On December 2nd, Brady went to Dr. Slayman to have blood drawn to check to see where his Potassium Bromide levels were. He also received his rabies shot today and Dr. Slayman agreed that we could skip his other vaccines this time. The rabies shot really worried me, but it's the law.
December 4th....blood work results are in at 0.8. According to Dr. Slayman the therapeutic range is 1-3 (if on KBr only) and 0.8-2 (if on KBr in combination with another anti-convulsant drug). Per Dr. Slayman-leave his KBr dose at 600mg once per day and increase to 750mg if he has another seizure. Everything stays the same with Pb. (97.2 twice per day).
Monday, January 11, 2010
October 30 Lab results are in
Brady's Alk Ph liver value came in at 263 with 131 being normal. This wasn't cause for alarm according to the VRCC doctor. Although his Alk Ph value was twice as high as normal, it wasn't worrisome to her. There is cause for concern however when those values are 3 to 5 times higher than normal. His other liver values were normal.
Potassium Bromide levels were 0.6 which is not in the therapeutic range so I was instructed by Dr. Jones (VRCC ER vet) to increase the Potassium Bromide from 450mg to 600mg once per day. We also adjusted his Pb back up to 97.2mg twice a day.
His Triglycerides were normal and his Thyroid was 0.9, just a hair low, with normal being 1-4.
Potassium Bromide levels were 0.6 which is not in the therapeutic range so I was instructed by Dr. Jones (VRCC ER vet) to increase the Potassium Bromide from 450mg to 600mg once per day. We also adjusted his Pb back up to 97.2mg twice a day.
His Triglycerides were normal and his Thyroid was 0.9, just a hair low, with normal being 1-4.
More seizure activity in October...this time he went 38 days seizure free
On September 23rd, Dr. Slayman started Brady on Potassium Bromide (KBr) at a dose of 450 mg once per day. This was considered a maintenance dose and not a loading dose since he was already on Phenobarbital. It can take up to 4 months for KBr to reach a therapeutic range. Brady's phenobarbital level came in at 29.1 from labwork done at the VRCC. Upon reviewing his lab results Dr. Slayman wanted to decrease his Phenobarbital (Pb)
from 97.2mg twice per day to 81mg twice per day in one week's time and we would re-check levels in a month or 2. Her reason was because she considered 29.1 at the high end of the therapeutic range and wanted to see that level lower due to the risk of liver damage. It shouldn't be a problem since he was now also on KBr.
Once again I was afraid to reduce his Pb dose and after explaining my concerns to her she agreed that we could leave the dose at 97.2 twice per day for a longer period. On October 25th, I reduced his phenobarbital dose down to 81mg twice per day as discussed.
On October 27th, 2 days after reducing the Pb dose, Brady had a grand mal seizure at 9:30 pm. It was his normal, for lack of a better word, type of grand mal. It lasted about 3-5 minutes and after 8 minutes total he was up and aware of his surroundings. An hour and a half later at 11:30 pm he went into another grand mal, which was basically the same of amout of time as the one before and he came out of this one quickly as well. However, at this point, we made the decision to take him to the VRCC (emergency critical care). If we didn't realize it before, we definitely realized it now, having a single grand mal seizure is much better than having these multiple seizures. Our fear of clustering had become a reality. Once at the VRCC, they kept him to monitor him for 24 hours (remember this happened in September as well). Brady did well and didn't have any more seizures. My plan was to pick him up at 9:00 pm on October 28th and unfortunately, my poor boy had another seizure right before I arrived. The doctor gave him valium in his IV and the seizure stopped automatically. I sat with him for 3 hours that night to see if another seizure was going to occur. It didn't and they consented to letting me bring him home. Of course, I had to sign a release form since it was against their medical advice. But I knew he would do better at home and if another seizure came on I would bring him back without a second thought. For the first time in all of this, they sent us home with rectal valium to give in case another seizure happened.
Again we would wait for the lab results to come in.
On October 29th, I increased his PB back up to 97.2mg twice per day.
from 97.2mg twice per day to 81mg twice per day in one week's time and we would re-check levels in a month or 2. Her reason was because she considered 29.1 at the high end of the therapeutic range and wanted to see that level lower due to the risk of liver damage. It shouldn't be a problem since he was now also on KBr.
Once again I was afraid to reduce his Pb dose and after explaining my concerns to her she agreed that we could leave the dose at 97.2 twice per day for a longer period. On October 25th, I reduced his phenobarbital dose down to 81mg twice per day as discussed.
On October 27th, 2 days after reducing the Pb dose, Brady had a grand mal seizure at 9:30 pm. It was his normal, for lack of a better word, type of grand mal. It lasted about 3-5 minutes and after 8 minutes total he was up and aware of his surroundings. An hour and a half later at 11:30 pm he went into another grand mal, which was basically the same of amout of time as the one before and he came out of this one quickly as well. However, at this point, we made the decision to take him to the VRCC (emergency critical care). If we didn't realize it before, we definitely realized it now, having a single grand mal seizure is much better than having these multiple seizures. Our fear of clustering had become a reality. Once at the VRCC, they kept him to monitor him for 24 hours (remember this happened in September as well). Brady did well and didn't have any more seizures. My plan was to pick him up at 9:00 pm on October 28th and unfortunately, my poor boy had another seizure right before I arrived. The doctor gave him valium in his IV and the seizure stopped automatically. I sat with him for 3 hours that night to see if another seizure was going to occur. It didn't and they consented to letting me bring him home. Of course, I had to sign a release form since it was against their medical advice. But I knew he would do better at home and if another seizure came on I would bring him back without a second thought. For the first time in all of this, they sent us home with rectal valium to give in case another seizure happened.
Again we would wait for the lab results to come in.
On October 29th, I increased his PB back up to 97.2mg twice per day.
Sunday, January 10, 2010
Another downward spiral in September
On September 18th, one month from the last two seizures in August, the seizures returned with a vengeance. For the first time ever, Brady had a seizure that I did not witness somewhere between 10am and 11am, but all of the evidence was there.
He did well throughout the day and then another seizure occurred that afternoon at 5pm. He recovered as normal and did well again throughout the night. At 4:55am on the morning of September 19th, Brady endured a full-blown grand mal seizure. Once again he recovered quickly and seemed fine. Later between 7:00 and 7:25pm there was all the evidence that he had another seizure. This time he had a small abrasion above his left eye.
After this seizure, Brady just didn't seem to be himself and we decided that he should go to the VRCC (Veterinary Referral Critical Care). After all, this had never happened before, 4 seizures in 36 hours. They kept him to monitor him for 24 hours.
He did well while in the hospital and didn't have anymore seizures. I picked him up the night of September 20th.
Blood work revealed that the phenobarbital was on the high end of the therapeutic range, even so, the seizures are still occurring more often and are by no means under control whatsoever.
September 23rd Dr. Slayman decides to bring Potassium Bromide, another anti-convulsant drug, on board with the phenobarbital. The Potassium Bromide dose would be 450mg once per day.
Dear God please let this be what Brady needs to get the seizures under control!
He did well throughout the day and then another seizure occurred that afternoon at 5pm. He recovered as normal and did well again throughout the night. At 4:55am on the morning of September 19th, Brady endured a full-blown grand mal seizure. Once again he recovered quickly and seemed fine. Later between 7:00 and 7:25pm there was all the evidence that he had another seizure. This time he had a small abrasion above his left eye.
After this seizure, Brady just didn't seem to be himself and we decided that he should go to the VRCC (Veterinary Referral Critical Care). After all, this had never happened before, 4 seizures in 36 hours. They kept him to monitor him for 24 hours.
He did well while in the hospital and didn't have anymore seizures. I picked him up the night of September 20th.
Blood work revealed that the phenobarbital was on the high end of the therapeutic range, even so, the seizures are still occurring more often and are by no means under control whatsoever.
September 23rd Dr. Slayman decides to bring Potassium Bromide, another anti-convulsant drug, on board with the phenobarbital. The Potassium Bromide dose would be 450mg once per day.
Dear God please let this be what Brady needs to get the seizures under control!
With August came 2 petite mal seizures
Things went well again for Brady up until 7:19am on August 18th when he had a petite mal seizure. This was the first time he endured a petite mal; all of his previous seizures have been grand mals. A petite mal is definitely the lesser of 2 evils.
It was much shorter and much less traumatic. He didn't fall over on his side with this one. He had this one standing with me holding onto him. He was stiff and convulsing, but no real thrashing or paddling and just a small amount of drool as opposed to a massive amount of drool with a grand mal. He didn't lose control of his bladder either. It was over rather quickly and when it was he wasn't panting excessively and he wasn't staggering or weak. This one was definitely different than the others.
On August 19 at 4:33am another petite mal seizure occurred. This one was as mild as the one the morning before. After a conversation with Dr. Slayman, I was instructed to increase the phenobarbital from 81 mg twice a day to 97.2 mg twice per day and to recheck blood levels in a month. I set the appointment for Sept.25th at 10am.
It was much shorter and much less traumatic. He didn't fall over on his side with this one. He had this one standing with me holding onto him. He was stiff and convulsing, but no real thrashing or paddling and just a small amount of drool as opposed to a massive amount of drool with a grand mal. He didn't lose control of his bladder either. It was over rather quickly and when it was he wasn't panting excessively and he wasn't staggering or weak. This one was definitely different than the others.
On August 19 at 4:33am another petite mal seizure occurred. This one was as mild as the one the morning before. After a conversation with Dr. Slayman, I was instructed to increase the phenobarbital from 81 mg twice a day to 97.2 mg twice per day and to recheck blood levels in a month. I set the appointment for Sept.25th at 10am.
Even though these 2 seizures were milder petite mals, nonetheless, he was still having seizures.
What is happening?! It seems more and more apparent that these awful seizures are getting harder to manage.
2 more grand mal seizures in July
Things went well for a while longer, 36 days to be exact, until July 13th at 12:21am when our poor boy suffered another grand mal. We were told to leave his phenobarbital dose the same.
At 4:24am on July 30th, the monster reared its ugly head again and Brady had another grand mal. This time only 17 days passed since the last one. Per Dr. Slayman's recommendation his phenobarbital dose was increased from 64.8 mg twice per day to 81 mg twice per day.
Once again we crossed our fingers and sent up many prayers for this to be the answer to getting these horrible seizures under control.
At 4:24am on July 30th, the monster reared its ugly head again and Brady had another grand mal. This time only 17 days passed since the last one. Per Dr. Slayman's recommendation his phenobarbital dose was increased from 64.8 mg twice per day to 81 mg twice per day.
Once again we crossed our fingers and sent up many prayers for this to be the answer to getting these horrible seizures under control.
Another grand mal seizure
Unfortunately, our hopes of the May seizure being a one time break-through seizures were quickly diminished 25 days later on June 6th at 2:40am when Brady had another grand mal seizure. He recovered fairly fast and seemed like himself soon after it was over, just as he had after his seizure in May. On Monday, June 8th, I took him to the vet to check the phenobarbital level in his bloodstream. The lab results came in on Wednesday, June 10th, revealing that the phenobarbital levels were just below the therapeutic range so Dr. Slayman increased his dosage from 48.6 mg twice per day to 64.8 mg twice per day. Fingers crossed and prayers raised to Heaven that this would be the end of the seizures.
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