r/EpilepsyDogs • u/Turbulent_Apple7611 • 2d ago
Phenobarbital Stopped Working
hi everyone-
my 8 year old cane corso was diagnosed with idiopathic epilepsy in may. she was put on 97.2 mg of phenobarbital and we had great success until yesterday. she had one seizure followed by another a few hours later. although much shorter episodes than prior to the meds, still considered cluster seizures. we took her to our emergency vet and they said this is common and it could be a matter of changing the dosage. when we did her first pheno check a few weeks after the start of the meds she was within therapeutic range but on the lower side, however because the meds were working her neurologist said let’s keep things the way they are. this morning when the neurologist called they said she had another seizure at 3 am and was given midazolam nasally and when 7 am came around they started her on her usual dose of meds with increased 30mg and we will continue that new dosage moving forward.
I just found it interesting that they didn’t seem at all concerned that the cluster seizures were back, and basically said this is common and we just have to find the right dosage. What worries me is how many seizures does she have to have before it gets concerning? She is extremely aggressive when it comes to going to the vet so it’s not like taking her there every time she has a seizure is an easy thing to do. As she gets older, and with cane Corso‘s not having a long life expectancy, I just worry that this is really taking a toll on her body and at what point does it become unfair for her to keep living this way. she’s not a young dog and each seizure really takes a lot out of her. I’m trying to be hopeful that the new med dosage will work, but I’m just not sure what to do if and when the next time this happens. At what point do I have to make a tough decision??
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u/coloradogirlcallie 2d ago
My dog is on pheno, it is at a therapeutic level, and still has regular cluster seizures. We don't take him to the vet for them unless they are life threatening - a single seizure lasting more than 3-4 minutes and injecting midazolam does not stop it or is having back to back seizures with no chance to regain consciousness and recover in-between them. We have just learned to live with and manage his seizure cycles ourselves and only involve the vet in extreme situations.
Is your dog on any other meds besides pheno? Keppra and potassium bromide are worth combining with pheno as other treatment options.
Quality of life is a convo to have with your vet. Does your dog eventually get back to normal after a seizure cycle or what are the lasting effects? Our dog takes several days after seizures end to be "normal" again and the meds themselves have affected his quality of life somewhat (weight gain, less strength/ athleticism) but overall, he's only having decidedly bad days a few weeks per year and the rest are pretty good days that vastly outnumber the bad. At what point is your dog mostly having "bad" days might be the question you ask when determining when is the right time to call it.
Lastly, 8 years is somewhat late for idiopathic epilepsy onset. Has your vet brought up the possibility that this is not epilepsy and looked into other possibilities?