Side effects of potassium bromide?

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.

Moderator: Box40Rin

Post Reply
Raven's mom
Posts: 27
Joined: Mon Apr 11, 2011 12:14 pm

Side effects of potassium bromide?

Post by Raven's mom » Thu Feb 16, 2012 2:54 pm

Hi all,

Raven had four seizure events in December, including two cluster seizures. We started him on potassium bromide at the end of the month on top of the phenobarbital, which had leveled out at 25 mg/ml in his blood (the highest I'm willing to go to protect his liver, and which has had little impact if any on his seizures).

He is now enjoying his longest seizure-free period since his epilepsy began. However, we're struggling with some behavior issues that I'm inclined to think are the result of the potassium bromide, but I'd like to hear what other people have noticed.

Raven's appetite and thirst have skyrocketed (making walks more difficult, as he is even better at finding dead deer and other "snacks"). As a result, he can no longer make it through a 9-hour night without going out to pee, even if we pick up his water bowl earlier in the evening. I guess we're going to have to live with this (a dog door where we live is out of the question).

However, even after going out, he is very restless and gets up and paces several times a night between 2 am and 5:30 (when we typically get up). Toenails on floorboards used to mean incipient seizures because he otherwise never got up, so I rarely sleep through this.

I have also found him much less responsive to known commands and generally more hyperactive and difficult to focus. I don't think this is just because I'm now chronically sleep-deprived!

I'm hoping that maybe at the end of the 3 month stabilization period, when the potassium bromide is stable in his bloodstream, that the behavioral changes will moderate and disappear as the initial phenobarbital side effects did...

Anyone else notice things like this? It has reached a point I almost think I'd rather deal with an occasional seizure if it meant I could have my old dog back...

Almost.

Jen and Raven
3.5 year old Aussie

seebr5640
Posts: 222
Joined: Mon Dec 27, 2010 10:34 am

Re: Side effects of potassium bromide?

Post by seebr5640 » Sat Feb 18, 2012 2:08 pm

Jen & Raven,

Sampson is on KBr and he had extra thirst, extra hunger and a little bit of aggression. After being put on KBr, he started jumping up on me when I would take him outside. Outside the jumping up and the barking would go on forever. When I mentioned this to the vet, she said, "He's a sheltie, he is trying to tell you something." Well luckily it eased up quite a bit. He doesn’t do it as much anymore. Also, the extra thirst and hunger seems to have decreased too. It seems that it probably took quite a few more before it started getting better.

Here is a link regarding Kbr side effects and I also copy/pasted it as well.

http://www.vspn.org/VSPNSearch/VINLibrary/lv980606.htm

What side effects of bromide are most common and how should they be managed?
Lethargy, sedation, ataxia, and hind limb weakness are quite common with bromide and Phenobarbital in combination. These side effects are dose-dependent and usually respond within several days to a 10-25% reduction in the dose of Phenobarbital. Although a reduction instead in the dose of bromide can also be considered, the goal in most patients is to reach therapeutic serum bromide concentrations and to reduce the dose of Phenobarbital over time, so that a dose reduction in Phenobarbital is preferred. If lethargy and sedation do not respond within 5 to 7 days to a reduction in the dose of Phenobarbital, serum bromide levels should be evaluated. Other side effects of bromide with or without Phenobarbital include polyuria, polydipsia, polyphagia with weight gain, and behavior changes. These side effects are a nuisance but are rarely significant enough to require drug discontinuation.

Hang in there! The side effects will ease up. :)

Barb & epi-Sampson (39 lb Sheltie)
Pb 64.8 BID
KBr 1.2 ml of 250 mg BID
Zonisamide 300 mg BID
Keppra (generic) 250 mg TID
Denamarin QD
Taurine 500 mg BID
Wellness Core Reduced Fat TID

“They too, are created by the same loving hand of God which Created us...It is our duty to Protect Them and to promote their well-being.”—Mother Teresa

Raven's mom
Posts: 27
Joined: Mon Apr 11, 2011 12:14 pm

Re: Side effects of potassium bromide?

Post by Raven's mom » Thu Mar 22, 2012 2:28 pm

I thought I should post an update. The side effects (incoordination, excess thirst and hunger, inability to focus, pacing behavior, inability to make it through the night without a potty break) began to subside about 2 weeks ago and now are nearly gone. We are continuing to drop the phenobarbital (now at 129.6 mg per day, along with the 750 mg potassium bromide for our 23 kg dog). We'll do the blood testing to determine levels of the potassium bromide (for the first time) and the latest levels for phenobarbital in a month. In the meantime, it is SO NICE to have our old dog back!

Jen and Raven
3.75 year old Aussie

seebr5640
Posts: 222
Joined: Mon Dec 27, 2010 10:34 am

Re: Side effects of potassium bromide?

Post by seebr5640 » Thu Mar 22, 2012 4:00 pm

Jen & Raven,

Good to hear that! :)

We hope all stays well......

Barb & Sampson

Danyelle
Posts: 1
Joined: Wed May 09, 2012 7:51 am

Re: Side effects of potassium bromide?

Post by Danyelle » Wed May 09, 2012 8:10 am

I was glad to see Jen's post because this is exactly what we are going through with our 3 year old GSP, Wyatt, who was put on 3.5 ml Potassium bromide a few months ago. His blood level after 5-6 weeks showed his level was low and increased it to 4 ml and we basically haven't slept or been able to take our eyes off him since. He is restless anxious, very clumsy, doesn't follow commands, gets into things, eats off the counter and is up between 2-4 a.m. every morning pacing and whining. He has another blood level done this week and we are awaiting the results now. He has not had a seizure since February, but winter has always been a better time for him. He is unhappy and we are unhappy, and there is no way he will be able to hunt this fall with the muscle weakness he has now, or he will likely hurt himself running in the woods. We are wondering if decreasing the dose may help or stopping the medication (with the help of the vet) and dealing with the monthly seizures he was experiencing.

We have had 6-7 weeks of adjustment on this dose with no improvement in side effects (and no sleep!). It is helpful to read other people's experiences and try to gain knowledge and ideas. Thanks!

Danyelle
Wyatt- GSP- 3 years old, seizures for approx 1 1/2 years, started meds at the beginning of Feb. 2012

Carolyn
Posts: 440
Joined: Thu Feb 16, 2006 12:08 pm
Location: Long Island, NY

Re: Side effects of potassium bromide?

Post by Carolyn » Wed May 09, 2012 8:57 am

Hi Danyelle,
I'm not sure of your dosage, but Kiya was put on 1200mg of liquid kbr over 6 years ago. It took several months for her to adjust. I actually just reduced the dosage, her last test levels were high. She developed the hind paw drag early on and that has never gone away. The ataxia did get better and she was/is able to go out on hikes and I used to take her out with my bicycle. She's going to be 8 next week so the bike is a bit too much for her now.
I would give your dog more time to adjust.
Carolyn
Kiya 11yr Shiloh Shepherd
PB 60mg am 90mg pm, 1teas kbr 1200mg, turmeric paste
1000mg milkthistle bid
First seizure 11/27/05
Last seizure 5/21/15

seebr5640
Posts: 222
Joined: Mon Dec 27, 2010 10:34 am

Re: Side effects of potassium bromide?

Post by seebr5640 » Mon Aug 17, 2015 5:04 pm

Hi David,

I think what Jen was referring to, is the fact the potassium bromide and phenobarbital can make our dogs act like they are hungry, when they aren't. They act like they are starving all the time. It makes them want to eat everything in site. And by doing so, they tend to find even things they shouldn't eat, like dead deer and other "snacks". :)

And when you are walking them, it is more difficult, because they are smelling everything and looking for something to eat.

Jen can correct me if I'm wrong....

Barb & epi Sampson

jaxey16
Posts: 1
Joined: Sun Oct 16, 2016 7:49 pm

Re: Side effects of potassium bromide?

Post by jaxey16 » Sun Oct 16, 2016 10:19 pm

Hi everyone,
It is nice to know that my dog is not alone. I have an 8-year old Australian Shepherd named Kylee who has been on Phenobarbital for 3 years now. She started having a seizure once a week and her Pheno level was getting too high, so two weeks ago the vet decided to add Potassium Bromide and lower her Pheno dose. Last week I noticed Kylee had seemed very "out of it." She seemed very clumsy and blind, bumping into walls and tables and she would constantly walk around the house, back and forth. When she isn't walking back and forth, she is sleeping. However, when she is sleeping she looks so still and I could barely see her chest move up and down. She is a totally different dog! All of this has started giving me anxiety but after reading all of your posts it gives me hope for my Kylee. I hope the side effects start to fade and I get my happy girl back.

Does anyone have any extra advice?

Thank you all,
Jacki & Kylee

truckerspeed
Posts: 3
Joined: Tue Oct 08, 2013 11:22 pm

Re: Side effects of potassium bromide?

Post by truckerspeed » Tue Jan 03, 2017 3:11 am

jaxey16 wrote:Hi everyone,
It is nice to know that my dog is not alone. I have an 8-year old Australian Shepherd named Kylee who has been on Phenobarbital for 3 years now. She started having a seizure once a week and her Pheno level was getting too high, so two weeks ago the vet decided to add Potassium Bromide and lower her Pheno dose. Last week I noticed Kylee had seemed very "out of it." She seemed very clumsy and blind, bumping into walls and tables and she would constantly walk around the house, back and forth. When she isn't walking back and forth, she is sleeping. However, when she is sleeping she looks so still and I could barely see her chest move up and down. She is a totally different dog!
Does anyone have any extra advice?

Thank you all,
Jacki & Kylee
My dog (Gwen) has been on KBR for three years without really any side effects. The only one being she isn't house broken anymore. She's inheritantly deaf, and has always been kind of a basket case though anxiety wise, so maybe she's not the best case study lol. But what I thought was important to add though was that she was initially on pheno, and she definitely showed some of side effects you mentioned during that period (clumsiness, excessive hunger, destructive chewing) but that all stopped when we moved her to KBR. So it could be the pheno causing some of that just as much as it could be the kbr

bigfork64
Posts: 2
Joined: Fri Dec 30, 2016 7:07 pm

Re: Side effects of potassium bromide?

Post by bigfork64 » Wed Jan 18, 2017 1:37 pm

jaxey16 wrote:Hi everyone,
It is nice to know that my dog is not alone. I have an 8-year old Australian Shepherd named Kylee who has been on Phenobarbital for 3 years now. She started having a seizure once a week and her Pheno level was getting too high, so two weeks ago the vet decided to add Potassium Bromide and lower her Pheno dose. Last week I noticed Kylee had seemed very "out of it." She seemed very clumsy and blind, bumping into walls and tables and she would constantly walk around the house, back and forth. When she isn't walking back and forth, she is sleeping. However, when she is sleeping she looks so still and I could barely see her chest move up and down. She is a totally different dog! All of this has started giving me anxiety but after reading all of your posts it gives me hope for my Kylee. I hope the side effects start to fade and I get my happy girl back.

Does anyone have any extra advice?

Thank you all,
Jacki & Kylee
Our Australian Shepherd Gyp began having seizures last summer at age 7. After the 3rd seizure the vet put her on phenobarbital. Within two weeks she was very sick and a blood test revealed very high liver enzymes. She simply couldn't take the phenobarbital. We switched to 500 mg of potassium bromide (KBr) and went five months with no seizures and were beginning to hope the problem was over. Unfortunately in November she had three more seizures and the vet doubled her dose to 500 mg KBr twice a day. Within three weeks Gyp exhibited the exactly same symptoms you describe: weak, pacing, walking into corners and standing there. On Christmas Eve she could not get up and we rushed her to the emergency vet who diagnosed bromide toxicity. We have gone back to 500 mg of KBr and added 500 mg of generic Keppra twice a day. Within four or five days she was pretty much back to herself. She went five weeks without another seizure (Dec. 5 -Jan. 13) then had back to back seizures on January 13th and 14th which we were able to control with anal injections of Midazolam. We see the vet tomorrow to discuss where to go from here. Very best wishes to all who are dealing with this terrible disease.

Post Reply