Medication Management: What Every Caregiver Should Know

Managing medication for a dog with epilepsy can feel overwhelming, but understanding how antiseizure medications work and how to administer them properly is crucial for your dog's health and quality of life.

Why Medication is Necessary

For most dogs with epilepsy, medication is essential because:

• Prevents seizures: Reduces frequency and severity
• Protects the brain: Prevents damage from repeated seizures
• Improves quality of life: Allows your dog to live normally
• Prevents status epilepticus: Reduces risk of life-threatening seizures

Important: Epilepsy medications are typically lifelong. Stopping medication suddenly can cause severe withdrawal seizures.

Common Antiseizure Medications

Phenobarbital

Most commonly prescribed medication for canine epilepsy

How it works:

• Increases the brain's threshold for seizures
• Slows down brain activity
• Takes 2-3 weeks to reach therapeutic levels

Dosing:

• Usually given twice daily (every 12 hours)
• Requires regular blood level monitoring
• Dosage adjusted based on blood levels and seizure control

Side effects to watch for:

• Increased thirst and urination (most common)
• Increased appetite and weight gain
• Sedation or lethargy (usually temporary)
• Liver enzyme elevation (requires monitoring)
• Ataxia (uncoordinated movement)

Important considerations:

• Never miss a dose - consistency is critical
• Blood levels must be checked regularly (every 6-12 months)
• Can interact with other medications
• May take several weeks to see full effect

Keppra (Levetiracetam)

Often used for breakthrough seizures or cluster seizures

How it works:

• Works differently than Phenobarbital
• Can be used alone or in combination
• Faster onset of action

Dosing:

• Usually given three times daily (every 8 hours)
• Available in tablets or liquid
• Generally well-tolerated

Side effects to watch for:

• Minimal side effects (one of its advantages)
• Possible sedation or ataxia (rare)
• May cause increased appetite

Important considerations:

• Shorter half-life requires more frequent dosing
• Good option for dogs with liver issues
• Often used when Phenobarbital alone isn't sufficient

Potassium Bromide

Often used in combination with Phenobarbital

How it works:

• Increases seizure threshold
• Works synergistically with other medications
• Takes longer to reach therapeutic levels

Dosing:

• Usually given once daily
• Can be given with food
• Requires regular blood monitoring

Side effects to watch for:

• Increased thirst and urination
• Sedation
• Pancreatitis (rare but serious)
• Skin irritation (if liquid form)

Zonisamide

Alternative medication with fewer side effects

How it works:

• Similar mechanism to Phenobarbital
• May have fewer side effects
• Good for dogs who can't tolerate Phenobarbital

Dosing:

• Usually given once or twice daily
• Requires regular monitoring

Side effects to watch for:

• Minimal compared to Phenobarbital
• Possible sedation
• Liver enzyme elevation (less common)

Medication Schedule Management

Consistency is Critical

Why timing matters:

• Maintains steady blood levels
• Prevents breakthrough seizures
• Ensures medication effectiveness

Best practices:

1. Set reminders: Use phone alarms or medication tracking apps
2. Link to routine: Give medication with meals or at specific times
3. Never double dose: If you miss a dose, contact your vet
4. Track adherence: Use PupPal to log every dose

Using PupPal for Medication Tracking

PupPal's medication management system helps you:

• Schedule reminders: Never miss a dose
• Track adherence: See your dog's medication history
• Identify patterns: Connect missed doses to seizures
• Generate reports: Share medication logs with your vet

What to Watch For

Signs Medication is Working

• Reduced seizure frequency: Fewer seizures over time
• Shorter seizures: Seizures last less time
• Milder seizures: Less severe episodes
• Longer intervals: More time between seizures

Signs You Need to Adjust Medication

Contact your veterinarian if:

• Seizures increase in frequency
• Seizures become more severe
• New side effects appear
• Your dog's behavior changes significantly
• Blood work shows concerning values

Red Flags - Seek Immediate Care

• Status epilepticus: Seizure lasting more than 5 minutes
• Cluster seizures: Multiple seizures in a short period
• Severe side effects: Difficulty breathing, collapse, severe lethargy
• Suspected overdose: Contact your vet or emergency clinic immediately

Blood Level Monitoring

Why It's Important

• Ensures therapeutic levels: Medication must be at the right level
• Prevents toxicity: Too high can cause side effects
• Confirms compliance: Verifies medication is being given correctly
• Guides adjustments: Helps your vet adjust dosages

When to Check Blood Levels

• Initial monitoring: 2-3 weeks after starting medication
• Routine monitoring: Every 6-12 months for stable dogs
• After dosage changes: 2-3 weeks after adjustment
• If seizures increase: May indicate levels are too low
• If side effects appear: May indicate levels are too high

Medication Interactions

Common Interactions

• Other medications: Always inform your vet of all medications
• Supplements: Some supplements can interact
• Food: Some medications must be given with or without food
• Other conditions: Liver or kidney disease affects medication processing

Always inform your veterinarian about:

• All medications your dog is taking
• Any supplements or vitamins
• Changes in your dog's health
• Other veterinarians your dog sees

Managing Side Effects

Common Side Effects and Solutions

Increased thirst and urination:

• Provide constant access to fresh water
• More frequent bathroom breaks
• Consider waterproof bedding

Increased appetite:

• Measure food portions carefully
• Use low-calorie treats
• Increase exercise (if approved by vet)
• Monitor weight regularly

Sedation or lethargy:

• Usually temporary (first few weeks)
• May improve as dog adjusts
• Contact vet if severe or persistent

Ataxia (uncoordinated movement):

• Usually temporary
• Keep dog away from stairs and hazards
• Contact vet if severe

Tips for Successful Medication Management

1. Create a Routine

• Give medication at the same times every day
• Link to daily activities (meals, walks)
• Use reminders and tracking tools

2. Stay Organized

• Use a pill organizer
• Keep medication in the same place
• Track doses in PupPal
• Keep a medication log

3. Communicate with Your Vet

• Report all seizures (even small ones)
• Share medication logs
• Discuss side effects immediately
• Ask questions when unsure

4. Be Patient

• Medication adjustments take time
• It may take weeks to see full effect
• Finding the right dose is a process
• Don't give up - work with your vet

Emergency Situations

What to Do If You Miss a Dose

1. Don't panic - one missed dose is usually okay
2. Don't double dose - this can be dangerous
3. Give the next scheduled dose at the normal time
4. Contact your vet if you're concerned
5. Watch for seizures - may be more likely after missed dose

What to Do If You Suspect Overdose

Signs of overdose:

• Severe sedation or coma
• Difficulty breathing
• Extreme lethargy
• Loss of coordination

Immediate actions:

1. Contact your veterinarian or emergency clinic immediately
2. Bring the medication bottle with you
3. Note how much was given and when
4. Don't wait - this is an emergency

Working with Your Veterinarian

What Your Vet Needs to Know

• Seizure frequency: How often seizures occur
• Seizure details: Duration, type, severity
• Medication adherence: Are doses being given on time?
• Side effects: Any changes in behavior or health
• Other medications: Everything your dog is taking

Questions to Ask Your Vet

• What should I do if I miss a dose?
• When should I contact you about side effects?
• How will we know if the medication is working?
• What are the signs of an emergency?
• How often do we need to check blood levels?

Conclusion

Successful medication management requires:

• Consistency: Give medication on time, every time
• Monitoring: Track seizures and side effects
• Communication: Work closely with your veterinarian
• Patience: Finding the right treatment takes time
• Organization: Use tools like PupPal to stay on track

Remember, you're not alone in this journey. With proper medication management and tracking, most dogs with epilepsy live happy, normal lives.

Track your dog's medications with PupPal - Our medication management system helps you stay organized, never miss a dose, and share accurate information with your veterinarian. Start tracking today.