You did the right thing by giving Pal a higher dose to stop the seizure activity and prevent further seizure episodes short term. Long term changes to the dose should be made based on the measurement of the phenobarbital level in Pal's blood so that toxicity could be avoided. At 97.2mg twice daily, Pal's phenobarbital level may be too low allowing for these "break-through" seizures, so it should be measured if it hasn't been recently to ensure that it's in the right range. If it's not too high now, then the dose could be increased safely. The reason it's important to check is because some dogs taking the "normal" dose of phenobarbital don't metabolize it efficiently resulting in higher blood levels and toxic
effects, each dog is different.
Another reason Pal may have had the break through seizures could be that he has some identifiable cause for seizures (versus epilepsy
, which is just seizures without a known cause), such as a brain
tumor or some other condition. I would first check his blood levels, prior to continuing the higher dose and then adjust the dose if needed, then if the seizures are still happening, investigate further. For now, go back to the lower dose and get him an appointment within the next few days. If seizures continue, please call your vet for more specific advice.
Hope this helps! Please let me know if you have any other questions or need clarification on the above information. Best of luck!