Dr. Natascha Hedegaard BVetMed MRCVS graduated as a veterinary surgeon from the Royal Veterinary College, London, in 2018. She is passionate about optimising canine health with a holistic approach to veterinary medicine and consideration for the individual patient .She is currently undertaking her Postgraduate Certificate in Small Animal Medicine with an aim to becoming an Advanced Practitioner.
Introduction:
Discovering that your loving dog needs medication to manage seizures can be daunting. However, with the right information and support, you can navigate this journey with more confidence. In this blog post, we'll explore what you need to know when starting your dog on levetiracetam including what to expect, how to administer the medication, and tips for ensuring your dog's comfort and well-being.
Understanding Levetiracetam:
Levetiracetam is a commonly prescribed anticonvulsant medication used to manage seizures in dogs. Veterinary brand names in the UK and US include Keppra ®, Elepsia ®, and Spiritam ®. It is an anticonvulsant medication that works by stabilising electrical activity in the brain, helping to reduce the frequency and severity of seizures. Levetiracetam is often recommended when other seizure medications have proven ineffective or when a dog experiences intolerable side effects with other medications.
Levetiracetam is available in tablet or liquid form and is given by mouth and is available in both immediate and extended-release formulations and is given two, three or four times daily depending on the elected dose and use. When given concurrently with phenobarbital and/or potassium bromide, dosage increases may be necessary as levetiracetam clearance from the bloodstream is faster when given with either of these drugs.
Starting Levetiracetam Treatment:
Here's what you can expect when starting your dog on levetiracetam:
Veterinary Consultation: The first step is to consult with your veterinarian. They will perform a thorough examination of your dog, review their medical history, and discuss treatment options with you.
Prescription and Dosage: If levetiracetam is deemed appropriate for your dog, your veterinarian will prescribe the medication and provide instructions on dosage and administration. The dosage is typically based on your dog's weight and severity of seizures. Your vet will advise you on the length of time this medication is recommended which will vary between patients but may be the rest of their life. Note: levetiracetam should not be stopped suddenly.
Administration: Levetiracetam is available in tablet or liquid form. Your veterinarian will advise you on the best method of administration for your dog. Tablets can usually be given with food to minimise stomach upset, while liquid medication may be administered directly into your dog's mouth using a syringe or mixed with food.
Gradual Introduction: Your veterinarian may recommend gradually introducing levetiracetam to your dog's system to minimise potential side effects. This often involves starting with a low dose and gradually increasing it over several days to weeks until the desired effect is achieved.
Monitoring: Once your dog is on levetiracetam, it's essential to monitor their response to the medication closely. Your veterinarian may schedule follow-up appointments to assess your dog's seizure activity and adjust the dosage if necessary.
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Understanding Potential side effects
While Levetiracetam can be highly effective in controlling seizures, it's essential for pet owners to be aware of potential side effects that may occur. In this blog post, we'll explore some of the possible side effects of levetiracetam in dogs. Levetiracetam has been documented as the most well tolerated anti-epileptic drug in humans, with adverse reactions equivalent to placebo.
Gastrointestinal Upset or Reduced Appetite: One of the most common side effects of levetiracetam in dogs is gastrointestinal upset. This may manifest as vomiting, diarrhea, hypersalivation or decreased appetite and are normally only seen when higher or overdoses are given. While these symptoms are usually mild and temporary, it's essential to monitor your dog closely and report any persistent or severe gastrointestinal issues to your veterinarian.
Sedation: Some dogs may experience mild sedation or lethargy when first starting levetiracetam or when the dosage is increased. While this side effect typically diminishes over time as the dog's body adjusts to the medication, it's important to ensure your dog has a safe and comfortable environment during this period.
Ataxia (Wobbliness, Loss of Coordination): In some cases, dogs may exhibit temporary ataxia or loss of coordination while taking levetiracetam. This may present as unsteady gait, stumbling, or difficulty standing. While ataxia is usually mild and resolves on its own, it's crucial to prevent your dog from engaging in activities that could lead to injury, such as climbing stairs or jumping on furniture.
Behavioural Changes: Occasionally, dogs may experience behavioural changes while on levetiracetam, such as increased agitation, anxiety, or restlessness. If you notice any significant changes in your dog's behaviour, it's essential to discuss them with your veterinarian to determine if they are related to the medication or another underlying issue.
Allergic Reactions: While rare, allergic reactions to levetiracetam can occur in some dogs. Signs of an allergic reaction may include facial swelling, hives, difficulty breathing, or severe itching. If you suspect your dog is having an allergic reaction to levetiracetam, seek veterinary care immediately.
Which patients may it not be suitable for?
Levetiracetam should be used with caution in patients with renal insufficiency (kidney problems) with dosage reductions considered.
In pregnant dogs, levetiracetam should be used with caution. Levetiracetam is excreted into the maternal milk and its safety in nursing offspring is unknown. It should be used with caution.
Levetiracetam can interact with antihistamines.
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Tips for Starting Your Dog on Levetiracetam:
Here are some tips to help ensure a smooth transition onto levetiracetam for your epi dog:
Follow Veterinary Instructions: Always follow your veterinarian's instructions regarding dosage, administration, and monitoring. They are the best resource for ensuring your dog's safety and well-being.
Be Patient: It may take some time to find the optimal dosage of levetiracetam for your dog. Allow your veterinarian to make adjustments as needed to achieve effective seizure control.
Monitor for Side Effects: Keep an eye out for any potential side effects, such as lethargy, loss of appetite, vomiting, or diarrhoea, and report them to your veterinarian promptly.
Provide Comfort and Support: Starting medication can be stressful for your dog, so be sure to offer plenty of love, comfort, and reassurance during this time.
If You Miss a Dose: Give the dose as soon as possible but do not give a double dose. Make sure the dose given does not exceed the total recommended dose in any 24-hour period.
Disposing of Unused/Out of Date Medication: Dispose of any unused levetiracetam safely – do not flush down the toilet or sink. Ask your veterinary team if they take back medication for disposal. Do not save levetiracetam for future use or give to other pets.
Conclusion:
Starting your dog on levetiracetam can feel overwhelming, but with the guidance of your veterinarian and a supportive approach, you can help your dog manage their seizures and enjoy a happy, fulfilling life. Remember to communicate openly with your veterinarian, monitor your dog's response to the medication closely, and provide plenty of love and support every step of the way.
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