Podcast: Anticonvulsants with Dr. Barnes
Heidi L. Barnes Heller, DVM, DACVIM (Neurology), Barnes Veterinary Specialty Services, Madison, Wisconsin
In this episode, host Alyssa Watson, DVM, talks with Heidi L. Barnes Heller, DVM, DACVIM, about her recent Clinician’s Brief article, “Anticonvulsants.” Dr. Barnes reviews some available resources on managing seizures in dogs and the necessary difficulty of extrapolating those to cats. She then dives into the discussion about phenobarbital, potassium bromide, levetiracetam, and zonisamide. Load up on all this seizure knowledge!
Additional resource: http://www.ivetf.org/
Key Takeaways
The International Veterinary Epilepsy Task Force has published guidelines for dogs that has been extrapolated for cats.
The biggest difference between cats and dogs relates to drug therapy. Some drugs are not appropriate for cats. We don't yet know the therapeutic ranges for cats.
All drugs have side effects. Start with monotherapy as often as possible to reduce exposure to more adverse effects. However, there are some cases where starting multiple drugs is in the best interest of a patient.
Steady state is reached when the amount of drug being absorbed by the body is the same amount that is being cleared. Levetiracetam is the quickest to steady state at about 36 hours. Potassium bromide takes longest to reach steady state at about 3 months.
If wanting to reach steady state faster, a loading dose protocol can be considered. A loading dose is best used when the seizure frequency or the interval between seizures exceeds the time to steady state.
About the Guest
Heidi L. Barnes Heller, DVM, DACVIM (Neurology), is the founder and owner of Barnes Veterinary Specialty Services in Madison, Wisconsin. Dr. Barnes Heller earned her DVM from Michigan State University, completed a rotating internship at University of Illinois, and completed a residency in neurology/neurosurgery at University of Florida.
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The Team:
Alyssa Watson, DVM - Host
Alexis Ussery - Producer & Digital Content Coordinator
Randall Stupka - Podcast Production & Sound Editing