My dog has seizures and high ALP. Is phenobarbital the best treatment?

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.

Hello there and thank you for using Pet Coach! There are multiple anti-seizure drugs available and some with less side effects than others. If Bailey is on Phenobarbital, Keppra may be a good option for him as this particular drug has fewer side effects and I find that it is less harsh on the liver. Switching to a different drug with less side effects will certainly help. You can also talk to your vet about prescription liver diets in addition to the Denmarin. Hepagen-C is a veterinary product that is over the counter, which we use at our clinic in conjunction with Denamarin or Denosyl. Your vet can also perform a Bile Acids test to determine how much function of the liver has been lost. A scan would certainly be recommended and there are sedative combinations and drugs that we can use that will not trigger seizures, as they are anti-seizure drugs that we use to control seizures. I would still recommend an ultrasound, but talk to your vet about the different drugs that can be used to prevent seizures while sedated. I hope this helps! Please do not hesitate to contact me with any other questions or concerns that you may have. I am also available via phone or text consultation if needed. Please remember to rate this post as helpful or not. Thank you!

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!

I'm so sorry that Molly is having these problems. I am attaching a handout below on Phenobarbital which may give you more information on her situation. https://www.veterinarypartner.com/Content.plx?P=A&S=0&C=0&A=522 Phenobarbital can certainly increase a dog's appetite, so you have to make sure that they are not eating more when they are receiving Phenobarbitial so they don't gain weight. Phenobarbital will also increase liver enzymes on a blood panel. In order to determine liver function, we need to do an additional test called a Bile Acid Profile. If Molly's Bile Acid Profile is abnormal, then her liver is not working properly and decreasing her dose of Phenobarb may be a good idea, but you will need to discuss with your veterinarian how to do that safely and if you need to add another anti-convulsant medication to prevent her from having seizures again. Milk Thistle and Same-E are my 2 favorite liver support supplements, so I think you have her liver well supported with those supplements. I have seen good results in decreasing liver enzymes with those 2 supplements. Good luck! I hope that was helpful. Thanks for using PetCoach.

Hello and thank you for contacting Petco Pet Education Center, formerly Petcoach. I assume Chhutki was prescribed phenobarbital for seizures. This medication can produce transient elevation of liver enzymes, increased thirst, increased appetite, lethargy and weight gain. It does not affect kidney or heart function and does not cause gallstones formation. If you don't use any anti-epileptic medications for your dog, she will likely have more seizures, which can be longer/more severe than her first seizure.

Hello, & thank you for using Petco Pet Education Center, formerly Petcoach. Keppra is an excellent anti-seizure medication used extensively in human & veterinary medicine. The advantage to keppra over phenobarb, is the keppra is metabolized unchanged by the body, thus the liver does not ever see it.. Therefore, it is an excellent drug when the liver has become compromised by the phenobarb. Not every dog needs to be switched, but when they are, the seizures are very well controlled. Hope this helps.

The good response to phenobarb makes a tumour less likely - these tend to respond very poorly and continue to have increasing seizures despite medication. His age also makes epilepsy likely so I would continue with the treatment as prescribed for 3-6months and possibly taper down carefully after this if no seizures occurring, or maintain as is if stable and limited side effects