Treatment and long-term follow-up of cats with suspected primary epilepsy

Abstract

We report an evaluation of the treatment and outcome of cats with suspected primary epilepsy. Phenobarbital therapy was used alone or in combination with other anti-epileptic drugs. Outcome after treatment was evaluated mainly on the basis of number of seizures per year and categorised into four groups: seizure-free, good control (1-5 seizures per year), moderate control (6-10 seizures per year) and poor control (more than 10 seizures per year). About 40-50% of cases became seizure-free, 20-30% were considered good-to-moderately controlled and about 30% were poorly controlled depending on the year of treatment considered. The duration of seizure events after treatment decreased in 26/36 cats and was unchanged in eight cats. The subjective severity of seizure also decreased in 25 cats and was unchanged in nine cats. Twenty-six cats had a good quality of life, nine cats an impaired quality of life and one cat a bad quality of life. Despite being free of seizures for years, cessation of treatment may lead to recurrence of seizures in most cats.

Pseudolymphoma in a cat on phenobarbital treatment

“…Side effects in cats are normally mild and include ataxia, sedation, polyphagia, polydipsia and polyuria, however, cytopenia including thrombocytopenia and leucopenia as well as immune‐mediated hypersensitivity reactions are described to occasionally occur (Smith & Dewey , Pakozdy et al . ). A study evaluating the effect of phenobarbital administration in cats on plasma levels of vitamin K‐dependent clotting factors showed a reduction of factor VII by 50% after 28 days of treatment with 10 mg/kg phenobarbital (Solomon et al .…”

“…Phenobarbital is currently the first choice for treatment of seizures in cats. Side effects in cats are normally mild and include ataxia, sedation, polyphagia, polydipsia and polyuria, however, cytopenia including thrombocytopenia and leucopenia as well as immune-mediated hypersensitivity reactions are described to occasionally occur (Smith & Dewey 2009, Pakozdy et al . 2013.…”

Evaluation of therapeutic phenobarbital concentrations and application of a classification system for seizures in cats: 30 cases (2004–2013)

“…1,19,20 In a recent study, 23 investigators evaluated cats with suspected primary epilepsy and found that PB was effective in 50% to 80% of these cats. Despite its frequent use in cats, to the authors' knowledge, there are few studies on the efficacy of PB for treating seizures in cats.…”

Imepitoin is well tolerated in healthy and epileptic cats

“…In this prospective clinical trial, seizure freedom was achieved in 50% of cats, however the follow-up period was relatively short for a definitive conclusion on long-term outcome [17]. Clinical experiences with phenobarbital resulted in seizure freedom in about 40–50% of patients treated [22–24]. A similar rate was reported for bromide, however associated with more adverse events including idiosyncratic allergic pneumonitis [25].…”