Phenobarbital side effects - Loki, epileptic dog

Hi

We've finally had to give phenobarbital a real try because Loki's clusters of fits have become too frequent over the last year on the potassium bromide alone.

We started him at a lower than usual dose (30 mg) of phenobarbital just over a week ago - and have seen the typical side effects of ataxia, increased thirst/urination, increased hunger. I understand the side effects are reported to take up to two weeks to calm down but his seem every bit as bad as on day one. It's breaking my heart, watching him struggling to get up and wobbling around. He sometimes loses his back legs completely and collapses in a heap.

How long did it take for them to get their legs back to normal? Should I be seeing an improvement in just over a week?

My big worry is that we cannot go on with just the bromide because the clusters are coming too frequently quite apart from the risks of having so many fits. If the side effects of the phenobarbital don't subside, this is no life for him - he is normally such a fit, strong, active dog and if we have to increase the dose to control the fits (as I suspect we probably will as this is such a low dose) we won't be able to anyway.

I always said I wouldn't allow his quality of life to be rubbish.

Hi Linda

How many 30mgs is he on a day?

I wonder if his reaction is to it being in conjunction with other meds? Is he still taking any other meds?

I would actually start him on a lower dose - half what he's currently on and increase up to what he's on now gradually over 2 weeks.

I still have those Epiphen if you want them - just PM me your address and I'll send them out.

Sorry but I'd talk to your vet before changing anything.

I think it may be the combination but you can't just muck around with it. My friends dog had the same issues when he was on both.

Hope you can sort it for him, I know how hard it can be.

rune

Pereg's ravenous hunger and extreme thirst eased off once her body had become accustomed to the Pb - although the hunger still affects her post-ictal. But she has never suffered from on-going ataxia and possibly it is the combination of Kbr and Pb that is causing that with Loki.

My Vet will not consider adding Kbr unless Pereg's seizures got totally uncontrollable, as he is of the opinion that even the increases of Pb she has had cause fewer side effects and will have far less long-term damage to her.

At the moment she is doing pretty well and the Pb is keeping her epilepsy reasonably well under control, with no nasty side effects. She is due for a full blood work-up as soon as Passover has finished, and as long as all her levels are within normal range we will carry on with Pb alone.

I think you know that she weighs 20kg [hopefully less now] and is on 50mg Pb TID, so a total of 150mg/day.

It is always a problem knowing what is best and how to tweak the medication - I do hope any addition to Loki's medication can help him.

Thanks for your thoughts.

I rang the vet but she doesn't think it is the bromide/combo because he's not had any problems on bromide alone (we have reduced the bromide a little too). She did start to mention a concern of organ problems because of the excess drinking and said she would have expected to see an improvement in ataxia by now. She also said the dose is very low (30 mg twice a day) and she saw that Loki does seem very sensitive to medication.

Anyway, she said to bring him in this evening so they can have a look at him and they may do the phenobarbital blood tests - or organ function tests - today, earlier than planned.

Sorry, no advice, I just wanted to give you a hug.

I'll be keeping my fingers crossed that things aren't as bleak as they might appear just now. xx

Thank you.
x

Rowan went straight onto 45mg of epiphen twice a day. He was never very wobbly but it did take a few weeks to get him back up to what I would consider to be 'normal' (for a top grade agility dog). As he hasn't had a seizure since starting meds over two years ago, I would very much like to reduce him to 30 mg twice a day - just need to persuade my vet!

Thinking of you and Loki *Hugs*

Really hope the vet can give him something to make him feel better xx

I have a feeling it's the combination with the other meds only because I can't recall ever hearing another dog reacting to PB in the same way. It's just a hunch - but something I would definitely want to rule out.

Has he been taken off the bromide before? Maybe it's worth asking the vet if it might be worth weaning him off all other meds and then trying the PB?

I'm not sure what else you can try - you seem to have tried everything else

*hug*