Bromide therapy in refractory canine idiopathic epilepsy

Area of Science:

• Veterinary Neurology
• Pharmacology
• Epileptology

Background:

• Canine idiopathic epilepsy (CIE) is a common neurological disorder.
• Refractory epilepsy in dogs often requires add-on therapies.
• Phenobarbital (PB) is a first-line antiepileptic drug (AED) but may not be sufficient for all cases.

Purpose of the Study:

• To evaluate the efficacy and tolerability of adding oral bromide (BR) to phenobarbital (PB) in dogs with refractory idiopathic epilepsy.
• To assess changes in seizure frequency, severity, and type following BR addition.
• To identify potential adverse effects of combined BR and PB therapy.

Main Methods:

• Retrospective study of 23 dogs with refractory CIE treated with PB and BR.
• Evaluation of seizure history before and after BR addition.
• Analysis of serum bromide and phenobarbital concentrations.
• Assessment of owner-reported seizure characteristics and adverse events.

Main Results:

• 83% of dogs showed a reduction in total seizure number with BR therapy.
• Dogs followed for 1 year experienced a 53% reduction in seizures.
• Seizure intensity decreased in 65% of dogs, and 22% had a less severe seizure type.
• 26% of dogs achieved seizure-free status.
• Common adverse effects included polydipsia (56%), polyphagia (30%), and sedation (30%).

Conclusions:

• Concomitant oral bromide and phenobarbital therapy is effective in managing refractory canine idiopathic epilepsy.
• The combination therapy demonstrated a significant reduction in seizure frequency and severity.
• BR and PB combination was generally well-tolerated in this cohort of dogs.