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Dr. Gary
Dr. Gary, Dog Veterinarian
Category: Dog Veterinary
Satisfied Customers: 19579
Experience:  DVM, Emergency Veterinarian, BS (Physiology)
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My dog takes 64.8 mg of phenobarbital twice daily plus the

Customer Question

My dog takes 64.8 mg of phenobarbital twice daily plus the time release version of keppra. Her dose was just raised to 1500 mg twice daily from a month at 750mg twice daily. She is still having a seizure very 10-14 days, and cannot control hr bladder. What can I do, and how much damage is this causing?
Submitted: 1 year ago.
Category: Dog Veterinary
Expert:  Dr. Gary replied 1 year ago.

Hello. Thanks for the question.

I think part of the issue here is the timing of the meds. Keppra is a medication that has to be given every 8 hours. If you're off more than 30-40 minutes, you won't get good control. If you're giving it every 12 hours, it's really not going to be effective. If you're unable to give a medication every 8 hours, then you can't use Keppra. In that case, you should use Zonisamide. Zonisamide can be given every 12 hours and be effective.

I would also make sure you have Phenobarb blood levels run. If they are < 20, then the dose should be increased before adding a second line drug. If we're in the mid 20's or up around 30, then we add Zonisamide at twice daily or Keppra at 3 times daily. You may want to consult with a neurologist to get this better controlled.

I wouldn't worry about the other organs. Just monitor blood levels every 6 months to make sure they are ok. The more important issue is getting the seizure numbers down to < 6-8 per year.

I hope this helps, let me know if you have any other questions.

Customer: replied 1 year ago.
Thanks. That was helpful
Expert:  Dr. Gary replied 1 year ago.

You're welcome.

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