Phenobarbital

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For the a quick summary of information on phenobarbital, click here. In addition to being used on a daily basis to prevent seizures, Phenobarbital can be used to stop seizures in progress.

Phenobarbital's peak activity occurs hours after the pill is given. While Pb is not FDA approved for use in dogs, it is one of two first choices for veterinarians and its use is accepted practice.

Phenobarbital comes in liquid or tablet form and is available both from a veterinarian and from a regular pharmacy by prescription. When Phenobarbital is started, it takes 1 to 2 weeks to reach a stable blood level. Until that period has passed, it cannot be fully relied upon to prevent seizures. Please contact your veterinarian if your dog has more than one seizure every two weeks or the buy liquid phenobarbital for dogs last longer than five minutes.

Some manufacturers use grams and some use grains as a unit of measure. In milligrams, Phenobarbital is available in 15 mg, 30 mg, 60 mg or mg tablets. Because absorption, distribution and speed of metabolism can vary among dogs, published dose recommendations only serve as a general guide. Most new patients buy liquid phenobarbital for dogs started at the lower end of the dose range; however, patients with frequent or severe seizures are often best managed by starting at the higher end of the dose range or by using a loading dose.

The initial starting dose that is frequently used is 2 buy liquid phenobarbital for dogs to 3 mg per kilogram of body weight every 12 hours to convert your dog's weight to kilograms, divide the weight by 2. Your veterinarian will adjust this dosage based on blood levels, seizure activity and side effects of the medication. As a general rule, Pb is given every 12 hours and should be given as close to every 12 hours to avoid seizures.

To determine the correct dose of Phenobarbital, it can be very helpful to monitor its level in the blood. Your veterinarian will want to test Phenobarbital levels after approximately two weeks of therapy to be sure that your dog is in a therapeutic range. It takes two weeks for Phenobarbital to reach a steady state after starting or adjusting Phenobarbital.

In most cases a single trough low level is collected just before a dose is administered. Once a therapeutic level or control is achieved, blood serum levels should be retested every 6 months to be sure that the blood concentrations have not drifted out of the intended range. Most important, chemistry panels with the liver enzymes GGT, ALT and Alkaline Phosphatase should be done every three or four months to monitor liver function. Of course probably the best buy liquid phenobarbital for dogs of whether you have hit a correct dose is whether your dog is still having seizures.

Having only one seizure a month is considered good control. If the seizures are under control, it may not be necessary to buy liquid phenobarbital for dogs the dose when the dog's blood level is below therapeutic range.

But levels higher than therapeutic range can lead to liver damage. Phenobarbital inhibits seizures by decreasing the activity of neurons. Unfortunately, this effect is not specific to the neurons involved in the seizures but affects other neurons as well. Many of the potential side effects of this drug are caused by this effect on neurons. These side effects can include sedation, lethargy, excessive urination, excessive thirst and excessive hunger, hyperexcitability, ataxia loss of coordination or hind end weakness and restlessness.

Most of these side effects diminish buy liquid phenobarbital for dogs disappear after the first few weeks of therapy. Excessive urination, excessive thirst and excessive hunger are the most common long-term side effects. Chronic or long term use over 3 months of Phenobarbital can lead to scarring in the liver and liver failure in a small percentage of dogs. We have included the stories of some of our members' dogs - members who have generously agreed to have their stories included so that others can avoid the heartbreak of irreversible liver damage in their dogs.

What we have learned from our other members is that we have a better chance of avoiding severe liver damage with proactive monitoring -- blood tests to check that the level of Phenobarbital is not above the therapeutic range run two weeks after beginning therapy and then every six months ; and, MOST IMPORTANT, pre and post bile acid buy liquid phenobarbital for dogs as early in therapy as possible for a baseline and then chemistry panels with the liver enzymes ALT, GGT and Alkaline Phosphatase every three or four months.

These tests are used because they can indicate the beginning of a problem in plenty of time to change medication and take appropriate action. Some vets will say that a chemistry panel is sufficient to determine liver damage.

Bile acid testing every 6 months can provide an earlier indication of a problem so that adjustments can be made before it is too late. Liver enzymes to watch in a chemistry panel are: Whatever you and your vet may decide buy liquid phenobarbital for dogs do about monitoring, here is a list of symptoms of liver damage. Early signs can be buy liquid phenobarbital for dogs general as loss of appetite, weight loss and chronic intermittent diarrhea and vomiting - vomiting is more common.

While an increase in drinking and urinating can also signal liver problems, these are common with Pb and it may be difficult to tell the difference. The decision to stop Phenobarbital must be made very carefully but is reasonable to consider with dogs that are seizure-free for one to two years, who are having side effects that affect their quality of life, who develop liver disease or where you wish to incorporate Potassium Bromide into the dog's treatment and eliminate or reduce the Pb dosage.

The dose should be gradually tapered off over a period of about 6 months. The major risk of discontinuing drug therapy is seizure recurrence, which is most likely to happen during withdrawal or within several months of stopping therapy. Phenobarbital speeds up liver activity and, when used with other medications that are normally broken down by the liver, may cause them to be metabolized more rapidly, therefore requiring them to be given at a higher dosage.

Some of these drugs buy liquid phenobarbital for dogs antibiotics buy liquid phenobarbital for dogs chloramphenicol and doxycycline, heart medications like digitoxin, corticosteroids and antiparasitic drugs such as metronidazole Flagyl. It is also reported to decrease intestinal absorption of the commonly used anti-fungal product, griseofulvin.

Return to Top of Page. Griffin, MD and Liisa D.

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Often there is no apparent reason why your dog should have developed epilepsy. In some breeds of dog, most notably the German Shepherd, epilepsy is inherited and is most often seen in males. Sometimes epilepsy is the result of minor damage to the brain caused by a blow to the head or as a result of oxygen starvation during a difficult birth.

Usually the seizures start many years after the damage had occurred, so it is not easy to make a connection between the two events. It is usually not possible to remove the cause of the seizures so your vet will use medication to control the seizures. It is important to realise that this treatment will not cure the disease but merely manage the signs — even a well-controlled epileptic will have occasional seizures.

Treatment for epilepsy is decided on an individual basis and it may take some time to find the best combination and dose of drugs for your pet. You must have patience when managing an epileptic pet. The drugs used to treat epilepsy often do not stop the seizures altogether, but will make them less frequent. Therefore, it is important to know how often the seizures occur without treatment to be sure that the treatment is having a positive effect. Once your dog starts on treatment it is likely that this will have to be continued for the rest of his life.

Treatment must be given regularly and at roughly the same time every day. If you stop the drugs suddenly it may cause your dog to seizure. It often takes a few months to get the dose of drug just right for your dog. During this time, your vet will keep in regular contact with you and may need to take a number of blood samples from your dog to check that the blood levels of the drug are not too high or too low.

It is rare for epileptic dogs to stop having seizures altogether. However, provided your dog is checked regularly by your vet to make sure that the drugs are not causing any side-effects, there is a good chance that your dog will live a full and happy life.

Most dogs with epilepsy can be controlled by drugs which are given every day by mouth. When your dog starts on treatment your vet will probably check them regularly over the first few weeks to monitor the frequency of their seizures and any side-effects of treatment.

Once things have settled down check-ups will probably be scheduled around twice a year. Check with your vet whether they would like to see your dog before or after they have received their medication for the day. Your vet may ask you to record a diary detailing all the seizures your pet has had. Keep this record up-to-date and take it with you every time you visit your vet. There are many drugs used in the control of epilepsy in people but very few of these are suitable for long-term use in the dog.

Many epileptic dogs require a combination of one or more types of drug to achieve most effective control of their seizures. Phenobarbital is sold under the name Epiphen.

Another anticonvulsant, primidone, is broken down in the body to make phenobarbital. Phenobarbital is the most commonly used drug for prevention of seizures. It is effective in most dogs when given twice daily — but it is important to remember to give the drug regularly because blood levels of the drug can drop quite quickly if a dose is missed and this may trigger seizures.

Phenobarbital is usually given as tablets but a liquid form is also available. The tablets come in a range of sizes, making it easy to give the correct dose to a tiny dog as well as a giant one! The drug is broken down in the liver and so with long-term use it may have some effects on the liver. It is very important when using phenobarbital that the blood levels of the drug are kept at an appropriate level. If levels get too high the drug can have more severe toxic effects, and if they are too low there may be no beneficial effect from the drug.

There is a blood test to measure levels of phenobarbital in the blood and if your vet has prescribed phenobarbital for your dog he will want to monitor blood samples. These tests may be done several times in the early weeks of treatment to help determine the correct dose of drug for your dog, and then on a less frequent basis to monitor long-term effects. All drugs have side-effects and phenobarbital is no exception. Usually these are relatively mild and may wear off once your dog gets used to the drug.

Drowsiness, increased appetite and thirst are common. Most vets will use phenobarbital in all dogs with epilepsy unless there is a reason not to do so. Dogs with liver disease may have problems with the drug and so alternative treatment may be better in these cases. For some dogs phenobarbital alone is not enough to control seizures sufficiently and a second drug may need to be added to their regime. Bromide is one of the oldest anticonvulsants in human medicine although it is not commonly used in people anymore.

Bromide remains in the body for a long time and only needs to be given once daily. It is removed from the body through the kidneys and so is suitable for use in dogs with liver disease, but must be used with care in animals with kidney disease. Bromide is usually given as a liquid with food. Giving it with food helps the dog to absorb the drug and if given on an empty stomach bromide can cause nausea.

If your dog is receiving bromide keep their food constant as fluctuations in the salt levels of the diet can affect the levels of the drug. Side effects of bromide are rare although occasionally drowsiness and increased appetite may occur.

Skin reactions are seen in some people and have been occasionally reported in dogs. Bromide is often used at the same time as phenobarbital particularly in dogs who tend to have groups of seizures cluster seizures.

Diazepam is very effective at stopping seizures but unfortunately it is quickly removed from the body and dogs become tolerant of its effects if it is given regularly. It is mainly used to stop a seizure while it is occurring. Diazepam can be given by injection but is also effective if given per rectum as a suppository. Your vet may give you a supply of diazepam to use as a suppository if your dog has a prolonged seizure.

New treatments are being developed for epilepsy but it takes a long time for these to come through the development process and be licensed for use. Other drugs used in humans are sometimes prescribed for dogs whose epilepsy cannot be controlled by the standard medications.

Once your dog has started on medication for his epilepsy there are a number of very important golden rules:. It is important that medication is given at the same time each day. Once your dog has been on treatment for a while he will become dependent on the levels of drug in his blood at all times to control seizures. If you miss a dose of treatment, blood levels can drop and this may be enough to trigger a seizure.

Once a dog has started on treatment it is usually continued for the rest of their life. However, if for any reason your vet asks you to reduce the dose of medication this must be done gradually.

Never change anything without contacting your vet. Never adjust the dose of medication or stop treatment without asking your vet. Increasing the dose of medication without careful monitoring can cause severe side-effects and reducing the dose may trigger seizures. Each epileptic is an individual and a treatment plan will be designed specifically for them — this will be based on the severity and frequency of their seizures and how they respond to different medications.

Each time you visit your vet take this diary along with you so your vet can see how your pet has been since their last check-up. If seizures are becoming more frequent it may be necessary to change their medication. However by careful use of medication the frequency of seizures can usually be reduced so that your dog is able to lead a happy and healthy life. Your dog will not be worrying about when their next seizure is going to strike he will be enjoying one day at a time, and as long as the good times outweigh the bad you can feel happy to do the same.

Discuss your concerns with your vet — it is important that you fully understand the goals of treatment right from the start. Why has my dog got epilepsy? Is there a treatment for epilepsy? When can treatment start?

Will my dog get better? How difficult is treatment? What drugs can be used to control epilepsy in dogs. How can I help to ensure treatment is successful? Once your dog has started on medication for his epilepsy there are a number of very important golden rules: Give medication regularly It is important that medication is given at the same time each day.

Never change anything without contacting your vet Never adjust the dose of medication or stop treatment without asking your vet. Keep records Each epileptic is an individual and a treatment plan will be designed specifically for them — this will be based on the severity and frequency of their seizures and how they respond to different medications.