I think Keppra is ruining our lives

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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Anastasia
Posts: 43
Joined: Wed Jul 09, 2008 6:30 pm
Location: Carbondale, Illinois

Post by Anastasia » Wed Aug 12, 2009 12:33 pm

Susan, thanks for the info on having the levetiracetam tested according to human standards. I had no idea this could be done, and I'm fairly sure our neuro did not either. I'll schedule that test when his thyroid panel/KBR results come back. Was it expensive? The Zonisamide levels ran me about $130 at a veterinary teaching hospital. Now that you mention the hypermetabolization of the Keppra I'm wondering if Dawson might be experiencing the same issue.

What really infuriates and disgusts me is that Dawson is having these focals every 10-15 minutes in 2-3 hour blocks of time throughout the day and it might have been avoided had someone (okay, I guess I'm included) been paying attention to these drug interactions/levels. If he were a person this type of seizure control would be totally unacceptable to a physician. As his human mom, this type of seizure control is totally unacceptable on two counts: 1) he's my boy and I couldn't do more for him if he were a human child, and 2) it makes for a miserable life for the both of us. While I'm not a doctor, I feel that I'm pretty informed. But shouldn't the professional have realized that after stopping the phenobarb cold turkey blood levels should have been run on all of the other meds within 1-2 months?

Vivian, it became apparent to me fairly quickly that our primary vet could not handle anything more complicated than grand mal seizures that could be controlled by phenobarb and/or KBr. As soon as Dawson started having focals I - and they - knew they were in over their heads. His neurological care/seizure management has been handled by a neurologist since July of 2008. I figured the neuro staff was probably quite competent; Dawson's primary neuro is a moderator of this forum....

(Sigh.)
Dawson (aka "Peanut") - Cavalier King Charles/chihuahua/terrier mix?
Adopted at 5 mos old, now 3.5 y/o
1st seizure at 10 mos old, 12/30/07
KBr: (1ml) 300 mg, SID
Zonisamide: 150 mg, BID
Keppra: 3 ml, TID
Thyroxine: 0.15 mg BID

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

Post by MK's mom » Wed Aug 12, 2009 12:48 pm

The levetiracetam levels test cost me about $120, not cheap.

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

claires friend
Posts: 194
Joined: Fri Sep 21, 2007 2:49 pm
Location: California

Post by claires friend » Wed Aug 12, 2009 1:43 pm

I believe Dr. Dodds at Hemopet can do Keppra levels.
Susan Marie
Morgan -Foster Golden, now ours FOREVER !!
First seizure Aug 16, 2006 @9 months old ,very low thyroid
She has been with me since the end of July 07
150mg PB BID
.5 soloxine BID
400 Kbr BID

Anastasia
Posts: 43
Joined: Wed Jul 09, 2008 6:30 pm
Location: Carbondale, Illinois

Post by Anastasia » Wed Aug 12, 2009 5:31 pm

Thank you both for the info on the cost of the Keppra test and having it done through Hemopet. I'll email Dr. Dodds. Maybe she'll have some suggestions for us.

Thanks, also, for your encouragement. It's what keeps Dawson and I going when the situation feels hopeless.

Anastasia
Dawson (aka "Peanut") - Cavalier King Charles/chihuahua/terrier mix?
Adopted at 5 mos old, now 3.5 y/o
1st seizure at 10 mos old, 12/30/07
KBr: (1ml) 300 mg, SID
Zonisamide: 150 mg, BID
Keppra: 3 ml, TID
Thyroxine: 0.15 mg BID

claires friend
Posts: 194
Joined: Fri Sep 21, 2007 2:49 pm
Location: California

Post by claires friend » Wed Aug 12, 2009 6:12 pm

Well I kind of feel like he is Morgan's "Cyber-twin" or something!!!
Susan Marie
Morgan -Foster Golden, now ours FOREVER !!
First seizure Aug 16, 2006 @9 months old ,very low thyroid
She has been with me since the end of July 07
150mg PB BID
.5 soloxine BID
400 Kbr BID

Anastasia
Posts: 43
Joined: Wed Jul 09, 2008 6:30 pm
Location: Carbondale, Illinois

Post by Anastasia » Thu Aug 13, 2009 7:29 am

Susan, if you and Morgan are going/have gone through what Dawson and I are going through then I'm so sorry Morgan ended up as Dawson's cyber-twin! I meant to ask earlier, do you think Morgan's hypothyroidism is contributing to the seizures?

The past few nights I've given Dawson his 3 ml Keppra dose at 8:30, he's had a focal 15-20 minutes later, and I give him 1/2 chlorazepate around 9 pm. He has been okay until 2:00 am or so, when he has a couple of focals and I give him another 1/2 chlorazepate so he can sleep until we get up in the morning. Last night I gave him 2.5 ml instead of 3 ml to see what would happen. He didn't have a focal within 15-20 minutes after the dose so I didn't give him chlorazepate. However, he woke up at 11:45 pm had a few focals, and over the course of an hour I ended up giving him one whole chlorazepate tablet. He was fine until morning, got all 3 of his meds at 6 am, and had his first focal of the day 10 minutes ago. I think I may give him 2.5 ml at each dose for the next few days and see what happens. I'm hoping it doesn't get any worse.

Was it you, Susan, or Vivian, that weaned your pup off of the Keppra? I remember one of you stopped it cold turkey without any side effects. I just wondered what I might expect if I start weaning him off. I'm sure it will be specific to Dawson, as it seems impossible to generalize anything when it comes to this horrible monster.

Are your respective neurologists affiliated with a teaching hospital or are they in private practice?

I know Dr. Dodds is perhaps a thyroid specialist, but I may email her to get her general opinion on Dawson. Maybe she will have a different perspective.
Dawson (aka "Peanut") - Cavalier King Charles/chihuahua/terrier mix?
Adopted at 5 mos old, now 3.5 y/o
1st seizure at 10 mos old, 12/30/07
KBr: (1ml) 300 mg, SID
Zonisamide: 150 mg, BID
Keppra: 3 ml, TID
Thyroxine: 0.15 mg BID

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

Post by MK's mom » Thu Aug 13, 2009 9:27 am

I weaned MK off of the levetiracetam, it isn't worth taking the chance that stopping cold turkey might plunge them into status.

My neurologist is not affiliated with a University.

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

claires friend
Posts: 194
Joined: Fri Sep 21, 2007 2:49 pm
Location: California

Post by claires friend » Thu Aug 13, 2009 1:55 pm

My Neuro is in private practice too. But I have had all of Morgan's records reviewed at UC Davis. I stopped Keppra cold turkey but she had only been on for 3 weeks. Started her right back up on Zonisamide, so that might have made a difference. You couldn't pay me enough to ever give her Keppra again.
Susan Marie
Morgan -Foster Golden, now ours FOREVER !!
First seizure Aug 16, 2006 @9 months old ,very low thyroid
She has been with me since the end of July 07
150mg PB BID
.5 soloxine BID
400 Kbr BID

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

Post by MK's mom » Thu Aug 13, 2009 2:01 pm

I'm with you Susan, especially with what the drug costs to do nothing! It IS a decent cluster buster though

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

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

Post by skrpio » Thu Aug 13, 2009 2:40 pm

If Morgan is hypothyroid are you giving him treatment for this?
If you are remember any meds for this increases their metabolism and the anti-seizure meds will have to be upped for a while until the thyroid treatment is complete. Check with Jean Dodds on this one.
Jane
In loving memory of my special KiKi Bean
Seizure free forever now
Nov 25th 2002 - Nov 1st 2006
Dogue De Bordeaux

Anastasia
Posts: 43
Joined: Wed Jul 09, 2008 6:30 pm
Location: Carbondale, Illinois

Post by Anastasia » Thu Aug 13, 2009 2:41 pm

I've already started to cut back by 1/2 ml on the Keppra. I'll try to decrease it by 1/2 ml every 1-2 weeks and see if it makes a difference. Of course he still had a focal 15 minutes after the dose, but so far the focals have been fewer and have seemed relatively mild compared to the last several days.

I will be interested in how Dawson's current situation will be handled when his thyroid levels come back and/or I can actually speak with someone other than a student, i.e. a board certified neurologist.

Have either of you tried the NuVets Plus supplement? I wondered if anyone has noticed that it helps reduce the seizure frequency/severity in addition to providing additional nutrition.
Dawson (aka "Peanut") - Cavalier King Charles/chihuahua/terrier mix?
Adopted at 5 mos old, now 3.5 y/o
1st seizure at 10 mos old, 12/30/07
KBr: (1ml) 300 mg, SID
Zonisamide: 150 mg, BID
Keppra: 3 ml, TID
Thyroxine: 0.15 mg BID

claires friend
Posts: 194
Joined: Fri Sep 21, 2007 2:49 pm
Location: California

Post by claires friend » Thu Aug 13, 2009 4:56 pm

NuVets promised that it would stop Morgan's seizures, should have known from that statement alone. It did nothing. I think it is probably an OK supplement but certain not going to stopped seizures!
Susan Marie
Morgan -Foster Golden, now ours FOREVER !!
First seizure Aug 16, 2006 @9 months old ,very low thyroid
She has been with me since the end of July 07
150mg PB BID
.5 soloxine BID
400 Kbr BID

claires friend
Posts: 194
Joined: Fri Sep 21, 2007 2:49 pm
Location: California

Post by claires friend » Thu Aug 13, 2009 5:02 pm

Morgan is on thyroid meds and will be for the rest of her life. She is at a very high dose for a dog her weight, apparently Pheno"eats" thyroid meds and you have to give more. Then because we have to give such a high dose of thyroid meds, we have to give more Pheno to compensate for that. I don't think the thyroid meds help with Morgan's seizures, but I do know they make the rest of her body healthier. BTW she did have a Grand Mal late last night. First one in a couple months, our 2nd longest streak. I am trying not to be too bummed about it. Just did a meds change the first of the month, so I am really hoping not to have to do another.
Susan Marie
Morgan -Foster Golden, now ours FOREVER !!
First seizure Aug 16, 2006 @9 months old ,very low thyroid
She has been with me since the end of July 07
150mg PB BID
.5 soloxine BID
400 Kbr BID

Anastasia
Posts: 43
Joined: Wed Jul 09, 2008 6:30 pm
Location: Carbondale, Illinois

Post by Anastasia » Fri Aug 14, 2009 9:54 am

I'm so sorry to hear that Morgan had a grand mal the other night, especially after going such a long time (and believe me, 2 months seizure free seems like a miracle after these last 2 years with Dawson) without one. Poor baby! Although I know you're trying not to get too down about it, it's okay if you do, just try to make it brief. It's impossible to be up all the time. You can only compartmentalize this stuff for so long before it gets the better of you. I hope this is just one of those "things" that passes and she has no seizures for at least another 2 months!

We had a pretty bad night last night: 3 hours of focals, he fell off the bed once, and the chlorazepate took forever to kick in. It felt like he had tremors all night long, but maybe that was just my nerve-wracked body I felt trembling.

If I see no improvement, even slight, while weaning him off of the Keppra, what does this mean? Could he need MORE of the Keppra, or is it just useless at ANY dose?
Dawson (aka "Peanut") - Cavalier King Charles/chihuahua/terrier mix?
Adopted at 5 mos old, now 3.5 y/o
1st seizure at 10 mos old, 12/30/07
KBr: (1ml) 300 mg, SID
Zonisamide: 150 mg, BID
Keppra: 3 ml, TID
Thyroxine: 0.15 mg BID

claires friend
Posts: 194
Joined: Fri Sep 21, 2007 2:49 pm
Location: California

Post by claires friend » Fri Aug 14, 2009 10:22 am

Didn't mean to imply Morgan hasn't had any seizures. She is still having 1-3 partials a day. It's the big ones that scare me so bad, always wondering if this is the ONE she won't come out of. A good friends just lost her boy Wednesday morning. He was 15 and a brain tumor for 2 years. He had been seizure free for 6 months until a big one took him Wednesday. I am trying to remember, Morgan's seizures didn't stop when I took he off the Keppra, but the physicalness and intensity went way, way down. Also they were back to 2-5 minutes instead of an hour.
Susan Marie
Morgan -Foster Golden, now ours FOREVER !!
First seizure Aug 16, 2006 @9 months old ,very low thyroid
She has been with me since the end of July 07
150mg PB BID
.5 soloxine BID
400 Kbr BID

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