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Mojarradi A, De Decker S, Van Meervenne S. Once-a-day oral treatment with phenobarbital in cats with presumptive idiopathic epilepsy. J Feline Med Surg 2023; 25:1098612X231196806. [PMID: 37747329 PMCID: PMC10812035 DOI: 10.1177/1098612x231196806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
OBJECTIVES Phenobarbital (PB) q12h is the most common treatment recommendation for cats with recurrent epileptic seizures. Medicating cats may be challenging and result in decreased quality of life for both cat and owner. The aim of this retrospective study was to evaluate treatment with oral PB q24h in cats with presumptive idiopathic epilepsy. METHODS Nine cats with presumptive idiopathic epilepsy, receiving oral PB q24h, were included in a retrospective descriptive study. RESULTS Seizure remission was achieved in 88% (8/9) of the cats and good seizure control in 12% (1/9) of the cats, treated with a mean dose of oral PB of 2.6 mg/kg q24h (range 1.4-3.8 mg/kg). No cats required an increase of their PB frequency at any time during a mean follow-up period of 3.5 years (range 1.1-8.0 years). No cats displayed side effects or issues with compliance at the last recorded follow-up. CONCLUSIONS AND RELEVANCE Once-a-day administration of PB for feline epilepsy was safe and resulted in satisfactory seizure control for the nine cats included in this study. The results of this study justify exploring this topic further in larger prospective studies.
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Affiliation(s)
- Abtin Mojarradi
- IVC Evidensia Referral Hospital in Helsingborg, Skåne, Sweden
| | - Steven De Decker
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, UK
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2
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Mizuno S, Asada R, Hasegawa D. Questionnaire survey on the usage of antiseizure drugs for dogs and cats in Japanese veterinary hospitals (2020). Vet Med Sci 2022; 8:1466-1471. [PMID: 35442522 PMCID: PMC9297804 DOI: 10.1002/vms3.810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Epilepsy is the most common neurological disorder in veterinary medicine. Recently, evidence‐based recommendations or systematic reviews for using antiseizure drugs (ASDs) in dogs and cats have been published, but there are many differences in economic, geographical, and historical backgrounds and/or the availability of each ASD between countries. In the present study, we conducted a questionnaire survey on the usage of ASDs in 511 veterinary hospitals in Japan in 2020. As a result, zonisamide (ZNS) was the most commonly prescribed drug for idiopathic (83%) and structural epilepsy (76%) in dogs. In cats, phenobarbital was the most frequently prescribed drug for idiopathic (48%) and structural epilepsy (51%), but ZNS was also commonly prescribed (41% and 36%, respectively). Additionally, ZNS was the most frequently used ASD in combination therapy for canine idiopathic epilepsy. We also surveyed the frequency of measuring ASD blood levels; however, a relatively high percentage of hospitals (22%) did not perform such measurements. Although the evidence level for ZNS is still poor for both species, it is generally used as the first‐line ASD in Japan. A large‐scale and higher evidential study for ZNS and the education of practitioners for adequate antiseizure medication are required.
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Affiliation(s)
- Satoshi Mizuno
- Laboratory of Veterinary Radiology, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Rikako Asada
- Laboratory of Veterinary Radiology, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Daisuke Hasegawa
- Laboratory of Veterinary Radiology, Nippon Veterinary and Life Science University, Tokyo, Japan.,The Research Center for Animal Life Science, Nippon Veterinary and Life Science University, Tokyo, Japan
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3
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Huaijantug S, Yatmark P, Chinnabrut P, Rueangsawat N, Wongkumlue A, Teerapan W, Chatchaisak D. Quantitative brain histogram of canine epilepsy using magnetic resonance imaging. Acta Radiol 2021; 62:93-101. [PMID: 32295389 DOI: 10.1177/0284185120914031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Quantitative magnetic resonance imaging (MRI) is used to study the anatomy of the brain in dogs with idiopathic epilepsy. PURPOSE To quantitate MRI images in terms of volumetric ratios and histogram analyses of the following regions of interest (ROI) in dogs with idiopathic epilepsy: frontal; parietal; temporal; piriform; thalamic; and hippocampal regions. MATERIAL AND METHODS Nine dogs with epilepsy and four healthy controls were evaluated. We examined the volumetric ratios and histogram analyses of six ROIs in all dogs. RESULTS MR images, in T1-weighted, T2-weighted, FLAIR, diffusion-weighted imaging, and apparent diffusion coefficient sequences detected changes in 4/9 (44%) epileptic dogs found in 5/6 regions: frontal; parietal; temporal; piriform; and hippocampal regions. However, no such changes were observed in the thalamic region. Interestingly, the frontal and piriform volumetric ratios of epileptic dogs were significantly lower than those of control dogs. The histogram analyses in 4/6 regions were significantly increased in epileptic dogs. CONCLUSION Our results demonstrated MRI finding abnormalities in several regions of the brain in several sequences including T1-weighted, T2-weighted, FLAIR, diffusion-weighted imaging, and apparent diffusion coefficient in epileptic dogs. In several regions of the brain, atrophy may exist, and hyperintensity may be present on MR images in epileptic dogs. These findings suggest that the diagnostic yield of MRI, which is an advanced neuroimaging technique, is high in epileptic dogs and has good reliability and sensitivity in detecting abnormal areas in patients.
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Affiliation(s)
- Somkiat Huaijantug
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Paranee Yatmark
- Department of Pre-Clinical and Apply Animal Science, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | | | | | - Avirut Wongkumlue
- Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
| | - Wuttiwong Teerapan
- Department of Companion Animals Clinical Sciences, Faculty of Veterinary Medicine, Kasetsart University, Bangkok, Thailand
| | - Duangthip Chatchaisak
- Department of Clinical Sciences and Public Health, Faculty of Veterinary Science, Mahidol University, Nakhon Pathom, Thailand
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4
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Molina J, Jean-Philippe C, Conboy L, Añor S, de la Fuente C, Wrzosek MA, Spycher A, Luchsinger E, Wenger-Riggenbach B, Montoliu P, Gandini G, Menchetti M, Ribeiro JC, Varejão A, Ferreira A, Zanghi B, Volk HA. Efficacy of medium chain triglyceride oil dietary supplementation in reducing seizure frequency in dogs with idiopathic epilepsy without cluster seizures: a non-blinded, prospective clinical trial. Vet Rec 2020; 187:356. [PMID: 32532842 PMCID: PMC7799411 DOI: 10.1136/vr.105410] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 03/31/2020] [Accepted: 04/24/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Despite appropriate antiseizure drug (ASD) treatment, around two-thirds of dogs with idiopathic epilepsy (IE) have seizures long-term and 20-30per cent of affected dogs remain poorly controlled. METHODS The current study aim is to test in a field trial the efficacy and tolerability of a commercially available diet enriched with 6.5per cent medium chain triglyceride (MCT) oil in dogs (n=21) with at least a tier 1 idiopathic epilepsy diagnosis, without cluster seizures, in 10 veterinary practices across Europe. Each dog's quality of life (QoL), ataxia, sedation and frequency and severity of seizures were recorded by owners throughout the study. RESULTS The mean seizure frequency per month, averaged over the entire 84-day study, significantly (P=0.04) decreased 32per cent compared with the baseline monthly seizure frequency recorded during the month immediately before feeding the diet. Similarly, the seizure days rate (days/month) also declined (P<0.001) by 42per cent. QoL was reported as very good to excellent (>8.5/10) in 20 of the 21 dogs before starting the diet and this remained unchanged during the trial. CONCLUSIONS This study demonstrates the use of a diet enriched with MCTs as an adjunct to ASD treatment may have some antiseizure properties for dogs diagnosed with IE, as demonstrated in previous studies.
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Affiliation(s)
- Jenifer Molina
- Technical Communications, Nestlé Purina PetCare EMENA, Barcelona, Spain
| | | | - Lisa Conboy
- Regulatory and Scientific Affairs, Nestlé Purina, Lausanne, Switzerland
| | - Sonia Añor
- Animal Medicine and Surgery, Universitat Autonoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Cristian de la Fuente
- Animal Medicine and Surgery, Universitat Autonoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Marcin Adam Wrzosek
- Department of Internal Diseases, Uniwersytet Przyrodniczy we Wroclawiu, Wroclaw, Poland
| | | | | | | | | | - Gualtiero Gandini
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano Emilia, Italy
| | - Marika Menchetti
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano Emilia, Italy
| | - João Carlos Ribeiro
- Referência Veterinária, Alcabideche, Portugal.,Faculdade de Medicina Veterinaria da Universidada, Lisboa, Portugal
| | - Artur Varejão
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal.,Centre for Animal Sciences and Veterinary Studies, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Antonio Ferreira
- Clinics, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Brian Zanghi
- Global Nutrition and Communications, Nestle Purina PetCare, St. Louis, United States
| | - Holger Andreas Volk
- Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, UK.,University of Veterinary Medicine, Hannover, Germany
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5
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Zabihollahpoor A, Rahimnejad M, Najafpour-Darzi G, Moghadamnia AA. Recent advances in electroanalytical methods for the therapeutic monitoring of antiepileptic drugs: A comprehensive review. J Pharm Biomed Anal 2020; 188:113394. [PMID: 32504972 DOI: 10.1016/j.jpba.2020.113394] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 05/22/2020] [Accepted: 05/23/2020] [Indexed: 12/24/2022]
Abstract
Frequency of seizures is often managed by a wide group of antiepileptic drugs. Regarding the pharmacokinetic variability, narrow targeted range, and difficulty of detecting signs of toxicity based on laboratory responses, therapeutic monitoring of antiepileptic drugs can play a pivotal role in optimizing the drug dosage. Electrochemical sensors and biosensors can facilitate analysis of these drugs due to their unique advantages such as fast analysis, sensitivity, selectivity, and low cost. This review article, for the first time, describes the recent advances in electrochemical sensors and biosensors developed for the analysis of antiepileptic drugs. General electrochemical measuring techniques and types of applied electrode substrates were described first. To simplify the work, various chemical and biological modifiers applied to improve the sensitivity and selectivity of the sensors were classified and explained briefly. Finally, the future prospective on the development of electrochemical platforms in the quantification of antiepileptic drugs will be presented.
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Affiliation(s)
- Atieh Zabihollahpoor
- Biofuel and Renewable Energy Research Center, Department of Chemical Engineering, Babol Noshirvani University of Technology, Babol, Iran.
| | - Mostafa Rahimnejad
- Biofuel and Renewable Energy Research Center, Department of Chemical Engineering, Babol Noshirvani University of Technology, Babol, Iran.
| | - Ghasem Najafpour-Darzi
- Biotechnology Research Laboratory, Faculty of Chemical Engineering, Babol Noshirvani University of Technology, Babol, Iran.
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Marin E, Ermolaev V, Marina O, Rezaeva E. Comparative evaluation of different treatment schemes for aseptic meningoencephalitis in dogs of dwarf breeds. BIO WEB OF CONFERENCES 2020. [DOI: 10.1051/bioconf/20202700128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
The article presents the results of treatment of aseptic meningoencephalitis in dogs of dwarf breeds. Diagnostics included a thorough neurological examination: assessment of mental status, ability to perform diagnostic tests, proprioceptive and postural reaction, the consistency and symmetry of cranial reflexes, including of pupil response to light and response to the threat, the presence of involuntary movements and forced poses, the intensity of the muscle tone and tendon reflexes. If an animal is suspected of having a brain lesion, other possible causes of encephalopathy were excluded. For this purpose, a General blood test was performed (to detect signs of inflammation, anemia); a detailed biochemical blood test (excluding renal and hepatic encephalopathy, indirect signs of the presence of a portosystemic shunt); if a portosystemic shunt was suspected, a blood test for bile acids was performed; when excluding all other causes of damage to the central nervous system. Magnetic resonance imaging of the brain was performed with contrast with the use of the drug OmniScan. During the magnetic resonance imaging, multiple foci were detected in all parts of the brain, including in the thalamus and trunk; including in some animals, foci that have a tendency to decay and form a necrotic cavity. It was established that before the start of treatment, animals had a wobbly gait, convulsive signs, a comatose state in some dogs, and weak visual reflexes. As a result of studies of morphological and biochemical parameters of blood in dogs, it was found that all the data obtained were within the reference values and did not have significant significance in the diagnosis of aseptic meningoencephalitis. Against the background of etiotropic and symptomatic therapy, positive dynamics was observed in patients with aseptic meningoencephalitis.
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Meland T, Carrera-Justiz S, Buckley GJ. Antiepileptic Drug Use Patterns in Suspect Epileptic Dogs Among Neurology and Emergency Specialists. J Am Anim Hosp Assoc 2019; 55:138-143. [PMID: 30870608 DOI: 10.5326/jaaha-ms-6795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study used a cross-sectional survey designed to inquire about antiepileptic drug (AED) use in newly diagnosed idiopathic epileptic dogs among board-certified emergency and neurology specialists. Results were obtained from 300 completed surveys by 128 board-certified neurologists and 172 board-certified emergency and critical care (ECC) specialists. Case volume was slightly different between groups, with 36% of neurologists and 18% of ECC specialists managing >50 cases of first-time canine seizure patients yearly. The initial AED of choice was similar between the groups, with 66% of neurologists and 64% of ECC specialists using phenobarbital and 16% of neurologists and 26% of ECC specialists using levetiracetam. Although most respondents gave a loading dose of phenobarbital, roughly one-fourth of neurologists did not load the drug versus 6% of ECC specialists. The total loading dose was similar between respondents (16 mg/kg) but varied in administration protocol. Approximately half of neurologists and nearly two-thirds of ECC specialists gave a higher initial dose of levetiracetam than recommended. Almost all the respondents who gave a higher initial dose of levetiracetam used 60 mg/kg IV once. Understanding the common practices in AED use may promote future discussions regarding best practices in the management of canine idiopathic epilepsy.
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Affiliation(s)
- Tessa Meland
- From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Sheila Carrera-Justiz
- From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
| | - Gareth J Buckley
- From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida
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8
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Ukai M, Hamamoto Y, Yu Y, Fujiwara-Igarashi A, Fujita M, Hasegawa D. Efficacy of zonisamide on interictal electroencephalography in familial spontaneous epileptic cats. J Feline Med Surg 2018; 20:962-967. [PMID: 29110561 PMCID: PMC11129232 DOI: 10.1177/1098612x17740247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Objectives The effectiveness of zonisamide (ZNS) against spontaneous epilepsy in cats has not yet been described. The purpose of this study was to investigate the effect of ZNS on interictal paroxysmal discharges (PDs) using scalp electroencephalography (EEG) in familial spontaneous epileptic cats (FSECs). Methods Eight FSECs were evaluated (six males and two females). Scalp EEG measurements were performed once a week for 3 weeks before ZNS administration (Pre-ZNS). Thereafter, administration of ZNS was started and an adjustment period was instituted until the drug in plasma achieved the steady state. When ZNS in plasma was confirmed to be within 10-40 μg/ml, scalp EEG measurements were performed once a week for 3 weeks (Post-ZNS). The number of PDs (counts/min) were compared between Pre-ZNS and Post-ZNS treatment. Results The median number of PDs for Pre-ZNS and Post-ZNS were 0.43/min (0.13-0.82/min) and 0.28/min (0.07-0.87/min), respectively. The number of PDs Post-ZNS was significantly reduced compared with Pre-ZNS ( P = 0.02). Conclusions and relevance This study showed that ZNS, within the recommended therapeutic range suggested for use in humans and dogs (10-40 µg/ml), reduced the number of PDs recorded on EEG in FSECs that are considered a model for cats with idiopathic epilepsy. Although phenobarbital is the antiepileptic drug of choice for epileptic cats, the results of this research provide evidence to support the use of ZNS in cats with phenobarbital-resistant epilepsy or for cats that cannot use phenobarbital due to adverse side effects.
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Affiliation(s)
- Masayasu Ukai
- Department of Clinical Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan
- Saitama Animal Medical Center, Saitama, Japan
| | - Yuji Hamamoto
- Department of Clinical Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Yoshihiko Yu
- Department of Clinical Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Aki Fujiwara-Igarashi
- Department of Clinical Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Michio Fujita
- Department of Clinical Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan
| | - Daisuke Hasegawa
- Department of Clinical Veterinary Science, Nippon Veterinary and Life Science University, Tokyo, Japan
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9
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Hazenfratz M, Taylor SM. Recurrent seizures in cats: Treatment - which antiepileptic drugs are recommended? J Feline Med Surg 2018; 20:825-834. [PMID: 30139319 PMCID: PMC10816270 DOI: 10.1177/1098612x18791874] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Practical relevance: Seizures are one of the most common neurological problems recognized in cats, affecting approximately 1-3% of the general population. Treatment options and prognosis are closely related to the underlying cause, so it is important that veterinarians are familiar with the diagnostic approach to cats with seizures and options for medical management. Series outline: This is the second of a two-part article series that reviews the diagnosis and treatment of seizures in cats. Part 2 describes chronic medical treatment options and prognosis for cats with recurrent seizures, and acute treatment of status epilepticus. AUDIENCE This review of recurrent seizures in cats is intended for all veterinarians who are facing the challenges of seizure diagnosis and management in the feline patient. Evidence base: Recommendations for diagnosis and management of feline seizure disorders have historically been extrapolated from the canine and human literature. The information and guidance provided in this two-part series is based on a review of the recent published literature addressing seizure disorders and antiepileptic treatment in cats, as well as the authors' clinical experience.
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Affiliation(s)
- Michal Hazenfratz
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Canada
| | - Susan M Taylor
- Department of Small Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N5B4, Canada
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10
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Drug utilisation study in patients receiving antiepileptic drugs in Colombia. NEUROLOGÍA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.nrleng.2015.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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11
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Podell M, Volk HA, Berendt M, Löscher W, Muñana K, Patterson EE, Platt SR. 2015 ACVIM Small Animal Consensus Statement on Seizure Management in Dogs. J Vet Intern Med 2016; 30:477-90. [PMID: 26899355 PMCID: PMC4913615 DOI: 10.1111/jvim.13841] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 01/18/2016] [Accepted: 01/18/2016] [Indexed: 11/27/2022] Open
Abstract
This report represents a scientific and working clinical consensus statement on seizure management in dogs based on current literature and clinical expertise. The goal was to establish guidelines for a predetermined, concise, and logical sequential approach to chronic seizure management starting with seizure identification and diagnosis (not included in this report), reviewing decision‐making, treatment strategies, focusing on issues related to chronic antiepileptic drug treatment response and monitoring, and guidelines to enhance patient response and quality of life. Ultimately, we hope to provide a foundation for ongoing and future clinical epilepsy research in veterinary medicine.
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Affiliation(s)
- M Podell
- Medvet Chicago, Medical and Cancer Centers for Pets, Chicago, IL.,Department of Neurosurgery, Pritzker School of Medicine, The University of Chicago, Chicago, IL
| | - H A Volk
- Department of Clinical Sciences and Services, Small Animal Medicine and Surgery Group, The Royal Veterinary College, Hatfield, Hertfordshire, UK
| | - M Berendt
- Department of Veterinary and Clinical Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - W Löscher
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine, Hannover, Germany.,Center for Systems Neuroscience, Hannover, Germany
| | - K Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC
| | - E E Patterson
- Department of Veterinary Clinical Sciences, University of Minnesota College of Veterinary Medicine, St. Paul, MN
| | - S R Platt
- Department of Small Animal Medicine & Surgery, College of Veterinary Medicine, University of Georgia, Athens, GA
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12
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van Beusekom CD, van den Heuvel JJ, Koenderink JB, Russel FG, Schrickx JA. Feline hepatic biotransformation of diazepam: Differences between cats and dogs. Res Vet Sci 2015; 103:119-25. [DOI: 10.1016/j.rvsc.2015.09.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 07/14/2015] [Accepted: 09/21/2015] [Indexed: 01/31/2023]
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13
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Bhatti SFM, De Risio L, Muñana K, Penderis J, Stein VM, Tipold A, Berendt M, Farquhar RG, Fischer A, Long S, Löscher W, Mandigers PJJ, Matiasek K, Pakozdy A, Patterson EE, Platt S, Podell M, Potschka H, Rusbridge C, Volk HA. International Veterinary Epilepsy Task Force consensus proposal: medical treatment of canine epilepsy in Europe. BMC Vet Res 2015; 11:176. [PMID: 26316233 PMCID: PMC4552371 DOI: 10.1186/s12917-015-0464-z] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 06/29/2015] [Indexed: 12/14/2022] Open
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.
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Affiliation(s)
- Sofie F M Bhatti
- Department of Small Animal Medicine and Clinical Biology, Faculty of Veterinary Medicine, Ghent University, Salisburylaan 133, Merelbeke, 9820, Belgium.
| | - Luisa De Risio
- Animal Health Trust, Lanwades Park, Kentford, Newmarket, CB8 7UU, Suffolk, United Kingdom.
| | - Karen Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, 1052 William Moore Drive, Raleigh, NC, 27607, USA.
| | - Jacques Penderis
- Vet Extra Neurology, Broadleys Veterinary Hospital, Craig Leith Road, Stirling, FK7 7LE, Stirlingshire, United Kingdom.
| | - Veronika M Stein
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Andrea Tipold
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg 9, 30559, Hannover, Germany.
| | - Mette Berendt
- Department of Veterinary and Clinical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Frederiksberg C, Denmark.
| | - Robyn G Farquhar
- Fernside Veterinary Centre, 205 Shenley Road, Borehamwood, SG9 0TH, Hertfordshire, United Kingdom.
| | - Andrea Fischer
- Clinical Veterinary Medicine, Ludwig-Maximillians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Sam Long
- University of Melbourne, 250 Princes Highway, Weibee, 3015, VIC, Australia.
| | - Wolfgang Löscher
- Department of Pharmacology, Toxicology and Pharmacy, University of Veterinary Medicine Hannover, Bünteweg 17, 30559, Hannover, Germany.
| | - Paul J J Mandigers
- Department of Clinical Sciences of Companion Animals, Utrecht University, Yalelaan 108, 3583 CM, Utrecht, The Netherlands.
| | - Kaspar Matiasek
- Section of Clinical & Comparative Neuropathology, Centre for Clinical Veterinary Medicine, Ludwig-Maximilians-University, Veterinärstr. 13, 80539, Munich, Germany.
| | - Akos Pakozdy
- Clinical Unit of Internal Medicine Small Animals, University of Veterinary Medicine, Veterinärplatz 1, 1210, Vienna, Austria.
| | - Edward E Patterson
- University of Minnesota College of Veterinary Medicine, D426 Veterinary Medical Center, 1352 Boyd Avenue, St. Paul, MN, 55108, USA.
| | - Simon Platt
- College of Veterinary Medicine, University of Georgia, 501 DW Brooks Drive, Athens, GA, 30602, USA.
| | - Michael Podell
- Chicago Veterinary Neurology and Neurosurgery, 3123 N. Clybourn Avenue, Chicago, IL, 60618, USA.
| | - Heidrun Potschka
- Department of Pharmacology, Toxicology and Pharmacy, Ludwig-Maximillians-University, Königinstr. 16, 80539, Munich, Germany.
| | - Clare Rusbridge
- Fitzpatrick Referrals, Halfway Lane, Eashing, Godalming, GU7 2QQ, Surrey, United Kingdom.
- School of Veterinary Medicine, Faculty of Health & Medical Sciences, University of Surrey, Guildford, GU2 7TE, Surrey, United Kingdom.
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, AL9 7TA, Hertfordshire, UK.
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14
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International Veterinary Epilepsy Task Force's current understanding of idiopathic epilepsy of genetic or suspected genetic origin in purebred dogs. BMC Vet Res 2015; 11:175. [PMID: 26316206 PMCID: PMC4552344 DOI: 10.1186/s12917-015-0463-0] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2015] [Accepted: 06/29/2015] [Indexed: 12/20/2022] Open
Abstract
Canine idiopathic epilepsy is a common neurological disease affecting both purebred and crossbred dogs. Various breed-specific cohort, epidemiological and genetic studies have been conducted to date, which all improved our knowledge and general understanding of canine idiopathic epilepsy, and in particular our knowledge of those breeds studied. However, these studies also frequently revealed differences between the investigated breeds with respect to clinical features, inheritance and prevalence rates. Awareness and observation of breed-specific differences is important for successful management of the dog with epilepsy in everyday clinical practice and furthermore may promote canine epilepsy research. The following manuscript reviews the evidence available for breeds which have been identified as being predisposed to idiopathic epilepsy with a proven or suspected genetic background, and highlights different breed specific clinical features (e.g. age at onset, sex, seizure type), treatment response, prevalence rates and proposed inheritance reported in the literature. In addition, certain breed-specific diseases that may act as potential differentials for idiopathic epilepsy are highlighted.
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Drug utilisation study in patients receiving antiepileptic drugs in Colombia. Neurologia 2015; 31:89-96. [PMID: 26304659 DOI: 10.1016/j.nrl.2015.06.015] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2015] [Revised: 06/09/2015] [Accepted: 06/15/2015] [Indexed: 02/03/2023] Open
Abstract
INTRODUCTION This study examines the indications according to which antiepileptic drugs are prescribed and used in a population of patients enrolled in the Colombian national health system (SGSSS). METHODS Retrospective cross-sectional study. From the pool of individuals in 34 Colombian cities who used antiepileptic drugs between 18 July, 2013 and 31 August, 2014 during a period of no less than 12 months, we obtained a random sample stratified by city. Socio-demographic, pharmacological and comorbidity variables were analysed. Continuous and categorical variables were compared, and logistic regression models were used. RESULTS Our patient total was 373 patients, with 197 women (52.1%) and a mean age of 41.9 ± 21.7 years; 65.4% of the patients were treated with monotherapy. The most frequently used drugs were valproic acid (53.1%) and carbamazepine (33.2%). Epilepsy was the most frequent indication (n=178; 47.7%); however, 52.3% of the patients were prescribed antiepileptics for different indications, especially neuropathic pain (26.8%), affective disorders (14.2%) and migraine prophylaxis (12.3%). A total of 81 patients with epilepsy (46.6%) displayed good seizure control while another 25 (14.4%) had drug-resistant epilepsy. In the multivariate analysis, medication adherence was associated with a lower risk of treatment failure in patients with epilepsy (OR: 0.27; 95%CI, 0.11-0.67). CONCLUSIONS In Colombia, antiepileptic drugs are being used for indications other than those originally intended. Monotherapy is the most commonly used treatment approach, together with the use of classic antiepileptic drugs.
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Current advances in biosampling for therapeutic drug monitoring of psychiatric CNS drugs. Bioanalysis 2015; 7:1925-42. [DOI: 10.4155/bio.15.123] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Many CNS drugs are effective for the treatment of psychiatric disorders. Psychotropic drugs work differently, thus clinical outcomes for many patients may be insufficient. For this reason it could be useful the measurement of drug levels for clinical decision-making. Analytical goals in therapeutic drug monitoring (TDM) should be established by selecting the appropriate biological matrix. The aim of this review is to highlight the usefulness of TDM for antiepileptics, antidepressants and antipsychotics, with a focus on current advances in biosampling. The literature on TDM was reviewed up to March 2015. An overview on the use of alternative biological matrices is provided to address the current issues and advances in the field of biosampling for psychiatric CNS drug TDM.
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Affiliation(s)
- Chris Thomson
- Massey University; Comparative Physiology and Anatomy; Private Bag 11 222 Palmerston North New Zealand
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Moore SA. Seizures and epilepsy in cats. VETERINARY MEDICINE-RESEARCH AND REPORTS 2014; 5:41-47. [PMID: 32670845 PMCID: PMC7337200 DOI: 10.2147/vmrr.s62077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/05/2014] [Accepted: 04/23/2014] [Indexed: 11/23/2022]
Abstract
Seizures are a common presenting complaint in cats, although causes and options for the treatment of seizures in this species have been historically poorly described in the veterinary literature. Seizure manifestation in cats may be different than what is typically seen in dogs, but the underlying causes of seizure activity are the same. These include primary epilepsies, structural epilepsies, and reactive seizures. Although primary epilepsy was once believed to be rare in cats, we now commonly appreciate this syndrome, albeit at a lower frequency than in dogs. Because of this, a complete diagnostic work-up is recommended for all cats presenting for initial evaluation of seizures. Symptomatic treatment of seizures in cats is similar to dogs, with only a few limitations related to species-specific antiepileptic drug toxicities. The goal of this review is to summarize the recent veterinary literature related to feline seizures, with a focus on seizure classification, clinical manifestation, diagnostic evaluation, and treatment options.
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Affiliation(s)
- Sarah A Moore
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
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