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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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2
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Sacks M, Byrne DP, McConnell EJ. Bromide intoxication in a 3‐year‐old Thoroughbred filly. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- M. Sacks
- School of Veterinary Medicine College of Science Health, Engineering and Education Murdoch University Perth Western Australia Australia
| | - D. P. Byrne
- School of Veterinary Medicine College of Science Health, Engineering and Education Murdoch University Perth Western Australia Australia
| | - E. J. McConnell
- School of Veterinary Medicine College of Science Health, Engineering and Education Murdoch University Perth Western Australia Australia
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Hazenfratz M, Taylor SM. Recurrent seizures in cats: Treatment - which antiepileptic drugs are recommended? J Feline Med Surg 2019; 20:825-834. [PMID: 30139319 DOI: 10.1177/1098612x18791874] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [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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4
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Combs MD, Edwards SH, Scherpenhuizen JM, Narayan EJ, Kessell AE, Ramsay J, Piltz J, Raidal SR, Quinn JC. Treatment with potassium bromide mitigates ataxia and reduces tremor in lambs with perennial ryegrass toxicosis. N Z Vet J 2019; 67:287-294. [PMID: 31248334 DOI: 10.1080/00480169.2019.1637300] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Aims: To assess the use of potassium bromide (KBr) as a therapeutic intervention for perennial ryegrass toxicosis (PRGT) in lambs fed ryegrass seed containing lolitrem B. Methods: Male lambs aged 10-12 months (n = 43) were assigned to receive ryegrass seed containing lolitrem B, at a dose of 0.16 mg/kg/day (Groups 2, 3 and 4), or lucerne chaff and molasses (Groups 1 and 5). Lambs in Groups 2 and 3 were observed for clinical signs and gait changes until defined signs of PGRT were observed, when they were transferred, with lambs in Group 1, to the Testing phase of the trial. Lambs in Group 3 were then treated with a single oral dose of 300 mg/kg bromide. Lambs in Groups 4 and 5 received KBr daily from the start of the trial (540 mg/kg bromide over 3 days then 20 mg/kg daily) and were transferred to the Testing phase after 18 days. Clinical examination and gait assessment, and surface electromyography of the triceps muscle, measuring root-mean-square (RMS) voltages, were carried out on Days 0, 1 and 2 of the Testing phase followed by necropsy, histopathology, measurement of concentrations of bromide in serum and CSF and faecal cortisol metabolites (FCM). Results: In Group 3 lambs, mean composite gait scores decreased between Testing phase Day 0 and Days 1 and 2 (p < 0.001), but increased in lambs in Group 2 between Day 0 and Day 2 (p = 0.015). Scores for lambs in Group 3 on Day 2 were lower than for lambs in Group 2 (p < 0.001). Mean RMS voltages on Day 2 were higher in lambs in Group 2 than Group 3 (p = 0.045). Mean concentrations of bromide in serum were >800 µg/mL in lambs in Groups 3 and 4 on Day 2. Concentrations of FCM were higher in lambs from Group 2 than in Groups 1 or 5, but were similar in Groups 2, 3 and 4. Histopathological findings in the cerebellum of lambs from Groups 2, 3 and 4 were similar, showing pyknosis of neurons within the granular layer of the cerebellum and Purkinje neuron proximal axonal spheroid formation. Conclusions and clinical relevance: A single oral dose of 300 mg/kg bromide in lambs with neurological signs of PRGT resulted in reduced composite gait scores and reduced RMS voltages, indicating a significant improvement in clinical signs of ataxia, movement disorder and muscle tremor associated with the neurotoxic effects of lolitrem B.
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Affiliation(s)
- M D Combs
- School of Animal and Veterinary Sciences, Charles Sturt University , Wagga Wagga , Australia
| | - S H Edwards
- School of Animal and Veterinary Sciences, Charles Sturt University , Wagga Wagga , Australia
| | - J M Scherpenhuizen
- School of Animal and Veterinary Sciences, Charles Sturt University , Wagga Wagga , Australia
| | - E J Narayan
- School of Science and Health, Western Sydney University , Penrith , Australia
| | - A E Kessell
- Veterinary Diagnostic Laboratory, City University of Hong Kong , Hong Kong
| | - J Ramsay
- School of Animal and Veterinary Sciences, Charles Sturt University , Wagga Wagga , Australia
| | - J Piltz
- New South Wales Department of Primary Industries , Wagga Wagga , Australia
| | - S R Raidal
- School of Animal and Veterinary Sciences, Charles Sturt University , Wagga Wagga , Australia
| | - J C Quinn
- School of Animal and Veterinary Sciences, Charles Sturt University , Wagga Wagga , Australia
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Anderson KM, Garner MM, Clyde VL, Volle KA, Ialeggio DM, Reid SW, Hobbs JK, Wolf KN. Gastric dilatation and enterotoxemia in ten captive felids. J Am Vet Med Assoc 2018; 253:918-925. [PMID: 30211645 DOI: 10.2460/javma.253.7.918] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
CASE DESCRIPTION 10 large felids at 8 facilities were determined or suspected to have developed gastric dilatation with or without enterotoxemia over a 20-year period. Four felids were found dead with no premonitory signs. CLINICAL FINDINGS 4 felids (2 male snow leopards [Uncia uncia], 1 male Amur tiger [Panthera tigris altaica], and 1 male Sumatran tiger [Panthera tigris sumatrae]) were found dead or died before they could be evaluated. Six felids had hematemesis (1 male and 1 female African lion [Panthera leo] and 1 male jaguar [Panthera onca]) or abdominal distention and signs of lethargy with or without vomiting (1 male African lion, 1 male Malayan tiger [Panthera tigris jacksoni], and 1 female Sumatran tiger). Gastric dilatation was radiographically and surgically confirmed in the male Malayan and female Sumatran tigers and the jaguar. TREATMENT AND OUTCOME In 3 felids with an antemortem diagnosis, the gastric dilatation resolved with decompressive laparotomy but then recurred in 1 felid, which subsequently died. Three others died at various points during hospitalization. Although Clostridium perfringens type A was recovered from 3 of the 5 felids for which microbial culture was performed, and 2 felids had a recent increase in the amount fed, no single factor was definitively identified that might have incited or contributed to the gastric dilatation. CLINICAL RELEVANCE Gastric dilatation was a life-threatening condition in the large felids of this report, causing sudden death or clinical signs of hematemesis, abdominal distention, or vomiting. Even with rapid diagnosis and surgical decompression, the prognosis was poor. Research is needed into the factors that contribute to this emergent condition in large felids so that preventive measures might be taken.
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Santifort KM, Luin M, Mandigers P. Pyridostigmine bromide intoxication in two domestic cats. VETERINARY RECORD CASE REPORTS 2018. [DOI: 10.1136/vetreccr-2018-000596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
| | | | - Paul Mandigers
- Department of Clinical Sciences of Companion AnimalsUniversiteit Utrecht Faculteit DiergeneeskundeUtrechtThe Netherlands
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Charalambous M, Pakozdy A, Bhatti SFM, Volk HA. Systematic review of antiepileptic drugs' safety and effectiveness in feline epilepsy. BMC Vet Res 2018; 14:64. [PMID: 29499762 PMCID: PMC5834883 DOI: 10.1186/s12917-018-1386-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 02/21/2018] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Understanding the efficacy and safety profile of antiepileptic drugs (AEDs) in feline epilepsy is a crucial consideration for managing this important brain disease. However, there is a lack of information about the treatment of feline epilepsy and therefore a systematic review was constructed to assess current evidence for the AEDs' efficacy and tolerability in cats. The methods and materials of our former systematic reviews in canine epilepsy were mostly mirrored for the current systematic review in cats. Databases of PubMed, CAB Direct and Google scholar were searched to detect peer-reviewed studies reporting efficacy and/or adverse effects of AEDs in cats. The studies were assessed with regards to their quality of evidence, i.e. study design, study population, diagnostic criteria and overall risk of bias and the outcome measures reported, i.e. prevalence and 95% confidence interval of the successful and affected population in each study and in total. RESULTS Forty studies describing clinical outcomes of AEDs' efficacy and safety were included. Only two studies were classified as "blinded randomised controlled trials". The majority of the studies offered high overall risk of bias and described low feline populations with unclear diagnostic criteria and short treatment or follow-up periods. Individual AED assessments of efficacy and safety profile showed that phenobarbital might currently be considered as the first choice AED followed by levetiracetam and imepitoin. Only imepitoin's safety profile was supported by strong level of evidence. Imepitoin's efficacy as well as remaining AEDs' efficacy and safety profile were supported by weak level of evidence. CONCLUSIONS This systematic review reflects an evidence-based assessment of the published data on the AEDs' efficacy and safety for feline epilepsy. Currently, phenobarbital is likely to be the first-line for feline epileptic patients followed by levetiracetam and imepitoin. It is essential that clinicians evaluate both AEDs' effectiveness and tolerability before tailoring AED to the individual patient. Further studies in feline epilepsy treatment are by far crucial in order to establish definite guidelines for AEDs' efficacy and safety.
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Affiliation(s)
- Marios Charalambous
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Akos Pakozdy
- Clinical Unit of Internal Medicine Small Animals, University of Veterinary Medicine, Vienna, Austria
| | - Sofie F. M. Bhatti
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Holger A. Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hawkshead Lane, Brookmans Park, UK
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Engel O, von Klopmann T, Maiolini A, Freundt-Revilla J, Tipold A. Imepitoin is well tolerated in healthy and epileptic cats. BMC Vet Res 2017; 13:172. [PMID: 28606140 PMCID: PMC5469074 DOI: 10.1186/s12917-017-1087-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 05/31/2017] [Indexed: 12/04/2022] Open
Abstract
Background Epilepsy in the cat is a serious medical condition. To date there are no licensed treatments for feline epilepsy and no well-controlled clinical studies on the efficacy or safety of antiepileptic drugs in cats. The aim of this study was to collect tolerability data and first exploratory efficacy data of imepitoin in both healthy and epileptic cats. Results In two tolerability studies, 30 healthy cats received imepition twice daily in doses of 0, 30, 40 or 80 mg/kg bodyweight for 30 days. No serious adverse events were observed in any of the dose groups. In the imepitoin treated groups, emesis was observed in some animals temporarily and intermittently mainly in the second and third weeks of treatment. In a small, single-arm, open label, uncontrolled clinical trial eight cats suffering from idiopathic epilepsy were treated with imepitoin twice daily at doses of 30 mg/kg bodyweight for 30 days. Four of these cats (50%) achieved seizure freedom for at least 8 weeks under treatment. Adverse events, mostly lethargy, decreased appetite and emesis, were often mild and transient. Conclusion In summary, imepitoin was well tolerated in healthy and epileptic cats and showed in a pilot trial indication for efficacy in treating feline epilepsy.
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Affiliation(s)
- Odilo Engel
- Boehringer Ingelheim Vetmedica GmbH, Binger Str. 173, 55216, Ingelheim am Rhein, Germany.
| | | | - Arianna Maiolini
- University of Veterinary Medicine, Department of Small Animal Medicine and Surgery, Bünteweg 9, 30559, Hannover, Germany
| | - Jessica Freundt-Revilla
- University of Veterinary Medicine, Department of Small Animal Medicine and Surgery, Bünteweg 9, 30559, Hannover, Germany
| | - Andrea Tipold
- University of Veterinary Medicine, Department of Small Animal Medicine and Surgery, Bünteweg 9, 30559, Hannover, Germany.,Center for Systems Neuroscience, Hannover, Germany
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Abstract
Practical relevance Although seizures occur less commonly in cats compared with dogs, they are one of the most common forms of neurological disease in the feline patient. Cats may experience both focal (partial) and generalized seizures and causes are divided into primary disorders, in which there is no underlying cause (ie, idiopathic epilepsy), and secondary disorders. Cats with secondary seizure disorders have either an underlying structural lesion or metabolic disease. Patient group Seizures affect cats of all ages. Cats with idiopathic epilepsy tend to be younger (approximately 3.5 years) than cats with secondary seizure disorders (approximately 8 years). Audience This review of feline seizures is directed at all veterinarians who treat cats, both in an emergency setting as well as in general practice. Clinical challenges Refractory seizures are often a diagnostic and therapeutic challenge. A systematic approach to the seizuring cat is described, easing the task of diagnosing the cause of the seizures. In addition, novel antiepileptics are discussed, which can be used as add-on drugs in challenging feline seizure cases. Evidence base Compared with the canine counterpart, the literature regarding treatment of feline seizures is less established. Recent clinical trials and studies are focusing on new treatment options for feline seizures. Specifically, these studies, some of which are ongoing, have led to the use of levetiracetam, zonisamide and pregabalin as add-on antiepileptics in cases that are refractory to phenobarbital.
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Affiliation(s)
- Kerry Smith Bailey
- Department of Neurology, Oradell Animal Hospital, 580 Winters Avenue, Paramus, NJ 07652, USA
| | - Curtis W. Dewey
- Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY 14850, USA
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Foster SF, Allan GS, Martin P, Robertson ID, Malik R. Twenty-five cases of feline bronchial disease (1995–2000). J Feline Med Surg 2016; 6:181-8. [PMID: 15135355 DOI: 10.1016/j.jfms.2003.12.008] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2003] [Indexed: 10/26/2022]
Abstract
Twenty-five cases of feline bronchial disease were identified retrospectively. The criteria for inclusion were consistent clinical signs or histopathology and no other identifiable aetiology. Patient records were analysed to determine historical, clinical, clinicopathologic and radiographic features. The main presenting complaints were coughing and dyspnoea. The most common physical finding was dyspnoea. The majority of radiographs had a bronchial pattern either as the sole change or as a component of a mixed pattern. Bronchoalveolar lavage cytology was neutrophilic or eosinophilic in the majority of cats. There was no association between age, breed, sex, clinical signs, bronchoalveolar lavage cytology or radiographic severity and disease severity.
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Affiliation(s)
- S F Foster
- Division of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, WA 6012, Australia.
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Foster SF, Martin P, Braddock JA, Malik R. A retrospective analysis of feline bronchoalveolar lavage cytology and microbiology (1995–2000). J Feline Med Surg 2016; 6:189-98. [PMID: 15135356 DOI: 10.1016/j.jfms.2003.12.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A retrospective study of 88 bronchoalveolar lavage specimens from 80 cats presenting to the University of Sydney Veterinary Centre between 1995 and 2000 was performed. Bronchoalveolar lavage cytology and microbiology in conjunction with other diagnostic aids and patient records were used to classify cases as lower respiratory tract infections (LTRIs), LRTI revisits, feline bronchial disease, cardiac disease, neoplastic disease and multisystemic disease. Cases for which a definitive diagnosis could not be made were classified as inconclusive. Infectious agents identified were Mycoplasma spp., Pasteurella spp., Bordetella bronchiseptica, Salmonella typhimurium, Pseudomonas sp., Cryptococcus neoformans, Aelurostrongylus abstrusus and Eucoleus aerophilus. The study highlights the importance of bronchoalveolar lavage cytology and microbiology in the evaluation of feline lower respiratory tract disease.
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Affiliation(s)
- S F Foster
- Division of Veterinary and Biomedical Sciences, Murdoch University, Murdoch, WA 6012, Australia.
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Lidbury JA, Cook AK, Steiner JM. Hepatic encephalopathy in dogs and cats. J Vet Emerg Crit Care (San Antonio) 2016; 26:471-87. [PMID: 27060899 DOI: 10.1111/vec.12473] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 11/04/2014] [Accepted: 11/07/2014] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To comparatively review the pathogenesis, clinical presentation, diagnosis, and management of hepatic encephalopathy (HE) in dogs and cats. DATA SOURCES The Medline database was searched for articles related to HE in people, dogs, and cats. Articles published within the last 5 years were given special importance. HUMAN DATA SYNTHESIS The pathogenesis of HE is complex and incompletely understood, but ammonia appears to play a central role. Hyperammonemia leads to accumulation of glutamine in astrocytes, with subsequent astrocyte swelling and neurological dysfunction. The development of HE in patients with hepatic cirrhosis is a poor prognostic indicator. The fermentable disaccharide lactulose and the antimicrobial rifaximin are US Food and Drug Administration approved treatments for human HE. Severe protein restriction is no longer recommended for patients with this condition. VETERINARY DATA SYNTHESIS HE is often associated with portosystemic shunting in dogs and cats. Ammonia plays a central role in the pathogenesis of HE in dogs and cats, but other factors such as manganese and endogenous benzodiazepines may also contribute. Recently, a soy protein-based diet was found to be beneficial in treating canine HE. Severe dietary protein restriction is likely to be detrimental in affected animals. There have been no clinical trials of drugs routinely used in the management HE in veterinary medicine, but lactulose and antimicrobials such as metronidazole are well-established treatments. CONCLUSIONS HE is a potentially life-threatening condition that is probably underdiagnosed in companion animals. Although various treatment recommendations have been proposed, there is a lack of evidence in the veterinary literature regarding optimal strategies for the management of this condition. As our understanding of the pathogenesis of HE in dogs and cats evolves, novel diagnostic tests and therapeutic agents may become available.
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Affiliation(s)
- Jonathan A Lidbury
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843
| | - Audrey K Cook
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843
| | - Jörg M Steiner
- Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, 77843
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Forlani A, Palmieri C, Santagostino SF, Queliti R, Roccabianca P. Pathology in Practice. Pulmonary alveolar proteinosis. J Am Vet Med Assoc 2016; 248:621-3. [PMID: 26953913 DOI: 10.2460/javma.248.6.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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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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Podell M. Antiepileptic drug therapy and monitoring. Top Companion Anim Med 2014; 28:59-66. [PMID: 24070683 DOI: 10.1053/j.tcam.2013.06.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 06/20/2013] [Indexed: 11/11/2022]
Abstract
Over the past 2 decades, the number of antiepileptic drugs (AEDs) available to veterinarians has grown exponentially. Coupled with this increase is the ability to rapidly and accurately diagnose underlying brain disease with readily accessible magnetic resonance imaging. As a result, the veterinary community is attuned to the need for early treatment intervention. As more treatment choices become available, the unrelenting questions still arise are when should treatment begin, which initial drug therapy is best for our patients, when should treatment changes be considered, and finally, what are the advantages that newer drugs provide for our patients. The purpose of this chapter is to review decision-making strategies for AED therapy, provide an overview of the applicability of current AED available, and present information on the therapeutic advances in epilepsy.
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Affiliation(s)
- Michael Podell
- Chicago Veterinary Neurology and Neurosurgery, Chicago Veterinary Emergency and Specialty Center, Chicago, IL, USA.
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Liu DT, Silverstein DC. Feline secondary spontaneous pneumothorax: a retrospective study of 16 cases (2000-2012). J Vet Emerg Crit Care (San Antonio) 2014; 24:316-25. [PMID: 24697868 DOI: 10.1111/vec.12150] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2012] [Accepted: 12/21/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe the demographics, clinical characteristics, diagnostic findings, underlying etiologies, treatment, and outcome associated with secondary spontaneous pneumothorax (SSP) in cats; and to identify clinical feature differences among cats with asthma associated secondary spontaneous pneumothorax (AASSP) versus nonasthma-associated secondary spontaneous pneumothorax (NAASSP). DESIGN Retrospective case series. SETTING University teaching hospital. ANIMALS Sixteen client-owned cats with secondary spontaneous pneumothorax. INTERVENTIONS None. MEASUREMENTS AND MAIN RESULTS Domestic short hair was the predominant breed in this study (n = 15). The median age was 8 years old (range: 7 weeks to 17 years) with no sex predilection. Fourteen cats were affected by multi-lobar pulmonary pathology of infectious, inflammatory, or neoplastic causes. Asthma was the most common cause of spontaneous pneumothorax (25%). Ten of 12 treated cats survived the initial episode of spontaneous pneumothorax to discharge with medical management, including all 4 cats with AASSP. Reoccurrence was documented in 4 cats. Pulmonary lobectomy was curative for 1 cat with congenital accessory lung lobe emphysema. No difference in clinical presentation was identified between cats with AASSP and cats with NAASSP. CONCLUSIONS Feline SSP is frequently associated with extensive pulmonary pathology. Supportive medical management is most appropriate, except in rare cases with focal congenital abnormalities that may benefit from surgical intervention. AASSP appears to carry a good prognosis for short-term outcome (survival to discharge). Clinical assessment, imaging, and invasive diagnostics were required to differentiate between AASSP and NAASSP.
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Affiliation(s)
- Debra T Liu
- Matthew J. Ryan Veterinary Teaching Hospital, University of Pennsylvania, 3900 Delancey St, Philadelphia, PA, 19104
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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: 40] [Impact Index Per Article: 4.0] [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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Palus V, Eminaga S, Cherubini GB. Seizuring cat: what to ask, what to do? COMPANION ANIMAL 2013. [PMCID: PMC7162338 DOI: 10.12968/coan.2013.18.7.332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A seizuring cat can be a challenging case for every veterinarian and, therefore, the correct diagnosis and the appropriate management of such a case requires understanding of the most common causes of feline seizures. The underlying cause of the seizures should be investigated by a thorough questioning of the diagnostic approach and most likely diagnoses. If the cause of the seizures can be found then the appropriate therapeutic approach may improve the prognosis. The treatment of the feline seizures is similar to the canine patients; however, the differences should be kept in mind. This article is tailored to answer the most common questions that veterinary surgeons should ask themselves when dealing with a seizuring cat.
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Affiliation(s)
| | | | - Giunio Bruto Cherubini
- in Veterinary Neurology Dick White Referrals Station Farm, London Road, Six Mile Bottom, Suffolk, CB8 0UH
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Pakozdy A, Sarchahi AA, Leschnik M, Tichy AG, Halasz P, Thalhammer JG. Treatment and long-term follow-up of cats with suspected primary epilepsy. J Feline Med Surg 2012; 15:267-73. [DOI: 10.1177/1098612x12464627] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We report an evaluation of the treatment and outcome of cats with suspected primary epilepsy. Phenobarbital therapy was used alone or in combination with other anti-epileptic drugs. Outcome after treatment was evaluated mainly on the basis of number of seizures per year and categorised into four groups: seizure-free, good control (1–5 seizures per year), moderate control (6–10 seizures per year) and poor control (more than 10 seizures per year). About 40–50% of cases became seizure-free, 20–30% were considered good-to-moderately controlled and about 30% were poorly controlled depending on the year of treatment considered. The duration of seizure events after treatment decreased in 26/36 cats and was unchanged in eight cats. The subjective severity of seizure also decreased in 25 cats and was unchanged in nine cats. Twenty-six cats had a good quality of life, nine cats an impaired quality of life and one cat a bad quality of life. Despite being free of seizures for years, cessation of treatment may lead to recurrence of seizures in most cats.
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Affiliation(s)
- Akos Pakozdy
- Department for Companion Animals and Horses, Small Animal Clinic, Internal Medicine, University of Veterinary Medicine, Vienna, Austria
| | - Ali Asghar Sarchahi
- Department of Veterinary Clinical Studies, School of Veterinary Medicine, Shiraz University, Iran
| | - Michael Leschnik
- Department for Companion Animals and Horses, Small Animal Clinic, Internal Medicine, University of Veterinary Medicine, Vienna, Austria
| | - Alexander G Tichy
- Platform Bioinformatics and Biostatistics, University of Veterinary Medicine, Vienna, Austria
| | - Peter Halasz
- Institute of Experimental Medicine, Budapest, Hungary, Budapest, Hungary
| | - Johann G Thalhammer
- Department for Companion Animals and Horses, Small Animal Clinic, Internal Medicine, University of Veterinary Medicine, Vienna, Austria
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Baird-Heinz HE, Van Schoick AL, Pelsor FR, Ranivand L, Hungerford LL. A systematic review of the safety of potassium bromide in dogs. J Am Vet Med Assoc 2012; 240:705-15. [PMID: 22380809 DOI: 10.2460/javma.240.6.705] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To critically evaluate and summarize available information on the safety of potassium bromide in dogs. DESIGN Systematic review. SAMPLE 111 references reporting safety information relevant to potassium bromide published between 1938 and 2011. PROCEDURES PubMed searches without date limitations were conducted with the terms "potassium bromide" and "sodium bromide" in December 2009 and October 2011. Additional articles were identified through examination of article reference lists and book chapters on seizures in dogs and pharmacology. RESULTS Reversible neurologic signs were the most consistently reported toxicoses and were generally associated with adjunctive potassium bromide treatment or high serum bromide concentrations. Dermatologic and respiratory abnormalities were rare in dogs. Insufficient information was available to assess the effects of potassium bromide on behavior or to determine the incidence of vomiting, weight gain, polyphagia, pancreatitis, polyuria, polydipsia, or reproductive abnormalities associated with potassium bromide administration. Evidence suggested that administration of potassium bromide with food may alleviate gastrointestinal irritation and that monitoring for polyphagia, thyroid hormone abnormalities, and high serum bromide concentrations may be beneficial. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that potassium bromide is not an appropriate choice for treatment of every dog with seizures and that practitioners should tailor therapeutic regimens and clinical monitoring to each dog. Abrupt dietary changes or fluid therapy may compromise seizure control or increase the likelihood of adverse events. Availability of an appropriately labeled, approved potassium bromide product could provide better assurance for veterinarians and their clients of the quality, safety, and effectiveness of the product for veterinary use.
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Affiliation(s)
- Hope E Baird-Heinz
- Center for Veterinary Medicine, US FDA, 7519 Standish Pl, Rockville, MD 20855, USA
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Bertolani C, Hernandez J, Gomes E, Cauzinille L, Poujade A, Gabriel A. Bromide-associated lower airway disease: a retrospective study of seven cats. J Feline Med Surg 2012; 14:591-7. [DOI: 10.1177/1098612x12445069] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Seven cats were presented for mild-to-moderate cough and/or dyspnoea after starting bromide (Br) therapy for neurological diseases. The thoracic auscultation was abnormal in three cats showing increased respiratory sounds and wheezes. Haematology revealed mild eosinophilia in one cat. The thoracic radiographs showed bronchial patterns with peribronchial cuffing in most of them. Bronchoalveolar lavage performed in two cats revealed neutrophilic and eosinophilic inflammation. Histopathology conducted in one cat showed endogenous lipid pneumonia (EnLP). All cats improved with steroid therapy after Br discontinuation. Five cats were completely weaned off steroids, with no recurrence of clinical signs. In one cat, the treatment was discontinued despite persistent clinical signs. The cat presenting with EnLP developed secondary pneumothorax and did not recover. Br-associated lower airway disease can appear in cats after months of treatment and clinical improvement occurs only after discontinuing Br therapy.
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Carnes MB, Axlund TW, Boothe DM. Pharmacokinetics of levetiracetam after oral and intravenous administration of a single dose to clinically normal cats. Am J Vet Res 2011; 72:1247-52. [DOI: 10.2460/ajvr.72.9.1247] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Reinero CR. Advances in the understanding of pathogenesis, and diagnostics and therapeutics for feline allergic asthma. Vet J 2010; 190:28-33. [PMID: 21036078 DOI: 10.1016/j.tvjl.2010.09.022] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2009] [Revised: 09/23/2010] [Accepted: 09/23/2010] [Indexed: 11/18/2022]
Abstract
Asthma is a common inflammatory disease of the lower airways and is believed to be of allergic etiology in cats. As little progress has been made in establishing rigorous criteria to differentiate it from other inflammatory lower airway diseases such as chronic bronchitis, descriptions of 'asthma' in the literature have often been inaccurate, grouping this syndrome with other feline airway diseases. With the development of more sensitive and specific diagnostics, it will become easier to distinguish asthma as a disease entity. Pulmonary function testing with bronchoprovocation/bronchodilator responsiveness trials and biomarkers hold particular promise. Discrimination is of critical importance as targeted therapies for the allergic inflammatory cascade are developed and become available for therapeutic trials in pet cats.
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Affiliation(s)
- Carol R Reinero
- Department of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA.
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Kluger EK, Malik R, Govendir M. Veterinarians' preferences for anticonvulsant drugs for treating seizure disorders in dogs and cats. Aust Vet J 2009; 87:445-9. [DOI: 10.1111/j.1751-0813.2009.00509.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Piperisova I, Neel JA, Papich MG. What is your diagnosis? Marked hyperchloremia in a dog. Vet Clin Pathol 2009; 38:411-4. [DOI: 10.1111/j.1939-165x.2009.00124.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Neurology: Seizures in younger dogs and cats. COMPANION ANIMAL 2008. [PMCID: PMC7162384 DOI: 10.1111/j.2044-3862.2008.tb00543.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Hasegawa D, Kobayashi M, Kuwabara T, Ohmura T, Fujita M, Orima H. Pharmacokinetics and toxicity of zonisamide in cats. J Feline Med Surg 2008; 10:418-21. [DOI: 10.1016/j.jfms.2008.01.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2008] [Indexed: 10/22/2022]
Abstract
With the eventual goal of making zonisamide (ZNS), a relatively new antiepileptic drug, available for the treatment of epilepsy in cats, the pharmacokinetics after a single oral administration at 10 mg/kg and the toxicity after 9-week daily administration of 20 mg/kg/day of ZNS were studied in healthy cats. Pharmacokinetic parameters obtained with a single administration of ZNS at 10 mg/day were as follows: Cmax=13.1 μg/ml; Tmax=4.0 h; T1/2=33.0 h; areas under the curves (AUCs)=720.3 μg/mlh (values represent the medians). The study with daily administrations revealed that the toxicity of ZNS was comparatively low in cats, suggesting that it may be an available drug for cats. However, half of the cats that were administered 20 mg/kg/day daily showed adverse reactions such as anorexia, diarrhoea, vomiting, somnolence and locomotor ataxia.
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Affiliation(s)
- Daisuke Hasegawa
- Department of Veterinary Radiology, Nippon Veterinary and Life Science University, 1-7-1 Kyounan-chou, Musashino-shi, Tokyo 180-8602, Japan
| | - Masanori Kobayashi
- Department of Veterinary Radiology, Nippon Veterinary and Life Science University, 1-7-1 Kyounan-chou, Musashino-shi, Tokyo 180-8602, Japan
| | - Takayuki Kuwabara
- Department of Veterinary Radiology, Nippon Veterinary and Life Science University, 1-7-1 Kyounan-chou, Musashino-shi, Tokyo 180-8602, Japan
| | - Tomoyuki Ohmura
- Department of Veterinary Radiology, Nippon Veterinary and Life Science University, 1-7-1 Kyounan-chou, Musashino-shi, Tokyo 180-8602, Japan
| | - Michio Fujita
- Department of Veterinary Radiology, Nippon Veterinary and Life Science University, 1-7-1 Kyounan-chou, Musashino-shi, Tokyo 180-8602, Japan
| | - Hiromitsu Orima
- Department of Veterinary Radiology, Nippon Veterinary and Life Science University, 1-7-1 Kyounan-chou, Musashino-shi, Tokyo 180-8602, Japan
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Bailey KS, Dewey CW, Boothe DM, Barone G, Kortz GD. Levetiracetam as an adjunct to phenobarbital treatment in cats with suspected idiopathic epilepsy. J Am Vet Med Assoc 2008; 232:867-72. [DOI: 10.2460/javma.232.6.867] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Seizures and Sleep Disorders. HANDBOOK OF SMALL ANIMAL PRACTICE 2008. [PMCID: PMC7152292 DOI: 10.1016/b978-1-4160-3949-5.50026-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
This article reviews anticonvulsant therapies in current use for dogs and cats and briefly describes new modes of anticonvulsant therapy that are being investigated or pending publication. Most of the information contained within the article is based on published information. Some of the information, however, is based on the author's clinical experience and is identified as such.
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Affiliation(s)
- Curtis W Dewey
- Department of Clinical Sciences, Cornell University, College of Veterinary Medicine, Ithaca, NY 14853, USA.
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Seizure Disorders and Treatment Options. CONSULTATIONS IN FELINE INTERNAL MEDICINE 2006. [PMCID: PMC7149571 DOI: 10.1016/b0-72-160423-4/50058-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
OBJECTIVE To determine the pharmacokinetics of potassium bromide (KBr) in horses after single and multiple oral doses. ANIMALS Twelve adult Standardbred and Thoroughbred mares. PROCEDURE Horses were randomly assigned to two treatment groups. Group 1 horses were given a single oral dose of 120 mg/kg potassium bromide. Part 2 of the study evaluated a loading dose of 120 mg/kg KBr daily by stomach tube for 5 days, followed by 40 mg/kg daily in feed for 7 days. Serum concentrations of KBr were measured to construct concentration versus time curves and to calculate pharmacokinetic parameters. Treated horses were monitored twice daily by clinical examination. Serum concentrations of sodium, potassium and chloride ions and partial pressures of venous blood gases were determined. RESULTS Maximum mean serum concentration following a single dose of KBr (120 mg/kg) was 423 +/- 22 microg/mL and the mean elimination half-life was 75 +/- 14 h. Repeated administration of a loading dose of KBr (120 mg/kg once daily for 5 d) gave a maximum serum concentration 1639 +/- 156 microg/mL. The administration of lower, maintenance doses (40 mg/kg once daily) was associated with decreased serum bromide concentrations, which plateaued at approximately 1000 microg/mL. Administration of KBr was associated with significant but transient changes in serum potassium and sodium concentrations, and possible changes in base excess and plasma bicarbonate concentrations. High serum concentrations of bromide were associated with an apparent increase in serum chloride concentrations, when measured on an ion specific electrode. CONCLUSIONS and clinical relevance Loading doses of 120 mg/kg daily over 5 d and maintenance doses of approximately 90 mg/kg of KBr administered once daily resulted in serum bromide concentrations consistent with therapeutic efficacy for the management of seizures in other species. The clinical efficacy of this agent as an anticonvulsant medication and/or calmative in horses warrants further investigation.
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Affiliation(s)
- S L Raidal
- Division of Veterinary and Biomedical Sciences, Murdoch University, South Street, Murdoch, Western Australia
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Tan JS, Lin F, Tanouye MA. Potassium bromide, an anticonvulsant, is effective at alleviating seizures in the Drosophila bang-sensitive mutant bang senseless. Brain Res 2004; 1020:45-52. [PMID: 15312786 DOI: 10.1016/j.brainres.2004.05.111] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2004] [Indexed: 11/16/2022]
Abstract
Human seizure disorders are a major health concern due to the large number of affected individuals, the potentially devastating consequences of untreated seizure occurrences, and the lack of an effective treatment for all patients. Although anticonvulsants have proven very helpful in treating seizures and remain the best option available for treatment, not all afflicted individuals respond to medication and many only do so in unique drug combinations or at the cost of adverse side-effects. Therefore, new and more effective anticonvulsants are continually sought after to combat this illness. In this study, we present results which offer the possibility of using Drosophila bang-sensitive (BS) mutants as a tool to screen anticonvulsants. By feeding the BS mutants a known anticonvulsant, potassium bromide, we have demonstrated that the drug dramatically reduces the seizures of bang senseless, the most severe of the BS mutants. This methodology suggests that the Drosophila system can potentially be a powerful instrument for assaying and testing new compounds with anticonvulsant properties.
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Affiliation(s)
- Jeff S Tan
- Department of Molecular and Cell Biology, Division of Neurobiology, University of California, Berkeley, CA 94720, USA
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