Bram's Epilepsy Diary 2000
Had 2 singles seizures and a cluster of 3. Also collapsed suddenly one night and was virtually unrousable. Took to the ER who kept him all night. Also this month cut his dewclaw which we tried to manage medically for a week. Unfortunately it didn't heal so he had to have surgery and have it amputated. Thankfully the diazepam and isofluorane worked well and he had a smooth induction and recovery.
February 2000
Again not a good month - perhaps the bad times are now catching up to the good one's? Had several cluster seizures. On 9th had at work and didn't do well, hardly responding to stimuli. In evening took to ER - he was cold and unable to stand. ER vet said was likely not thermoregulating and offered euthanasia twice. As usual the comeback kid did it again!
We repeated the bromide level and was still at 3.9 :-( Spoke to the vet school who recommended diuresing with IV NaCl to reduce levels. Diuresis took a whole week, used 2 jugular catheters, 4 1/2 litres of NaCl, 10cc's of diazepam and remarkable understanding on the part of vets and techs.
March 2000
March saw a great improvement. Bram only had 5 seizures, two doubles and three singles. The first week was spent finishing off his diuresis, ending with a bromide level of 2.1 which was acceptable, seeing as he had fluids for a while after the bloods were taken. Unfortunately there were a couple of strange episodes where he'd collapse and be unrousable for a few minutes before returning almost to normal. Dr Munana thinks he might be spiking his intra cranial pressure, but with Bram there is no way of knowing, just another thing we are learning to deal with. By the end of the month Bram was doing superbly, looking like a "normal" dog.
April 2000
The beginning of April saw us set a seizure free record, going 24 days between seizures - we even left him in kennels for 4 days and he had none. The middle of the month saw a sudden deterioration with 5 night of seizures one week and as of now (4/25/00) seizures for the past 3 nights. We redid his levels and found that the PB was a disappointing 15 and his bromide had fallen to 1.5 which while within therapeutic range probably wasn't enough to control the seizures. To try to regain control we raised his PB to 73mg PB am, 97mg midday and pm and 500mg KBr once daily and are considering restarting the valium protocol again.
May 2000
The start of May again saw Bram spending time at work and at the Emergency Clinic. He was increasing agitated and uncoordinated and had several of his "episodes" where he collapsed and was unrousable. Finally I managed to have him at the clinic when one of these happened and the vets said they thought these were actually unusual seizures as there was some paddling.
With a change in his meds (increased his KBr to 750mg sid and the timing of his PB) things began to improve as the month progressed and he only had 2 sets of 2 seizures the rest of the month.
June 2000
Miracle month! We actually went seizure free (well GM free) the whole month. I would like to think that this might be a result of the changes in medications but I guess it is more likely just to be a coincidence. Bram did have some twitching and a couple of definite partials but at this stage I'm not concerned about these in the least.
July 2000
As of today (9th July) Bram is 40 days GM free, a new record for us. Over the last couple of days he has been increasingly ataxic and perhaps slightly disoriented which is a slight concern but he is looking great and behaving like an almost normal dog again :-) Well, we made it to 49 days seizure free, the streak broken by a typical cluster of 3 GM's lasting 2-3 minutes each. The seizures appeared severe but then again perhaps I just have forgotten what they had been like.
August 2000
I don't believe it - a month seizure free and with no other medical problems, it was such a refreshing change :-)
September 2000
The first of the month saw another cluster, this time of 2 GM's lasting shorter than usual and being slightly less severe. This makes it 48 days between seizures, another great run. Unfortunately the month also saw an increase in Bram's allergies but his dermatologist isn't too worried as allergy breakthroughs are to be expected every so often.
October 2000
Again no seizures :-)
November 2000
The 4th saw the end to our last seizure free strek. This time it was a whopping 64 days between seizures. The cluster he had was definitely severe but was limited to 3, each lasting approximately 2 minutes. Bram's post ictal was longg and his ataxia prolonged however given the increasing time between seizures I am in no way complaining.
December 2000
At last things seem to be on the up. There have been no seizures this month and no evidence of any other strange neurological activity. Perhaps we have at last got the medication balance correct?
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