UPDATE ON BUTCHY

Hey Pals,
It's me Katie.  I'm so anxious to attend the Royal Wedding this week with my best friends Lacie & Asta.  It is going to be so much fun!  Many of our pals are going to be there too.  It's going to be a terrier free for all!!

My brudder Butchy is having so much trouble.  He had a seizure last Thursday night, then again on Saturday night.  Then this morning, he had one and fell off of the big bed!  Yep, right onto the floor.  Scared Mama almost to death.  Luckily he was not injured.

We do have carpet on the floor.  Mama thinks maybe she needs to put some of our cushions on the floor beside the bed that we lay on.  Or maybe hook a leash onto Butchy while he is in bed and Mama can wrap the leash around her arm.  This way Mama could keep Butchy close to her on the bed so he couldn't fall off.

Does anyone else have any tips???  And please don't say put Butchy in his kennel crate at night, he would be very upset.  This would cause him major stress and might cause him to have a seizure.  He must be near his Mama at all times.  Ever since Mama rescued him, he has been glued to her.  He is such a Mama's boy, heheheh!  But then again, I'm such a Mama's girl!  Hah!  I'm almost as bad as Butchy, well, maybe just as bad.

Butchy's new anti-seizure medication Potassium Bromide should be in at the vet sometime Tuesday.  Then Mama can pick it up.  This is a very expensive compounded medication, so it is not mixed up until someone orders it.  ( it does come in capsule form, but this is even more expensive then the liquid form and is harder to adjust small increases in the drug )  Each dog has a specific dosage too.  It's hard to tell what dosage will work for Butchy at the start.  For those of you not familiar with this drug, here is some information to help explain how it works and how long it takes to get into the system.

Potassium Bromide (KBr) is often used for dogs with Idiopathic Epilepsy.  It has no effect on the liver, unlike Phenobarbital (Pb).  It is stored in body fluids and eliminated unchanged by the kidneys.  Potassium Bromide can take up to three-four months to reach its full effect in the dog's system.  (this is the part that Mama hates, too bad the effects don't come on faster)  Sometimes loading doses may be used for dogs if Phenobarbital must be withdrawn rapidly because of liver damage or disease.

Potassium Bromide & Phenobarbital can be used together.  Angel Snickers needed to be on both of these drugs to help control her cluster seizures.  These drugs never fully eliminated her seizures.  She still had them but less frequent.  By using both drugs, this can greatly improve seizure control.  Sometimes you can reduce the dosage of Phenobarbital when combined with the Potassium Bromide and in certain cases, Phenobarbital can gradually be eliminated.

Potassium Bromide has been around a long time but is seldom used in people.  It has never received FDA approval as a drug.  Potassium Bromide has been used in dogs for a long  time, and has proven to be reliable and safe.

The long half life of Potassium Bromide, which is about 24 days, means that the timing of an individual dose is much more flexible - unlike Phenobarbital.  You don't need to stay on a strict 12 hour schedule for giving this medication.  Giving this medication twice daily is most recommended because some dogs can't tolerate too much salt in their gastrointestinal tract at once - imagine eating a  tablespoon of sodium chloride.

If you miss giving a dose, it is not likely to cause an adverse effect.  But the long half life also means that the effectiveness of a particular dosage should not be evaluated until the dog has been on the dosage for three or four months, unless loading doses have been given.  If your dog is having seizures, adding an extra dose will not help.

Most  new patients are started at the lower end of the dosage range for their weight.  Some dogs with frequent or severe gran mal seizures are sometimes managed by starting at the higher end of the range for their weight or by using a loading dose.

An average maintenance dose for Potassium Bromide is 9 mg to13.5 mg per lb. of body weight divided in half, given twice a day.  Your veterinarian may adjust the dosage based on blood levels, seizure activity and side effects of the medication.  Be sure to get the blood tests that your vet requests.  It is important to get your dog on the best dosage for his or her situation.  Any change in dosage should be made based upon the actual drug concentration in the blood.

High chloride (salt) intake can increase the elimination of Potassium Bromide through the kidneys.  This means that if your dog's salt intake increases, you may need to adjust the dosage.  It is not necessary for your dog to be on a low salt diet, but it is very important that the salt content of the diet stays steady, no drastic changes should occur.  It's best to keep the diet as stable as you can.

The most common side effects of taking Potassium Bromide are sedation, ataxia  (hind end weakness and loss of coordination), increased urination and  rare skin disorders.  Increased urination, hunger and thirst are also common for dogs taking Potassium Bromide alone or with Phenobarbital.

Butchy already has the increased urination, thirst and hunger and ataxia from taking Phenobarbital.  The increased thirst is unreal from the Phenobarbital.  Butchy will stand at the water bowl and drink the WHOLE thing if Mama doesn't stop him.

Sometimes abnormal  behavior, such as irritability or restlessness may require a reduction in the Potassium Bromide dosage.  Angel Snickers did have the restlessness from this drug.  Side effects are more common in dogs with Potassium Bromide concentrations greater than 2.5 mg/ml and symptoms may usually go away within a week after the dose is decreased.  If  your dog is too groggy and is on both Phenobarbital and Potassium Bromide, you may be able to decrease the Phenobarbital dosage, rather than the Potassium Bromide.  If the dosage of Potassium Bromide is decreased, then it is recommended that blood levels be monitored before any dosage change in order to establish a target if seizures start again.

Potassium Bromide may cause an upset stomach, nausea or vomiting.  If this happens, you can try giving the drug at meal time.  Potassium Bromide should be used with caution in dogs with renal insufficiency.

* CAUTION *
Never just stop giving Potassium Bromide to your dog.  Consult with your vet.  The dose should gradually be tapered down over a period of 6 months.  Discontinuing the drug causes seizure recurrence.

To read more about epilepsy, please visit The EPI Guardian Angels.  We also have their link in our sidebar.

A special thanks to everyone that has already donated to help us pay for Butchy's ongoing medication costs.  We appreciate this so much!  We are very thankful for such giving, loving friends.

Wirey Hugs, Purrz & Licks,
Katie, Butchy, Ruby, Sylvester, Scuby, Hootie & Zeek