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Flashcards in CS - Seizures Deck (25):
1

What drugs are licensed for first line use in idiopathic epilepsy?

- phenobarbital
- imepitoin

2

First licensed drug for dogs with epilepsy

phenobarbital

3

FIrst line drug - cats - epilepsy

- phenobarbital

4

First line drug - cats -status epilepticus

diazepam (you can keep cats long-term on this, not dogs nowadays d/t a few case failures. Diazepam reaches brain within seconds, phenobarbitone takes 22 minutes)

5

First line drug - horse - epilepsy

phenobarbital (thi sis not licensed first line but is accepted first line)

6

In dogs given phenobarbitone, when do you check serum phenobarbitone levels?

1st time to check = 14 days

7

When do you check canine KBr serum levels for 1st time?

60-90 days (thus difficult to titrate as takes a long time to build up)

8

When do you need to check canine imepitoin serum levels?

Never - it has a 2.5 hour half life discrepancy b/w serum and EC fluid in brain. It also has a wide therapeutic margin so relatively safe if more given.

9

Side effects - dogs - phenobarbitone

- sedation
- PU / PD
- polyphagia
- liver toxicity (v high dose)
- wobbly (worst in first 2 weeks)
- ataxia (worst in first 2 weeks)
- do haematology for blood dyscrasias

10

Side effects - dogs - KBr

- similar to phenobarbitone except no blood dyscrasias with KBr
- ataxia may be worse than phenobarbitone
- pancreatitis
- bromide toxicity (if 3-4 x daily dose for several days)

11

Side effects - dog - imepitoi

- polyphagia
- sedation
- ataxia (?)
- hyeracitve (often transient)

12

Side effects - cat - diazepam

- severe liver necrosis/ acute hepatotoxicosis

13

Side effects - cat - KBr

feline asthma

14

What is the licensed 2nd line (add on) drug to phenobarbital in dogs?

KBr

15

What is the licensed 2nd line (add on) drug to imepitoin in dogs?

leveteracitam (although this example is more a case of personal preference than official recommendation)

16

Can idiopathic epilepsy patients have focal seizures?

Yes - but they will be symmetrical

17

How do you differentiate a propofol twitch from a seizure?

Move the animal about, twitching stops with propofol-induced twitching, not seizure-induced twitching

18

What part of forebrain can explain marked obtundation?

thalamus (gate of consciousness). Interestingly if you have a thalamus lesion, animals can look very obtunded but when you stimulate them, they wake up and look a lot more alert. With lesions affecting brainstem, this usually doesn't occur to same level (you can see some improvement in mentation but only minimal)

19

What type of urine crystals are seen in HE?

ammonium biurate crutals

20

How can you dx heavy metal poisoning (lead)?

- measure lead blood levels
- CYTOLOGY: basophilic staining of RBCs

21

Dx - glucose metabolism problems such as glycogen storage diseases (rare)

- measure blood glucose level
- liver biopsy

22

Dx - mitochondriopathies (rare)

- high lactate levels in blood/ CSF

23

Features - uraemic encephalopathy

- older animals
- not associated with food
- normally associated with high BP
- biochem/urine should be helpful

24

Dx - storage diseases

- WBC cytology
- liver/ mm biopsies

25

What diagnostic tests can confirm HE?

- bile acid stimulation (more sensitive and more specific for a PSS)
- ammonia (only if in-house test available and you put blood straight on ice
- ultraasound: large liver, small kidneys, PSS