Epilepsy means two or Seizures, characterized by an acute

more seizures 24 hours increase in aberrant electric activity in the ALGORITHM FOR SEIZURE MANAGEMENT IN CANINES
apart resulting from non brain, may lead to excessive and abnormal
toxic and non metabolic neuronal transmission that often results in Parenteral maintenance
cause. uncontrolled muscular activity Benzodiazepines (BZD) Phenobarbital 2-6 mg/kg IV, IM
MOA-gaba facilitatory,inhibits
WHEN TO START TREATMENT MOA-GABA facilitatory,reduce glutamate activity,reduce calcium
Seizures occur more than once a month, or in clusters serotonic utilization by neuron
SEIZURES induced neurotransmitter release or
Underlying cause of seizures is identified that could Diazepam 0.5-2.0 mg/kg IV, IN, PR or
increase intracranial pressure (eg, brain tumor) STOPS Levetiracetam 20-60 mg/kg IV, IM,
Midazolam 0.1-0.3 mg/kg IV, IN, IM or SC .MOA-binds with synaptic vesicle
Lorazepam 0.1-0.2 mg/kg IV protein 2A(SV2A),inhibits ca
SEIZURE dependent neurotransmitter release
CONTINUES
Initiate oral maintenance AND
investigate seizure etiology
PRN BZD bolus or CRI SEIZURE Phenobarbital 2-3 mg/kg PO q 12 hrs
Repeat BZD IV bolus 2-3X or STOPS Potassium bromide 20-40 mg/kg/day
Diazepam IV CRI 0.1-0.5 mg/kg/hr and Levetiracetam 20-30 mg/kg PO q 8
BASED ON
ETIOLOGY hours
SEIZURES MISCELLANEOUS DRUGS
CONTINUE • FELBAMATE(NMDA inhibition)
BEYOND • ZONISAMIDE
20 MIN • CARBAMAZEPINE-prolong inactivate state
of sodium channels(difficult to maintain
Refractory SE Parenteral Treatments therapeutic dose in dogs due to rapid
Propofol 2-6 mg/kg titrated IV bolus elimination
and • Lamotrigine-blocks voltage sensitive
ACCORDING TO
NATURE OF FIT Propofol 0.1-0.5 mg/kg/min IV CRI; or sodium channels
Ketamine 3- 5mg/kg IV bolus and
FOCAL Ketamine IV CRI 0.1-0.5 mg/kg/hr; or
GENERAL EPILEPSY
EPILEPSY
PARTIAL
Fosphenytoin 15mg/kg (PDE) IV bolus • Do not administer phenobarbital to
CORTI
PSYCHOMOTO WITH animals with impaired hepatic function.
GRAND PETIT STATUS CAL
TONIC SEIZURE
MAL/toni MAL/absen EPILEPTI FOCAL R Not for use in pregnant animals and
c clonic CUS
CLONIC CONTINUES
ce seizures nursing bitches
• Withdrawal of levetiracetam therapy or
Inhalant anesthesia transition to or from another type of
Isoflurane 1-2% MAC antiepileptic therapy should be done
graduallY