RADAR'S TRIUMPH OVER EPILEPSY
Many people have asked me about Radar's epilepsy. How bad is it? How long did it take to get control of his seizures? And how is he doing now. Here's his story:
We adopted Radar on June 8, 1999 knowing that he had epilepsy. He was on 30 mg of Phenobarbital twice a day when we adopted him and had just had a seizure at his foster mom's house about a week prior so we weren't expecting to see seizures in the near future. Unfortunately we were wrong. On June 11th, Radar had a grand mal seizure at about 6:00pm. The seizure itself was worse than any seizure I had ever seen but even more frightening to me was the fact that Radar had a horrible post ictal period (the period of time after a seizure, but before the brain has fully recovered). He paced and cried. He was blind and kept bumping into things. He would walk into a corner and wouldn't know how to get out! I wanted to gather him in my arms and comfort him but he couldn't tolerate being held. He had to pace!
After about 30 minutes of this, Radar had another grand mal seizure and when it was over continued with the pacing, crying and abnormal behavior. Bogie and Hawkeye tried to stay out of his way, but Radar kept running into them or walking over them. Fortunately they are both good natured and just looked at me as if to say "what's with him, mom".
Over time, I learned that Radar would always have a long and horrible post ictal period and the more seizures he had in an episode, the worse this period would be. The post ictal period would last anywhere from 8 to 24 hours.
Radar's next episode of seizures happened on June 22nd (eleven days since his last one) and this time he had 4 seizures in about an hour. Off to the emergency room we went but by the time we arrived the seizures had stopped and the ER veterinarian didn't want to give him any medication. The next day our vet told us to increase his Phenobarbital to 45 mg twice a day.
We went 26 wonderful seizure free days before Radar had another seizure but this episode was the worst ever. There was about 45 minutes between his first and second seizure, but then he started having seizures every 10 minutes. This time the ER told us that he was in status. They gave him an injection of Phenobarbital and kept him over night. I've never been so devastated but unfortunately, this was to become somewhat of a routine for us.
After this episode Radar's Phenobarbital was raised to 60 mg twice a day and potassium bromide was added. Finally, something was working and Radar was seizure free for 120 days before he had his next seizure episode. The bad news is that every episode was still getting worse. This time Radar had 17 seizures spread over 22 hours. His post ictal period was horrible. Radar couldn't see and could barely walk, but still he was driven to pace.
We had to do something. There had to be a better way to treat his seizures. Once Radar started having seizures, they just wouldn't stop. We changed vets and our new vet prescribed liquid valium to be given per rectum along with valium pills to be given every two hours for 24 hours after his last seizure. We were much more confident knowing that we had something that would stop his seizures at home instead of having to take him to the ER every time he had a seizure episode.
Our new vet also suggested that we start to wean him down to a much lower dose of Phenobarbital, since it can cause liver damage and it didn't seem to be doing a good job of controlling his seizures. Our goal was to reduce his dose to 15 mg three times a day over the next year. Our approach to reducing Phenobarbital was much slower than is necessary because his seizures were so severe.
The potassium bromide seemed to be working so much better for Radar and we had 139 days before we had a chance to try the valium. The good news is that Radar only had three seizures using it, the bad news is that instead of sedating him, valium made him hyper. Now instead of pacing during his post-ictal time, he ran in circles. One time he went running full speed into a wall and kept trying to run through it. In addition to being hyper, Radar was ravenous on valium and had to be fed every hour. The problem was that he was so disoriented and so hungry that he inhaled food and I was afraid he would aspirate food into his lungs so I hand fed him one piece of kibble at a time.
After gaining more and more time between seizures, Radar threw us a curve and had a seizure just 37 days after his last one. It was so disappointing but I've learned over the years that there is nothing predictable about this disorder. Even worse than the time period was the fact that Radar had his seizure in the middle of the day. Up until this time, all of his seizures were in the early evening when we were home with him. This raised a whole new fear of "what if Radar starts to have a seizure while we're at work and is dead by the time we get home?"
His next seizure was 135 days and back to his normal pattern, however, the valium didn't work. Radar started having seizures at eight in the morning and had five seizures over a 24-hour period then went into status with seizures every 5 minutes. My husband drove while I tried to keep Radar from hurting himself in the car on the way to the ER. By the time we arrived Radar was in a constant seizure. He was put on a valium drip which didn't stop his seizures and I was sure that this time he wouldn't make it. It took four hours of sedation with Propofol to stop his seizures and Radar had to be hospitalized for two days. When we finally brought him home, you could tell that he had some brain damage from the seizures. He forgot where to go potty, didn't seem to know the rules of the house and was just not himself. Fortunately, the brain is a wonderful organ and has a huge capacity to compensate. It took about a week, but Radar totally recovered and is as normal as he ever was.
We'd completed our program of Phenobarbital reduction and Radar was on 15 mg three times a day when we had an abnormal bile acid test on one of his routine tests. More to worry about, now I thought my baby had liver disease. We scheduled an ultra-sound which showed a perfectly normal liver. Another lesson to be learned. Don't get upset over a lab test until you have the results verified. Lab tests are very prone to error.
It was after the scare of liver disease that my vet suggested that we try to take Radar off of Phenobarbital totally and again we set a schedule to slowly reduce the medication. We were down to 7.5 mg once a day and I was afraid to take the plunge and eliminate it totally. I think that I must have had a premonition of what would happen, but I didn't listen to it. Eventually, I mustered up the courage to eliminate that last small amount of Phenobarbital and two days later Radar had seizures. Radar continued to have seizures every day until we could get enough Phenobarbital back into his system. This period of time was the only time that I've ever questioned his quality of life. For seven days Radar was seizuring and on valium which was making him agitated and hyper. The poor guy must have been miserable and I hated myself for causing him to go through it.
We'd been dealing with Radar's seizures for three years by now and he continued to have seizures every three to five months. He went into status about 60% of the time because valium didn't work for him. The valium continued to make him miserable. My vet kept telling me that because Radar went more than 30 days between seizures, he had good control. I wouldn't accept this. Not for a dog who had to be treated in the ER 60% of the time that he had a seizure episode. By now, I was on a first name basis with the ER staff.
In June of 2002, we learned that Chicago was getting a full time veterinary neurologist and made an appointment for Radar. I was happy with the time we had between seizures but still very unhappy with the severity of his seizures. Dr. Podell adjusted Radar's daily medications and reminded me that the goal of treating this disorder was to reduce the frequency of seizures and DECREASE THE SEVERITY OF SEIZURES. We were fine with the frequency, but the medication he was on did not decrease the severity. He also wanted us to use rectal valium alone (at a higher dose) without the oral valium. In his opinion, it was the constant low dose of valium that was causing a problem for Radar.
It was nine months before Radar had his next seizure. I was so sure that Radar would go into status with only rectal valium to stop his seizures but we followed the advice our neurologist gave us. What a surprise! Radar had one seizure. He paced for about 30 minutes and then went to sleep.
He's had three seizures since being on the new dose of medications with the same result. Now his seizures are very easy to deal with and my fear that he'll go into status and die is subsiding a little bit more each day. He is currently over one year seizure free and still going.
My advice to anyone dealing with seizures is to work with your vet as much as possible but if your dog's seizures aren't well controlled with his/her guidance ask for a referral to a neurologist. And most of all, never, ever give up. There are always new treatments and medications available; maybe one of them will be the magic solution for your dog.
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Last Updated August 2009