Flashcards in CS - Seizures Deck (25):
What drugs are licensed for first line use in idiopathic epilepsy?
First licensed drug for dogs with epilepsy
FIrst line drug - cats - epilepsy
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)
First line drug - horse - epilepsy
phenobarbital (thi sis not licensed first line but is accepted first line)
In dogs given phenobarbitone, when do you check serum phenobarbitone levels?
1st time to check = 14 days
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)
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.
Side effects - dogs - phenobarbitone
- PU / PD
- liver toxicity (v high dose)
- wobbly (worst in first 2 weeks)
- ataxia (worst in first 2 weeks)
- do haematology for blood dyscrasias
Side effects - dogs - KBr
- similar to phenobarbitone except no blood dyscrasias with KBr
- ataxia may be worse than phenobarbitone
- bromide toxicity (if 3-4 x daily dose for several days)
Side effects - dog - imepitoi
- ataxia (?)
- hyeracitve (often transient)
Side effects - cat - diazepam
- severe liver necrosis/ acute hepatotoxicosis
Side effects - cat - KBr
What is the licensed 2nd line (add on) drug to phenobarbital in dogs?
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)
Can idiopathic epilepsy patients have focal seizures?
Yes - but they will be symmetrical
How do you differentiate a propofol twitch from a seizure?
Move the animal about, twitching stops with propofol-induced twitching, not seizure-induced twitching
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)
What type of urine crystals are seen in HE?
ammonium biurate crutals
How can you dx heavy metal poisoning (lead)?
- measure lead blood levels
- CYTOLOGY: basophilic staining of RBCs
Dx - glucose metabolism problems such as glycogen storage diseases (rare)
- measure blood glucose level
- liver biopsy
Dx - mitochondriopathies (rare)
- high lactate levels in blood/ CSF
Features - uraemic encephalopathy
- older animals
- not associated with food
- normally associated with high BP
- biochem/urine should be helpful
Dx - storage diseases
- WBC cytology
- liver/ mm biopsies