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 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 guide, we'll explore what potassium bromide is, when it's used, how to start your dog on it, and what to expect along the way.
Understanding Potassium Bromide:
Potassium bromide is a medication commonly prescribed by veterinarians to manage seizures in dogs when the initial medications haven't sufficed on their own. It belongs to a class of drugs known as anticonvulsants, which means it helps control or prevent seizures. Seizures in dogs can be caused by various factors, including epilepsy, brain tumours, or metabolic disorders. Potassium bromide works by stabilising electrical activity in the brain, reducing the likelihood of seizures occurring.
Possible Veterinary brand names you may come across include Epilease, K-Bro Vet, Libromide and Vetbromide. It comes in tablet, capsule and liquid form. Oral administration is tolerated well by most dogs. Some capsule formulations can be sprinkled on food so please check this with your veterinarian.
Potassium Bromide is not recommended for dogs who have a history of or a predisposition for the development of pancreatitis and should be used with caution in dogs with kidney problems. If your dog is dehydrated or has diarrhoea this can affect the uptake of the drug.
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Starting Your Dog on Potassium Bromide:
If your veterinarian has recommended potassium bromide for your dog, the first step is to schedule a consultation to discuss the treatment plan. Your vet will take into account your dog's medical history, current health status, and any other medications they may be taking. It's essential to follow your vet's instructions closely to ensure the safety and effectiveness of the treatment.
Here's what to expect when starting your dog on potassium bromide:
Initial Evaluation: Your vet will conduct a thorough physical examination and may recommend additional tests, such as blood work or imaging, to assess your dog's overall health and the severity of their condition.
Prescription and Dosage: Based on the evaluation, your vet will prescribe the appropriate starting dosage of potassium bromide for your dog. This dosage may need to be adjusted over time based on your dog's response to the medication.
Gradual Introduction: Potassium bromide is typically introduced gradually to minimise side effects and allow your dog's body to adjust to the medication. Your vet will provide specific instructions on how to administer the medication, which is usually given orally.
Loading Dose: Potassium Bromide usually takes a minimum of 3 weeks to reach the therapeutic range and up to 3-4 months to achieve steady state concentrations in the blood due to the long half life of this drug, therefore persistence is key. In certain cases, dogs will be given a high loading dose in order to reach therapeutic levels in their bloodstream more rapidly but this will likely be associated with more adverse effects (particularly sedation and wobbliness) being seen in your pet. Please discuss these with your vet and ensure that you understand the dose that is being chosen in your dog's case.
Monitoring: Throughout the treatment process, your vet will monitor your dog closely for any signs of improvement or side effects. It's essential to keep track of your dog's seizures and report any changes or concerns to your vet promptly. Regular blood tests will likely be recommended in order to monitor the levels of Potassium Bromide (KBr) in their blood and overall health while on these medications.
Lifestyle Adjustments: In addition to medication, your vet may recommend lifestyle adjustments to help manage your dog's condition, such as changes to their diet or exercise routine. High levels of dietary salt increase the elimination of KBr via the kidneys therefore a low salt diet is recommended and it is essential that the diet remain consistent from the point of starting this medication.
Potential Side Effects:
Every dog responds differently to medication, so it's essential to be patient and observant during the treatment process. Some dogs may experience the following side effects from Potassium Bromide. If you have any concerns at all about your dog's response to potassium bromide, don't hesitate to reach out to your vet for guidance. Some degree of wobbliness and sedation are to be expected with loading doses of KBr but please always check with your vet whether any adverse effects you are seeing are fine to monitor or require intervention. It is good practice to note down and monitor the effects of this medication on your dog so that you can report all of them to your vet in a clear and informative matter.
Wobbliness or loss of balance: Your dog might have difficulty with balance or coordination, appearing unsteady on their feet.
Sedation or drowsiness: Your dog may appear sleepy, less alert or less responsive than usual.
Vomiting or nausea: Your dog might vomit or refuse to eat, showing signs of nausea or digestive upset.
Increased thirst: Your dog may start drinking more water than usual, leading to more frequent trips to the water bowl or noticing you need to fill it up more frequently.
More frequent urination: With increased water intake, your dog may need to urinate more often. This could also lead to accidents in the house if not managed properly.
Increased appetite: Your dog might start eating more than usual, showing increased interest in food and possibly gaining weight.
Lethargy or sluggishness: Your dog may appear more tired and less active than usual, showing signs of fatigue or even sleeping more.
Skin reactions, such as rashes or itching: You might notice changes in your dog's skin like redness, rashes, or your dog might scratch more due to itchiness. Please report these to your vet as in humans, signs of chronic toxicity from this drug include skin rashes alongside gastrointestinal and neurological signs.
Changes in behaviour: examples include as hyperactivity, restlessness, increased aggression or anxiety.
Pancreatitis: Pancreatitis in dogs is an inflammation of the pancreas, which can disrupt digestion and cause severe discomfort. Common signs include loss of appetite, vomiting, abdominal pain, and lethargy.
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What Happens If I Accidentally Give An Overdose?
If you accidentally double dose your dog please contact your veterinary surgeon or a Veterinary Poisons Information line immediately. Overdosage can produce brominism which can cause ataxia (wobbliness), depression, tremors, neurological problems and even coma.
Due to the long half life of this medication, brominism can also occur in some dogs months after treatment. Signs of this can include:
Muscular pain
Proprioceptive deficits (not knowing where their feet are which can lead to knuckling and stumbling)
Anisocoria (different sized pupils)
Hyporeflexia
Tips for Starting Your Dog on Potassium Bromide:
Here are some tips to help ensure a smooth transition onto Potassium Bromide for your epileptic doggy:
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. Ensure your dog is receiving all their medications at the correct times and that you discuss with your veterinarian the potential interactions with other medications they may be on.
Be Patient: It may take some time to find the optimal dosage of Potassium Bromide 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, wobbliness, sedation, skin reactions, vomiting, increased appetite or thirst or behavioural changes and report them to your veterinarian promptly.
Speak to Your Vet: Never stop the drug suddenly without consulting your vet first as abrupt cessation can precipitate seizures or even status epilepticus. It is important to advocate for your dog and establish a clear line of communication with your vet regarding you and your dog's experience with the drug so that you can work together to wean your dog off the drug if it does not suit your dog.
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 Potassium Bromide 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 potassium bromide can be a positive step towards managing their seizures and improving their quality of life. By working closely with your veterinarian and following their recommendations, you can help ensure a safe and effective treatment plan for your dog. Remember to be patient, stay informed, and provide plenty of love and support along the way. Your dog's health and happiness are worth it!
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