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He is a 4 yr old mixed breed. We rescued him from a sheltet.

He is a 4 yr...
He is a 4 yr old mixed breed. We rescued him from a sheltet. He started with seizures when he was 3. He had been on numerous meds. Zonisamide which didn't seem to work. We then added phenobarbital . That combo didn't work. He has been on phenobarbital and keppra with gabapentin and valium when he has a seizure. They up meds today to 9000 mg
JA: I'm sorry to hear that. What sort of animal are we talking about?
Customer: Dog 9000 mg of keppra 97.2 mg of phenobarbital 600 mg og gabapentin. Today he has had 7 plus seizures. It never fails but everytime he lays down he goes into one. The flanging and paddling only last less than a min. Its the recovery that takes some time. We don't know what to do.
JA: OK. Seizures always look scary. Let's get you talking to the Veterinarian. What is the dog's name?
Customer: Buster
JA: Is there anything else the Veterinarian should be aware of about Buster?
Customer: Mixed breed 95 lbs chow pitt mastiff husky shep
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Answered in 17 minutes by:
3/27/2017
Dr. Gary
Dr. Gary, Veterinarian
Category: Veterinary
Satisfied Customers: 19,806
Experience: DVM, Emergency Veterinarian, BS (Physiology)
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Hello, I'm Dr Gary. I've been practicing veterinary medicine since 2007. I look forward to helping with your questions/ concerns.

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When was the last time he had his phenobarbital blood levels checked? Do you know where they were?

Do you have rectal valium to give at home?

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Customer reply replied 8 months ago
Blood work was good except the one liver due to meds he has been on. Toxic level was low so there was room to add meds. We have done that the past 2 days and still have had multiple seizures 7 per day roughly. I do have anal valium and have used it about 4 to 5 times

When we have a dog with cluster seizures, the only thing that pulls them out of it is Valium. I usually have owners give a rectal dose at home or come in for IV Valium.

I would probably take him in so they can give an IV dose and then probably an IV dose of Phenobarbital that lasts a little longer to increase the seizure threshold.

Going forward, I would have a neurologist manage this epilepsy as it's more serious than most dogs. They would want to MRI the head to make sure there is not a structural lesion or brain tumor. If that's clear, then they can get the Phenobarbital to a high blood level (low 30's) and also get the Keppra up as high as is needed.

I have seen some dogs on Phenobarbital, Keppra and Zonisamide together if that is what is needed to manage the seizures. It's tough, but sometimes it's needed.

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If you've used the rectal valium more than 2 or 3 times, which you have, then I think it's time for an IV dose and an IV dose of Phenobarbital to get this cluster under control. We also have IV Keppra that we can give for cluster seizures like this.

I don't think it's something you're going to be able to manage appropriately at home, I'm afraid.

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Customer reply replied 8 months ago
Have you seen other dogs on this many meds

Oh yeah, I see a lot of seizure dogs on Pheno and Keppra together.

Adding Zonisamide and Gaba is less commonly needed, but I do see a fair number on all 4, along with rectal valium as needed at home.

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Customer reply replied 8 months ago
What if there is a structural lesion or brain tumor?

If it's a brain tumor, then it depends on the location and size. Some can be surgically removed. Others can be treated with a gama knife or radiation. Medically, we add steroids if surgery is not an option to hopefully shrink them down.

Any dog that is this "hot" really should have an MRI. Hot referring to the cluster seizures vs a typical epileptic that has one fairly mild seizure every 2-3 months.

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Customer reply replied 8 months ago
It seems as though everytime he tries to sleep is when the seizures occur. Does this sound like maybe a tumor. Right now on all these meds he is loopy but still wanting to pace.
Customer reply replied 8 months ago
We haven't had sleep in 3 days. We are taking turns
Customer reply replied 8 months ago
Love our big guy.

It could be a tumor. It's hard to tell as tumor dogs and epileptics can look very similar.

I would definitely get him hospitalized as soon as you can to get IV meds in. That'll allow you guys to get some rest as well.

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Customer reply replied 8 months ago
We are planning a trip to cornel in the morning. What does an MRI cost? My regular vet thought it may be a heart arithmia?

An MRI usually runs ~ 2000.

Heart arrhythmias can cause passing out (syncope), but not true seizures. I think that's less likely based on your description.

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Customer reply replied 8 months ago
Ok thank you for your time and consideration.

You're welcome. Best of luck with him. I know it's not easy.

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Customer reply replied 8 months ago
Do you think we should be ok til morning?
Customer reply replied 8 months ago
Cornel is 2 hrs away. Do local vets have all the iv meds
Customer reply replied 8 months ago
I just gave him a phenobarbital

I would go in to an ER vet now if you can. They have all the IV meds that he needs. They can then set up a transfer to Cornell later in the morning.

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Customer reply replied 8 months ago
Ok thank you

No problem.

Dr. Gary
Dr. Gary, Veterinarian
Category: Veterinary
Satisfied Customers: 19,806
Experience: DVM, Emergency Veterinarian, BS (Physiology)
Verified
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Dr. Gary
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Category: Veterinary
Satisfied Customers: 19,806
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Experience: DVM, Emergency Veterinarian, BS (Physiology)

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