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Keppra ups & downs?

Posted: Thu Sep 21, 2017 2:35 am
by midousuji
hi everyone, i am brand new to this forum. thank you for all the information and tips youve already posted here, you have all already helped me immensely! i hope i can be of help to someone too.

i have an australian cattle dog, 4 or 5 years old, a rescue named hal. we adopted him knowing he had epilepsy after hearing his previous owners refused to medicate him. the shelter had him on phenobarbital which was very effective, i forget the dose now but when it was taken on time he was totally free of seizures. he was on it for about 8 months before we took him in for a routine liver panel and all his levels had spiked up into the danger zone. the vet recommended we add keppra and decrease his phenobarb dose asap.

now he is on 375 mg of keppra, every 8 hours, with no phenobarb. the vet felt that hal's levels and other symptoms he was presenting (various early signs of liver failure) warranted a total split from everything but the keppra. his levels are back to normal after a few months of this and a liver cleanse diet, but the keppra seems less effective at controlling his seizures?

he is having a seizure at strange, random times of the day, maybe one every week or if he's lucky he can make it two weeks. i think it's because of the size of the pill. they are big pills, ones that i would definitely be uncomfortable swallowing, and i'm twice his size! although he only takes half a pill every eight hours he has started despising the taste. we use pill pockets, which he used to scarf down without even chewing, but now he chews them up, spits them out, and eats around the keppra. More often than not he has been crunching up the pill as he eats it, which i know causes a foul taste and makes the medication less effective. i have had to shove the tiny crushed bits of keppra down his throat several times in the past month. i started cutting the half pills into quarters, which has made it easier for him to take, but it causes breakthrough seizures because leppra isn't made to be cut up in the first place.

my question is: does anybody else's dog have issue with the size of keppra pills, or chew pills that are not meant to be chewed? what can i do to encourage him to take his pill without mangling it, spitting it out, chewing it to dust, or chomping down on it and breaking it up in his mouth? is anyone else's dog solely on keppra and still having breakthrough seizures? hal seems to have only recently discovered that he hates the taste of the pill, so i'm hoping that if i can find a solution fast, he won't continue to think of pill time as something to dread, which i know is how he thinks of it now.

Re: Keppra ups & downs?

Posted: Fri Sep 22, 2017 10:43 am
by ShilohsMom
Hi there & welcome to the boards! First I have to commend you on taking on a dog that you know has seizures. It's one thing to deal with this monster when it rears it's head for the first time but another to take on a dog with it. Says something special about you.

I was fortunate that Shiloh would eat ANYTHING I put in front of him but I've had problems with other dogs not wanting to take meds and getting wise to my efforts. First I would suggest that whatever treats you use that that you give Hal treats without a pill in it. Rylie catches on if I only gave her the treat with a pill in it, then she wouldn't take it even if it didn't have a pill. Try switching it up too. Maybe one time use hamburger meat, then cheese (I used to keep cubed Velveeta in the fridge cause it was easy), cream cheese, hot dogs, anything soft really. Might be helpful to make a sandwich using peanut butter (no Hal doesn't get a whole sandwich :D ) But take however much bread you need, add a good dose of peanut butter with the pill in it, fold the pieces of bread over the peanut butter. This would work for Rylie because she was more inclined to eat it instead of lick the peanut butter off the pill. Another thing to try is if you can get Hal really excited about getting the treat where he'll inhale it instead of chewing. Hope something works for you, I know how frustrating it can be.

Re: Keppra ups & downs?

Posted: Fri Nov 10, 2017 10:35 pm
by midousuji
Hi Shilohsmom! It really wasn't even a choice- I could NOT leave him to grow old in a shelter for the rest of his life just because of his epilepsy. He is the sweetest and smartest dog I have ever met, and he is so well trained and well behaved. It really broke my heart to learn he had been adopted and returned to the shelter twice because of his seizures, mostly because those previous owners I mentioned did not want to medicate him properly/on time. He is just too great of a dog to even think about not having in my life, epilepsy or not!

This issue actually resolved itself. He was getting picky about eating the pills because of a MASSIVE hairball forming in his stomach. He threw it up a few weeks ago and has been eating great since then, perfectly back to normal, and he has been put on a diet that will help prevent future hairballs. The only problem is that the keppra still isn't doing a great job at controlling the seizures. His dose was upped to 500 mg 3 x per day, and he went two weeks seizure free (almost unheard of) before having one. Now he is back to going five days to a week with no seizure, then randomly having up to 3 in a day. They usually happen about an hour or two before his pill is scheduled.

He is starting potassium bromide tonight with his third pill of the day. He has had two seizures today about six hours apart and I'm not sure what's caused them. But now I am just wondering about the general effectiveness of keppra. Do some dogs just not respond to it well? Will I see an immediate improvement with the bromide? I know the bromide levels can take months to even out, but can it prevent any potential seizures that might be coming in the next 48 hours? I really just want him to be comfortable and not have to go through them so much.

Re: Keppra ups & downs?

Posted: Thu Nov 16, 2017 9:16 am
by ShilohsMom
That's interesting, never gave a thought to a dog getting a hair ball but it makes sense especially if they shed a lot. Glad to hear that issue has cleared up at least. Have to take our victories where we can.

Shiloh was one of those dogs that Keppra didn't seem to do much for (don't let that discourage you, Shiloh was that one dog that all the vets we went to didn't know what else to do for him). We tried both regular and XR Keppra and when that wasn't successful added Potassium Bromide. It can take a while for the Bromide to kick in and side effects can suck, I'm assuming your vet has started you on loading doses? Has the vet talked to you about rectal Diazepam to stop seizures?