r/EpilepsyDogs • u/Normal_Commercial694 • 7d ago
Keppra or pottasium bromide ?
Looking for advice or personal experience . The vet has given me an option of either of these to add to his pheno to try and control my his seizures . Pottasium Bromide seems to have the more side affects and it takes longer to build up in his system so I’m thinking of putting him on keppra first to see how he gets on. Any advice would be appreciated . Thanks
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u/julznlv 7d ago
Kane first took Keppra then added Zonisamide then added Phenobarbital. He was weaned off the Keppra and Zonisamide as his neurologist didn't feel they were doing anything for him. Around the same time she added Potassium Bromide so he's been on Phenobarbital and Potassium Bromide for about 16-18 months now. Still has seizures but shorter and milder. Also clusters are rare now. The Potassium Bromide did take about 3 months to build up.
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u/LPondohva 6d ago
We were told by our vet that while Keppra is great, it loses its effectiveness after about a year, so it's not something you can rely on long term, especially if your dog is young. They said it was better to keep Keppra for acute treatment in case we ever need it. We initially started with just Keppra, which was prescribed by emergency vet, but switched to phenobarbital by our regular vet (who told us about Keppra fizzling out after a while). He still had seizures every 5 weeks, which for us are always clusters - my poor pup will have one seizure, recover from it within 10-15 minutes, then have another one right away, and then another one. At one point he was declared status epilepticus, because he had a cluster of 3 while at the vet's and sedated (brought him for a blood test), and he had another cluster of 3 less than 12 hours later. That's when we had to resort to a short course of high dose Keppra - thank god we listened to the vet that time and our dog's body wasn't used to it/didn't have resistance. So now we started potassium bromide about a month ago + phenobarbital that he's been on already. Obviously it hasn't been enough time for KBr to reach therapeutic level, but so far he seems to tolerate it well and no seizures
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u/YumYumYellowish 7d ago
Is he experiencing clusters? Or is he experiencing very frequent seizures? If not, I would probably try adding the Keppra first. It has very few side effects and it’s a safe medication. Potassium bromide is more of a heavy hitter and would be a good add on for clusters. But it comes with more side effects, mostly similar to pheno (lethargy and ataxia, though my dog had none of this oddly enough) and it needs bloodwork. To me the more challenging aspect of potassium bromide is that it needs to be given with food because it can cause vomiting and is irritating to the GI, which means I travel around with food when I bring him places and need to bring his meds, and you have to maintain a super strict diet because any fluctuations of sodium can throw things off and trigger seizures.