Veterinary Clinical Medicine-I (General and Systemic)

SEIZURES

• Not seizing at the time of presentation – perform complete physical examination.
• Complete profile – hematology, biochemical including urogenital examination
• Start Potassium Bromide 450 – 600 mg /kg p/o (loading) dividing 4 doses and administer in food.
• Maintenance: 40-50 mg / kg q 24 hours.
• If seizing (status epileptics). Primary aim: stop seizing.
  • Diazepam: 1 mg/kg i/v. If seizure does not subside within 1-2 minutes repeat Dz (1-2 times it can be repeated). Restore and maintain homeostasis, airway, oxygen, temperature, glucose and vital signs.
  • Diazepam: Inline burette 0.5 – 1 mg /kg/hour. Prepare only requirement for 1-2 hours. If no seizure occurs during 4-6 hours reduce by 25% every 4-6 hours.
  • If more than or equal to 2 seizures during Dz therapy can increase dose upto 1-5 mg/kg/hour.
  • Add phenoarbitone 15 mg/kg i/v in addition to above and see for seizure. If still seizure is present give propofol 1-3.5 mg/kg to effect followed by constant rate infusion 0.01-0.25 mg/kg/min for 24-48 hours.
• If the above method fails, induce GA using propofol 4-6 mg/kg i/v followed by 0.1-0.3 mg/kg/min to effect or Isoflurane or pentobarbital 2.5 mg/kg i/v to effect followed by 5 mg/kg/hour for several hours. Ggo for maintenance phenobarbitone once seizure cases.
• Oral Antiepileptic drugs:
  • I choice: Potassium Bromide: 40-50 mg/kg q 24 hours. Contraindicated in renal insufficiency.
  • II choice: Phenobarbitone: 2.5-4 mg/kg q 12 hours. Contraindicated in liver disorders. Increase by 50% incase of puppies. No seizure occurs for 6-12 months slow weaning over a period of few months. If seizure occurs, 1 per 6-8 weeks resume therapy.
• For cats:
  • I choice phenobarbitone: 2-2.5 mg q 12 hours.
  • II choice: Dz: 0.5-1mg/kg q 24 hours
  • III choice: KBr: 30-40 mg/kg q 24 hours.
• Contraindications: Accpromazine, Ketamine, Aminophylline, Xylazine as they lower the seizure threshold.