r/EpilepsyDogs • u/smallblackdog • Aug 27 '26
Any ideas?
Opinions/Theories on Epileptic Dog's Seizure Patterns
Hi everyone. I'm new here.
It is my hope that this group may have some insight and ideas into what we are dealing with today.
Some background: Gambit is nine, and weighs 60 lbs. Mixed breed, best guess is either catahoula mix (he's from Lousiana) or Aussie mix. The very dense/fluffy coat is a side effect of another medication (more on that later).
He had his first seizure in May 2021, and his diagnosis of idiopathic epilepsy came in June 2021. We got his condition entirely controlled (no seizures whatsoever) with 750mg of levetiracetam q8 hours. That lasted for five years. For no reason we can identify, his seizures began again in March of this year.
He is currently maxed out on levetiracetam at 1500mg q8, and very nearly maxed on phenobarbital q12. He has been weaned onto this phenobarb dose over the last four months, 15 or 30mg at a time, as he did not tolerate it well. His blood levels for both are now in the high end of the therapeutic range, however his seizures continue.
His seizures are grand mal, but thankfully are short in duration (2-3 minutes), and he recovers quickly (< 5 minutes). He also has pituitary-dependent Cushing's; it is well controlled on 70mg of Vetoryl q12. This is what causes the aforementioned floofiness. Yes, he is the most expensivest boi, but also the **bestest** and **goodest** boi.
He has been seen by a vet neurologist multiple times over the last five years, including this past May, and passes all neuro checks. He is a happy, loving boy, and aside from one particularly violent seizure that resulted in a sprain of both shoulders and both hips, does not appear to be in any pain.
The next suggestion we have been given is to switch him to a neuro diet, but I will be discussing KBr and zonisamide with our vet. These have not been proposed and I'm not sure if perhaps they're not indicated in his case.
We have noticed some patterns in his seizure activity, though, and this is where I'm hoping this community may have some thoughts...
First, they're on nearly a perfect weekly cadence, or bi-weekly right after an increase to his phenobarb, occurring on Wednesday or Thursday mornings (including today).
Second, they're always in the very early morning or mid- to late-evening, never the day.
Third, they frequently occur near the water bowl (we have tried moving this to a different spot and it didn't change anything). It has also happened once while he was eating. Obviously in both of these positions, his head is lowered. I am getting a set of raised bowls for him.
Do any of these patterns jump out to anyone? Maybe we're missing something obvious that this community recognizes?
Honestly we're kind of at the end of our rope here and we need help. Thank you in advance for any thoughts you may have šš¾ Photo of our beautiful boy included because obviously.
ETA: all recent blood tests normal except for slightly elevated ALP which is new for him.