Peer-reviewed veterinary case report
Combination of imepitoin and phenobarbital for drug-resistant
By Neßler, Jasmin et al.·Published in BMC veterinary research·2017·Department of Small Animal Medicine and Surgery, Germany·View original on PubMed →
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Original publication title: Clinical evaluation of a combination therapy of imepitoin with phenobarbital in dogs with refractory idiopathic epilepsy.
- Species:
- dog
Plain-English summary
A group of dogs with epilepsy that didn't respond to standard medications was treated with a combination of two drugs: imepitoin and phenobarbital. The dogs showed a significant reduction in the number of seizures, with about 36-42% experiencing at least a 50% decrease in their monthly seizure frequency. The lower starting dose of imepitoin was better tolerated, and many dogs were able to increase their dose comfortably. While this treatment helped many dogs, it didn't completely stop cluster seizures, which can indicate a tougher case of epilepsy. Overall, this combination therapy offers hope for dogs struggling with drug-resistant epilepsy.
People also search for: dog epilepsy treatment · imepitoin for dogs · phenobarbital side effects in dogs
Abstract
BACKGROUND: Imepitoin was tested as a combination treatment with phenobarbital in an open-label mono-centre cohort study in dogs with drug-resistant epilepsy. Diagnosis of idiopathic epilepsy was based on clinical findings, magnetic resonance imaging and cerebrospinal fluid analysis. Three cohorts were treated. In cohort A, dogs not responding to phenobarbital with or without established add-on treatment of potassium bromide or levetiracetam were treated add-on with imepitoin, starting at 10 mg/kg BID, with titration allowed to 30 mg/kg BID. In cohort B, the only difference to cohort A was that the starting dose of imepitoin was reduced to 5 mg/kg BID. In cohort C, animals not responding to imepitoin at >20 mg/kg BID were treated with phenobarbital add-on starting at 0.5 mg/kg BID. RESULTS: The add-on treatment resulted in a reduction in monthly seizure frequency (MSF) in all three cohorts. A reduction of ≥50% was obtained in 36-42% of all animals, without significant difference between cohorts. The lower starting dose of 5 mg/kg BID imepitoin was better tolerated, and an up-titration to on average of 15 mg/kg BID was sufficient in cohort A and B. In cohort C, a mean add-on dose of 1.5 mg/kg BID phenobarbital was sufficient to achieve a clinically meaningful effect. Six dogs developed a clinically meaningful increase in MSF of ≥ 50%, mostly in cohort A. Neither imepitoin nor phenobarbital add-on treatment was capable of suppressing cluster seizure activity, making cluster seizure activity an important predictor for drug-resistance. CONCLUSION: A combination treatment of imepitoin and phenobarbital is a useful treatment option for a subpopulation of dogs with drug-resistant epilepsy, a low starting dose with 5 mg/kg BID is recommended.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/28118828/