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Potassium Bromide side effects (anti-seizure meds)


Fly and Sweep
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My 12 yr. old BC/Aussie Mix, Sweep, was diagnosed with a meningioma in August after experiencing seizures. She went through a month of radiation (daily treatments, Mon-Fri for 3 weeks) in September. We just had a follow up MRI last week that showed a 25%-40% reduction in the size of the tumor (yea!).

 

Our biggest challenge has been the side effects of her anti-seizure medicine - potassium bromide. It makes her very wobbly when she walks - and she often "wipes out" while walking or even standing. We're now dealing with a partial CCL tear that she suffered during one of her wipe-outs. The neurologist tells us that we're probably about "as good as we're going to get" as far as the wobbliness goes. She's on a very low does of bromide, and she doesn't want to decrease it any more, or stop it, for fear of seizures returning. We have throw rugs everywhere to cover the hard wood floors and give her traction; we've tried the lilttle rubber-bottomed booties; we carry her outside to go potty and use a sling to help her keep her balance. If we could just get the CCL to heal, daily life will be easier for her! (and us!)

 

Has anyone dealt with this side effect before? Any advice or support?

 

Thanks for your help!

Fly and Sweep's Mom

 

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Sorry to hear about Sweep's health problem. We gave my GSD/Rough Collie 500 mg. potassium bromide for seizures, twice a day, for the last four years of his life (which is a relatively high dose). I have to say, he never experienced anything like you described poor Sweep going through. The potassium bromide worked very well and really had no side effects for Kamp at all. However, I know that ataxia (loss of muscle coordination) can be a side effect for some dogs. Is the PB the only other medication she is taking? Could it be the residual effects of the radiation therapy or other drugs she was given?

 

Wishing you and Sweep good luck.

 

Regards,

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How long has your dog been on KBR (potassium bromide)? KBR ususally takes about 4 months to stabilize in the system. Have you had a recent blood level done? That may tell you if the dog is being overdosed on it or not. When my dog was on KBR, her ataxia was a great concern. When her blood test came back within recommended range, I still decided to lower the dosage (with vet supervision), very slowly, over a long period of time. I was able to wean her entirely off the drug. Each dog is different, but MY dog was very sensitive to AEDs (anti-epileptic drugs), and required a lower dose than normal.

 

Personally, I prefer phenobarbital (pB) over KBR, because KBR takes so long to become effective and take a long time to see changes when dosages are adjusted. KBR is more expensive, an unstable compound, and blood levels can be affected by diet changes. pB is very cheap, readily assessible, and changes in dosages can be made relatively quickly.

 

The website: www.canine-epilepsy.com, and the related email group, epil-K9 group was an immense resource to me when my dog started seizureing.

 

Good luck to you and your dog,

 

Wendy

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Thanks for your posts! I appreciate the support. We did start out with Phenobarb, but Sweep was metabolizing it too quickly which kept it from getting to theraputic levels, so her seizures returned. That's when the neurologist switched us to Potassium Bromide. She's been on it since October. She metabolizes this drug much more slowly, so her levels were way too high at first, and the neurologist cut the dose back. She's now only on 1 mil, once a day. Thankfully, she's been seizure-free for about 2 months now, but the ataxia hasn't improved a whole lot. It's been really tough balancing the freedom from seizures with her reduced ability to get around. She's also on Prednisone to keep brain swelling down, and just started hydroxyurea to help slow the re-growth of the tumor. The neurologist thinks that her ataxia is primarily because of the bromide, but it could also be an effect of the brain tumor. (not to mention the CCL issue)

 

She's eating great -- she will NOT miss a meal :rolleyes: --, and she still "bitches" at her brother, Fly, so we're using those two things as our measuring stick for how she's feeling overall. I've also found the T-Touch (tteam-ttouch.com), which is helping her CCL and is very relaxing for her (and me!). I'll be sure to check out the sites you posted.

 

Thanks again for the support and suggestions - it's helpful to know others are going/have gone through similar situations.

 

Fly and Sweep's Mom,

Lynn.

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Thanks for your posts! I appreciate the support. We did start out with Phenobarb, but Sweep was metabolizing it too quickly which kept it from getting to theraputic levels, so her seizures returned. That's when the neurologist switched us to Potassium Bromide. She's been on it since October. She metabolizes this drug much more slowly, so her levels were way too high at first, and the neurologist cut the dose back. She's now only on 1 mil, once a day. Thankfully, she's been seizure-free for about 2 months now, but the ataxia hasn't improved a whole lot. It's been really tough balancing the freedom from seizures with her reduced ability to get around. She's also on Prednisone to keep brain swelling down, and just started hydroxyurea to help slow the re-growth of the tumor. The neurologist thinks that her ataxia is primarily because of the bromide, but it could also be an effect of the brain tumor. (not to mention the CCL issue)

 

She's eating great -- she will NOT miss a meal :rolleyes: --, and she still "bitches" at her brother, Fly, so we're using those two things as our measuring stick for how she's feeling overall. I've also found the T-Touch (tteam-ttouch.com), which is helping her CCL and is very relaxing for her (and me!). I'll be sure to check out the sites you posted.

 

Thanks again for the support and suggestions - it's helpful to know others are going/have gone through similar situations.

 

Fly and Sweep's Mom,

Lynn.

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Hi Lynn - we haven't seen the ataxia effects on Tux on 300 mg (1.2 mL) two times per day. But the neurologist said it could take 3 or 4 months to get up to therapeutic levels. So maybe with the brain tumor, it might take her longer to overcome the ataxia effects?

 

How long ago when they checked the level and found it was high? How much was it reduced? You said 1 mL, but do you know how many mg?

 

T-Touch is a great thing

 

Hang in there and wish I could help more!

 

Liz D

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check out my other post. get that poor dog off kbr before it falls down and really injures itself.my golden was on kbr and it just messed him up. pheno will take 2 months to reach therapeutic levels in its blood.my golden eats 300 mg a day. and he is slightly on the low end so we have lots of room to adjust.is the kbr making your dog act like hes really drunk?walks forward with head always down? walks into doors,walls,cabinets,etc?

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Guest SweetJordan

We had a dog when I was a kid(older kid by this time) who had epilepsy. We took him to a neurologist after the GP failed to get his seizures under control. PB was the only thing that worked for him. It made him a bit lethargic but w/o the med. we would of had to put him to sleep. Others probably didn't notice the effect on him as he was quite the wild man before and w/ it he justed ended up with the energy level of your avg. dog. He was happy though and eventually the doc. was able to wean him off it completely a couple of years before he died at age 11. He did end up w/ liver cancer which may or may not have been related to the PB, but again w/o it he would have died as a puppy. Now my story is bit different than yours but thought I would share as I do have experience with PB, and we never noticed any of the things that you are describing.

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Hi all:

 

Thanks for your posts!

 

The vet just checked Sweep's bromide levels, and she is finally within therapeutic levels, so I think we have that battle won - and she continues to be seizure-free, even though the ataxia is still trouble-some. It's pretty hard to tell how bad the ataxia is, because of the CCL, which is even more of a challenge - we think she re-injured it while getting her follow up MRI, because she came home not walking at all where she was walking before. Major disappointment. So, with all the positive progress on the brain tumor and meds, the CCL is turning out to be the biggest issue. The vet tells us that conservative management is our only option - surgery is out because of her age and all her other issues. So, slow and steady, we're moving forward.

 

Liz D:

She's on 1 mil once a day of 200 mg/ml, so it's a pretty low dose. She weighs about 35 lbs.

 

BorderBob:

Unfortunately, the phenobarb didn't work for Sweep. We started with that, but she metabolized it too quickly, so it wasn't getting to therapeutic levels and her seizures continued. That's when the neurologist changed to KBR. She started with a pretty aggressive loading dose, which ended up being an overdose, so it has been quite a challenge getting the dosage correct. Now it's under control, so we're pleased - and she hasn't had a seizure for over two months now. On the phenobarb, she was seizing several times a week.

 

ALL:

Sweep is a fighter with a strong will. She's working on standing on her own, but remains unsteady. She's definitely in pain, but I think she's learning what she can and can't do that causes her too much pain. We've got her on some pain meds, so that seems to be helping a bit. We continue to restrict her activity and carry her outside to go potty and use the sling to keep too much pressure off her injured leg.

 

Thanks again for all your support! Any other thoughts are definitely welcomed!

 

Fly and Sweep's Mom,

Lynn.

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  • 2 weeks later...

I haven't posted for more than a week, as things became very difficult very quickly with Sweep. I'm heartbroken to write that we had to make the painful decision to put Sweep to sleep last Thursday.

 

She began having severe bouts of pain the weekend before last that cycled every couple of hours and lasted for a few minutes each time. We were assuming it was the torn CCL that we were trying to rehab. After a visit to the orthopedic vet, he told us that the knee was ok, and he didn't think that was the source of her pain. He suspected something was going on in her lower spine or pelvis, and sent us back to Sweep's neurologist.

 

The neurologist agreed and thought that it could be anything from a herniated disc to nerve damage/pressure from the brain tumor, to a secondary tumor in the spine that had started pressing on nerves. At the same time, Sweep was continuing to become weaker on her left side, and was walking in circles to the left when we had her up and about with the sling. (She still wasn't standing on her own.) The neurologist said that no matter what we found in the spine, and even if it was treatable, her weakness, walking in circles and other neurological issues she was experiencing were definitely caused by the brain tumor, and there wasn't anything more we could do for the tumor. After radiation and the mixture of medications, we had done everything possible to treat it. For the last four weeks, it had been all about trying to rehab the knee. All of the sudden, it was not about the knee anymore, it was back to the brain tumor. We had the awful realization that she just wasn't going to get better, she would only continue to be in more pain and discomfort. So, Thursday morning, we said our very tearful goodbyes. As much as we wanted her to stay with us forever, she was suffering too much.

 

Our vet was wonderful - very compassionate, loving and caring. He was so helpful in getting us through one of the most painful things in life.

 

I know she is free from pain and suffering, and that gives me some comfort. But I sure miss those blue eyes and that spunky little way of hers. We're giving extra love to her adopted brother, Fly, and are remembering the joy she brought us for the 10 years we were blessed to have her.

 

Thanks for listening, and for helping with your advice these past few weeks. Hug and kiss your babies closer today, and cherish every minute you have with them. Whether it's one year or ten, we don't get to keep them here with us long enough!

 

Fly and Sweep's Mom,

Lynn.

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Lynn, just wanted to add my condolences on the passing of your lovely Sweep. You certainly went more than the extra mile for her, but as OffTopic said, even when you know it's the right thing to do to say goodby, it really doesn't make it less painful. Give your Fly lots of love, and keep enjoying those lovely memories of your pretty girl at her best.

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Thank you all for your kind words. I have those moments where thoughts go through my head...."could we have done something more? did we really do the right thing? could she still be here with us?" But then I remind myself that our regular vet, the radiologist, the neurologist and the orthopedic vet all were saying the same thing...everything possible was investigated and done for Sweep. It really was time to set her free, as painful as it was and is.

 

Thank you again for your support!

 

Fly and Sweep's Mom,

Lynn.

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