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Packer RMA, Nye G, Porter SE, Volk HA. Assessment into the usage of levetiracetam in a canine epilepsy clinic. BMC Vet Res 2015; 11:25. [PMID: 25889090 PMCID: PMC4328478 DOI: 10.1186/s12917-015-0340-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Accepted: 01/22/2015] [Indexed: 11/23/2022] Open
Abstract
Background Retrospective studies can complement information derived from double-blinded randomized trials. There are multiple retrospective studies reporting good efficacy and tolerability of the anti-epileptic drug levetiracetam (LEV) in human patients with epilepsy; however, reports of LEV's tolerability and efficacy in dogs with epilepsy remain limited. The purpose of this retrospective study was to describe the use of LEV in a canine epilepsy clinic and determine the long-term efficacy and tolerability of LEV in veterinary clinical practice. The electronic database of a UK based referral hospital was searched for LEV usage in dogs with seizures. Information and data necessary for the evaluation were obtained from a combination of electronic and written hospital records, the referring veterinary surgeons’ records and telephone interviews with dog owners. Only dogs that were reportedly diagnosed with idiopathic epilepsy were included in the study. Results Fifty-two dogs were included in this retrospective study. Two treatment protocols were recognised; 29 dogs were treated continuously with LEV and 23 dogs received interval or pulse treatment for cluster seizures. LEV treatment resulted in 69% of dogs having a 50% or greater reduction of seizure frequency whilst 15% of all the dogs were completely free from seizures. Seizure frequency reduced significantly in the whole population. No dog was reported to experience life-threatening side effects. Mild side effects were experienced by 46% of dogs and a significantly higher number of these dogs were in the pulse treatment group. The most common side-effects reported were sedation and ataxia. Conclusions LEV appears to be effective and well tolerated for reduction of seizures.
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Affiliation(s)
- Rowena M A Packer
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL97TA, UK.
| | - George Nye
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL97TA, UK.
| | - Sian Elizabeth Porter
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL97TA, UK.
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL97TA, UK.
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Zaccara G, Giovannelli F, Schmidt D. Placebo and nocebo responses in drug trials of epilepsy. Epilepsy Behav 2015; 43:128-34. [PMID: 25703333 DOI: 10.1016/j.yebeh.2014.12.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 12/02/2014] [Accepted: 12/04/2014] [Indexed: 12/19/2022]
Abstract
Placebo response can be defined as any therapeutic change on placebo, while the nocebo response is any ill effect during placebo exposure. Several meta-analytic approaches have investigated the extent of placebo response in randomized, placebo-controlled, clinical trials of focal epilepsies. Placebo response rates (proportion of patients with ≥50% improvement of seizures versus baseline) ranging from 9.9% up to 15.2% have been reported. Interestingly, a sham response of 15.8% has been noted in trials of transcranial magnetic stimulation. Recently, nocebo response rates of 60.3% and 3.9% were noted, which were defined as the proportion of patients with adverse events (AEs) and those withdrawing because of intolerable AEs, respectively. Factors which were found to influence placebo response were as follows: the year of publication (with more recent studies showing higher rates of placebo response), some clinical characteristics of recruited patients (lower placebo response rates with a history of 7 or more prior lifetime AEDs, a high baseline seizure frequency, prior epilepsy surgery, and higher age at diagnosis), trial design and statistical analysis, and whether studies have been conducted in children or adults. Furthermore, placebo and nocebo rates were correlated with respective seizure outcome and adverse events of the experimental AED. Several mechanisms of placebo and nocebo responses are discussed. Specifically, the role of positive or negative expectations of patients and of investigators may influence the placebo and the nocebo response. Finally, recommendations are given on how to address placebo and nocebo responses in clinical practice.
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Affiliation(s)
- Gaetano Zaccara
- Unit of Neurology, Department of Medicine, Florence Health Authority, Firenze, Italy.
| | - Fabio Giovannelli
- Unit of Neurology, Department of Medicine, Florence Health Authority, Firenze, Italy; Department of Neuroscience, Psychology, Pharmacology and Child Health (NEUROFARBA), University of Florence, Firenze, Italy
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Abstract
The Theory of neural Cognition (TnC) states that the brain does not process information, it only represents information (i.e., it is ‘only’ a memory). The TnC explains how a memory can become an actor pursuing various goals, and proposes explanations concerning the implementation of a large variety of cognitive abilities, such as attention, memory, language, planning, intelligence, emotions, motivation, pleasure, consciousness and personality. The explanatory power of this new framework extends further though, to tackle special psychological states such as hypnosis, the placebo effect and sleep, and brain diseases such as autism, Alzheimer's disease and schizophrenia. The most interesting findings concern robotics: because the TnC considers the cortical column to be the key cognitive unit (instead of the neuron), it reduces the requirements for a brain implementation to only 160,000 units (instead of 86 billion). A robot exhibiting human-like cognitive abilities is therefore within our reach.
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Charalambous M, Brodbelt D, Volk HA. Treatment in canine epilepsy--a systematic review. BMC Vet Res 2014; 10:257. [PMID: 25338624 PMCID: PMC4209066 DOI: 10.1186/s12917-014-0257-9] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2014] [Accepted: 10/15/2014] [Indexed: 12/17/2022] Open
Abstract
Background Various antiepileptic drugs (AEDs) are used for the management of canine idiopathic epilepsy (IE). Information on their clinical efficacy remains limited. A systematic review was designed to evaluate existing evidence for the effectiveness of AEDs for presumptive canine IE. Electronic searches of PubMed and CAB Direct were carried out without date or language restrictions. Conference proceedings were also searched. Peer-reviewed full-length studies describing objectively the efficacy of AEDs in dogs with IE were included. Studies were allocated in two groups, i.e. blinded randomized clinical trials (bRCTs), non-blinded randomized clinical trials (nbRCTs) and non-randomized clinical trials (NRCTs) (group A) and uncontrolled clinical trials (UCTs) and case series (group B). Individual studies were evaluated based on the quality of evidence (study design, study group sizes, subject enrolment quality and overall risk of bias) and the outcome measures reported (in particular the proportion of dogs with ≥50% reduction in seizure frequency). Results Twenty-six studies, including two conference proceedings, reporting clinical outcomes of AEDs used for management of IE were identified. Heterogeneity of study designs and outcome measures made meta-analysis inappropriate. Only four bRCTs were identified in group A and were considered to offer higher quality of evidence among the studies. A good level of evidence supported the efficacy of oral phenobarbital and imepitoin and fair level of evidence supported the efficacy of oral potassium bromide and levetiracetam. For the remaining AEDs, favorable results were reported regarding their efficacy, but there was insufficient evidence to support their use due to lack of bRCTs. Conclusions Oral phenobarbital and imepitoin in particular, as well as potassium bromide and levetiracetam are likely to be effective for the treatment of IE. However, variations in baseline characteristics of the dogs involved, significant differences between study designs and several potential sources of bias preclude definitive recommendations. There is a need for greater numbers of adequately sized bRCTs evaluating the efficacy of AEDs for IE.
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Affiliation(s)
- Marios Charalambous
- Department of Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Hatfield AL9 7TA, Herts, UK.
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55
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Farhadi A. Non-Chemical Distant Cellular Interactions as a potential confounder of cell biology experiments. Front Physiol 2014; 5:405. [PMID: 25368582 PMCID: PMC4201089 DOI: 10.3389/fphys.2014.00405] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2014] [Accepted: 09/30/2014] [Indexed: 11/21/2022] Open
Abstract
Distant cells can communicate with each other through a variety of methods. Two such methods involve electrical and/or chemical mechanisms. Non-chemical, distant cellular interactions may be another method of communication that cells can use to modify the behavior of other cells that are mechanically separated. Moreover, non-chemical, distant cellular interactions may explain some cases of confounding effects in Cell Biology experiments. In this article, we review non-chemical, distant cellular interactions studies to try to shed light on the mechanisms in this highly unconventional field of cell biology. Despite the existence of several theories that try to explain the mechanism of non-chemical, distant cellular interactions, this phenomenon is still speculative. Among candidate mechanisms, electromagnetic waves appear to have the most experimental support. In this brief article, we try to answer a few key questions that may further clarify this mechanism.
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Affiliation(s)
- Ashkan Farhadi
- Digestive Disease Center, Memorial Care Medical GroupCosta Mesa, CA, USA
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56
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Sümegi Z, Gácsi M, Topál J. Conditioned placebo effect in dogs decreases separation related behaviours. Appl Anim Behav Sci 2014. [DOI: 10.1016/j.applanim.2014.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Affiliation(s)
- Clare Rusbridge
- Fitzpatrick ReferralsHalfway LaneEashing, GodalmingSurreyGU7 2QQUK
- School of Veterinary MedicineUniversity of SurreyGuildfordSurreyGU2 7XHUK
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58
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Van Meervenne SAE, Volk HA, Matiasek K, Van Ham LML. The influence of sex hormones on seizures in dogs and humans. Vet J 2014; 201:15-20. [PMID: 24878266 DOI: 10.1016/j.tvjl.2014.05.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2013] [Revised: 05/01/2014] [Accepted: 05/04/2014] [Indexed: 11/27/2022]
Abstract
Epilepsy is the most common chronic neurological disorder in both humans and dogs. The effect of sex hormones on seizures is well documented in human medicine. Catamenial epilepsy is defined as an increase in frequency and severity of seizures during certain periods of the menstrual cycle. Oestradiol increases seizure activity and progesterone is believed to exhibit a protective effect. The role of androgens is controversial and there is a lack of research focusing on androgens and epilepsy. Indeed, little is known about the influence of sex hormones on epilepsy in dogs. Sterilisation is believed to improve seizure control, but no systematic research has been conducted in this field. This review provides an overview of the current literature on the influence of sex hormones on seizures in humans. The literature on idiopathic epilepsy in dogs was assessed to identify potential risk factors related to sex and sterilisation status. In general, there appears to be an over-representation of male dogs with idiopathic epilepsy but no explanation for this difference in prevalence between sexes has been reported. In addition, no reliable conclusions can be drawn on the effect of sterilisation due to the lack of focused research and robust scientific evidence.
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Affiliation(s)
- Sofie A E Van Meervenne
- Läckeby Djursjukhus, Örntorp 201, 39598 Läckeby, Sweden; Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium.
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield AL9 7TA, UK
| | - Kaspar Matiasek
- Section of Clinical & Comparative Neuropathology, Ludwig Maximilians University, Veterinärstrasse. 13, D-80539 Munich, Germany
| | - Luc M L Van Ham
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, 9820 Merelbeke, Belgium
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Pakozdy A, Halasz P, Klang A. Epilepsy in cats: theory and practice. J Vet Intern Med 2014; 28:255-63. [PMID: 24438024 PMCID: PMC4857998 DOI: 10.1111/jvim.12297] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Revised: 11/14/2013] [Accepted: 12/04/2013] [Indexed: 11/29/2022] Open
Abstract
The veterinary literature on epilepsy in cats is less extensive than that for dogs. The present review summarizes the most important human definitions related to epilepsy and discusses the difficulties in applying them in daily veterinary practice. Epileptic seizures can have a wide range of clinical signs and are not necessarily typical in all cases. Whether a seizure event is epileptic can only be suspected based on clinical, laboratory, and neuroimaging findings as electroencephalography diagnostic techniques have not yet been developed to a sufficiently accurate level in veterinary medicine. In addition, the present review aims to describe other diagnoses and nonepileptic conditions that might be mistaken for epileptic seizures. Seizures associated with hippocampal lesions are described and discussed extensively, as they seem to be a special entity only recognized in the past few years. Furthermore, we focus on clinical work‐up and on treatment that can be recommended based on the literature and summarize the limited data available relating to the outcome. Critical commentary is provided as most studies are based on very weak evidence.
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Affiliation(s)
- A Pakozdy
- University Clinic for Small Animals, Clinical Department for Companion Animals and Horses, University of Veterinary Medicine, Vienna, Austria
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60
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Baraban SC, Löscher W. What new modeling approaches will help us identify promising drug treatments? ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2014; 813:283-94. [PMID: 25012385 DOI: 10.1007/978-94-017-8914-1_23] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Despite the development of numerous novel antiepileptic drugs (AEDs) in recent years, several unmet clinical needs remain, including resistance to AEDs in about 30 % of patients with epilepsy, adverse effects of AEDs that can reduce quality of life, and the lack of treatments that can prevent development of epilepsy in patients at risk. Animal models of seizures and epilepsy have been instrumental in the discovery and preclinical development of novel AEDs, but obviously the previously used models have failed to identify drugs that address unmet medical needs. Thus, we urgently need fresh ideas for improving preclinical AED development. In this review, a number of promising models will be described, including the use of simple vertebrates such as zebrafish (Danio rerio), large animal models such as the dog and newly characterized rodent models of pharmacoresistant epilepsy. While these strategies, like any animal model approach also have their limitations, they offer hope that new more effective AEDs will be identified in the coming years.
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Affiliation(s)
- Scott C Baraban
- Epilepsy Research Laboratory, Department of Neurological Surgery, University of California, San Francisco, CA, 94143, USA,
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Black V, Garosi L, Lowrie M, Harvey RJ, Gale J. Phenotypic characterisation of canine epileptoid cramping syndrome in the Border terrier. J Small Anim Pract 2013; 55:102-7. [PMID: 24372194 PMCID: PMC4277704 DOI: 10.1111/jsap.12170] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To characterise the phenotype of Border terriers suspected to be affected by canine epileptoid cramping syndrome and to identify possible contributing factors. METHODS Owners of Border terriers with suspected canine epileptoid cramping syndrome were invited to complete an online questionnaire. The results of these responses were collated and analysed. RESULTS Twenty-nine Border terriers were included. Most affected dogs had their first episode before 3 years of age (range: 0·2 to 7·0 years). The majority of episodes lasted between 2 and 30 minutes (range: 0·5 to 150 minutes). The most frequent observations during the episodes were difficulty in walking (27 of 29), mild tremor (21 of 29) and dystonia (22 of 29). Episodes most frequently affected all four limbs (25 of 29) and the head and neck (21 of 29). Borborygmi were reported during episodes in 11 of 29 dogs. Episodes of vomiting and diarrhoea occurred in 14 of 29, with 50% of these being immediately before or after episodes of canine epileptoid cramping syndrome (7 of 14). Most owners (26 of 29) had changed their dog's diet, with approximately 50% (14 of 26) reporting a subsequent reduction in the frequency of episodes. CLINICAL SIGNIFICANCE This study demonstrates similarities in the phenotype of canine epileptoid cramping syndrome to paroxysmal dystonic choreoathetosis, a paroxysmal dyskinesia reported in humans. This disorder appears to be associated with gastrointestinal signs in some dogs and appears at least partially responsive to dietary adjustments.
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Affiliation(s)
- V Black
- Davies Veterinary Specialists, Higham Gobion
| | - L Garosi
- Davies Veterinary Specialists, Higham Gobion
| | - M Lowrie
- Davies Veterinary Specialists, Higham Gobion
| | - R J Harvey
- Department of Pharmacology, UCL School of Pharmacy, London
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62
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Löscher W, Hoffmann K, Twele F, Potschka H, Töllner K. The novel antiepileptic drug imepitoin compares favourably to other GABA-mimetic drugs in a seizure threshold model in mice and dogs. Pharmacol Res 2013; 77:39-46. [DOI: 10.1016/j.phrs.2013.09.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2013] [Revised: 09/09/2013] [Accepted: 09/09/2013] [Indexed: 11/27/2022]
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Marioni-Henry K, Haworth P, Scott H, Witte P, Guo LT, Shelton GD. Sarcolemmal specific collagen VI deficient myopathy in a Labrador Retriever. J Vet Intern Med 2013; 28:243-9. [PMID: 24147807 PMCID: PMC4895551 DOI: 10.1111/jvim.12224] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 08/05/2013] [Accepted: 09/10/2013] [Indexed: 11/30/2022] Open
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64
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Mariani CL, Schubert TA, House RA, Wong MA, Hopkins AL, Barnes Heller HL, Milner RJ, Lester NV, Lurie DM, Rajon DA, Friedman WA, Bova FJ. Frameless stereotactic radiosurgery for the treatment of primary intracranial tumours in dogs. Vet Comp Oncol 2013; 13:409-23. [PMID: 24007303 DOI: 10.1111/vco.12056] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2012] [Revised: 06/01/2013] [Accepted: 06/24/2013] [Indexed: 11/29/2022]
Abstract
Stereotactic radiosurgery (SRS) is a procedure that delivers a single large radiation dose to a well-defined target. Here, we describe a frameless SRS technique suitable for intracranial targets in canines. Medical records of dogs diagnosed with a primary intracranial tumour by imaging or histopathology that underwent SRS were retrospectively reviewed. Frameless SRS was used successfully to treat tumours in 51 dogs with a variety of head sizes and shapes. Tumours diagnosed included 38 meningiomas, 4 pituitary tumours, 4 trigeminal nerve tumours, 3 gliomas, 1 histiocytic sarcoma and 1 choroid plexus tumour. Median survival time was 399 days for all tumours and for dogs with meningiomas; cause-specific survival was 493 days for both cohorts. Acute grade III central nervous system toxicity (altered mentation) occurred in two dogs. Frameless SRS resulted in survival times comparable to conventional radiation therapy, but with fewer acute adverse effects and only a single anaesthetic episode required for therapy.
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Affiliation(s)
- C L Mariani
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - T A Schubert
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - R A House
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - M A Wong
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - A L Hopkins
- North Florida Neurology, Orange Park, FL, USA
| | - H L Barnes Heller
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - R J Milner
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - N V Lester
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - D M Lurie
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA
| | - D A Rajon
- Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, USA
| | - W A Friedman
- Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, USA
| | - F J Bova
- Department of Neurosurgery, College of Medicine, University of Florida, Gainesville, FL, USA
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Kiviranta AM, Laitinen-Vapaavuori O, Hielm-Björkman A, Jokinen T. Topiramate as an add-on antiepileptic drug in treating refractory canine idiopathic epilepsy. J Small Anim Pract 2013; 54:512-20. [PMID: 24032479 DOI: 10.1111/jsap.12130] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate the efficacy and safety of topiramate as an add-on therapy in dogs with refractory idiopathic epilepsy. METHOD Prospective, open label, non-comparative clinical trial of topiramate in dogs with idiopathic epilepsy and poor seizure control despite therapeutic serum concentrations of phenobarbital and potassium bromide. The efficacy of topiramate was evaluated by comparing seizure and seizure day frequencies during a retrospective 2-month period with a prospective short-term follow-up of 6 months. An additional long-term follow-up period ranging from 3 to 9 months was conducted on dogs that responded to topiramate therapy during the short-term follow-up. RESULTS Ten dogs were included. Five (50%) responded to topiramate therapy during the short-term follow-up showing a significant (P=0·04) decrease of 66% in seizure frequency. Three of the five dogs remained responders during the long-term follow-up. Weight loss, sedation and ataxia were the most common adverse effects of topiramate therapy, but in dogs with moderate sedation or ataxia, signs subsided in a few weeks to few months to mild sedation or ataxia. CLINICAL SIGNIFICANCE Topiramate may be effective as an add-on medication in treating canine idiopathic epilepsy. Apart from sedation and ataxia reported in some of the dogs, topiramate was well-tolerated.
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Affiliation(s)
- A-M Kiviranta
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, FI-00014, Helsinki, Finland
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67
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Abstract
Placebo effects in the therapy of epilepsy were already known before the introduction of effective antiepileptic drugs (AEDs). They have physiologic correlates, and are even stronger in other neurologic disorders such as pain. Placebo effects in epilepsy have many facets. Our understanding of this phenomenon has increased in the last two decades: placebo effects are stronger in children than in adults, and may be culture- and setting-dependent; and impressive placebo effects occur in animals with epilepsy as well. More research is needed to fully elucidate the mechanism of placebo effects in epilepsy care, particularly as we go forth with studies addressing the issue of pharmacoresistance.
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68
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Muñana KR. Management of Refractory Epilepsy. Top Companion Anim Med 2013; 28:67-71. [DOI: 10.1053/j.tcam.2013.06.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Accepted: 06/14/2013] [Indexed: 11/11/2022]
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Rusbridge C. Choosing the right drug 2. Anticonvulsants used for second‐ line therapy, other anticonvulsants and alternative therapies. IN PRACTICE 2013. [DOI: 10.1136/inp.f2015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Potschka H, Fischer A, von Rüden EL, Hülsmeyer V, Baumgärtner W. Canine epilepsy as a translational model? Epilepsia 2013; 54:571-9. [PMID: 23506100 DOI: 10.1111/epi.12138] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2013] [Indexed: 01/01/2023]
Abstract
Dogs with spontaneous diseases can exhibit a striking similarity in etiology, clinical manifestation, and disease course when compared to human patients. Therefore, dogs are intensely discussed as a translational model of human disease. In particular, genetic studies in selected dog breeds serve as an excellent tool to identify epilepsy disease genes. In addition, canine epilepsy is discussed as a translational platform for drug testing. On one hand, epileptic dogs might serve as an interesting model by allowing the evaluation of drug efficacy and potency under clinical conditions with a focus on chronic seizures resistant to standard medication, preventive strategies, or status epilepticus. On the other hand, several limitations need to be considered including owner-based seizure monitoring, species differences in pharmacokinetics and drug interactions, as well as cost-intensiveness. The review gives an overview on the current state of knowledge regarding the etiology, clinical manifestation, pathology, and drug response of canine epilepsy, also pointing out the urgent need for further research on specific aspects. Moreover, the putative advantages, the disadvantages, and limitations of antiepileptic drug testing in canine epilepsy are critically discussed.
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Affiliation(s)
- Heidrun Potschka
- Institute of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximilians-University, Munich, Germany.
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Clausen J, Albrecht H, Mathie RT. Veterinary clinical research database for homeopathy: placebo-controlled trials. Complement Ther Med 2013; 21:115-20. [PMID: 23497815 DOI: 10.1016/j.ctim.2012.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Revised: 10/08/2012] [Accepted: 11/27/2012] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Veterinary homeopathy has led a somewhat shadowy existence since its first introduction. Only in the last three decades has the number of clinical trials increased considerably. This literature is generally not well perceived, which may be partly a consequence of the diffuse and somewhat inaccessible nature of some of the relevant research publications. The Veterinary Clinical Research Database for Homeopathy (VetCR) was launched in 2006 to provide information on existing clinical research in veterinary homeopathy and to facilitate the preparation of systematic reviews. OBJECTIVE The aim of the present report is to provide an overview of this first database on clinical research in veterinary homeopathy, with a special focus on its content of placebo controlled clinical trials and summarising what is known about placebo effects in animals. RESULTS In April 2012, the VetCR database contained 302 data records. Among these, 203 controlled trials were identified: 146 randomised and 57 non-randomised. In 97 of those 203 trials, the homeopathic medical intervention was compared to placebo. COMMENT A program of formal systematic reviews of peer-reviewed randomised controlled trials in veterinary homeopathy is now underway; detailed findings from the program's data extraction and appraisal approach, including the assessment of trial quality (risk of bias), will be reported in due course.
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Affiliation(s)
- J Clausen
- Karl und Veronica Carstens-Stiftung, Am Deimelsberg 36, 45276 Essen, Germany.
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Matthews H, Granger N, Wood J, Skelly B. Effects of essential fatty acid supplementation in dogs with idiopathic epilepsy: a clinical trial. Vet J 2012; 191:396-8. [PMID: 21641244 DOI: 10.1016/j.tvjl.2011.04.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Revised: 03/09/2011] [Accepted: 04/25/2011] [Indexed: 11/17/2022]
Abstract
The effects of essential fatty acid supplementation (EFA) on the control of idiopathic epilepsy in dogs were investigated in a blinded, placebo-controlled trial. Fifteen dogs were treated with triple purified Ω-3 oil containing 400 mg eicosapentaenoic acid, 250 mg docosahexaenoic acid and 22 mg vitamin E per 1.5 mL at a dose of 1.5 mL/10 kg once daily for 12 weeks, followed by a 12 week placebo period of supplementation with olive oil. Owners recorded seizure frequency and severity and any adverse events. EFA supplementation did not reduce seizure frequency or severity in dogs with idiopathic epilepsy.
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Affiliation(s)
- Helen Matthews
- Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK
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73
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Muñana K, Thomas W, Inzana K, Nettifee-Osborne J, McLucas K, Olby N, Mariani C, Early P. Evaluation of Levetiracetam as Adjunctive Treatment for Refractory Canine Epilepsy: A Randomized, Placebo-Controlled, Crossover Trial. J Vet Intern Med 2012; 26:341-8. [DOI: 10.1111/j.1939-1676.2011.00866.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Revised: 11/07/2011] [Accepted: 12/02/2011] [Indexed: 11/28/2022] Open
Affiliation(s)
- K.R. Muñana
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh; NC
| | - W.B. Thomas
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Tennessee; Knoxville; TN
| | - K.D. Inzana
- Department of Small Animal Clinical Sciences; Virginia-Maryland Regional College of Veterinary Medicine; Virginia Tech; Blacksburg; VA
| | - J.A. Nettifee-Osborne
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh; NC
| | - K.J. McLucas
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Tennessee; Knoxville; TN
| | - N.J. Olby
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh; NC
| | - C.J. Mariani
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh; NC
| | - P.J. Early
- Department of Clinical Sciences; College of Veterinary Medicine; North Carolina State University; Raleigh; NC
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Mustonen K, Ala-Kurikka E, Orro T, Peltoniemi O, Raekallio M, Vainio O, Heinonen M. Oral ketoprofen is effective in the treatment of non-infectious lameness in sows. Vet J 2010; 190:55-9. [PMID: 21035362 DOI: 10.1016/j.tvjl.2010.09.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Revised: 09/22/2010] [Accepted: 09/22/2010] [Indexed: 10/18/2022]
Abstract
The efficacy of ketoprofen in the treatment of non-infectious lameness in sows was examined in a double-blinded study. Two dose rates of oral ketoprofen were compared to placebo treatment over five consecutive days. Lameness was assessed with a five-grade scoring system prior to and on the last day of the treatment. The rate of treatment success was 54.3% for the ketoprofen 4mg/kg group (n=46), 53.2% for the ketoprofen 2mg/kg group (n=47) and 20.8% for the pigs in the placebo group (n=48). The difference between both ketoprofen groups and the placebo group was significant (P=0.001), but there was no difference between the two ketoprofen groups (P=0.78). Oral ketoprofen was well tolerated and no adverse events were observed. As lameness is a very common problem in sows, oral ketoprofen appeared to be a practical way to alleviate pain and improve the welfare of sows.
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Affiliation(s)
- Katja Mustonen
- Department of Equine and Small Animal Medicine, University of Helsinki, Helsinki, Finland.
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