My dog has monthly seizures on phenobarbital. What else can help?

Poor guy. The treatment is ok; however, if we suspect any kind of liver involvement there are safer anti-seizure medications to consider here such as Zonisamide or Keppra. Although we would suspect the ALT to be elevated over the ALP in most liver problem dogs. You should certainly discuss these concerns with your vet. This may be why the liver supplement was prescribed, in case there is liver involvement. I would also consider getting an abdominal ultrasound done on him to evaluate his liver and adrenal glands. Both these organs can cause the elevated ALP, so we need to check if this is the underlying problem for sure or not. And ultimately seizures should be evaluted via MRI/CT scan; however, the cost of this limits most pet owners from having this done. Here is more information on seizures --> https://veterinarypartner.vin.com/default.aspx?pid=19239&id=4951440 I hope that Milo's seizures stabilize and that he does well moving forward. Take care.

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.

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!

Thank you for submitting your question regarding your dog. I recommend contacting his veterinarian. He will likely need to start another medication to control his seizures. Phenobarbital, potassium bromide and zonisamide are common choices. However, your veterinarian will know his medical history and which would be the best choice. Being able to have his seizures better controlled will improve his quality of life. I hope this information helps!

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 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.

Phenobarbital therapy in dogs is begun at 2 to 4 mg/kg twice daily. So for a 33kg dog that would mean 66 to 132 mg twice a day. We always try to start low and increase if needed but he was essentially really underdosed in the beginning with taking 30mg twice a day. He is now on a more appropriate dose. Sedation is normal when therapy is initiated but once the dog's body gets used to the drug (after about 2 weeks) he should become more like himself. If you are really worried, you can ask the vet to run a phenobarbital level blood test to see if his dosing is too high and it can be adjusted accordingly. Please be aware that dogs will never be completely seizure free even while on anti-seizure medication. Breakthrough seizures are common but they should be pretty infrequent. If he continues to seizure or does not do well on the phenobarbital there are other medication options so please work closely with your vet.