The Animal Health Trust in Newmarket would like to invite referral of dogs with refractory epilepsy for inclusion in the following study. For further details of this study or to discuss a case for potential referral contact Dr Luisa De Risio.
The
purpose of this investigation is to evaluate the efficacy and
the therapeutic range of levetiracetam as
an anticonvulsant in dogs with idiopathic epilepsy refractory
to the combination of phenobarbitone and bromide. Each dog
will be given a standard dose of levetiracetam and the dose
will be adjusted based upon serum drug concentrations, until
the concentration is within the therapeutic range, and minimal
side-effects are apparent. Trough and estimated peak serum
levetiracetam concentrations will be compared for all animals.
At the beginning and end of the 2-month study, each dog will
have a haematology, a comprehensive biochemistry, a dynamic
bile acids, in addition to serum PB and Br levels evaluated.
Seizure
Frequency Recording
Seizure frequency is to be estimated from medical records and owner reports
over a two-month period prior to the initiation of levetiracetam. Seizure frequency
will be recorded for 2-months following initiation of levetiracetam therapy.
Case
Inclusion Criteria
The study is limited to dogs with idiopathic epilepsy. Idiopathic epilepsy
will be diagnosed via characteristic clinical features for the disease in addition
to normal diagnostic tests. Ten cases will be included and all will have:
| • |
An
onset of generalised tonic clonic seizures
between 1 and 5
years of age |
| • |
A
normal interictal neurological examination |
| • |
Normal
haematology and comprehensive biochemistry
including dynamic
bile acid tests |
| • |
Normal
magnetic resonance (MR) imaging of the brain |
| • |
Normal
cerebrospinal fluid (CSF) analysis |
| • |
Negative
EDTA blood and CSF PCR analysis for Toxoplasma gondii,
Neospora caninuum and canine Distemper virus. |
A
dog will be considered eligible for the study if seizures have
been uncontrolled despite adequate serum levels of phenobarbitone
and bromide. Dogs with subtherapeutic serum levels of these anticonvulsants
will be considered eligible for the study if unacceptable side-effects
attributable to these drugs are reported by the owner. A minimum
average of two seizures per month and a total of at least six
seizures over the pre-inclusion recording period are required
for case inclusion.
Owners
will be required to attend the Animal Health Trust in Newmarket
for one appointment during the 2 month trial period and their
dog will not be required to stay in the hospital. Owners must
give their permission for their pet to undergo general anaesthesia
(required for the MR scan and CSF tap), and for the collection
of 3 sets of blood samples during the course of the trial. Additional
funding is not yet available for this study and the owner will
be responsible for meeting all costs incurred in the investigation
of their pet. The AHT are presently seeking funding for the study
and separately for the drug supply. If the drug was paid for
by the study, this could only be guaranteed for the two months
duration of the trial. Levetiracetam would be available on prescription
after the trial but continued costs of treatment would have to
be met by the client.
For
further details of this study or to discuss a case for potential
referral contact:
The Animal Health Trust in Newmarket would like to invite referral of dogs with refractory epilepsy for inclusion in the following study. For further details of this study or to discuss a case for potential referral contact Dr Luisa De Risio.
References
Cereghino
JJ, Biton V, Abou-Khalil B, et al (2000) Levetiracetam
for partial seizures. Results of a
double-blind, randomised control trial. Neurology 55,
236-242. - PubMed -
Isoherranen
N, Yagen B, Soback S, et al (2001) Pharmacokinetics
of levetiracetam and its enantiomer
(R)-alpha-ethyl-2-oxo-pyrrolidine acetamide in dogs. Epilepsia 42,
825-830. - PubMed - |
