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My dog had his first niralone tablet today and has now just

Hi my dog had his...
Hi my dog had his first niralone tablet today and has now just had a seizure.
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 and age?
Customer: He has had them before but not for a long time.
JA: Is there anything else the Veterinarian should be aware of about your dog?
Customer: Rex 11 Maltese X
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Answered in 4 minutes by:
9/18/2017
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 31,695
Experience: University of California at Davis graduate veterinarian with 45 years of experience
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You're speaking to Dr. Michael Salkin. Welcome to JustAnswer. I'm currently typing up my reply. Please be patient. This may take a few minutes.

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I'm sorry to hear of this with Rex. Niralone contains the glucocorticoid (steroid) prednisolone and the antihistamine chlorpheniramine - neither of which are epileptogenic - predisposes to seizures. His history of seizures, then, suggests that this current one represents a seizure unrelated to these drugs. It's important to note that correlation doesn't imply causation. Please respond with further questions or concerns if you wish.

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Customer reply replied 3 months ago
We where at the vet today a he had an ear infection and was given Dermotic for that Rex is prone to skin and ear problems.
I think the seizures started after his last vaccination, but can't be sure?
He is also a bit anxious at times and it could be the stress of going to the vet as well I guess

You're correct to consider stress - a known trigger for seizures. Vaccine-induced seizures are less well understood. Regretfully, seizures arising after 5 years of age too often represent brain tumor or, less commonly, adult-onset epilepsy. Seizures arising prior to 5 years of age are usually due to idiopathic (unknown cause) epilepsy. Can you describe to me what you're witnessing that you're describing as seizures? Here are the types I see:

Partial seizures (previously called petit mal): focal or asymmetric sensory or motor activity affecting any part of the body (e.g., facial twitching, chomping of the mouth); can be associated with autonomic signs (salivation, vomiting, defecation).

Simple partial seizures don’t alter consciousness. Complex partial seizures (also called psychomotor seizures) alter mentation (mental status) and/or cause behavioral abnormalities in addition to what is seen with simple partial seizures.

Generalized seizures (previously called grand mal) cause diffuse motor activity with loss of consciousness.

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Customer reply replied 3 months ago
More importantly the vet said he now has a slight heart mermer and that is a new thing!
Has not had a seizure for over a year!
Anyway he is seeping now but it seemed to take longer for him to recover this time and was quite disoriented and wobbly on his legs for longer than before. I just hold him and talk to him until he is ok and back to himself

Thank you for the additional information. Mark your calendar for this event and for just what you witnessed. Rex's vet will need all the information you can gather when deciding if Rex should be prescribed an anticonvulsive drug. Most of us will accept one mild (lasting less than 5 minutes, no thrashing about, no loss of consciousness) event monthly before prescribing such a drug. Should Rex suffer another event within 24 hours of this one clustering is diagnosed and that may presage status epilepticus - the state in which seizure activity doesn't abate unless I heavily sedate or anesthetize my patient. He would then need the attention of a vet at your earliest convenience. Please continue our conversation if you wish.

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Customer reply replied 3 months ago
Rex gets kind of ridgid and shaking, he salivates at the mouth and lost bladder content, he did not lose control of his bowels this time but has befor. When he stopped shaking and thrashing about he was very confused and had trouble trying to sit so I wrapped him up and just hold him until he was better. Only about 5 min but took much longer to get back to walking this time.
He was about 8/9 when he first had a seizure and had about 6 in a yr but not closer than a week to a month or so apart and then nothing for over a yr?
He never had them close enough for medication at the time
Could the heart be the problem as well?

It doesn't sound as if he loses consciousness nor does he thrash about and so complex partial seizures are most likely. I would find a brain tumor unlikely because he's still with us 3 years after the onset of his seizures. Adult onset epilepsy is more likely. I believe that simply following my guidelines for treating or not would be prudent. At this time I can't justify treating Rex.

Heart problems can cause syncopy (fainting) episodes but you're not describing syncope. Heart problems can be thromboembolic, however, and so throwing a blood clot into the brain could certainly cause a seizure.

Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog Veterinary
Satisfied Customers: 31,695
Experience: University of California at Davis graduate veterinarian with 45 years of experience
Verified
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Customer reply replied 3 months ago
He does thrash about a bit because that is usually how I know as I hear him do it we are together inside and he sleeps or sits where I am. I do not go out for very long periods so he is not unsupervised that much. Anyway they never last that long but think this one may have been a bit worse as it took him longer to recover fully! I will call the vet when they open it is4 am here now and I will try to get some sleep as he is settled and sleeping now!
Thanks for the chat
Cheers Nina

Thank you for your kind accept, Nina. I appreciate it. I can't set a follow-up in this venue so please return to our conversation - even after rating - with an update at your convenience. You can bookmark this page for ease of return.

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Hi,
I'm just following up on our conversation about your pet. How is everything going?
Dr. Michael Salkin
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Customer reply replied 3 months ago
Hi
Rex is doing well now
He had another small seizure about 12 hours after the first one but nothing since then!
So just keeping up medication to his ears which are better now and he is not itchy at all with the niralone tablets but almost finished the course of that medication so will probably be scratching again in a week or two! Going through life being itchy all the time is not pleasant but will keep going and do the best I can for him!
Thanks for the chat
Nina and Rex

Thank you for the good update, Nina. I appreciate your taking the time to let me know.

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Dr. Michael Salkin
Dr. Michael Salkin
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Category: Dog Veterinary
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