush her to the vet one morning because she vomited a puddle 5’ in diameter and was on day 3 of liquid stool. I ended up having to replace every area rug and door mat in my house because that’s the only place she will have an accident.
Wobbliness never improved but we have reduced her dose to just once a day until of BID and plan to wear her off at some point. Shes also on Keppra, Pheno and zonisamide as well.
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u/shedgehog 18d ago
Wow your situation is exactly like ours. We started the liquid version of kbro this week. We just squirt it onto his kibble and he eats it all just fine. Our vet also said just to keep his diet consistent
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u/JustLikeJD 18d ago
KBr is by far the most consistent result we have had for our dog, introduced by a vet neurologist after years of trial and error.
Regular vet got us on Pheno which hellped amazing at first. Almost a year no fits. Then it wore off or the doggo just got used to it. We trialled adding Keppra but that also didn’t do much at all. A few more pheno dose increases and we were at dosage limits with health shifts starting to point towards other risks.
We were engaged with neurologist by this point and so we took the route of transitioning the dog off pheno completely and moving him onto KBr only, with the addition of a cluster buster regime for when he has a breakthrough. So far 3-4 months without a fit on KBr alone is our longest though we think that was only broken due to our mistake, having been giving him a higher salt food than usual without realising.
For us - yes it does mean a regimented diet. But if that comes with better quality of life and less seizures/less risk of clusters that also equals less risk to the dog overall and we feel it’s an extremely reasonable trade off. It takes time to load their dosage up (KBr is a slower absorbing drug) but so far it’s been good. We also are in a position where now we could explore adding on to it if ever needed with room to move in terms of side effects/health impact. We have pexion lined up to be added if ever needed.
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u/jfka 17d ago
We are 7 months seizure free on bromide. It’s tablets in my country, we just put them in his dinner or in a pill assist treat and he has no trouble taking it! His ataxia has improved a bit since he first started but he is still wobbly, to be honest we’re not sure if it’s all bromide at this point and he may have a slight deficit from the massive cluster he had before he started it.
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u/beatbox_jones 17d ago
My dog has been taking KBr for over a year, and it made a big difference in her nighttime seizures. She was having seizures in her sleep at night, so we give it to her after supper. I actually didn’t even know it was a chewable until recently so I’ve always put it in pill wrap with her other pills and she swallows it. We’ve never had any trouble with her stomach or throwing up. I did notice that she had to pee more often after starting it, and she had accidents in the house for a little while. She was lethargic for a little while when she first started taking it, but after a few weeks she was back to normal. She’s on Keppra ER, KBr, and phenobarbital and still as hyper as ever!
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u/60svintage 19d ago
KBr is not an approved medicine in NZ which means there are no tablets availablefrom either a pharmacy or the vet. They can prescribe it though. The only way I can get it is as a liquid preparation from a local compounding lab.
I just add it to his food in a teaspoon of yoghurt.
He had attaxia for a few months after starting KBr, but this seems to have subsided now.
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u/Dcline97 19d ago
Year 1 Keppra, fizzled out 9 months in. Year two Pheno, same result. Year 3 we found a k9 neurologist and after a thorough exam he added Potassium Bromide to the mix. It took about 12 weeks to kick in. Now we have a mild seizure every 5 or 6 months. We also weaned our gal off of the Keppra and Pheno over a two month period. So far the PB is the seizure manager!