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Medication Selection for Newly Diagnosed Dogs with Epilepsy

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    November 14, 2022 2:19 PM EST

    Question submitted during Session II of The Canine Epilepsy Summit:

    "Can Dr Muñana rank her drug choice in a newly diagnosed dog. Is Phenobarbital or KBr always first choice meds in her opinion? She stated that Phenobarbital is often her first choice but is it appropriate to use Keppra first line in any situations?"

    - Answer provided by Dr. Karen Muñana:

    I tend to use either phenobarbital or levetiracetam most often as first line drugs. If the caregiver is more concerned about side effects, I often recommend levetiracetam. But if the caregiver is more concerned about seizure control, then I recommend phenobarbital.

    I was also asked about adding ASDs (e.g. a dog on levetiracetam as their daily ASD and what to add on as a second-line drug for breakthrough seizures) ...There is no set recommendation on how to add on ASDs in an individual dog. Potassium bromide, phenobarbital and zonisamide have all been used in this regard. There is no information on which is more effective when used in combination with levetiracetam.