International Veterinary Epilepsy Task Force consensus proposal: medical treatment of canine epilepsy in Europe

Abstract

In Europe, the number of antiepileptic drugs (AEDs) licensed for dogs has grown considerably over the last years. Nevertheless, the same questions remain, which include, 1) when to start treatment, 2) which drug is best used initially, 3) which adjunctive AED can be advised if treatment with the initial drug is unsatisfactory, and 4) when treatment changes should be considered. In this consensus proposal, an overview is given on the aim of AED treatment, when to start long-term treatment in canine epilepsy and which veterinary AEDs are currently in use for dogs. The consensus proposal for drug treatment protocols, 1) is based on current published evidence-based literature, 2) considers the current legal framework of the cascade regulation for the prescription of veterinary drugs in Europe, and 3) reflects the authors’ experience. With this paper it is aimed to provide a consensus for the management of canine idiopathic epilepsy. Furthermore, for the management of structural epilepsy AEDs are inevitable in addition to treating the underlying cause, if possible.

Generalized myoclonic epilepsy with photosensitivity in juvenile dogs caused by a defective DIRAS family GTPase 1

“…A few dogs had potential brain abnormalities on neuroimaging evaluations that may be incidental findings, such as ventricular asymmetry (12) (Table S2). Twenty-one RRs with myoclonic epilepsy were treated with a variety of antiepileptic drugs (AEDs: phenobarbital, potassium bromide, primidone, levetiracetam, clonazepam, imepitoin; monotherapy or combination) in adequate dosages and with serum concentrations (phenobarbital: mean 28.6 mg/L; potassium bromide: mean 1,353 mg/L) within therapeutic range (13). Levetiracetam, which is also an effective drug for juvenile myoclonic epilepsy (JME) in humans (14), and potassium bromide seemed to be the most effective based on response of dog owners.…”

2015 ACVIM Small Animal Consensus Statement on Seizure Management in Dogs

“…From these guidelines, several commonalities exist in guiding clinical practice including confirmation of an epileptic seizure event and seizure type, obtaining a definitive diagnosis, knowledge that recurrent seizure activity is correlated with poorer long‐term treatment success, and the influence of treatment on quality‐of‐life (QOL) factors 18. Thus, the decision to treat is a reflection of the treatment goals to decrease or eliminate epileptic events, decrease seizure severity, avoid adverse effects, and decrease seizure‐related mortality and morbidity 7, 19, 20…”

The Evidence Behind the Treatment of Canine Idiopathic Epilepsy

“…Munana et al At this point it is worth mentioning that the international veterinary epilepsy task force (IVETF) recently published a consensus statement (Bhatti et al 2015) for treatment suggestions based mainly on current published evidence as provided and analyzed in this knowledge summary and in the systematic review by Charalambous et al (2014) and it was additionally supported and adjusted by expert's opinions.…”