Added 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
bethad5
Posts: 14
Joined: Fri Jul 08, 2016 4:49 pm
Location: Des Moines, IA

Added potassium bromide...

Post by bethad5 » Wed Mar 29, 2017 2:32 pm

Hi all,

After a 7 month seizure free streak with the addition of zonisamide back in August, my 4 year old lab/akita mix, Archer, had 5 seizures within 6 hours in the early morning of March 6. His med regime at that time was 1000mg keppra 3x/day; 150mg zonisamide 2x/day; 500mg GABA per day; 500mg taurine per day; and a supplement called cholodin. Archer is about 65 pounds.

Last Saturday, the 25, I got home and there was a large wet spot in Archer's kennel. It was cold and not warm, and didn't really smell, so I didn't think too much of it. That night around 7:00pm Archer had a seizure that lasted 9 minutes. He has never, ever, had a seizure last that long. It wasn't full out grand mal for the entire time, but it was definitely nonstop seizure. So I loaded him up and took him to the ER Vet. They wanted to keep him overnight for monitoring. They gave him IV keppra, and started him on potassium bromide. He received a "Loading dose" of 1500mg every 6 hours for 8 doses, or 48 hours. Then, starting yesterday, his regular dose is 1000mg per day. They told me to expect side effects - ataxia, increased thirst and urination, etc. - and that I'll need labs drawn in 2 weeks, a month, and six months to monitor the bromide levels.

Archer was out of it Sunday night when we got home, but, knock on wood, has been totally normal since. He isn't ataxic, he isn't really eating or drinking much more than normal, etc. Is this just because the med hasn't fully hit him yet? They told me to expect side effects for 2-3 weeks.

They mentioned referring us to a vet neurologist, but the nearest is approximately 3 hours away. Unsure if I want to do a MRI, but do think it'd be nice to talk to a neurologist about medications.

What has been your experience with potassium bromide? Does it help with your dog's seizure control? Is being on keppra, zonisamide, AND potassium bromide overkill?

Archer can't tolerate phenobarbital so that isn't an option. The ER vet made it sound like potassium bromide is usually a neurologist's first or second line of defense, so I'm not sure why I haven't been told about this until now.
Archer, Lab/Akita mix

First seizure: July 6, 2015
Last seizure: March 25, 2017

Current meds:
Potassium Bromide 1000mg 1x/day (started 3/28/17)
Keppra 1000mg 3x/day
Zonisamide 150mg 2x/day
Cholodin 1 tablet 2x/day
GABA 500mg 2x/day
Taurine 500mg 2x/day

SpencerBhumi
Posts: 219
Joined: Sat Feb 11, 2012 9:25 am
Location: South Australia

Re: Added potassium bromide...

Post by SpencerBhumi » Wed Mar 29, 2017 7:59 pm

Hi bethad5

We’ve been on KBrom for many years now…

Spencer is an English Springer Spaniel, nearly 11.5 years old, 21Kg. He had his first fit just after he turned 4. We watched him for the first four months then commenced phenobarb. After a year of not good control we added KBrom – a loading dose over a week. We upped his doses several times and seven months later re-loaded him (1400mg twice daily over 7 days, then backed it off to 700mg twice daily. A month later we did levels and dropped him down to a maintenance dose of 600mg twice daily).

We stayed on 600mg twice daily for another year whilst we trialed and failed both Keppra & Zonisamide. After which his KBrom levels were low so we upped him to 800mg twice daily (and by this stage the phenobarb was up to 300mg twice daily).

For the last four years we have been stable on KBrom 800mg & Pheno 300mg, both twice daily (plus milk thistle & Taurine). Spencer still has breakthrough fits from 2 to 5 weekly but we manage to keep these down to one or two seizures & minimal post ictal using a Valium & 3 day Keppra bolus.

Triggers? Anything!? Everything!?

For the big part Spencer is still active but this last year he has slowed down to sloth-like activity, sleeping most of the day & woeful hindleg drag, but for an hour or two of life before mealtimes. (During the last 12 months his mother and our two cats have died so when we are not home he is truly alone – I don’t know if depression is also adding to his 11 years). But he is still full of love and affection. And is driven by food! And can open his food bin. And can still steal food from the counter top!

I note you are giving a daily dose of KBrom. We do twice daily dosing with food, due to its high gut irritant nature, and we do this 12 hourly to fit in with the pheno requirements.

Overkill? We have tried them all but found no great benefit so we have backed off to an “acceptable” tolerance of seizure activity V affordable/practical regimen and in consideration to Spencer’s activity scale. It has been years of trial and trial again.
We have no clear triggers.
We get on with life – drives, beach walks, holidays and lap-time, and as necessary we reach for the fit-kit without fear (although with some dismay).

I hope you soon find some reasonable control over life with your epi-dog.

My thoughts and prayers go out for you and Archer.

Regards,
Trevor and Spencer
Grateful for the good days, weeks (months)

Post Reply