The most effective way to prevent your dog from having further seizures is with the use of medication that has been prescribed by your veterinarian.
The general rule of thumb for when to start seizure medications are:
- If a dog has clusters (more than 1 seizure in a 24 hour period)
- If a dog has seizures more frequently than every 3 months
- If a dog has a status epilepticus event (active seizure more than 5 minutes)
- If they have structural disease like a brain tumour
These factors should be discussed at length between you and your vet to determine if medications are right for your dog. If you and your vet make the decision to put your dog on medication for seizures, there are four main medications that are most often prescribed, and sometimes your vet will combine several of them together.
Phenobarbital has been the go-to for anti-seizure control for decades. It is highly effective and relatively inexpensive. The main downside to using this drug is the side effects. Phenobarbital has a sedating effect, but the good news is that this is usually just a temporary thing until your dog gets used to the drug.
It does, however, cause increased thirst, urination and appetite and these side effects can be difficult to live with in some pets. Your vet will also need to monitor your dog’s blood levels of phenobarbital, as well as liver enzymes periodically to ensure that their levels are not too high. Some dogs’ livers do not tolerate phenobarbital use and they need to change medications over time.
Potassium Bromide was originally used to control seizures in humans almost a century ago. Once Phenobarbital was developed, potassium bromide fell out of favor, but not in veterinary medicine. Great results have been achieved on this medication. The main downside to potassium bromide, like phenobarbital, is that it causes adverse effects like increased thirst, urination and appetite. Monitoring your dog’s blood levels of potassium bromide will need to be done periodically. It also has a sedating effect that tends to improve over time.
Levetiracetam (Keppra) is an alternative drug that your vet may discuss with you. The side effects are minimal which is it’s great benefit, however, its effectiveness for adequate seizure control is not very reliable and needs to be assessed in each patient. It is most often used in conjunction with phenobarbital or potassium bromide for dogs that get breakthrough seizures on those medications alone. However, many pets do get good seizure control with Keppra alone and it is often tried as a first line medication because of how well tolerated it is.
An important consideration when using Keppra is that it needs to be given THREE times a day which can be difficult for people who work away from their pets. Any dog on long-term medications will need to have their blood work checked periodically to make sure it isn’t causing problems.
Zonisamide is a newer anticonvulsant that is being used in veterinary medicine. It’s use is similar to Keppra but the benefit is that it can be given TWICE daily (instead of three times a day). It has a disadvantage of being quite costly, especially for a bigger dog.
Your vet may also recommend that you make some changes to your pet’s diet. Purina developed a veterinary therapeutic diet that was released in 2017 to enhance the use of medications. The fat source in the diet comes from medium-chain fatty acids that have been proven to have a direct effect on helping prevent seizures. This diet was never intended to replace traditional medications, but it is another option that may be worth discussing.
Acupuncture is recommended in certain cases as well, and is often recommended in holistic treatment plans. Seizure management is a constantly evolving area of veterinary medicine.