Responses to successive anti‐epileptic drugs in canine idiopathic epilepsy

Packer, Rowena M. A.; Shihab, Nadia; Torres, Bruno Benetti Junta; Volk, Holger A.

doi:10.1136/vr.102934

Cited by 25 publications

(31 citation statements)

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“…Response rates in people with epilepsy for the first-, second- or third-line AED as proportion of the population were 47–50 per cent, 10–13 per cent and 2–4 per cent, respectively (Kwan and Brodie 2000, Mohanraj and Brodie 2006). Similarly, in dogs with epilepsy, the response rate as proportion of the population for first-, second- and third-line AEDs was 37 per cent, 11 per cent and 6 per cent, respectively (Packer and others 2015). There was an association between both seizure frequency and severity and carer-perceived acceptability of these traits, with higher seizure frequencies and severities perceived to be less acceptable by carers.…”

Section: Discussionmentioning

confidence: 99%

Quality‐of‐life aspects in idiopathic epilepsy in dogs

et al. 2016

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10Quality of life (QoL) plays a significant role in the treatment of dogs with idiopathic epilepsy 11 (IE) yet is so far understudied. This study describes the outcome evaluation of an online 12 questionnaire based on the carer's perception focusing on 62 QoL-questions in 159 dogs with 13 IE. 14 Results showed that seizure frequency, but not seizure severity or presence of cluster seizures 15 was significantly associated with carer perceived dog's QoL. Dogs receiving third line 16 antiepileptic drugs had a significantly lower perceived QoL than those that did not. 17Generalised linear mixed model analysis demonstrated that severity of the side effects 18 sleeping more and ataxia were significantly associated with carer perceived dog's QoL, with 19 higher severities predicting lower QoL scores. The degree of carer acceptability of seizure 20 frequency and severity was significantly associated with the dog's reported seizure frequency 21 and severity. Moreover, there was a significant association between IE-related QoL changes 22 of the dog and the carer, with reductions in perceived canine QoL scores associated with 23 reductions in carer QoL, and vice versa. 24In conclusion, aspects of canine IE can affect both the carer and their dog's QoL. This has 25 implications for the management and requires consideration when treatment options and 26 outcomes are discussed. 27 28

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Section: Discussionmentioning

confidence: 99%

Quality‐of‐life aspects in idiopathic epilepsy in dogs

et al. 2016

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“…Idiopathic epilepsy is a common neurological disorder of dogs that is characterized by recurrent, unprovoked seizures for which an underlying cause cannot be identified other than a confirmed or suspected genetic predisposition, and for which antiseizure drugs (ASD) remain the cornerstone of treatment. Seizure freedom, the primary goal of treatment, is achieved in as few as 14% of dogs with epilepsy . For the remainder of the population, the objective of epilepsy management focuses on reducing the seizure frequency to an acceptable level while minimizing medication‐related adverse effects.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of a collar‐mounted accelerometer for detecting seizure activity in dogs

Muñana

Nettifee

Griffith

et al. 2020

Veterinary Internal Medicne

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Background: The majority of dogs with idiopathic epilepsy continue to have seizures despite appropriate treatment.Objectives: To assess the use of a commercially available, collar-mounted accelerometer to detect generalized seizures in dogs.Animals: Twenty two client-owned dogs with idiopathic epilepsy.Methods: Six-month prospective clinical study during which dogs wore a collarmounted accelerometer. Seizure documentation was based on owner observations and video recordings. The accelerometer used a predefined algorithm to detect seizures in the first study phase, and an individualized algorithm in the second study phase. Caregivers completed a quality of life (QoL) questionnaire at the initial and final study visit.Results: Using the predefined algorithm, the accelerometer detected seizures with a sensitivity of 18.6% (95% CI [13.4%, 23.8%]) and mean false detection rate of 0.096/ day. Values did not change significantly with use of an individualized algorithm (sensitivity 22.1%, 95% CI [15.1%, 29.0%]; false detection rate 0.054/day). Mean composite QoL score was significantly improved at study completion (50.42) compared to study initiation (39.53; P = .005), and this change was moderately correlated with a change in weekly exercise (r = 0.46, P = .05).Conclusions and Clinical Importance: Generalized seizures in dogs can be detected with a collar-mounted accelerometer, but the overall sensitivity is low. K E Y W O R D S activity monitor, canine, clinical trial, idiopathic epilepsy

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“…This is unsurprising, as it has previously been demonstrated that drug response diminishes with the successive use of AEDs [50]. No predictors were found that were significantly associated with imepitoin drug-response and future research should focus on this to elucidate why some dogs do not experience a reduction in seizure frequency, or experience an increase in seizure frequency when receiving imepitoin, while others become seizure free.…”

Section: Discussionmentioning

confidence: 96%

Investigating the potential of the anti-epileptic drug imepitoin as a treatment for co-morbid anxiety in dogs with idiopathic epilepsy

2017

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BackgroundBehavioural changes associated with idiopathic epilepsy (IE) have been identified in dogs, with fear and anxiety-related problems seen in both drug-naïve dogs and dogs treated with anti-epileptic drugs (AEDs). Treating anxiety-related behaviour in dogs with IE may be challenging, as seizures are a contraindication for many conventional anxiolytic drugs. In addition, many dogs with IE are already treated with AEDs to reduce their seizure frequency, which may have negative effects if used in polytherapy. Imepitoin is low-affinity partial agonist at the benzodiazepine (BDZ) site of the GABAA receptor, and has been demonstrated to have both anticonvulsant and anxiolytic effects in laboratory rodents. Imepitoin has been developed for the treatment of IE in dogs, with demonstrated anticonvulsant effects and high tolerability and safety. To date, imepitoin’s potential to reduce anxiety in dogs with IE has not been investigated. An online survey was conducted to investigate the effect of imepitoin on fear and anxiety-related behaviours in dogs with IE. Eighty-five valid responses were received from owners of dogs with IE currently treated with imepitoin. Anxiety-related behaviour was quantified before and during imepitoin treatment using a validated questionnaire tool (C-BARQ).ResultsNo differences were observed in the five fear/anxiety-related measures between the two time periods (before vs. during treatment) for dog directed fear, stranger directed fear, non-social fear, pain sensitivity and separation related behaviour. A median 45% reduction in seizure frequency/month was observed following imepitoin treatment; however, imepitoin did not appear effective in reducing seizure frequency in a minority of cases. Polyphagia was the most common chronic side effect, and more side effects were reported in polytherapy cases.ConclusionsImepitoin does not appear to improve anxiety-related behaviour in dogs with IE treated with this medication for its anti-epileptic effects. Investigating the effects of imepitoin upon the behaviour of dogs with recognised behavioural anxiety-related problems (e.g. specific fears and phobias, separation related behaviours), in both healthy dogs and dogs with epilepsy is required to further explore any potential anxiolytic effects of this medication.

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Responses to successive anti‐epileptic drugs in canine idiopathic epilepsy

Cited by 25 publications

References 14 publications

Quality‐of‐life aspects in idiopathic epilepsy in dogs

Quality‐of‐life aspects in idiopathic epilepsy in dogs

Evaluation of a collar‐mounted accelerometer for detecting seizure activity in dogs

Investigating the potential of the anti-epileptic drug imepitoin as a treatment for co-morbid anxiety in dogs with idiopathic epilepsy

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