Original Question: Hi, my rescue dog is now 3 and about 23.5kg. He had been seizing daily for 3 days and 2 weeks ago. He is now on Phenobarbital 30mg BID but he had just been seizing again today and it happened twice. I feel so bad for him and I want to do something to help him however he is unable to be examined without sedation even though they are collecting blood. So should I still send him to vet for another blood test or what should I do? He had just been sedated 2 weeks ago. - Gigi
Thanks for your question and I am sorry that you’re dealing with this.
Seizures are not typically life-threatening unless they persist for a long time. A grand mal seizure is one that lasts 20 minutes and as a seizure length approaches this duration, it has a greater chance of being fatal. Most practitioners agree that when seizures start to group together in frequency within a short period of time, such as 3 seizures within 24 hours, or they start to become longer in duration, such as 1 min seizures increasing to 3 and then 5 and then 8 minutes long, then you are certainly risking a grand mal seizure. This is when you enter a high-risk stage of epilepsy.
Dogs that have short seizures that occur once or twice a month may not even be considered for therapy. I assume your dog has been started on treatment because the seizures have worsened in frequency and duration. Now when you mention that there have been 2 seizures just today, I certainly recommend that you have your dog seen by your veterinarian and have the phenobarbital levels checked and determine with your veterinarian if therapeutic levels of the drug are present in the body. If not, then the dose can be adjusted. Keep in mind that there are many different medications for seizure control and they work very differently. Some dogs will respond better to one versus another and they may also require treatment with more than one drug at a time for optimal control.
I recommend that you see your veterinarian about this and manage the treatment to better control the seizures. Keep in mind that if your dog is not responding well to the medication, then you could consider seeing a neurologist and having them consult on the case. They frequently see the more challenging cases and will have greater experience with a broader range of medications.
You can read our article about seizures, “Epilepsy in Seizures in Cats and Dogs: 8 Things You Need to Know” that discusses general concepts in diagnosis, treatment and control of them.
I hope this helps and good luck!
Dr. Clayton Greenway
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