By Dr. Becker
A significant number of dogs and cats with seizure disorders don't do well on traditional drugs for epilepsy like phenobarbital and bromide.
Some pets' seizures can't be well-controlled on these drugs. And then there are the side effects.
Side Effects of Traditional Anticonvulsant Drugs
Phenobarbital is the most commonly used drug for seizures.
It's not expensive and comes in both liquid and tablet form, so the right dose is relatively easy to achieve.
Side effects include sedation and stimulation of hunger and thirst. The combination of a tired pet who is eating more can cause obesity.
Phenobarbital is processed by the liver, and long term use can result in liver damage in some dogs.
Bromide salts have been around since the Victorian era, but because they're rarely used in human medicine any more, they have never received FDA approval.
Bromide is combined with either potassium or sodium, and the resulting powder can be put into capsules or mixed with water to form a liquid for easy dosing.
A drawback to bromide is its long half life. It takes quite awhile for the body to eliminate the drug, so it's important to monitor blood levels to avoid giving too much.
Bromide can cause stomach upset, so it's best given with food. It can also cause sedation and stumbling similar to phenobarbital. Increased appetite is common, and rarely, skin problems.
Although bromides are considered safer drugs than phenobarbital, they may not completely control seizures as a sole medication and are most commonly used in conjunction with other anticonvulsant drugs.
Alternative Anticonvulsant Drugs (AACDs)
Because of the problems associated with traditional seizure medications, other types of human anticonvulsant drugs have been tested for use in veterinary medicine. Some of these drugs show promise in seizuring pets and have gained popularity with vets who treat epileptic patients.
These alternative anticonvulsant drugs (AACDs) include felbamate, gabapentin, levetiracetam, pregabalin, topiramate, and zonisamide.
These drugs can be useful for certain animals, including:
- Pets with seizures that can't be adequately controlled with phenobarbital or bromide
- Pets who've had significant adverse reactions to traditional anticonvulsants
- Animals with secondary epilepsy arising from a condition that already compromises their level of consciousness
- Pets taking other drugs that don't safely interact with phenobarbital or bromide
Some of the AACDs are contraindicated for certain pets. For example, the liquid form of gabapentin contains xylitol, which is toxic to dogs.
And as is the case with any drug, these medications must be used with extreme caution in pets with liver or kidney disease.
Natural Help for Pets with Seizure Disorders
Human medicine is having some success treating seizure disorders with a ketagenic diet containing no carbs, moderate amounts of fat, and high levels of protein. Since this is the definition of species-appropriate nutrition for dogs and cats, it makes sense for pets as well.
I always urge parents of seizuring pets to get rid of carbs in their dog's or cat's diet, and feed food high in protein with a moderate amount of fat.
At Natural Pet, my animal hospital, the rule of thumb in treating seizuring pets is that an animal must have more than one grand mal seizure a month to even consider drug therapy with traditional anticonvulsants, AACDs, or a combination.
There are a number of natural substances and therapies that can increase a pet's seizure threshold, which reduces the potential for epileptic events. I have had success using chiropractic and acupuncture, as well as herbal formulas and nutraceuticals to extend seizure thresholds.
In animals with mild seizures, often natural therapies are enough to control the disorder.
I typically treat pets with frequent grand mal seizures with an integrative approach, using both drugs and natural therapies.
I always ask owners to keep a log of the dates, times and intensity of seizures. Often there are links between seizures and a particular time of month or year. If we identify a cycle, often we can develop a plan to control the episodes using the safest effective treatment options available.