Puppy on Gardenal: Why is he constipated and peeing so much?

I just answered your other question (https://www.petcoach.co/question/?id=814394). I've reiterated here for reference. I understand how frightening it can be when seizures occur. Seizures can be caused by a variety of conditions, such as epilepsy, toxin exposure, portosystemic liver shunts, or brain tumors, among others. While most seizures are treated with medications, the precise treatment is depends on the cause of the seizures. Gardenal (also known by the generic name phenobarbital) is a very common medication used to manage seizures in dogs. When used long term (as is often the case), it can cause elevation in the liver enzymes. It's important to routinely monitor full blood chemistry panels and phenobarbital levels in the blood while using this medication. I am concerned about Chhutki's very low sodium levels. Looking at the low ratio of her sodium and potassium levels, it's possible that she could have Addison's disease (hypoadrenocorticism). Very low sodium levels can cause neurologic issues, which could also be the cause of her seizures. At this point, a balanced commercial dog food (such as Royal Canin, Hill's Science Diet or Purina ProPlan) is her best dietary option. Yogurt, table foods or over the counter supplements are not going to help with this issue. Chhutki really needs to be further evaluated by her vet to get to the bottom of this issue. Further diagnostic tests, such as an ACTH Stim, bile acid testing and an MRI would be helpful. Your vet may also need to hospitalize her for fluid therapy to slowly increase her sodium level to see if the seizures improve. I hope that she feels better soon!

I wish I had a little more information to help you with this question. IF she is just starting the medication and is on a loading dose then she could just be pretty drunk from the medication and may improve in time as her body adjusts. However, if she has been on the meds for a while and these are new changes then I would be concerned that this may be part of her underlying neurologic problem and not due to the meds. Regardless, I would encourage you to follow up with your veterinarian soon. In the meantime if you have other questions I would encourage you to request a consultation for more direct question and answer and “discussion” format. Best of luck and thank you for using Pet Coach.

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.

Hi, thanks for using Petco Pet Education Center, formerly Petcoach! This is very normal in the first 2 weeks of starting phenobarbital. The dogs experience lethargy and the hind legs are wobbly and they appear to walk drunk. This will resolve in 2-4 weeks. The dogs do remain thirsty and have increased hunger on the medication. I wish Ceasar the best!

Hi there and thank you for using Petco Pet Education Center, formerly Petcoach to address your concern. In the initial stages of starting Phenobarbital, dogs develop what we call transient symptoms. These include becoming wobbly (ataxia), drooling, disorientation, panting, etc. These symptoms will eventually subside as the dog's body becomes used to the phenobarbital. If Trapper is no longer having seizures, I would call the veterinarian and ask if the dose can be slightly lowered. I hope this helps! Please let me know if you have any other questions or concerns and I would be more than happy to help you further.

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.

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.