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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EIt is important to accurately diagnose and treat seizure disorders because prolonged seizure activity can result in brain damage. This article discusses best practices in treating dogs with epilepsy.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ENeurologic Diseases\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECompanion Animals\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EVeterinary Medicine\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003ENeurologic Diseases\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ECompanion Animals\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EIt is important to accurately diagnose and treat seizure disorders because prolonged seizure activity can result in brain damage. Patricia Dowling, DVM, MSc, Western College of Veterinary Medicine, Saskatoon, Saskatchewan, Canada, gave a presentation regarding best practices in treating dogs with epilepsy. Pharmacotherapy is typically recommended in dogs having seizures more than once a month, those having \u0026gt; 1 seizure per day, or those presenting with status epilepticus. Phenobarbital and potassium bromide (KBr) remain the most effective antiepileptic drugs in dogs. Characteristics of both drugs are summarized in \u003Ca id=\u0022xref-table-wrap-1-1\u0022 class=\u0022xref-table\u0022 href=\u0022#T1\u0022\u003ETable 1\u003C\/a\u003E. Dr. Dowling emphasized that when a treatment strategy is devised, the expectations of the owner must be considered. Owners must understand that their dogs will continue to have seizures while on medication and that the objective is to decrease seizure frequency, duration, and severity.\u003C\/p\u003E\u003Cdiv id=\u0022T1\u0022 class=\u0022table pos-float\u0022\u003E\u003Cdiv class=\u0022table-inline\u0022\u003E\u003Cdiv class=\u0022callout\u0022\u003E\u003Cspan\u003EView this table:\u003C\/span\u003E\u003Cul class=\u0022callout-links\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022\/\u0022 class=\u0022table-expand-inline\u0022 data-table-url=\u0022\/highwire\/markup\/15027\/expansion?postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media%2Chighwire_embed\u0026amp;table-expand-inline=1\u0022 html=\u00221\u0022 fragment=\u0022#\u0022 external=\u00221\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView inline\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022\/highwire\/markup\/15027\/expansion?width=1000\u0026amp;height=500\u0026amp;iframe=true\u0026amp;postprocessors=highwire_figures%2Chighwire_math%2Chighwire_inline_linked_media\u0022 class=\u0022colorbox colorbox-load table-expand-popup\u0022 rel=\u0022gallery-fragment-tables\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView popup\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/15027\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cdiv class=\u0022table-caption\u0022\u003E\u003Cspan class=\u0022table-label\u0022\u003ETable 1.\u003C\/span\u003E \n            \u003Cp id=\u0022p-3\u0022 class=\u0022first-child\u0022\u003EPhenobarbital and Potassium Bromide Characteristics in Dogs\u003C\/p\u003E\n         \u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cp id=\u0022p-4\u0022\u003EPhenobarbital is often the first-line treatment of seizures in dogs, with KBr added if needed. A typical slow-induction dosing regimen is phenobarbital, 2 to 4 mg\/kg\/d, divided every 8 or 12 hours. If necessary, the phenobarbital dose may be increased to 18 to 20 mg\/kg\/d divided every 8 or 12 hours. Phenobarbital is primarily metabolized by the liver and induces microsomal P-450 enzymes in dogs within days of starting the drug. This induction can affect concurrently administered drugs. If treatment needs to be stopped, phenobarbital should be tapered by decreasing the dose by 10% to 25% every 2 weeks. However, in cases where the dog has serious adverse effects, the drug must be stopped abruptly. Given the long half-life of phenobarbital, dogs generally do not experience withdrawal symptoms or breakthrough seizures.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EKBr is used as an add-on to phenobarbital or as a monotherapy alternative in dogs that cannot tolerate phenobarbital. KBr is renally eliminated and does not undergo hepatic metabolism, so it is useful in dogs with liver disease. The typical starting dose for dogs on a normal commercial dog food diet is 20 mg\/kg divided every 12 hours in food to reduce nausea. When KBr is given as monotherapy, the starting dose is 40 to 50 mg\/kg\/d, although some dogs may require higher doses to achieve seizure control. In dogs with renal insufficiency, half the recommended dose of KBr should be administered, and drug concentrations should be frequently checked.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EKBr doses of 50 to 80 mg\/kg\/d may be needed in dogs on a high-salt diet to maintain adequate serum concentrations. Bromide and chloride compete for renal tubular reabsorption, so the bromide elimination rate is greater in dogs with high chloride intake. The chloride content of commercial dry dog food varies from 0.45% to 1.09%, and prescription diets may be even higher. Owners should therefore be cautioned to not change their dogs\u0027 diets while on KBr therapy and to avoid giving salty treats. Swimming in the ocean has also been associated with breakthrough seizures in some KBr-treated dogs.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2014 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/14\/25\/6.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzozgd\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_tables.js?nzozgd\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}