Minutes after my last post about Gimme deciding on her own cues, she had another seizure!
It was the first seizure in 6 months and 8 days. It came on the fourth day after the recent reduction in medication, so we are back up to the prior dosage. We started at 500mg Keppra three times a day, then three months ago reduced it to 500mg twice a day. The emergency vet said we might be able to reduce it over time until we used none. So this time I went to 250mg twice a day. I thought it made better sense to have some Keppra in her system at all times. I've put her back on the 500mg twice a day dose and we have an appointment with our veterinarian Tuesday morning.
When it first started, Gimme came out from under the desk (remember I'd been writing the blog post) and sort of stopped with one foot up on a cushion. I thought I was in her way, so I moved and encouraged her to come out. She moved about three feet further and then stopped, looking a bit hunched over. She'd woken me up in the middle of the night with an urgent need to go outside, so I thought for a moment this was related and she might puke.
Then I saw her trembling and how her body was sinking to the floor. Realizing it was a seizure, I got down with her and just held her until it passed. I think it lasted less than 2 minutes. Overall I think it was less intense than the prior seizures. It seemed to have a cycle, like waves. So I think perhaps the reduced levels of Keppra in her system was enough to reduce the intensity, just not enough to prevent it entirely.
I couldn't get through to talk to my vet, this being the day before Thanksgiving. He had an office full, standing room only, two techs out sick, and had plans to catch a flight. So I called the emergency clinic where they'd originally prescribed Keppra and asked my question about moving the dose back up, whether I should do 2 or 3 doses of 500mg. They pulled her file and said twice a day would be good, reiterating how important it was to keep our Tuesday appointment. About an hour later the receptionist from the clinic called to say she'd talked to Doc and he said to get her back on the twice a day regimen. So it was good to have both veterinarians in agreement.
My first account on Wednesday is the same place I get her prescriptions filled, so I talked to the pharmacist. He looked it up online and said it takes about 1½ days for Keppra to completely leave the body. It took 72 hours for it to get low enough to no longer control her seizures. Thus, I don't have to panic if it so happens we miss a dose (not that I'd ever skip one on purpose, but, things happen). I'm on the K9Epilepsy list and there are cases where the owners are pretty much slaves to their beloved dog's disease. So I'm thankful on this account, since my life is pretty chaotic much of the time.
Although I was in panic mode most of the first few days, I've settled into this new reality. Gimme will need to be on medication for life. The bad news is, this shows her seizure disorder has progressed. Between her first and second seizure with no medication was 6 months and 4 days. Between the second and third seizures was 6 months and 8 days, which looks okay until you consider this was with a reduced level of medication. It only took 72 hours of reduced meds for the seizure to occur.
The good news is, her seizures are controlled easily with a medication which is low risk, has minimal side-affects and is inexpensive (about $20 per month). Twice a day is a regimen which fits well into my day, even on the more hectic days, so I can keep things regular for her.
Another interesting outcome - The first episode was during a RFE class and the second was minutes after a RFE practice. In this case, it occurred during our typical morning routine. I knew all along it was crazy, but there's been a subtle tension when we go anywhere to practice/train RallyFree. So now I can now let go of the superstition that it had anything to do with RallyFrEe or Obedience type training. Woooosh - that's me heaving a big sigh of relief.
I should point out, within 20 minutes after the seizure Gimme was her usual self. She was bouncing around, cavorting, bringing me toys - all as if to say, "I'm fine, I'm fine, don't worry, quit obsessing, let's play".
Last time she had a seizure, Gimme told me ice cream prevents seizures. Now she claims peanut butter is also a seizure preventative. Obviously she should get plenty of both. She's also been telling me that some day she is going to die and if I didn't play with her, I'm going to feel very guilty. Then she adds, we should play more often, probably several times a day. She's my girl - always working the angles...