A. Have your pet rechecked by your vet or a veterinary neurologist. A phenobarb and Kbr level should be checked and the dose adjusted if indicated. The blood work (CBC, chemistry panel, thyroid panel, urinalysis along with drug levels mentioned) can also assess major organ function. Your dog may need a change in meds or additional meds to control the seizures. Start a Seizure Log. Record data such as time of day/night, duration, description, diet, activity, etc. Around each episode. This may help your vet pinpoint a cause or triggers. The diet should be reviewed with your vet to determine if there are nutritional deficiencies that may account for the pica your are observing or if it related to the seizures.
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While the majority of dogs respond very well to Phenobarbital and/or potassium bromide, there are a few dogs that will continue to have a high seizure frequency despite having adequate serum levels of these medications, and are called “refractory”. For these dogs newer anticonvulsants may help.
Toxicity to potassium bromide due to chronic overdose presents as profound sedation, muscle pain, central nervous system signs, lack of coordination, stupor, and tremors.
Phenobarbital can cause side effects like increased appetite, thirst, and urination in most dogs when they first start the medication. Phenobarbital is a medication that needs to be tapered off slowly to avoid withdrawal seizures so if you are considering stopping the drug, please talk to your vet first.
Treatment of Bromide Toxicity in Dogs
It can take up to three to four months for bromide to really begin to work to control your dog`s seizures. Your veterinarian may prescribe what is known as a loading dose; these doses are higher than what your dog`s dose will usually be, to build up the bromide quickly.
As with any medication, potassium bromide does have the potential to cause side effects in dogs. The side effects that may be seen with potassium bromide include: Increased appetite. Increased thirst.
Contact your vet immediately if your dog continues to have seizures after taking phenobarbital for 2 weeks. Seizures after this point may mean the dose is not right or that your dog needs a different medication.
* Potassium Bromate may be a CARCINOGEN in humans since it has been shown to cause kidney, thyroid, and gastrointestinal cancer in animals.
Abruptly discontinuing potassium bromide can cause severe seizures. If you need to stop giving it, your veterinarian can instruct you how to do so. That said, if a single dose is accidentally skipped, this is unlikely to be a problem as blood levels change so slowly.
Dogs on steroid medications such as prednisone or anti-seizure medications like phenobarbital often have an insatiable appetite, which can lead to pica.
Some dogs on phenobarbital become hyperactive and aggressive. Other adverse effects include diarrhea, vomiting, poor appetite, and itching. During prolonged use, phenobarbital in dogs can damage the liver. Your veterinarian will test liver function with blood tests at regular intervals to guard against this risk.
In modern medicine, phenobarbital is preferred to potassium bromide as it is safer to administer and cheaper to make. As a result, potassium bromide is typically combined with phenobarbital or prescribed to animals with an intolerance to phenobarbital.
What results can I expect? Some dogs may experience sedation (drowsiness) when first starting this medication. This often resolves within several weeks of starting the medication. Some dogs also experience an increased thirst, which causes increased urination, and an increased appetite which can cause weight gain.
What to expect and monitor in your pet with congestive heart failure: Some pets may experience increased thirst and urination. If this seems excessive, please contact CVCA as we can often modify dosages to help improve or resolve this concern.
Many conditions can lead to excessive thirst or dehydration in your dog, including diabetes, Cushing`s disease, cancer, diarrhea, fever, infection, kidney disease, and liver disease. Sometimes, however, it may not be the condition itself causing your dog`s excessive thirst, but the medication used to treat it.
Exposure may cause coughing, sore throat, shortness of breath and dizziness. It may irritate the skin, eyes and respiratory tract. Skin contact may cause redness, pain and burns. Eye contact may cause redness and pain.
“If you`ve been taking phenobarbital and then abruptly stop, you may experience more severe seizures than if you had never taken it to begin with,” Dr. French says. It could also produce serious “status epilepticus” seizures, which can be life-threatening, she says.
The most common extracranial causes are hypoglycemia, hypocalcemia, hyperthermia, hypothyroidism, liver disease, or ingested poisons such as caffeine, and chocolate. Intracranial causes of seizures are diseases that cause either structural or functional changes inside the dog`s brain.
The starting dose of KBr is 22 to 40 mg/kg orally per day. However, given the reversibility of side effects, the upper limit of the dosage is dictated by the animal and owner`s ability to tolerate side effects. In the dog, the t1/2 of KBr is approximately 25 days (range 15 to 45 days).
Background: Potassium bromide was a common treatment for epilepsy in the 19th century and still currently used in veterinary medicine to treat animals with epilepsy.
Potassium bromide is not acutely toxic and it poses a low toxicity hazard. Its oral toxicity is well known and is very low. A high dose will cause only nausea and vomiting. Similarly, its dermal toxicity is low, and it is not a skin irritant.
Bromide (potassium bromide [KBr] or sodium bromide [NaBr]) is a halide anticonvulsant used in veterinary medicine for the treatment of epilepsy. KBr was first used in the treatment of epilepsy in humans in 1857 but since then has been replaced by newer anticonvulsants with fewer adverse effects.
Mild side effects are common when first starting treatment for epilepsy in dogs (or increasing the dose) with Phenobarbitone or Bromide and include increased thirst and appetite, more frequent urination, mild sedation and mild wobbliness in the back legs.
Serious side effects that may indicate a high potassium level include muscle weakness, severe vomiting, diarrhea, blood in the stool or vomit, and collapse.
If a medical issue is to blame, treating it should eliminate the pica behaviors. Medical reasons for pica in dogs are the easiest to treat. For example, if a nutritional deficiency is to blame, dietary supplements, comprehensive dietary change, or a fix in the feeding schedule can correct the problem.