By Dr. John Koch
Question: My dog recently began treatment for epilepsy. He is taking phenobarbital, but I am thinking of taking him off of it. Max doesn't seem like the same dog since beginning this medication. All he wants to do is sleep, eat and drink. He has also had several accidents in the house. When he does get up and move, he staggers and stumbles around like he is drunk. Are there any other drugs that can be used to treat epilepsy?
Answer: There are other drugs; however, phenobarbital is still considered to be the medication of choice. After the drug is started, the side effects you describe are considered to be normal for a brief period of time. They usually disappear within a couple of weeks.
There are other medications that may be used to treat epileptics not responding to phenobarbital. However, in most circumstances, a second drug should be added to the treatment regime only after phenobarbital has been used for one to two months.
Currently potassium bromide is the second medication of choice used to treat epilepsy. Occasionally it is used by itself, however in most instances it is given together with phenobarbital. These two medications seem to work well in combination. There are some other new drugs that are reported to offer exciting potential for treating refractory epilepsy. Unfortunately they have not been well studied in dogs and our knowledge of them is still somewhat limited. Another disadvantage is their high cost.
The goal of treatment is control, because elimination of the seizures rarely occurs. If the frequency and severity of the seizures can be lessened, then treatment is considered successful. Pet owners should be aware that referral veterinary institutions report that approximately 20 percent to 50 percent of epilepsy patients are not well controlled with medication.
Dr. Koch is a Cape Girardeau area veterinarian.