Jade's Long, Valient Battle Against Epilepsy.

Jade, a Samoyed is 6 years old. She, with the help of her owners, has dealt with epilepsy for much of those 6 years. When I called for permission to write about Jade her owner said she is currently doing "wonderful" and back to her old self. A few weeks ago Dr. Cumberland, who was treating Jade through a serious crisis, and I probably would not have believed this would have happened.

Jade was in "status epilepticus." She was "stuck" in a seizure and, in spite of medication she showed no sign of coming out of it. Most seizures in epileptic dogs last just a few minutes before the dog recovers to normal, except for possibly some drowsiness or confusion. If a seizure lasts longer than that, or if a dog has multiple seizures, one right after the other, it is an emergency, worthy of a nighttime call to your veterinarian.

Seizures can usually be prevented by daily administration of a drug, either phenobarbital or potassium bromide. At first, phenobarbital prevented Jade's seizures. But we had to keep increasing the dose, to the point where blood tests showed worrisome increases in liver enzymes, indicating possible liver damage from the phenobarbital.

We switched Jade gradually, from the phenobarbital to potassium bromide. That worked really well for a while but then, even with the highest safe dose Jade began having seizures again. We added Phenobarbital and after using lab tests to monitor blood levels and adjusting the dose of each of the two drugs to the maximum safe blood level, she stopped having seizures. There were no side effects, and her liver tests, though not normal, were stable and acceptable.

But after a year or so Jade suddenly began having trouble walking. Her hind legs were weak and uncoordinated. She would stagger and fall from side to side, and sometimes not get up at all. A delayed reaction to the potassium bromide was likely, and after ruling out spinal disease and other possible causes, we reluctantly stopped the potassium bromide. We would have to go back to the higher dose of phenobarbital and hope that her liver could hold up. Other epilepsy drugs used in human medicine are very expensive and not used much in veterinary medicine so not much is known about their safety and efficacy in dogs.

Jade was OK for nearly a year, until they brought her to the hospital in status epilepticus. The phenobarbital she was taking, like the potassium bromide we had stopped, takes time to begin working, and even at increased doses is not appropriate for stopping the continuing seizure of status epilepticus. Sometimes, a tranquilizer, diazepam, given rectally, may stop a seizure. Some drugs, like diazepam, are absorbed through the lining of the rectum almost as quickly as if given intravenously. Jade's epilepsy had proven difficult to control, and she still had seizures occasionally in spite of daily medication. So her owners kept several syringes of diazepam at home. This time they didn't work.

The next thing to try is intravenous diazepam, and when that didn't work, Dr. Cumberland consulted with Dr. Whitaker, a neurologist at the Washington State University Veterinary Teaching Hospital. Under his direction, using drugs given continuously through an IV, Jade was finally stabilized. Over the next two days she gradually, slowly recovered from the drugs, without seizures.

Jade's family know what they're up against. They've made many tough decisions during Jade's troubled life. But for them, with a dog like Jade, and I think for Jade too, the good times are just so good that they outweigh those bad times.