Q: My 7.5-year-old cockapoo, Lila, has had epilepsy for the past five years. She is currently managed with phenobarbital, Keppra, and potassium bromide. In the early days before effective control, she would have as many as 15 seizures in three days every two weeks. Are there any studies that indicate epilepsy can resolve after a period of time? I raise this question because her medication has not changed for a long time, and she has gone from one seizure every couple months to none in over six months. This amount of medication, while useful for warding off seizures, seems to keep her docile and relatively inactive. If there was any proof of epilepsy resolving I would consider reducing the medication under the direction of her veterinarian.
Doug White
Clyde, North Carolina
Dear Mr. White,
A: First, congratulations on the dramatic reduction in Lila’s seizures. Anti-seizure medications are very good at reducing seizure frequency, but not always as good as they have been for Lila.
On whether canine epilepsy can resolve, the answer is typically not. By one estimate, only one in about 15 dogs with the condition “outgrows” it. Thus, most dogs remain on anti-seizure medication for life.
In Lila’s own particular situation, you can reasonably ask yourself, “If it ain’t broke, why fix it?” Consider that even a pattern of seizures that lasts only a short time creates tremendous stress on the brain, lungs, and other organs. Body temperature can rise, too, from all the muscle activity associated with the tremors.
But you can also reasonably want to keep your dog on the lowest doses of medication possible. The drugs Lila gets can cause side effects ranging from increased thirst and urination to increased appetite. They can also cause the docileness and relative inactivity (lethargy) that you describe, but that tends to happen more up front, during the “loading” period of administering the drug. It may be that Lila is more docile because she’s in mid life rather than the young dog she was when first diagnosed.
Definitely do speak with Lila’s vet before making any changes to her medication protocol. You may want to consult a board-certified veterinary neurologist as well, who sees cases like Lila’s more frequently. (You can find one in your area by getting a recommendation from Lila’s primary care vet or plugging in your city and state at vetspecialists.com.) Rest assured, however, that whatever Lila’s side effects are from the drugs, they are nothing compared to the assault on the brain and body that seizures bring.
