Lok's seizures continue. He had his fifth last night. It's been about a month since the last one. For anyone who hasn't experienced a seizing dog, this description is pretty spot-on:
A typical seizure unfolds like this: At 3:30 am you hear a loud bump as your dog falls off the bed. His whole body is rigid, with his neck pulled backward so strongly that his head nearly touches his back. His eyes are rolled back in his head, and his mouth is wide open - champing frantically at nothing, saliva spewing forth. His legs gallop nowhere. He empties his bladder, his anal glands, and often his bowels. This continues for up to several minutes, during which time he does not breath. Lack of oxygen to the brain means death for brain cells. As the seizure declines, he is unconscious. Suddenly he snaps into a semblance of awareness, but is totally uncoordinated and often blind. He pulls himself up and staggers into a wall or a piece of furniture. Not having an understanding of why he isn't moving forward, he continues to shove blindly against the barrier until it moves or someone pulls him away from it. Over the next 20 minutes to several hours he gradually comes back to his senses.
Then the pacing begins. He doesn't know why, but he must pace - back and forth, back and forth - without end. This can go on for hours. Finally he goes into an exhausted sleep. With some luck, he doesn't "cluster" (having anywhere from 2 to over 50 seizures over the next 2-3 days) or go into status epilepticus (continual seizing that often means death). You try to go back to sleep for a few hours, praying that the seizures are over for now, and thanking God that he lived through this one.
The "post-ictal" phase is the worst. That's after the convulsions stop when he suddenly jumps up and needs to move continually with no idea where he is going. He will walk into walls, and like a video game character will just keep trying to go forward, or will stand there confused about why he can't keep going. He will fall down stairs. I can't hold him still or comfort him (and he doesn't really seem to be un-comfortable--his tail will be wagging like crazy while he's pacing) because he just keeps struggling against me to keep moving, so I put him in his crate where he will pace in circles but he is less likely to hurt himself. I keep him there and sit with him and talk to him until he calms down and then bring him onto the bed with me when he is able to lie still and sleep. It's not nearly as traumatic for me as the first couple were--I kind of have the routine down now--but I still hate to see him going through it.
We went to the UofM several weeks ago. The neurologist decided that it was most likely "idiopathic epilepsy" which is a fancy way of saying "your dog is having seizures and we have no idea why." The other options--some kind of poison or toxin, or a brain tumor--he said were unlikely, and that it wasn't worth doing a CT or MRI at this point. A blood test showed Lok's phenobarbital was not at a therapeutic level, so they decided to increase his dose of phenobarbital to double what it was. He has been getting 60mg twice a day and is now at a therapeutic level. I realized this morning that I missed his dose last night. That may or may not have contributed to the seizure he had last night. He missed a dose last week due to having run out and he didn't seize at that time.
So right now, I will try to do better at remembering to give him his Pb. I am also switching him back from Taste of the Wild kibble to Orijen kibble. I can't remember when exactly I started mixing in TOTW to save money (it's still a pretty high quality grain-free food, but much cheaper), but I think it was around the time he started seizing. So just in case that could be a factor, I put him back on Orijen starting today. I will give that a couple months and if he's still seizing I will look into other supplement options or consider feeding raw. It seems many Epi dogs have improved when started on a raw diet. I also plan to start supplementing with Milk Thistle, which does nothing to help the seizures, but is supposed to prevent liver damage from the Pb.
The UofM also gave me the go-ahead to put him back on Prozac, so he's been getting that again for a few weeks and is doing better again with his anxiety. I'm expecting it to be several more weeks before he's back to where he was. His paw-licking is getting better, he's relaxing in the house when I'm home at night instead of standing around or pacing and obsessively bothering Elo. He's been better in his crate and isn't chewing his crate pan anymore.
So, that's what's up with Lok. He's not doing too bad, but I do hope I can take him off both of these drugs at some point. If anyone has any experience with epi or anxiety and has any input I'd be happy to hear it!