# Epilepsy in Dogs, by Darleen Rudnick



## MSK (Aug 13, 2008)

Epilepsy in Dogs, by Darleen Rudnick Sat 31 May 2008 - 11:04 
Epilepsy is a growing concern with pet owners and is becoming a very common problem in veterinary medicine. Epilepsy, sometimes called a seizure disorder, is a sudden, involuntary change in behavior, muscle control, consciousness, and/or sensation. A seizure is often accompanied by an abnormal electrical discharge in the brain.

Common Types of Seizures
There are two BASIC forms of epilepsy. Infrequent "Petit mal" or "partial motor seizures" is a less severe form of epilepsy, which affects only a specific group or groups of muscles. "Grand mal" or "major motor" seizures are more severe. These include a loss of consciousness and gross body movements.

Common Symptoms your Pet May Suffer During a Seizure
Stiffness
Loss of consciousness
Urinating
Salivating
Sudden, violent shaking
Muscle twitching or slight shaking of a limb
Staring, altered vision

A seizure may last from one to five minutes. Afterwards, the pet may seem exhausted, confused and disoriented.

Major Causes of Seizures
Genetic Factors. Some forms of epilepsy are inherited. Sodium, potassium, and calcium serve the brain as ions and produce electric charges that must fire regularly in order for a steady current to pass from one nerve cell to another. If the channels that carry them are genetically damaged, an imbalance occurs that can cause misfire and seizures.

Brain Tumors. Both cancerous and non-cancerous brain tumors can cause seizures.

Liver disease. Liver disease is a degenerative inflammatory disease that results in the hardening and scarring of liver cells. The liver becomes unable to function properly due to the scarred tissue, which prevents the normal passage of blood through the liver.

Severe worm infestation. Parasites release toxins that have an adverse affect on the central nervous system.

Low blood sugar. Hypoglycemia, which brings on feelings of fatigue and stress, may be a factor in triggering seizures. Scientists have estimated that between 50 to 90 percent of all epileptics suffer from low blood sugar, and 70 percent have abnormal glucose tolerance levels.

Lead, Chemicals, Additives and Poisoning. Toxic metals such as lead, copper, mercury, and aluminum have also been known to cause seizures. Some pets are very sensitive to such metals, and exposure is common through aluminum cookware, auto exhaust, industrial pollution, household cleaners and copper water pipes. Flea sprays, collars and yard sprays are also toxic to pets.

Vaccinations. Because vaccines may contain proteins and/or organisms, they may produce an allergic encephalitis inflammation of the brain.

Infections, cysts and cancer.

Head Trauma. A blow to the head from an auto accident, abuse or other accident can lead to life-long seizures.

Renal Kidney Failure. The role of the kidneys is to remove toxins and excess fluid. When the kidneys become diseased or damaged, they may lose their ability to perform these functions, causing a toxic build-up in the body. A toxic build-up can lead to a seizure disorder.

Vitamin deficiencies. Research points to vitamin and mineral deficiencies as possible causes of epilepsy. The key nutrients that appear deficient in epileptics are vitamin B6, vitamin A, folic acid, vitamin D, zinc, taurine, magnesium, and calcium.

Types of Treatments
Types of traditional treatments such as Phenobarbital, Primidone, Diazepam (Valium) and Potassium Bromide are typically prescribed by veterinarians for seizure disorders. Although medications can be very effective, some may cause side effects that can eventually lead to other symptoms. Many pet owners are now looking into other methods of treating seizure disorders. A more natural approach is outlined below.

Prevention Plan For Treating Seizure Disorders Naturally

A prevention plan is a simple method of enhancing the level of nutrition and making lifestyle changes. It is an attempt to address any special needs your pet may have.

Rule Out Other Health Problems
Rule out other health problems such as Thyroid, Diabetes, Cancer, Liver or Kidney disease. A health problem may be triggering seizures.

Feed Homemade Diet or High Quality Commercial Food
Poor nutrition is a direct cause of many major and minor diseases. Therefore, a commitment to optimum health and longevity for your pet must include a high quality diet.

Research has shown that a low quality diet -- meaning a diet loaded with chemicals, fillers, stabilizers, coloring agents, sodium nitrate (found to produce epileptic-like changes in the brain activity of rats who ate it regularly) and by-products -- can lead to allergies, nervousness, hypertension, diabetes, weight problems, dry skin, and many other common ailments.

A homemade diet is recommended as this is the best you can do for your pet. If you are interested in recipes, please email our Pet Nutritionist. Home cooking does not fit into everyone's lifestyle and if this is the case, it is essential to choose a high quality dry food.

Because of what goes into pet foods today and what does not, it is important to know how to read labels, and know the history of the company manufacturing the pet food. Purely Pets has done extensive research on many of the pet food companies and we recommend Flint River Ranch and Azmira Pet Foods. These products use high quality ingredients -- healthy ingredients that are useful to your pet's body.

Rule Out Hypoglycemia
Hypoglycemia is a medical term meaning low blood sugar, a condition that is becoming more common in pets and especially pets suffering from seizures.


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## MSK (Aug 13, 2008)

It is recommended that pets suffering from seizures follow the suggestions given below to rule out hypoglycemia.


Feed a high quality diet to maintain proper blood sugar levels.

Keep stress to a minimum.

Exercise moderately.

Supplement with high quality vitamins.

Feed small frequent meals.

Symptoms of a hypoglycemic attack

Staggering or collapse

Weakness

Aggression

Moodiness

Glassy eyes, staring, dazed looked

Seizure - If this happens it is essential to administer a source of glucose. The best source is honey. Honey, is made up of 35% protein & contains half of all the necessary amino acids. It is a highly concentrated source of many essential nutrients, including large quantities of carbohydrates (sugars), some minerals, B complex, and C, D, and E. Therefore, honey will immediately raise the blood sugar putting the body in balance and stabilizing the blood sugar level. If honey is not available use jelly, karo syrup or maple syrup. Put a small amount of one of these directly into the mouth. It will be quickly absorbed.

Recommendations to Prevent Hypoglycemia Attacks

The Hypoglycemia feeding schedule is as follows:
7:00 AM Breakfast - high quality dry food or home cooked meal
11:00 AM Snack - see suggestions below
3:00 PM Snack
7:00 PM Dinner - high quality dry food or home cooked meal
11:00 PM Snack -- this should be a high protein, high carbohydrate snack. For example, two plain rice cakes with peanut butter in the middle, egg and toast, chicken and brown rice, etc.

Snack Suggestions:

Celery

Carrots

Apples

Pears

Bran crackers

Rice cakes

Peaches

Hard Boiled eggs

Scrambled eggs

Oatmeal

Low sodium saltine crackers with peanut butter

Cottage cheese

Plain yogurt

Homemade meatballs

Chicken


The goal is not to put weight on your pet, but to balance out the body, stabilize the blood sugar level and ultimately control the seizures.

Eliminate Toxins in the House, Yard and on your Pet

Many household cleaners contain formaldehyde (also known as embalming solution), which could cause severe irritation to eyes, throat and skin. Some floor polishes contain chemicals that can cause cancer as well as damage to the heart, kidneys, liver and central nervous system. It is important to keep your pets in a well-ventilated area when cleaning.

Flea collars, flea sprays, air fresheners, carpet powders and yard control products are not recommended.

Exercise!

Exercise helps with muscle development, digestion and overall health. A well-conditioned body will work and perform better and increase the ability to carry blood and oxygen to muscles. Exercising burns fat and increases your pet's metabolism.

Be sure your pet gets at least an hour of exercise everyday. However, age, health and weather should be taken into consideration. Do NOT over exercise older pets, or pets suffering from hypoglycemia, epilepsy, heart problems, etc. Pets suffer from exhaustion just as humans do.

Supplement

Purely Pets does not recommend discontinuing traditional medications cold turkey or discontinuing them at all. This is YOUR decision based on how the following program works. We highly recommend you work closely with your veterinarian.

Super C 2000
Vitamin C is known as the king of vitamins and absolutely essential to the living process. Dogs do produce Vitamin C, but stress, separation from the mother, relocation to a new home, neutering, immunizations, sickness, skin problems, ear crops, de-worming, heartworm pills, teething, weather changes, seizures and other ailments quickly deplete the little amount they produce. Medical science has described Vitamin C as one of the least toxic substances known. It is the single most important thing you can do for the health of your pet.

Mega Pet or Nupro
Vitamins and minerals are necessary to build the immune system and strengthen your pet. They have the power to neutralize the possible harmful effects of impurities and toxins present in a pet's food or environment. They will also ensure against possible dietary deficiencies and provide extra nutrition in times of stress. Supplements make a tremendous difference in improving the quality of a pet's life. Mega Pet Daily is recommended for pets 25 lbs. and over, because these are fairly large capsules. Nupro is recommend for pets 25 lbs. and under.

EpiPlus
This powder supplement is an alternative to the traditional medicines being used to control seizures. It has long been known that a deficiency in the B complex vitamins can cause seizures in any species. EpiPlus contains high dosages of B complex vitamins and herbs. It is an all-natural product and should be given on a daily basis. There are no known side effects unless your pet is allergic to one of the herbs in the product. If this is the case, EpiPlus can be tailor-made to fit your pet's needs at no extra charge. EpiPlus has had success in eliminating seizures completely or cutting them down dramatically. The time factor depends on the individual pet and it's individual biochemical status.

Keep a Positive Attitude

Positive thinking reaps positive results!! Talk positive to your pet, and be a positive person in your own life.

What to do When a Seizure Occurs

If there is forewarning, administer honey. Give about one tablespoon. For smaller pets use 1 teaspoon. In many cases, this will lessen the severity of the seizure.

Remain calm. This is so important as YOU will prolong the seizure if you scream or get upset.

Turn off all lights, TV and music. Get to a quiet, dark room and hold your pet in a comforting reassuring way. Say only positive things, "You will be okay, you will be better."


Factors That May Trigger a Seizure

Below is a list of factors that most commonly trigger seizures. This does not mean your pet will have a seizure each time it comes in contact with one. EACH pet is different and sensitive to certain things. This list does not apply to every pet.

Some of these factors are impossible to avoid, but are listed for your knowledge.
Hair spray - Do not spray when pet is in the same room.
Wool - Wool blankets, wool sofas, etc.
Heartworm pills - A seizure may occur 1 to 1 ½ wks. after administering heartworm medication.
Cigarette smoke.
Environmental Pollution from chemical plants.
BHA - A preservative commonly used in dog foods, read - "Additives in Pet Foods,"
BHT - A preservative commonly used in dog foods.
Sodium nitrate - Proven in research studies to cause severe seizures. Sodium nitrate is found in many foods we eat. Read the ingredient labels carefully.
Carpet powders.
Air fresheners.
Fabric softeners - If exposed to clothes that have fabric softener on them.
Dryer sheets - If exposed to clothes that have been in the dryer with the dryer sheets.
Salt, Ferrous Sulfate, Copper Sulfate, Calcium Iodate, Monosodium Glutamate - in excess.
Sugar - Sucrose, corn syrup, molasses, cane sugar.
Low quality commercial dog biscuits and treats.
Low quality dry food.
Low quality canned food.
Plastic bowls - All plastics release some undetectable fumes, especially when heated. This out-gassing means the fumes can pass into the foods that are served or stored in the bowl or container. Stainless steel or glass bowls are recommended.
Cheap ceramic bowls - Cause the same problem as described above.
Fumes from all bathroom cleaners.
Fumes from bleach.
Fumes from dusting products.
Household cleaners - Pine cleaners should be avoided.
All toxic flea products - If the product states "Hazardous To Humans And Domestic Animals", it is hazardous to your pet.
Toxic shampoos.
Toxic flea collars.
Dust - Change air filters in your home once a month, and wash curtains twice yearly.
Crabgrass.
Mold.
Eating cat or dog feces.
Stress.
Vaccinations.
Lyme vaccine.
Lyme encephalitis.
Rabies vaccine.
Head trauma.
Worm infestation.
Lead - Pets like to lick lead because it tastes sweet, and lead poisoning can result from licking or eating wood chips on which there is lead paint. This can be checked when doing regular blood work, but it must be specified that you would like a LEAD POISONING TEST which is not part of a normal blood work.
Paint fumes.
Paint chips from lead based paint.
Excessive exercise.
Overheating.
Abuse or neglect.
Rawhides - Many are dipped in a solution of salt and bleach
Cheap painted pet toys
Loud noises - Yelling, fighting, doorbell ringing
Scented candles.
Vitamins with high sodium level.
Inconsistent routine.
FALL - Research studies have shown that more seizures occur in the fall. This is due to mold and bacteria in the air.
Blinking lights - Christmas lights, bright lights, etc.
Pine cleaners.
Red food dye.
Ethoxyquin.
Fungi, Bacteria and Germs.
Mobile Phones - Research carried out on animals suggests that mobile phone emissions may trigger seizures. Check out this site - Epilepsy and Mobile Phones
Hereditary Factors.

Conclusion
An epileptic seizure is something no one likes to watch and even more disturbing for the pet because he doesn't know what is happening to his body. Therefore, it is up to you to find all the answers and learn what is causing the seizures and how to prevent them.

The above program does not apply to every pet and therefore it is important to have your pet thoroughly examined by a veterinarian. If you decide to seek natural methods, Purely Pets recommends a consultation with our on-staff nutritionist.

A consultation will include a personalized diet and holistic program suggestions, all custom-tailored to your pet's personal needs. This is particularly imperative in pets with complicated health issues, or if you've done outside reading and have conflicting information.

Article submitted by: © Darleen Rudnick


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## MSK (Aug 13, 2008)

DRUG CAUTIONS


Many sources helped to compile this information. Special thanks to Dr. William Thomas for his input and to Kathy and Roy Dvorak whose posts to the K-9 Epilepsy list appear here.

This is a list of medications which 'may not' be good for a seizure prone dog to take. As to be expected, what may be a problem for one dog isn't for another. Always share with your vet, a substitute vet, the emergency clinic, etc. exactly what current meds your dog is on and the fact (s)he has epilepsy.

NAME OF DRUG: Acepromazine
COMMON NAME: ace
USE OF DRUG: tranquilizer
Notes: There are several anesthetic protocols that are safe for dogs with epilepsy. In general, phenothiazine tranquilizers (such as acepromazine) and ketamine should be avoided.

NAME OF DRUG: Ketamine
USE OF DRUG: anesthetic
Notes: There are several anesthetic protocols that are safe for dogs with epilepsy. In general, phenothiazine tranquilizers (such as acepromazine) and ketamine should be avoided.

NAME OF DRUG: Chloramphenicol
USE OF DRUG: antibiotic
Notes: This drug will affect the metabolism of phenobarbital (it slows it and could cause phenobarbital toxicity unless the dose is adjusted.)

NAME OF DRUG: Baytril
USE OF DRUG: antibiotic
Notes: (use may be for persistent urinary tract infection. comparable less expensive human equivalent is called Cipro. perhaps an alternate might be Clavamox)

NAME OF DRUG: Kelflex
USE OF DRUG: antibiotic
Notes: (use may be for urinary tract infection. Maureen Sefter found the following warning in a book "About your Medicines" - let your doctor know if you have liver problems; let the pharmacist know if you are on Valporic acid -Depakene)

TYPE OF DRUG: Antihistamines
Notes: can potentially precipitate seizures, so should be used carefully.

NAME OF DRUG: Carprofen
COMMON NAME: Rimadyl
USE OF DRUG: Non-steroidal antinflammatory
Notes: Cautions recommends it should be used carefully in dogs taking phenobarbital.

NAME OF DRUG: Metronidazole
USE OF DRUG: control of diarrhea caused by bacteria

NAME OF DRUG: Phenylpropanolamine
USE OF DRUG: urinary incontinence

NAME OF VITAMIN: B6
Notes: "While it is true that B vitamins are water soluble and reasonably safe, almost any substance can be toxic at high enough dose. In dogs, massive doses of vitamin B6 causes spinal cord degeneration resulting in an abnormal gait." Wm. B. Thomas,DVM,MS.


A COUPLE OTHER COMMENTS:
Phyllis Walker said "key concern with the antibiotic, Baytril, is that its prolonged use may, in conjunction with the pb, compromise the liver--or, at least, such may have been what happened in our case". She went on to state "Apart from the possible (*speculated*) tie to liver damage, another concern with the use of the Baytril is that vets are going to start finding drug resistant bacteria if they use it without careful discretion.

Chris Mara wrote that the book "Principles of Medical Pharmacology" mentions phenobarb as a drug that affects how other drugs are broken down and used by the body, something to take into consideration when giving other drugs to our dogs who are also on pb.


Side Effects of KBr (Potassium Bromide)
A summary of the answers regarding side effects of KBR follows:


1.) According to the JAVMA, Vol 207, No. 2, July 15, 1995, adverse effects: "in human beings, the adverse effects of bromide are primarily neurologic (headaches, vertigo, halluncinations, delirium, ataxia, stupor), although acneform skin eruptions are also seen in about a quarter of these patients. In dogs, polyuria, polydipsia and polyphagia are common and apear to be magnified by concurrent administration of phenobarbital. Sedation, ataxia and hind limb weakness often are seen in the first few weeks of treatment, particularly in dogs given phenobarbital or in dogs that have received loading doses of bromide. These neurologic effects frequently resolve with a 10 to 30% reduction in the dosage of phenobarbital, usually without any need for a reduction in the dosage of bromide. Adverse neurologic effects in dogs can also be seen with serum bromide concentrations greater than the recommended therapeutic range. In these dogs, a reduction in bromide dosage and an evaluation of renal function are indicated. Skin lesions have not been reported in dogs treated with pharmacologic doses of bromide. Although pancreatitis in association with the administration of bromide has been suggested by some investigators, there is no real evidence of a direct relationship between bromide administration and pancreatitis in dogs. Pancreatitis has not been observed in semichronic toxicity studies of bromide in rats even at massive doses. In these same studies, which included histologic and biochemical evaluations, there was no of the development of nephrotoxicosis. Dogs overdosed with bromide at 100 to 600 mg/kg/d for up to 25 weeks similarl had no clinical evidence of either renal or hepatic damage, although histologic results were not reported."

2.) The most noticeable side effect of KBr is sedation. Other side effects incluse hallucinations or mild skin irritation. The best thing about this drug are that the side effects are completely reversable once the drug is discontinued or the dose is reduced.

3.) KBr can cause pancreatitis, with vomiting, diarrhea, etc. Most cases don't show any side effects.

4.) The most common adverse effect of KBR therapy is polyphagia, recognized in about 25% of dogs on therapy. The polyphagia is usually quite striking, necessitating a change to a low calorie diet to prevent weight gain. Polydipsia and polyphagia are less common than with phenobarbital therapy, but are sometimes seen. About 1% of dogs experience an intolerable personality change, requiring a dose reduction or permanent discontinuation. Personality changes include irritability leading to snapping at people or other animals, seeking constant attention from the owner, aimless pacing, and most commonly, depressed mentation as a result of sedation. All dogs will show signs of bromide toxicity once the serum bromide concentration becomes too high for each individual's tolerance. Clinical signs of bromism are sedation, incoordination, and in dogs, most commonly pelvic limb weakness andlor stiffness is observed. This is a unique toxic effect of bromide and is easily misdiagnosed as osteoarthritis, etc. Initially, they may be slow to rise or have difficulty with stairs. If the signs are ignored and weakness progresses, they my be unable to stand. The best way to rule out bromide toxicity as the cause of weakness is to discontinue therapy for 5-7 days. Serum Br levels are useful, but cannot be used as the only way to diagnose bromism because of the wide range of sensitivity between individuals.

5.) KBr has a very narrow margin of safety -- signs of toxicity to be vigilant for are dizziness, ataxia (staggering), lethargy, depression (can progress to recumbency & stupor), hyper reflexes, and muscle pain.

6.) I have seen as the most common side effect, a crusting and drying of the nose in dogs.


SOURCE LIST FOR POTASSIUM BROMIDE (KBr) By State :

AZ Sun City Pet Health Pharmacy (800) 742-0516
CA Bellflower B&BPharmacy (800) 231-8905 fax (800)705-8964
CA * Rohnert Park Drugs (800) 448-4355
IL Naperville Martin Ave. Pharmacy (630) 355-6400
MD Balitmore Professional Arts Pharmacy (888) 663-5686
PA Emporium Lundberg Pharmacy (888) 792-6737 or (814) 486-3310
WI Wood ruff Island Pharmacy Service (800) 328-7060

*Greg is on the list and has/had an epi dog. They will ship overnight if needed.
Medicine Shoppe Pharmacy - check local yellow pages
NOTE: All these pharmacies will require an Rx from your veterinarian to be mailed or fared.


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## MSK (Aug 13, 2008)

PROTOCOLS FOR THE USE OF RECTAL VALUIM
THIS IS VERY IMPORTANT INFORMATION
FOR EPI'S ON PHENOBARBITAL

This was from a paper presented at the ACVIM (neurology)Forum in San Diego in 1998. It is titled "High Dose Benzodiazepine per Rectum to Treat Cluster Seizures in Dogs". It was presented by Michael Podell MSc, DVM, Dipl. ACVIM and Susan Wagner, DVM, MS, Dipl. ACVIM Ohio State University, Columbus Ohio
It talks about Lorazepam and Diazepam. Lorazepam, it says, appears to not be acceptable. MOST IMPORTANT it specifies that 2mg. per kg. of liquid valium (diazepam) is safe for epi's on phenobarbital. One kg. is equal to 2.2 Ibs.
NOTE ... You divide the weight of your epi by 2.2 to get the kilo weight, then times 2 (mg) for the amount for an epi on phenobarbital as recommended by Dr. Podell and Dr. Wagner.
ie. 100 Ibs. divided by 2.2 = 45.45 kgs. Your epi would need 90 mgs of liquid valium
75 Ibs. divided by 2.2 = 34.09 kgs. 68 mgs of liquid valium rectally
50 Ibs divided by 2.2 = 22.72 kgs. 45 mgs of liquid valium
25 Ibs divided by 2.2 = 11.36 kgs. 22 mgs of liquid valium

These are the conclusions from the article on diazepam:

CONCLUSIONS:
- Diazepam per rectum at 2mg/kg is safe to administer to primary epileptic dogs after seizure activity in the home environment.

- Owner compliance may be a limiting factor in the success rate to stop further cluster seizure activity.
- When owner compliance was present, diazepam per rectum was 72% more likely than placebo to stop recurrent seizure activity after the first injection

- Overall, diazepam per rectum at 2mg/kg should be used to treat cluster seizure events in the home environment for dogs on chronic phenobarbital therapy.

PROTOCOL FOR THE EMERGENCY MANAGEMENT OF CLUSTER SEIZURES

This protocol combines an approach for the emergency management of cluster seizures in dogs at home and has proven to be very effective. As always, consult with your Veterinarian before trying anything different.

The main approach this protocol is based on is described in Dr. Thomas' work with cluster seizures: WB Thomas DVM. Dipi.ACVIM (Neurology) University of Tennessee, Knoxville, TN e-mail: [email protected]

Also used were observations of the use of rectal and oral diazepam successfully to stop cluster seizures by many list members and Dr. Podell's article:
Podell, M. The use of diazepam per rectum at home for the acute management of cluster seizures in dogs. J Vet Int Med (1995) 9:68-74.

It has been has been highly effective for list members to use oral valium, after the administration of rectal Valium, to maintain an anti-seizure level until the usual cluster time frame is past to be on the safe side. This can be 12, 24 or even 36 hours. Your vet can advise you on the proper time frame according to the usual cluster time period of your epi.

Another approach is to administer an extra dose of whatever antiepileptic drugs (AED) the dog is on after the Ist seizure and another dose in case of any successive seizures.

Some key points :
1.) You must hit the cluster as early as possible with administration of the liquid valium administered rectally to be most effective. Liquid valium should be administered rectally immediately after the 1st seizure or definitely after the 2nd seizure within a relatively short period of time, say, 30 minutes or less. The more seizures that they have in a cluster before starting treatment, the harder it is to break the cluster. Dr. Thomas' e-mails and Dr. Podell's article have guidelines of 1.0 mg/kg to 2.0mglkg. (if the epi is on phenobarb) A kg is equal to 2.2 pounds. (for example a 100 Ib. dog is 45.45 kg., 50 Ibs, 22.72 kg) It is important to use valium or the generic equivalent diazepam. There are other Varieties, i.e. oxazepam that have different half lives and periods of efficacy and do not apparently work as well.

2.) ABSOLUTELY necessary to be effective is to immediately use the recommended amount of rectal and oral valium. You are not going to kill them by giving them too much valium. It is almost impossible to overdose an epi.. There are guidelines in Dr, Thomas' e-mail (enclosed) and Dr. Podell's article on his research on the use of rectal valium on how much to use per kg of the dog'sweight. These guidelines are a low dose of 1.0 r-mg valium per kg of dog's weight to a high dose of 2.0mg valium per kg of dog's weight, a kg being equal to 2.2 pounds.

3.) This "safe" period would normally be at least Maintain valium administration with oral doses once the dog comes around and can swallow the tablets until you feel they have gone a "safe" period seizure free. 12 hours, perhaps as long as 24 hours depending on the individualcase. For a 100 1b. dog, this maintenance dosage would be about 30 -mg of valium every 3 hours, again needing to be adjusted for the individual case.

NOTE: The only difference with the use of the rectal and the oral valium is how quickly it gets into the bloodsteam and is effective. The liquid valium administered rectally is absorbed quickly and begins being effective within 10 minutes, whereas the oral valium could take 30 minutes or longer. Also, the liquid valium can be administered rectally eVen while the dog is having a seizure, which would not be possible with the oral valium. Therefore, liquid valium is used rectally for the Ist dose to start having an effect to break the cluster as quickly as possible. After the Ist dose of rectal valium, you can use the oral valium to maintain the level.

4.) Valium has a short life, therefore you need to give additional oral valium every 3 to 4 hours to keep the level up.

5.) After the 1st seizure and again after the 2nd seizure, (if the 2nd follows within 4 hours of the 1st,) an additional dose of the AED drugs is administered (in this case, Pb and Kbr).

In summary :
a) during the 1st seizure, administer liquid valium per rectum in a dosage at least equal to the recommended low dose. After your dog has started to come out of the seizure and you feel they can once again swallow safely, administer additional oral valium tablets to bring the total dosage of combined rectal liquid Valium and oral valium tablets into at least the mid- range of recommended dosages. At the same time, administer an extra dose of the antiepileptic drugs that they are normally on.
b.) if a 2nd seizure occurs within a fairly short period of time, say within 4 hours, repeat step a).
c) if there is not a 2nd seizure within 3 hours after the Ist, administer additional oral valium to maintain the level. Continue every 3 hours until you feel the emergency has passed, usually for the period of the next 12 to 24 hours

NOTE: Once again, you should always consult with your Veterinarian. The dosages and timing of administration would need to be adjusted to your individual case. The key point is use of the rectal valium early in sufficient dosage to be effective, followed by oral valium to maintain the level, and additional dosages of the AED that your particular dog is on.

PROTOCOL FOR RECTAL VALIUM ,
submitted to the K-9 Epilepsy Mailing List
by Rich Brady & Joanne Carson Ph.D.
(310) 476-1235 Los Angeles, California

Here is a valium (diazepam) protocol that has proved to be very effective for stopping cluster seizures and being able to keep your dog at home, rather than having to rush them to the ER and perhaps leave them there. Look it over and let us know if you or your vet have any questions. Vets refer to diazepam which is the generic name but the brand name of valium is more commonly known by non-professionals.

Key points:
1.) use the liquid valium rectally as soon as possible and use enough valium (guidelines in the protocol -
I.Omg. Per kg., 2.0 mgs per kg if your dog is on phenobarb - 1 Ib = 2.2kg.)
2.) maintain the valium level every 3 hours with oral valium until you think you are past the seizures (could also be maintained with liquid rectal valium, but oral valium is usually easier to obtain and the dogs when conscious do not particularly like the rectal administration)
3.) give an extra dose of the regular anti-epileptic meds also as soon as possible after the 1st. administration of valium, but just make sure they have come around enough to be able to swallow safely


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