Pereg and her medication

After her last blood tests on 17 November, the results of which when I got them the following week showed that the Phenobarbitone level in Pereg's blood was a bit over the top therapeutic level, I started reducing her 3pm dose from 100mg to 80mg keeping her 7am and 11pm the same.

The next reduction is planned for her 11pm dose, also reducing it from 100mg to 80mg.

The thing is that neither I nor Ram, her vet, knows how the reductions will affect her, so it is very much a case of playing it by ear, especially as there is not firm guide as to what to do.

Today will be Day 8 since her 3pm dose is reduced, and is Day 14 seizure-free. I know that nobody here can probably advise me as to what to do, and Ram really leaves it up to do as he knows that I do what I consider is the best for Pereg, so I guess what I am asking for is some psychological support in helping me decide whether to start the evening dose reduction today or leave it for another week.

It's difficult to say Malka as you say it is very much a trial and error situation. I suppose another week wont hurt just to be sure. I would hate to have to make those sort of decisions but Good luck we know you will do what you think is best for Pereg and bless her little heart she knows it too. God bless and have a good day.

Maybe leave it a few more days to make sure like Moyra says, wouldn't like to make a call on it as I just don't know enough about it all.

Nobody knows June because all epis are different, and the thing is that neither Ram nor I know how it will go. Her blood Pb level really should go down a bit even though she has, so far, had none of the possible bad side effects from it, and our discussion last week was to reduce the dose each week to get her back to the dosage at her last major blood tests at the end of April this year.

I just do not want to do it too quickly - I already reduced her 3pm dose from 100mg to 80mg on Ram's advice although I thought the reduction should be less than 20mg - but as I say, neither of us really know how she would, and will react.

I will phone him again in about an hour or so when he should have finished the morning's operations, and see what he thinks. But the problem is that there is no one-size-fits-all and it is basically up to make the decisions regarding Pereg's medication, with Ram's consent of course.

Oh how I wish it was a simple as, say, giving an antibiotic at such and such a dose for such and such many days.

At the moment it is like banging my head against a brick wall.

Just a personal opinion but I would leave her a few days to see how she gets on with the lower dose before lowering it again. Easier to say that from here I know and I do know you will be doing what you feel is best whatever you decide.

Really just want to give a cyber hug for you both, she is lucky she has you, she really is !

I am of no help whatsoever on this one but me, Ima and mad Molly send you both lots of hugs a licks (me the hugs )
xx

I have spoken with Ram and he says to reduce Pereg's 11pm dose from 100mg to the 80mg we have reduced her 3pm dose to - but if I am not happy to leave it for another few days.

So the decision is up to me whether I start reducing that dose now or leave it for another few days. I think I will reduce it this evening and on alternate evenings for a few days and see what happens, but as he said, the increases we gave her over the last few months did not stop her seizures, so it should not hurt to reduce the doses to see what happens, always knowing that I can, and will, increase it again it I think necessary.

I just wish I knew what to do for the best, knowing that too much is bad but not enough is also bad.

I do feel for you it's so difficult knowing what to do for the best, all as I said before I do know is you will be doing what you think is best for her she is lucky to have you.

I can't help Malka but I hope it all works out okay. The only thing that occurs to me is that Pereg has been having frequent fits even on the higher dose and I would be worried that decreasing would make them worse.

It's always a balance between fits and medication levels isn't it? This worries me with Loki because he is still having fits every few weeks, so I feel for you.

If only I knew what to do for the best Linda, if only I knew. But eight days so far, including today, with the reduced dose at 3pm and so far so good, and I would have thought that if it was going to make a difference it would have done by now. But am still wary about any reduction on her 11pm dose and for today at least I will stick to the 100mg. After all I did not increase both the 3pm and 11pm doses at the same time, and her 7am has stayed the same for months now.

Maybe in a couple of days if all is well I will start to reduce the 11pm dose, probably on alternate days for a week. At the moment I just do not know, and Pereg has seizures when her brain has an overload and short-circuits, and who knows when or why that will happen.