? re: Potassium Br & phenabarb combined treatment

This is the place for general questions about drugs, long-term treatment concerns, possible influences of other drugs (such as antibiotics, heartworm preventatives, or anesthetics) for epileptic dogs, and other concerns. Please note that we cannot make specific recommendations for individual dogs - for this, please consult your veterinarian.

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hebutt
Posts: 7
Joined: Wed Jun 09, 2004 10:57 am
Location: Windsor, Ontario

? re: Potassium Br & phenabarb combined treatment

Post by hebutt » Thu Nov 08, 2007 12:20 pm

We are now finding that my 6 year old black lab, Magic, who is on 2.5 cc's of Potassium Bromide twice, has increased her frequency and severity of her seizures quite dramatically in the last 6 months. They were very much under control with one approximately every 6 months, then they went to every other month, then to ever month and unfortunately she has now had one every day for the last 3 days.
Her original treatment 4 years ago was Phenabarb, but the vets took her off that and put her strictly on the Potassium Br.
My parents dog is on a combination of both drugs and seems to be doing quite well with the management of the seizures yet when I mentioned this to our vet for Magic he was not keen on it. And I never really got a good answer as to why (I also think he doesn't like his treatment methods being questioned). Are there rational reasons for not combining the two drugs in treatment?
Are other people finding other medicines useful for seizure management?

skrpio
Posts: 1143
Joined: Sun Sep 25, 2005 5:34 pm
Location: Auckland , New Zealand

Post by skrpio » Thu Nov 08, 2007 12:44 pm

If your vet is like that - change your vet to one who does not think he is God. You need a vet that will advise the best.
There are many on this site that need to give both drugs to control the seizures. In fact there are more dogs on a combination than just on one.
It also appears that this time of the year is bad for seizures - why we don't know - just that a lot of dogs have more problems now.
Has your vet done blood tests to find out if Magic is in the theraputic range ? Could be the meds need to be tweeked.
Jane
In loving memory of my special KiKi Bean
Seizure free forever now
Nov 25th 2002 - Nov 1st 2006
Dogue De Bordeaux

hebutt
Posts: 7
Joined: Wed Jun 09, 2004 10:57 am
Location: Windsor, Ontario

Post by hebutt » Thu Nov 08, 2007 12:52 pm

Last time we had her tested -the vet felt her Potassium levels were at the highest -he did not want to increase her further.
We have an appointment tonight -I assume we wil be doing more test. {However the expense of all of this is really stressing my husband out so much that last night he said he was not sure how much longer he could do this for!!}
Hopefully he will be more accepting of my idea to try her on both [and to get some valliuim to have on hand should we need it -he previously did not like this idea either -Which I find so frustrating as he say he had an epileptic dalmation!!]

MK's mom
Posts: 1708
Joined: Wed Mar 01, 2006 9:48 am
Location: Michigan

Post by MK's mom » Thu Nov 08, 2007 1:47 pm

Hmmm... I have to agree with Skrpio, you need to find another vet. Pb and KBr (potassium bromide) combination is very common in dogs. The use of valium to calm the dog or break a cluster is also very common.

Do you purchase your KBr from the vet? My vet wants an arm and a leg for it ($81 for 480 ml/250 solution). I get mine from PA at a discount pharmacy for $33.

Vivian
Nathan
3.5 yo Irish Setter boy
First seizure 7/26/2013
Last seizure 3/24/2014
__________________________________
MK
5 yo Irish Setter boy
First seizure 1/25/06
Last seizure 9/4/2009

Aug 17, 2004- Sept. 22, 2009
May the shamrocks fall softly sweetpea

hebutt
Posts: 7
Joined: Wed Jun 09, 2004 10:57 am
Location: Windsor, Ontario

Post by hebutt » Thu Nov 08, 2007 1:56 pm

Yes I get the meds from the vet -did not know I had another option!
Do you just get the vet to write a perscription (like your GP would do for you) so that you can take it to the pharmacy?

MK's mom
Posts: 1708
Joined: Wed Mar 01, 2006 9:48 am
Location: Michigan

Post by MK's mom » Thu Nov 08, 2007 2:00 pm

the pharmacy is in Pennsylvania, so you'd have to have your vet fax the Rx in order for them to fill it.

On the Epilepsy Guardian Angels website, there's quite a few discount pharmacies. I see you're in Windsor, just across the river from me. I live north of Detroit and I've found that the Lundberg Pharmacy in Emporia, PA offers me the cheapest KBr.

Vivian
Nathan
3.5 yo Irish Setter boy
First seizure 7/26/2013
Last seizure 3/24/2014
__________________________________
MK
5 yo Irish Setter boy
First seizure 1/25/06
Last seizure 9/4/2009

Aug 17, 2004- Sept. 22, 2009
May the shamrocks fall softly sweetpea

hebutt
Posts: 7
Joined: Wed Jun 09, 2004 10:57 am
Location: Windsor, Ontario

Post by hebutt » Thu Nov 08, 2007 2:23 pm

Thanks for your response. Perhaps living this close to the border could be a benefit in regards to getting meds for my baby girl!

Dylans Dad
Posts: 490
Joined: Sun Oct 08, 2006 5:12 am
Location: SE Iowa
Contact:

Post by Dylans Dad » Thu Nov 08, 2007 2:31 pm

Dylan is on them both
the pb I get from the vet, really cheap, 15$ for 2 months worth
the kbr I get from a compounding pharmacy, about $40 a month.
he and my vet work together on other animals meds, so they just call each other to update the RX
Wags & Slurps
Debby & Dylan
6 yr old Border collie
1st aug 7 2006
last 7-18-08
375 MG kbr twice a day
1 47.5 pb twice a day

High_Voltage_Head
Posts: 193
Joined: Thu Jan 25, 2007 10:00 pm
Location: Minnesota

Post by High_Voltage_Head » Fri Nov 09, 2007 12:18 am

Maybe new vet and new husband too. Sorry, bad joke. Strange how Magic's seizures were well-controlled for years and now have gotten much worse. Or maybe that happens more than i'm aware of. If KBr is maxed out then there aren't many options besides adding Pb it seems to me.
Me: Kurt
Dog: Jackson the 6 y.o. Standard Poodle 55lbs
died March '08

MK's mom
Posts: 1708
Joined: Wed Mar 01, 2006 9:48 am
Location: Michigan

Post by MK's mom » Fri Nov 09, 2007 7:21 am

Just a thought, did you increase the amount of food you're giving your dog or perhaps change the brand? I didn't know until this year that increasing food also increases the sodium intake therefor affecting the KBr levels.

My dog hasnt' done as well as yours has, but he goes several months seizure free then starts seizing again. I wish the docs knew why, I guess it's just the breakthrus that plague our pups.

Vivian
Nathan
3.5 yo Irish Setter boy
First seizure 7/26/2013
Last seizure 3/24/2014
__________________________________
MK
5 yo Irish Setter boy
First seizure 1/25/06
Last seizure 9/4/2009

Aug 17, 2004- Sept. 22, 2009
May the shamrocks fall softly sweetpea

hebutt
Posts: 7
Joined: Wed Jun 09, 2004 10:57 am
Location: Windsor, Ontario

Vet visit for Magic

Post by hebutt » Fri Nov 09, 2007 7:58 am

Last night we went in to see the vet . . . it was actually his partner that does the day time shift rather than our usual guy -so a fresh take on the situation!!
Does agree we can't increase the Kbr. But did not that her kidney enzymes were pretty much back to normal (the high levels is why they took her of the Pb) So we could potentially put her back on the Pb. He also is game for getting us some Valium (for Magic not us -although sometimes I wonder!) He is going to do some research for us -I really liked that he said this and did not just pretend that he knew everything and was playing GOD! So we at least feel calmer about the situation and the potential for a good resolution.
Of course the one thing he did say that we already knew was that she was about 15 lbs overweight . . . and perhaps this is effecting her metabolizing of the Kbr. We will have to be more vigilant with this!!
As for changes in food, pattern etc that could have triggered this set of seizures (and we will pray that there is not another today!!) the only thing besides the weather is that we had my little niece and nephew over for the day on Sunday. But visitors have not been triggers in the past. But as we all know nothing is certain or constant in this struggle our fur children go through!!
Thanks for everyones responses. It always makes me feel better to know I am not alone. I will let you know what the vet's research comes up with when I see him on Monday!

MK's mom
Posts: 1708
Joined: Wed Mar 01, 2006 9:48 am
Location: Michigan

Post by MK's mom » Fri Nov 09, 2007 8:19 am

Hey!! Stick with the new guy, he sounds more willing to accept ideas and/or look for different solutions. When dealing with primary vets who have to treat everything under the sun, you may end up knowing more about epilepsy than they do. If you've found a guy who is open to suggestions rather than being the 'know-it-all' guy, I think you'll be better off. He also sounds like he WANTS to learn more about epilepsy by doing research on the subject.

Vivian
Nathan
3.5 yo Irish Setter boy
First seizure 7/26/2013
Last seizure 3/24/2014
__________________________________
MK
5 yo Irish Setter boy
First seizure 1/25/06
Last seizure 9/4/2009

Aug 17, 2004- Sept. 22, 2009
May the shamrocks fall softly sweetpea

hebutt
Posts: 7
Joined: Wed Jun 09, 2004 10:57 am
Location: Windsor, Ontario

Update -finally the vet got back to us!

Post by hebutt » Fri Nov 16, 2007 2:28 pm

He has givne us 50mg tablets of Vallium to be used:
1: After a seizure
2: If we think she may be going to have a seizure
3: if she is over excited or nervous ie: with company or going on a trip

The dose is 1-2 tablets.
I really don't think that we will use them in any case other than #1. Especially since, for us, we really can't determine if she is going to have a seizure -after she has one then we go "Oh that's why she was being such a suck" but then again she is a suck sometimes and she doesn't have a seizure.
So I guess this is more a maintenance treatment rather than preventative. He is still reluctant to do the Pb & Kbr. But we will see how this goes for a while.

High_Voltage_Head
Posts: 193
Joined: Thu Jan 25, 2007 10:00 pm
Location: Minnesota

Post by High_Voltage_Head » Fri Nov 16, 2007 9:33 pm

Are you sure those pills are 50mg? Something fishy about this. How are the seizures coming along now? This is a case where i think adding Pb makes sense....i don't understand his hesitation unless he's worried about a visit from a narcotics agent. And really, prescribing Valium for when the dog gets excited sounds a little questionable too. Oh, i dunno, what do i know about anything.
Me: Kurt
Dog: Jackson the 6 y.o. Standard Poodle 55lbs
died March '08

skrpio
Posts: 1143
Joined: Sun Sep 25, 2005 5:34 pm
Location: Auckland , New Zealand

Post by skrpio » Fri Nov 16, 2007 10:07 pm

Hebutt - change your vet. He seems to have strange ideas on the drugs. If he is ready to give vallium before controlling the seizures with PB - very strange.
PB gives quicker theraputic levels but only stays in the body 12 hours while KBr gives a longer time between needing to give a dose - not sure what it is called. ie KBr will take several days to leave the body.
If he cannot adjust the level of KBr he needs to add PB.
Jane
In loving memory of my special KiKi Bean
Seizure free forever now
Nov 25th 2002 - Nov 1st 2006
Dogue De Bordeaux

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