Patrick was what I call a "lifetime dog" - one which, if you are very lucky, you get to know once in a lifetime. I used to claim that I didn't have favorites among my dogs, but then came Patrick, whelped on St. Patrick's Day 1993.
He had 3 seizures in one month when he was 14 months old, one single grand mal, then a double. We did all the $$$ testing with a neurologist, with inconclusive results. Both seizure episodes occurred the day after we had been at noticeably bug-free show sites, so the neurologist (and we) suspected Patrick had been exposed to a toxin when he then went 8 months seizure free with no medication.
Then came the clusters, frequently 20+ grand mals, and he was technically in status 3 times.
The search for control began, with steadily increasing dosages of phenobarb, since we didn't know bromide was an option back then. Since our access to emergency care is limited by our vet's distance from his pager, we learned to break clusters by giving extra doses of oral phenobarb IMMEDIATELY (Patrick was totally resistant to valium). It took a couple of mistakes to learn to give a dose after every seizure, not to wait and see if 'maybe it's just one.' (This regimen should only be attempted on advice from your vet.) We also succeeded in spacing the clusters out, with gaps of 10 and 8 months.
We finally discovered bromide, and the importance of peak and trough level testing for phenobarb. We found that Patrick metabolized phenobarb much more quickly than normal, so his troughs were dangerously low. Instead of continuing to increase the dosage, we added sodium bromide (NaBr, therapeutically the same as KBr).
Patrick died from heart failure on March 5, 1999, but his battle with epilepsy was a success. He had remained completely seizure-free since May 1997.
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