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Barney and the bottle top - by Dr Andrew Pollock
Barney is a middle aged Beagle who has been visiting us for seizures and was doing quite well until his owners decided to spoil themselves and take a holiday.
Barney was looking after his Grandparents and started to have cluster seizures (small and frequent groups), typically as always with pets, it was just before the weekend.
We were able to stabilise Barney through the weekend and whilst monitoring his blood work noted some abnormalities in his liver tests and a rather large abdomen, these were to be discussed more when Barneys owners returned from holiday.
Once back at home, Barneyâ€™s parents visited the clinic to discuss Barneyâ€™s situation and follow up on his liver changes. At that time the vet and his owners decided to alter Barneyâ€™s seizure medications, as some medications can be implicated in liver disease. It was during this early change over that Barney seemed to take a turn for the worst and came in feeling weak and quite hot with abnormal breathing.
With Barney we knew some of his problems may be associated with the high induction levels of Bromide he was receiving. He had no obvious abdominal pain, vomiting or diarrhea so we decided to take an x-ray to gather more information. We were certainly not expecting this to be in his stomach.
We rushed Barney into surgery to remove the offending bottle top and pleasingly Barney recovered well. Being a beagle he was never off his food even with the bottle top in his stomach.
At present Barney is still stable on his new medication and without seizures or side effects. He has recovered well from his big surgery and has hopefully learnt his lesson about eating things he shouldnâ€™t.
Barney will stay on his seizure medication for life and have routine blood tests to monitor the levels of his medication. He should make a full recovery from his exploratory surgery.
MORE INFORMATION ABOUT SEIZURES AND TESTING
Seizures are periods of higher than usual nerve activity within the brain, sort of like an electrical storm. They result in many varied clinical signs from local ticks to full body convulsions.
Epilepsy is used to describe repeated seizures occurring due to a brain problem. Juvenile epilepsy is a genetic condition found more commonly in certain breeds including some spaniels retrievers and collies
Other cause of seizure can be:
- exposure to toxins like chocolate
- low blood sugar
- low blood calcium levels after giving birth
- brain injury
- some infections
To understand seizures our vets will always perform a thorough clinical examination and history taking, the depending on age and findings may need to pursue some causes with blood work and or urine testing. More advanced testing like MRi are generally needed to fully understand the individual brain causes of seizures
Seizure management is most typical by medical therapy (generally tableting) and will be decided on an individual case by case approach based on severity and frequency of any seizure activity, health of the dog, lifestyle and cost factors. It is generally a life long need although some animals do stop medication slowly over time without have further seizures. Generally only a single medication is preferred and it is known that about 1 in 4 dogs will need more than one medication to control there seizures
Phenobarbitone has typically been the mainstay of seizure control in most dogs it can cause some changes in the liver and interfere with certain other tests,Therefore when used long term it needs to be monitored to see that the levels
in the blood stream are suitable to control the seizures without causing any negative effects.
Potassium bromide is a salt used to control seizure activity and is generally a very safe drug. It takes a very prolonged time(several months) to stabilise levels in blood making it less useful for
early seizure control and can be variably absorbed when salt water is drunk making it more complicated to use in those dogs whom love exercising in our beautiful seas
Valium is very safe and often used in short term control. Unfortunately animals rapidly develop a tolerance to valium making them poor choices for long term seizure control
There are other options for seizure control which are not as commonly used.
I worked for a very long time with a Vet who qualified the year I was born and one of his common sayings was "if you don't look , you wont find" and this is so absolutely true of many processes in medicine.
With all things in biology there is a constant change and variable presentation. It is for this reason that every time we see you pets we are going to make a full physical exam, and ask for all your help in noticing any changes or problems that might be present. When things don't add up or we just need to know with more certainly then we look to further testing.
Seizure medication like all medication that can have a positive effect may also have some negative effects - good medications just have less of these negative effects. To ensure that we are getting the benefits without anything untoward happening we will perform periodic monitoring tests. These help us make adjustments in the dose of medications, understand at what levels your pets are currently controlled and allow us to monitor the wider health of our patients.
Barney is a great case to illustrate that. When he presented we knew some of his problems were likely due to his high loading dose of bromide, he also had abnormal breathing and a high fever which would not normally be anticipated with those medications. He had no reported diarrhoea or vomiting or abdominal pain on physical exam, but then not much stops a Beagle from eating. It was only because we looked a bit further that we found something unexpected in Barneys stomach and were able to correct his problems.