|
|
|
WHAT IS A
SEIZURE?
Any involuntary
behavior that occurs abnormally may represent a
seizure. Seizures are classified into several
categories.
GENERALIZED
(GRAND MAL) SEIZURES - This
is the most common form of seizure in small animals.
The entire body is involved in stiffness and possibly
stiffness/contraction cycles (tonic/clonic action).
The animal loses consciousness and may urinate or
defecate.
PARTIAL
SEIZURES - This form of
seizure originates from some specific area in the
brain and thus involves the activity of a specific
region of the body. Partial seizures may
"generalize" to involve the whole body.
PSYCHOMOTOR
SEIZURES - This type of
seizure is predominantly behavioral with the animal
involuntarily howling, snapping, circling, etc. The
abnormal behavior may be followed by a generalized
seizure.
Seizures
(neurological events) are often difficult to tell from
fainting spells (cardiovascular events). Classically,
true seizures are preceded by an aura, or
special feeling associated with a coming seizure.
As animals cannot speak, we usually do not notice any
changes associated with the aura. The seizure is
typically followed by a post-ictal period
during which the animal appears disoriented, even
blind. This period may last only a few minutes
or may last several hours. Fainting animals are
usually up and normal within seconds of the spell.
***
POST-ICTAL DISORIENTATION IS THE HALLMARK OF THE
SEIZURE ***
CAUSES OF
SEIZURES AND DIAGNOSTICS:
Seizures may be
caused by situations within the brain (such as trauma
or infection) or by situations centered outside the
brain (such as low blood sugar, circulating metabolic
toxins, or external poisons). The first step is
to rule out situations centered outside the brain,
easily done with a blood test. An ophthalmic exam may
also be performed as the retina may show signs of a
brain infection. If these tests are negative,
the next step is determined by the age of the pet.
ANIMALS LESS THAN
AGE ONE YEAR - seizures are usually caused by
infections of the brain. Analysis of cerebrospinal
fluid, obtained by a tap under anesthesia, would be
important.
ANIMALS BETWEEN
AGES 1 AND 5 - In these animals, usually no cause can
be found and the term "epilepsy," which
simply means "seizure disorder," is applied.
If seizures are occurring frequently enough,
medication is used to suppress them. Schnauzers,
Basset hounds, Collies, and Cocker spaniels have 2-3
times as much epilepsy as other breeds.
ANIMALS MORE THAN
AGE FIVE YEARS - In this group, seizures are
usually caused by a tumor growing off the skull and
pressing on the brain (a “meningioma”). Most
such tumors are operable if found early. A CAT
scan or MRI would be the next step.
Special referral is necessary for this type of
imaging. For patients where surgery is not an option,
corticosteroids may be used to reduce swelling in the
brain. Treatment to suppress seizures may also be
needed (see below).
Epilepsy is the
name given to seizure disorders for which no cause can
be found. It is not a unique disease in and of itself.
MEDICATION TO
SUPPRESS SEIZURES: PHENOBARBITAL
Treatment of any
seizure disorder is aimed at suppressing the seizure
with medication. The drug of choice is phenobarbital.
WHEN TO BEGIN
TREATMENT:
- When seizures
occur in "clusters," that is one after
the other.
- When isolated
seizures occur once a month or more.
- When special
circumstances exist regarding how often the animal
is observed. (If an animal cannot be observed,
there is no way of knowing how frequently
its seizures are occurring. It may be best
to "play it safe.")
- The German
Shepherd dog, Golden retriever, Irish setter, or
Saint Bernard breeds are notorious for difficulty
in seizure control. It is best not to wait for
frequent seizures in these cases as each
seizure makes the next more difficult to control.
WHAT YOU SHOULD
KNOW ABOUT PHENOBARBITAL:
This medication is
a long-acting barbiturate capable of suppressing
seizure activity in the brain. It is an inexpensive
drug though the appropriate monitoring blood tests
amount to about $300 per year.
It takes 1-2 weeks
to build up a blood level capable of suppressing
seizures. This means that the effectiveness of a
given dose cannot be assessed before this period.
After this time, a phenobarbital blood level
should be run to determine the effectiveness of the
dose being used. Phenobarbital blood levels, once
therapeutic, are checked every six months or sooner if
breakthrough seizures occur.
Twenty to thirty
percent of epileptic dogs cannot be controlled with
phenobarbital alone. If an animal on
phenobarbital continues to seizure, a blood
level must be drawn. Before adding other drugs,
however, it must be shown that the maximum therapeutic
phenobarbital blood level has been ineffective; most
animals in this situation are nowhere near the maximum
level and simply require a dose higher than what they
are receiving. If phenobarbital is simply not
effective or has unacceptable side effects, potassium
bromide may be used to complement phenobarbital at a
lower dose.
Another important
part of monitoring regards the toxicity of
phenobarbital. This medication can be harmful to the
liver thus liver function is periodically checked. Our
hospital recommends a bile acids liver function test
and a phenobarbital blood level twice a year.
COMMON SIDE
EFFECTS:
- SEDATION
- animals may become quite stuporous as they get
used to this drug. This effect is temporary,
lasting until the patient's metabolism adjusts
(usually no longer than a few days).
- EXCESSIVE
THIRST AND APPETITE -
These side effects are annoying and,
unfortunately, permanent if they occur. If
these side effects become too objectionable, the
phenobarbital dose will have to be lowered and
another medication added for seizure control.
WHAT IF
PHENOBARBITAL DOESN'T WORK OR CAUSES
UNACCEPTABLE SIDE EFFECTS?
This can happen and
in such cases Potassium bromide becomes the next best
choice. The phenobarbital dose is generally cut back
and Potassium bromide is given at a high dose for a
day or two before dropping to a maintenance bromide
dose. Potassium bromide is felt to be an
investigational treatment by the FDA and special
permission is needed to use it (hence it is not the
first choice treatment); still, 85% of phenobarbital
failures can be controlled with potassium bromide.
Bromides reach therapeutic levels very slowly (months)
thus, in most cases, bromides and phenobarbitol are
used in combination.
SEIZURES AT HOME
(WHEN IS IT AN EMERGENCY?)
It is a lucky pet
that never has another seizure after beginning
medications; but an occaisional breakthrough seizure
(as disturbing as it may be to watch) is rarely of
serious concern. It is important not to put yourself
in danger around a seizuring pet. Involuntary jaw
snapping may bite you and in the period of post ictal
disorientation the pet may not recognize you and may
snap. There are, however, some emergency
situations:
- SEIZURE
ACTIVITY NON-STOP FOR FIVE MINUTES OR MORE
(this is called
“status epilepticus”)
- MORE THAN 3
SEIZURES IN A 24 HOUR PERIOD
If a particular bad
seizure occurs at home or if either of the above
emergencies occur, a special first aid technique can
be used: Rectal administration of valium. In
initial studies the injectable product was delivered
rectaly with a special syringe that could be kept at
home. The rectal route avoids any danger of being
bitten while trying to asminister medication. Recently
compounding pharmacies have been able to produce
valium rectal suppositories which may be easier to use
than the syringe method. Rectal valium administration
has been used successfully for many years in epileptic
children; the technique has adapted well to veterinary
patients.
CAN SEIZURE
MEDICATION BE STOPPED?
While there is some
risk to discontinuing seizure medications, this may be
appropriate for some patients. Dogs should be
completely seizure-free for at least a year before
contemplating stopping treatment. In breeds for which
seizure control is difficult, it is probably best
never to stop medication (German Shepherds, Siberian
Huskies, Keeshands, Golden retreiver, Irish Setter,
St. Bernard). Phenobarbital is a medication that
cannot be suddenly discontinued; if you are interested
in discontinuing seizure medication, be sure to
discuss this thoroughly with your veterinarian.
OTHER
INFORMATION
The Epilepsy
Genetic Research Project
Veterinary
Neurologists at several universities are looking for
a genetic answer to epilepsy. They seek DNA samples
from epileptic dogs and their close relatives if
possible. For more information, visit
www.canine-epilepsy.net/cerc.html
Canine
Epilepsy Network
Affiliated
with the Veterinary School at the University of
Missouri at Columbia, this site reviews canine
seizure disorders, treatment, history and more.
www.canine-epilepsy.net/basics/basics_main.html
Epil-K9
his is a support
and news group for owners of seizuring dogs. The
group has a substantial library of useful resources
which can be viewed at:
www.canine-epilepsy.com
|
|
Epilepsy
& Seizures
Race
Foster, DVM
Marty
Smith, DVM
Holly Frisby, DVM
Drs. Foster & Smith, Inc.
What
is epilepsy?
| Epilepsy
generally starts in dogs 6 months to 5 years of age, usually at
2-3 years. |
Epilepsy is a disorder
of recurring seizures. Seizures are described as an uncoordinated firing
of the neurons usually within a portion of the brain called the cerebrum.
The mechanisms of why these neurons do not function normally is not
understood, but is similar if not identical to the causes in humans.
Probably certain substances called neurotransmitters
are not in the proper chemical balance, so the nerves do not behave in
the normal coordinated fashion. A patient with epilepsy will exhibit
periodic bouts of uncoordinated firing of the neurons within the brain.
These episodes are called seizures and occasionally referred to as
convulsions or "fits."
Causes
of seizures
When we are first
presented with a patient that has had a seizure, we initially attempt to
find the cause. Seizures can be caused by many conditions:
- Congenital
defects
- Blood glucose levels
that are too high (e.g.; diabetes
mellitus) or too low (hypoglycemia)
- Low oxygen levels in
the blood that could be caused by anemia,
heart problems, or difficulties with breathing
- Kidney disorders
- Liver disorders
- Infections such as
canine
distemper
- Tumors
- Toxins, like
antifreeze, lead, or chocolate
- Fevers and hypothermia
- Brain damage
resulting from trauma or poor blood flow to the brain
- Certain medications
- Low calcium in
females that are nursing young (eclampsia)
- Primary or
idiopathic epilepsy
Types
of seizures
Partial seizures affect
only a small part or one side of the body. These are often caused by a
brain lesion.
Generalized seizures
affect the whole body and can be divided into two types, grand mal and
petit mal. Grand mal seizures are the most common. A patient experiencing
a grand mal seizure usually falls on her side and has uncontrollable
muscle activity such as kicking her legs as if swimming or paddling.
Salivation is profuse and often the patient involuntarily urinates and
defecates. The patient is unaware of you, her surroundings, or her own
actions. Petit mal seizures do not result in convulsions, but the animal
loses consciousness. It may look like the animal just collapsed.
The worst form of
seizure is one in which the patient exhibits one or more grand mal
episodes without recovering from the first. This patient may actually be
in a seizure for hours. This is termed Status Epilepticus and is usually
referred to simply, as Status. Seizures by themselves are not life
threatening unless they progress into Status, in which case, medical
attention should be sought immediately.
What
are the phases in a seizure?
If you observe closely,
you can often recognize three phases to a seizure.
Pre-Seizure
Phase: The pre-seizure phase is
commonly called the aura. Your pet may appear restless, pace, seek
affection, salivate, whine, or hide. These signs occur just minutes
before the actual seizure begins.
Ictus:
The seizure itself is called ictus. Your pet may
appear excited, vomit, salivate, run in circles, collapse, and have
uncoordinated muscle activity. This stage generally lasts less than 5
minutes.
Post-Ictal
Phase: After the seizure, the
recovery (post-ictal) period begins. Your pet may seem disoriented,
uncoordinated, and occasionally blind (temporary). This may last several
minutes to days.
Rarely does a patient
become vicious during a seizure. In fact, most patients will actually
feel the seizure coming on and seek out the owner for comfort. During the
actual seizure, a patient is unaware of his surroundings, so it does
little good for the owner to try to comfort the seizuring patient. It is
best to be there for comfort when the pet recovers.
What
triggers a seizure?
The actual triggering of
a seizure is unknown, but most patients tend to seizure during periods of
excitability. Often, the owner will state that the patient seizures while
playing ball or when the children returned home from school. We had one
patient who seizured the day after visiting our veterinary hospital, no
matter what the reason for the visit. Some patients have been known to
seizure while sleeping. Please do not confuse this with dreaming, where
it is common for the patient to bark or shake while sleeping. A dreaming
patient can be awakened, but a seizuring patient cannot.
How
is epilepsy diagnosed?
First, a detailed
history is needed. A physical and neurological exam are performed by your
veterinarian, a panel of laboratory tests are run, and sometimes x-rays
(radiographs) are taken. If a cause of the seizure can not be identified,
the condition is diagnosed as idiopathic or primary epilepsy. There is no
test to diagnose epilepsy per se, our tests simply rule out other causes
of seizures.
What
type of information can the owner provide to help the veterinarian make
the diagnosis?
It is helpful if you,
the owner, can give your veterinarian answers to the following questions:
- What does your pet
look like when he is having seizures?
- What is the duration
of each seizure and how often do they occur?
- Are there signs that
only appear on one side of your pet (is one side worse than the
other)?
- Has your pet had a
high fever?
- Has your pet been
exposed to any toxins?
- Has your pet
experienced any trauma recently or years ago?
- Is your pet current
on vaccinations?
- Has your pet been
recently boarded or with other dogs?
- Has your pet had any
other signs of illness?
- Has your pet been
running loose in the last several weeks?
- What and when does
your pet eat?
- Has your pet had any
behavior changes?
- Do the seizures
occur in a pattern related to exercise, eating, sleeping, or
certain activities?
- Does your pet show
different signs right before or right after the seizures?
Are
some animals more prone to epilepsy?
Epilepsy generally
starts in animals 6 months to 5 years of age, usually at 2-3 years.
Epilepsy occurs in all
breeds, including mixed breeds. Epilepsy can be a genetic trait. It can
even be familial where the epileptic disorder can pass down through
generations within one family. Beagles, German Shepherds, Irish Setters,
Poodles, St. Bernards, Springers, Malamutes and Huskies, Cockers,
Collies, Dachshunds, and Golden and Labrador Retrievers are some of the
breeds which have a higher tendency to develop epilepsy. It is
recommended that dogs with epilepsy should not be used for breeding,
since this tendency can be inherited.
How
is epilepsy treated?
Treatment for epilepsy
is usually not begun until a seizure is severe, or multiple seizures have
occurred and a pattern is observed. It is very important to know the
pattern of seizures in your pet so your veterinarian can determine if the
treatment is helping.
TREATMENT IS NEVER
CURATIVE. The goal is to decrease the frequency, severity, and duration of
the seizures.
Medications used to
treat epilepsy are given orally. Each animal reacts differently to the
medications. Your veterinarian may need to try different types or
combinations to find what will be right for your pet. Many pets will
become sleepy when they first start medication, but this soon wears off
after several weeks.
The drug most commonly
used to control epilepsy is Phenobarbital. Dilantin and Primidone are
other drugs used in veterinary medicine. All are phenobarbital-related
drugs. These medications must be given every day. These medications are
classified as sedatives, in which case, the objective is to sedate the
neurons of the brain, but not to the point where the patient becomes
obviously sedated or "dopey." In the normal patient receiving
these drugs, you can seldom detect that the dog is on any medication.
These are the same medications used in humans with epilepsy and the goal
of treatment is the same. Other medications such as potassium bromide
(KBr), clorazepate, phenytoin and clonazepam, dimethylglycine, and
felbamate may be used alone or in combination with phenobarbital, if
phenobarbital alone is not effective. Once medication has started, it is
IMPORTANT to NOT suddenly discontinue or 'skip' a dose of medication.
Severe seizures could result.
If a patient experiences
prolonged seizures referred to as Status, injectable drugs such as valium
are administered intravenous
for rapid effect.
Phenobarbital
and related anti-epileptic drugs can have side
effects on the liver,
especially if high dosages are required. We usually suggest liver
function tests before we adjust dosages upward. Although this is a good
practice, it is very rare to see liver damage even at high levels.
It is common for one
dosage level of medication to work for a period of time, then have the
seizures increase in length or frequency. In these cases, the drug
dosages may be adjusted. If the treated patient goes months with no
seizures, then we may try a lower dosage, which may still control the
seizures. We might add here that we have all of our clients keep a
calendar or log of the seizures, recording the date, and length of time
they lasted. This makes it easier for us to determine if adjustments are
necessary. Obviously, the owner may miss some episodes, since they can
not watch their dog every minute, but the calendar is beneficial.
What
should I do if my pet has a seizure?
- Remain calm.
- Do not put your hand
in your pet's mouth. This will not help your pet and you may be
bitten. (Contrary to popular belief, a dog will not swallow his
tongue.)
- To prevent injury to
your pet, remove nearby sharp or hard objects (e.g.; tables and
chairs).
- Observe your pet
closely. Call your veterinarian if the seizure lasts more than 20
minutes, or if your pet has one seizure right after another. Severe
and long seizures are a medical emergency and can be fatal.
A single, mild seizure
is not an emergency and rarely indicates the need for long-term
treatment. But at a convenient time, you should call your veterinarian
and report what occurred. Be sure to record the date, time, and duration
of any seizure.
|
| Summary
Diazepam
is available by prescription only and is used in a
variety of forms to treat seizures and anxiety,
cause sedation, or stimulate appetite (in cats). Can
become addictive - do NOT suddenly stop treatment,
but consult veterinarian regarding withdrawal
protocol. Consult your veterinarian if your pet
experiences extreme changes in behavior, jaundice
(yellow gums), vomiting or loss of appetite while
taking diazepam.
|
Thursday
July 11, 2002
Diazepam
(Valium)
Jennifer
Prince, DVM
Veterinary Services
Department, Drs. Foster & Smith, Inc.
Generic
Name
Diazepam
Brand
Name
Valium
Type
of Drug
Class
IV controlled benzodiazepine tranquilizer,
antiseizure medication
Form
and Storage
Tablet, oral solution, rectal gel, and injectable
Store at room temperature in tight, light resistant
container. Store liquid form in the original container. Do
not transfer the injectable form to a plastic container as it
may become less effective.
Indications
for Use
Used to treat epilepsy
and seizures in dogs, seizures
in cats, and anxiety; to promote sedation and muscle
relaxation; and in cats, as an appetite stimulant.
General
Information
Not FDA
approved for use in dogs and cats but it is a common and
accepted practice to use diazepam in veterinary medicine.
Available by prescription. Used mainly in the control of status
epilepticus and as a sedative before or with
anesthesia due to its central nervous system (CNS)
effects.
Usual
Dose and Administration
Varies depending on circumstances. Please contact your
veterinarian. Give orally on an empty stomach unless that
causes stomach upset-then give with food.
Side
Effects
Side effects may include drowsiness, mild lack of
coordination, and in cats, increased appetite for a short
period of time. May also see excitement, aggression, bizarre
behavior, and in cats, liver
failure.
Contraindications/Warnings
Do not use in patients hypersensitive
(allergic) to it.
Not for use
in debilitated, pregnant, or nursing animals. Do not use in
animals with liver or kidney disease. Monitor temperature of
small animals due to loss of ability to maintain body
temperature. Impairs ability of working dogs. May be
addictive.
Drug
or Food Interactions
Increases effects of other central nervous system (CNS)
depressants, monoamine
oxidase inhibitors (MAOIs), antihistamines, and
other antidepressants. Use of cimetidine, erythromycin,
isoniazid, ketoconazole, propranolol, and valproic acid may
increase diazepam's effects. Antacids may decrease the oral
absorption of diazepam. Digoxin and phenytoin levels may
increase to toxic levels if used with diazepam. Rifampin may
decrease the effectiveness of diazepam. Give orally on an
empty stomach unless that causes stomach upset-then give with
food.
Overdoses/Toxicity
Signs include sleepiness, disorientation, depression,
decreased reflexes, coma,
and death.
|
|
| Summary
Potassium
bromide is an oral medication used to control seizures and
epilepsy in dogs. Often see sedation during first few weeks of
treatment. May take 4-5 months to see full effect. Consult your
veterinarian if your pet experiences a change in appetite,
thirst, weight, urination, or activity level, or if jaundice
(e.g., yellow gums) develops.
|
Potassium
Bromide (KBr)
Jennifer
Prince, DVM
Veterinary Services Department, Drs.
Foster & Smith, Inc.
Generic
Name
Potassium Bromide (KBr)
Brand
Name
None
Type
of Drug
Antiseizure
Form
and Storage
Available as a reagent
and USP
grade bulk form.
Store in tight containers. Do not put in contact with metals.
Indications
for Use
Used to control epilepsy
and seizures in dogs.
General
Information
Not FDA
approved for use in dogs and cats but it is a common and accepted
practice to use potassium bromide in dogs. Obtained from a chemical
supply company or a specialty compounding pharmacy. Available by
prescription. Useful in dogs whose seizures are not controlled with or
who cannot take phenobarbital. The bromide is the element with the
antiseizure properties of inhibiting excitability of nerve cells in the
brain. May take months for the full effect of a dosage change to occur.
Usual
Dose and Administration
Varies. Please contact your veterinarian. May take months for the full
effect of a dosage change to occur. Not recommended for use in cats.
Side
Effects
Side effects may include transient sedation (occurs when used with
phenobarbital and may last several weeks), loss of appetite, vomiting,
constipation, or pancreatitis
if potassium bromide is given in combination with phenobarbital or
Primidone.
Contraindications/Warnings
Not for use in pregnant or nursing animals.
Not for use in cats.
Drug
or Food Interactions
Increase in sedative effect is seen when used with other central nervous
system (CNS)
depressants.
Low salt diets may
increase the risk of side effects. High salt diets may decrease the
effects of KBr.
No known food
interactions.
Overdose/Toxicity
More likely seen from chronic
overdosing than with a single large dose. Signs may include sedation,
loss of appetite, vomiting, constipation, pancreatitis, muscle pain,
staggering, decreased/slow reflexes, pupils of different sizes, tremors,
and other central nervous system (CNS) symptoms.
|
| Summary
Primidone is an
oral antiseizure medication used in dogs. Used less commonly
because it must be given three times a day, is poorly absorbed
from the intestines, and causes a greater incidence of liver
toxicity. Consult your veterinarian if your pet experiences
changes in eating, drinking, behavior, or develops jaundice
(e.g., yellow gums) while taking Primidone.
|
Primidone
(Mylepsin, Mysoline)
Jennifer
Prince, DVM
Veterinary Services Department, Drs.
Foster & Smith, Inc.
Generic
Name
Primidone
Brand
Name
Mylepsin, Mysoline
Type
of Drug
Antiseizure medication
Form
and Storage
Tablets and oral suspension
Store in a tightly closed container at room temperature. The oral
suspension should also be protected from light.
Indications
for Use
Used to control seizures
and epilepsy in the dog.
General
Information
Class
IV controlled substance. Available by prescription. Primidone
is not FDA
approved for use in dogs and cats but it is a common and accepted
practice to use Primidone in dogs. The liver
rapidly converts Primidone to phenobarbital and phenylethamalonamide
(PEMA). These agents raise the seizure
thresholds or alter the pattern of the seizures. Some dogs
that do not respond to phenobarbital alone may respond better when it is
in the Primidone form as PEMA has been demonstrated to increase the anticonvulsant
activity of phenobarbital in animals.
Usual
Dose and Administration
Varies. Please contact your veterinarian. Not recommended for use in
cats.
Side
Effects
Side effects may include anxiety and agitation when beginning therapy
which usually resolves with time and small dose increases. Also seen are
depression, drinking more, urinating more, eating more, sedation, and
staggering. Less commonly seen are loss of appetite, increased heart
rate, skin disease, hyperventilation, and rarely a severe form of anemia.
Contraindications/Warnings
Not for use in cats due to increased toxicity in this species.
Do not use in patients
with dehydration, anemia, decreased adrenal function (Addison's
disease), heart disease, kidney or liver disease, or respiratory
disease.
Not for use in pregnant
or nursing animals, or those who are hypersensitive
(allergic) to the Phenobarbitals.
Primidone can cause
liver disease; therefore, liver monitoring is essential.
Drug
or Food Interactions
Oral acetozolamide may decrease the absorption of
Primidone.
The following drugs may
increase the effect of phenobarbital (and presumably Primidone): other
central nervous system (CNS)
depressants, valproic acid, and chloramphenicol.
Phenobarbital (and
presumably Primidone) may decrease the effect of oral anticoagulants
(like heparin), corticosteroids,
beta
blockers, quinidine, theophylline, and
metronidazole.
Use with furosemide
increases the risk of low blood pressure.
Griseofulvin may have
decreased absorption when given simultaneously with
phenobarbital/primidone.
Rifampin may reduce the
effect of phenobarbital (and perhaps primidone).
No known food
interactions.
Overdose/Toxicity
Symptoms include depression, drinking more, urinating more, eating more,
sedation, staggering, loss of appetite, increased heart rate, skin
disease, hyperventilation (panting), vomiting, nystagmus
(eyes wiggle back and forth), depression, kidney disease, liver disease (jaundice),
coma,
and death.
Copyright ©
1997-2002, Drs. Foster & Smith, Inc. All Rights Reserved.
Reprinted from PetEducation.com.
|
| Related
Articles: The
Use of Phenobarbital (Solfoton) in Dogs and Cats |
|
| Summary
Phenobarbital
is used to control epilepsy and seizures on a long term basis.
(Epilepsy can NOT be cured, only controlled.) Blood tests are
used to monitor level of drug in the blood and adjust dosage.
Can cause an increase in certain liver tests. Contact your
veterinarian if your pet develops jaundice, vomiting, depression
or weakness while on phenobarbital.
|
Thursday
July 11, 2002
Phenobarbital
(Solfoton)
Jennifer
Prince, DVM
Veterinary Services Department, Drs.
Foster & Smith, Inc.
Generic Name
Phenobarbital
Brand
Name
Solfoton
Type
of Drug
Barbiturate and antiseizure medication
Form
and Storage
Tablet, capsule, elixir, powder, and injectable
Unless stated otherwise by the manufacturer, store in tightly closed
containers at room temperature.
Indications
for Use
Used for long-term control of epilepsy
and seizures in dogs and seizures
in cats. Not very useful for stopping an active seizure.
General
Information
Not FDA
approved for use in veterinary medicine but is a common and accepted
practice. Class
IV controlled medication available by prescription. It is
commonly the first drug used in the long-term treatment of seizures as it
decreases the risk of more seizures but does not overly sedate the
patient. Epilepsy can Not be cured but it can be controlled.
Usual
Dose and Administration
Dogs 0.5-4.0 mg/pound by mouth (tablet, capsule, elixir) every 8-24
hours. Cats 0.5-1.0 mg/pound by mouth (tablet, capsule, elixir) every
8-24 hours. Dose dependent on level of drug in the blood and the effect.
Blood tests are used to monitor the level of the drug in the blood. It
may take a week for the level of the drug in the blood to stabilize after
a dose change. May need to treat the pet for life.
Side
Effects
May see anxiety and agitation when begin treatment. This usually is
short-term and stops with small changes in the dosage. May see depression
at lower dosages. May see increase in drinking, urinating, and eating.
Sedation and staggering may occur at higher dosages. Infrequently seen
are liver
damage and anemia.
In a chemistry
panel, certain enzymes
produced by the liver are often elevated.
Contraindications/Warnings
Do not use in patients who are hypersensitive
(allergic) to barbiturates.
Not for use in patients
who are dehydrated or anemic or who have heart/lung disease, Addison's
disease, kidney disease, or liver disease.
Addiction is possible
with long-term use.
Not for use in pregnant
or nursing animals.
Drug
or Food Interactions
Phenobarbital's effect may be increased if used with other central
nervous system (CNS)
depressants, valproic acid, or chloramphenicol.
Phenobarbital may
decrease the effect of oral anticoagulants,
chloramphenicol, corticosteroids,
doxycycline, griseofulvin, beta
blockers, quinidine, theophylline, and metronidazole.
Monoamine
oxidase inhibitors (MAOIs) may
increase the duration of Phenobarbital's action.
Phenobarbital may
increase or decrease the metabolism of phenytoin.
Rifampin may decrease
the effect of phenobarbital.
No known food
interactions.
Overdose/Toxicity
May see loss of appetite, vomiting, depression, jaundice
(e.g., yellow gums), sedation, decreased breathing and heart rates, coma,
and death.
|
| Summary
Pentobarbital
is used to treat serious seizures in cats and
dogs in a hospital setting.
|
Thursday
July 11, 2002
Pentobarbital
(Nembutal Sodium)
Jennifer
Prince, DVM
Veterinary Services
Department, Drs. Foster & Smith, Inc.
Generic
Name
Pentobarbital
Brand
Name
Nembutal Sodium
Type
of Drug
Barbiturate and anti-seizure medication
Form
and Storage
Injectable, capsule, elixir, and rectal suppository
The suppositories should be refrigerated. The other forms
should be stored at room temperature unless otherwise
indicated by the manufacturer.
Indications
for Use
Used for short-term control of status
epilepticus, cluster
seizures (multiple seizures in a short amount of time)
in dogs. Also used for similar seizures
in cats.
General
Information
FDA
approved for use in veterinary medicine. Class
II controlled medication used in a hospital
setting. It is used to treat seizures that need longer
control than diazepam (Valium) offers and faster control
then phenobarbital offers.
Usual
Dose and Administration
Used in hospital setting. Given by injection into a vein
to effect (given in small amounts until seizures stop).
Side
Effects
Decreased rate of breathing and loss of body temperature.
May see excitement in dogs recovering from its sedative
effects.
Contraindications/Warnings
Do not use in patients who are hypersensitive
(allergic) to barbiturates.
Not for
use in patients who are dehydrated, anemic, or who have Addison's
disease, heart or lung disease.
Do not
use in patients with kidney or liver
disease.
MUST be
given SLOWLY due to respiratory
depressant effect.
Do NOT
use to treat lidocaine intoxication (toxicity from
lidocaine, a medication used for anesthesia and to treat
certain heart problems).
Not for
use in pregnant or nursing animals.
Drug
or Food Interactions
Pentobarbital's effect may be increased if used with
phenobarbital or other central nervous system (CNS)
depressants, valproic acid, or
chloramphenicol.
May
decrease the effect of oral anticoagulants, corticosteroids,
beta
blockers, quinidine, theophylline, or
metronidazole.
Increased
risk of low blood pressure if used with furosemide
(Lasix).
May
change the metabolism of phenytoin.
Deaths
have occurred when used to treat lidocaine induced
seizures.
No known
food interactions.
Overdose/Toxicity
May see sedation, coma,
decreased rate of breathing, and death.
|
|
If you
think your pet has been poisoned...
Contact your
veterinarian or the ASPCA National Animal Poison Control Center (at one
of the numbers below) if you think your pet may have accidentally
received or been given an overdose of the medication.
1-900-443-0000 ($45.00
per case. The charge is billed directly to caller's phone.)
1-888-4ANI-HELP
(1-888-426-4435. $45.00 per case, credit card only.)
Follow-up calls can be
made for no additional charge by dialing 888-299-2973.
There is no charge when
the call involves a product covered by the Animal Product Safety Service.
|
|
Website
designs by Swiftwater
Innovations Copyright
© 2002 - All Rights Reserved |
| Original
textual content and photos by LGHN. Copyright © 2002 - All Rights Reserved |
|
Updated
12-27-03 |
|