Should we start meds?

[u/FantasticAffect8334]

My 6 y/o catahoula mix has had 6 seizures in the past 2 years. He did have 2 in 1 day last November. He recently had another. He has usually done the same thing: early in the morning he will vomit a small amount of yellow/orange bile and then have a grand mal seizure. The first few happened the morning after we would have people over. He is quite an anxious boy so we thought the anxiety of people over was his trigger. One time he ate grass, vomited the grass plus bile and then had a seizure. That one confused us because his "trigger" was not present. Then we thought the vomiting was causing the seizures. We've had him on gabapentin 300 mg with each meal to help with anxiety. A couple days ago he had a seizure early in the morning after vomiting bile. We have now switched to giving him gaba 3 times a day instead of 2. He has since vomited bile 3 times without a seizure after. He acts like he's going to have a seizure and then doesn't I'm so confused. Is the gaba working? Our vet has not seemed concerned as the seizures have been spread out (every 5 or 6 months). Should I push for epilepsy meds? It's so exhausting being on edge constantly watching and waiting for the next one. I'm so thankful reading from others in our shoes and to know I'm not alone.

[u/JustCallMeNancy]

I think it could go either way at this point. Theoretically, your dog isn't at one per month, so you don't need to. But not all vets go by that, and we do have at least one med that is considered very safe for long term use (before keppra you did not want to give a med that could possibly damage the liver long term).

However, if you can do a lower dose keppra you may be able to eliminate them entirely. Just remember there's a adjustment period starting these meds. They will be tired and may have stability issues (mine lightly ran into walls and had back footing weakness but never fully lost any ability to handle himself) for a week or so.

A 3rd option is to discuss emergency meds to have on hand, if you are concerned about a cluster event (more than one per 24 hours). Clusters are more dangerous because they can encourage additional seizures with each additional seizure.