Peer-reviewed veterinary case report
Felbamate add-on treatment for drug-resistant seizures in six dogs
By Dewey, Curtis Wells et al.·Published in Open veterinary journal·2022·Elemental Pet Vets, United States·View original on PubMed →
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Original publication title: Felbamate as an oral add-on therapy in six dogs with presumptive idiopathic epilepsy and generalized seizures resistant to drug therapy.
- Species:
- dog
Plain-English summary
A group of six dogs with idiopathic epilepsy (a type of epilepsy with no known cause) were experiencing frequent generalized seizures that didn't respond to standard medications. They were given an additional treatment of oral felbamate, which led to a significant reduction in seizures—on average, an 82% decrease. Out of the six dogs, five showed a good response, with three becoming completely seizure-free. Most of the dogs continued to do well over the following months, with some remaining seizure-free for over a year. No serious side effects were noted from the felbamate treatment.
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Abstract
BACKGROUND: Idiopathic or genetic epilepsy commonly affects dogs; affected dogs are often refractory to anti-seizure drug therapy. Felbamate is an anti-seizure drug with established pharmacokinetic and safety data for dogs, but little published evidence of efficacy for managing generalized seizures in this species. AIM: The purpose of this retrospective case series was to evaluate the clinical efficacy and tolerability of oral felbamate in six presumptive epileptic dogs experiencing generalized seizures. METHODS: Medical records from six dogs with presumptive idiopathic/genetic epilepsy manifesting as generalized seizure activity, for which oral felbamate was used as an add-on treatment, were reviewed. The number of seizures recorded for the 3-month period immediately before instituting felbamate was recorded for each dog. Short-term (3 months) and long-term (6 months or greater) seizure frequency post-felbamate therapy was recorded for each dog and compared with baseline. RESULTS: Overall, dogs experienced a reduction (82%) in seizures after adding felbamate in the short term, with 5/6 dogs (83%) classified as responders (50% or greater reduction in seizures) and 3/6 dogs (50%) attaining seizure-free status. Mean and median long-term follow-up times were 13 and 11 months, respectively (range: 6 to 23 months). Four of the 6 dogs (67%) remained drug responders at final follow-up, with an average seizure reduction of 98%, 2 of which remained seizure-free at 8 and 21 months. Two dogs (33%) experienced increased seizure activity during long-term follow-up (12 and 23 months) and were considered non-responders. The non-responder dogs had an average long-term seizure reduction of 33%. No dog experienced any obvious adverse effects associated with felbamate administration. However, one dog not included in the analysis because of insufficient (<3 month) post-felbamate follow-up, was weaned off felbamate because of suspected hepatotoxicity. CONCLUSION: Our small case series suggests that oral felbamate might show promise as an add-on drug for epileptic dogs experiencing generalized seizures resistant to drug therapy. These results warrant a more controlled, prospective investigation into felbamate as a therapeutic agent for canine epilepsy.
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Search related cases →Original publication on PubMed: https://pubmed.ncbi.nlm.nih.gov/36118733/