Teach Old Drugs New Tricks in Canine Epilepsy

Holger VolkLast week we hosted a free webinar presented by Professor Holger Volk, on Canine Epilepsy, which was sponsored by VetPlus. Holger started his webinar by providing an overview of epilepsy and how it can affect the quality of life for the patient depending on: the nature of the epilepsy; brain development and ageing; brain pathology; neurobehavioural comorbidities; and epilepsy treatment. Dogs with poorly controlled epilepsy have an increased risk of premature death, behaviour changes and reduced quality of life. The references for this data are provided in the webinar. The unpredictable and uncontrolled nature of seizures is stressful for owners and their perception of their dogs’ quality of life is impacted by increased seizure frequency and use of several medications to control seizures.

I often deliberated over when to initiate treatment for canine epilepsy, if this is something you are currently debating, I would definitely recommend watching this webinar. Holger’s advice on when to start treatment depends on the nature and frequency of the seizures, and the presence of a structural lesion. Client education before treatment starts is imperative because owners need to be informed that medication will be life-long and their dog may still experience seizures. Education on the side-effects of antiepileptic drugs (AED) and the need for regular health checks for monitoring purposes is also important. An app. is available for both Apple and Android devices developed by the Royal Veterinary College (RVC) to help pet owners by providing medication reminders, the ability to record seizures and a PDF document can be created based on the data inputted which can be forwarded to their vet.

The American College of Veterinary Internal Medicine (ACVIM) Panel Grade of Recommendations (with the level of evidence in brackets) for AED monotherapy using Phenobarbital, Imepitoin, Bromide, Levetiracetam, Zonisamide and Primidone is presented in a table in the webinar and the full paper is free to access online in the Journal of Veterinary Internal Medicine. The International Veterinary Epilepsy Task Force (IVETF) consensus for treating idiopathic epilepsy in an otherwise healthy dog would be to start with Phenobarbital or Imepitoin for recurrent single generalised epileptic seizures. For cluster seizures and/or status epilepticus for idiopathic epilepsy or other epilepsy types, Phenobarbital is favoured. Potassium Bromide is recommended as an ‘add-on’ medication if the dog doesn’t respond to the first line medication. The most common pharmacoresistant breeds are Border Collies, German Shepherds, Staffordshire Bull Terriers, Crossbreeds and Labradors. Holger describes in more detail about treatment regimes, monitoring patients and therapeutic success. Reasons for treatment failure include: incorrect diagnosis; incorrect choice or dosage of AED; concurrent disease (liver/kidney/pancreatic); patient weight change or tolerance to AED; monotherapy is insufficient or poor owner compliance.

I’ve tried my best to summarise the webinar which is FULL of really useful information and so I would highly recommend watching the webinar to revise and update your knowledge on canine epilepsy. Holger has also provided the links for the current research projects currently being undertaken at the RVC with respect to further improvements to the epilepsy app., directing future research and canine behaviour which can be found on their Facebook page. The link to watch this webinar:  https://www.thewebinarvet.com/webinar/teach-old-drugs-new-tricks-in-canine-epilepsy/

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