My dog on phenobarbital still has cluster seizures. How to prevent?

Thanks for using Petco Pet Education Center, formerly Petcoach! I'm so sorry to hear Hunter has been suffering from seizures. I would recommend reaching out to your regular veterinarian to discuss alterations in his medication protocol, as it is best for someone familiar with him, his case and his medications to make any alterations. Good luck!

I'm sorry to hear that Frank is having this problem! I agree that it's concerning for him to still be having cluster seizures, even on a combination of different meds. I would recommend consulting with your veterinarian about the next recommended steps from here (possibly a dosage adjustment, or a different/additional medication such as zonisamide or gabapentin), or requesting referral to a specialist for further evaluation to see what else can be done.

Based on the history, a toxicity seems less likely and a primary disease of the brain more likely. If the seizures are not well controlled on phenobarbital it may be that she needs a higher dose. You should discuss phenobarbital levels with your veterinarian. If the levels are in therapeutic range, a second anticonvulsant such as levetiracitam should be considered. Furthermore, you may consider following up with a veterinary neurologist to discuss diagnostics including an MRI of the brain.

Hi and thanks for your request. The aim of the phenobarbital administration is to reduce effectively seizure frequency and severity. In my experience a frequency of once a month is fair and acceptable. Ideally Phenobarbital concentration should be checked 3 and 6 months after starting the treatment to monitor liver parameters and make sure the concentration of the drug in the blood is within therapeutic ranges. Dose could be even increased, but to be able to give you specific advices about it I would need to know Shadow's weight. Hope this answer was helpful, but please do not hesitate to contact us again on the forum or by requesting a consultation if you have any more questions or to discuss it any further. If this answer was helpful please let us know, this will be used to improve our service!

The pacing could be a side effect of the phenobarbital or a side effect of the underlying cause for Frito's seizures. If the pacing continues or he has any decreased appetite, vomiting, or seems excessively sedate then you need to contact your veterinarian to discuss altering the dose potentially.

The phenobarbital level in her blood should be checked to make sure she gets enough of it daily. Other medicine can be tried (Potassium Bromide for example). I sure hope this input will help Stormy. Good luck.

Hello, thank you for using Petco Pet Education Center, formerly Petcoach. It is probably the overstimulation of her brain and the nerves that causes the breakthrough seizures. Exercise would not make her burn through the medication faster. It is really best to minimize excitement in any dog that has a history of seizures. That being said, if this is a new thing and it has been longer than 4 months since her last phenobarbital blood test, it would be best to go ahead and have that checked to see if the dosage needs to be adjusted. Hope this helps. Best wishes.