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My small pomeranian mix has been on phenobarbital since

Customer Question
December. Over three weeks ago...
My small pomeranian mix has been on phenobarbital since December. Over three weeks ago she was diagnosed with IMHA and has not responded to the medications. Her vet is speculating her lack of response is due to the phenobarbital interfering with her IMHA meds. We started to taper her phenobarbital today and added keppra as a substitute. Since she is now taking the keppra, can we reduce her phenobarb at a faster rate without as great a risk of her seizures returning?
JA: I'm sorry to hear that. Seizures always look scary. Let's get you talking to the Veterinarian. What is the dog's name?
Customer: Foxy Brown
JA: Is there anything else the Veterinarian should be aware of about Brown?
Customer: She has had two blood transfusions and is on three medications to treat IMHA
Submitted: 5 months ago.Category: Dog Veterinary
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Answered in 42 minutes by:
6/16/2017
Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 5 months ago
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 30,797
Experience: University of California at Davis graduate veterinarian with 45 years of experience
Verified

It's best that you don't hasten the taper. Even though you're instituting another anticonvulsant, we mustn't taper a barbiturate too quickly lest break-through seizures arise if for the only reason that we don't know how effective the levetiractam is going to be. Please note too, that in dogs, ongoing (21 days in the study) phenobarbital use significantly increased levetiracetam clearance and reduced half-life (from 3.43 hours. without phenobarbital to 1.73 hrs. after 21 days of phenobarbital; dosage adjustments may be required temporarily. Please respond with further questions or concerns if you wish.

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Dog Veterinarian: Dr. Michael Salkin, Veterinarian replied 5 months ago
Hi,

I'm just following up on our conversation about your pet. How is everything going?

Dr. Michael Salkin
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Dr. Michael Salkin
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
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