This Drug May Cause Seizures

I am a veterinarian and I love my colleagues. But I get a little NUTS when I receive records like these.

This dog was referred to me for evaluation of a seizure disorder. This is a young beagle. Beagles are prone to epilepsy and seizures, so it's not a big surprise to see this sort of case. What IS surprising is the treatment given to this pet and the fact that these drugs were dispensed.

The dog was started on Phenobarbital to suppress seizure activity. Phenobarbital is the most commonly used anti-seizure medication for pets. But it does have side effects, including increased thirst and urination, increased appetite, weight gain, and liver damage.

This pet was also treated with monthly Heartgard for heartworm and intestinal parasite prevention. Since the dog was living in the south (Tennessee), I don't have a big problem with the use of heartworm preventative during the summer. However, neurologic side effects are a possibility with Heartgard.

The Vectra 3D can have side effects which include extreme restlessness and jitteriness, described as anxiety or manic behavior. The product insert states "Do not use this product on debilitated, aged, medicated, pregnant or nursing dogs, or dogs known to be sensitive to pesticide products." Does the fact that the dog is taking phenobarbital not count as "medicated"?

But the big problem here is the Nexgard. Notice that on the print-out from the veterinarian it clearly states "IN DOGS THAT SEIZURE THE ACTIVE INGREDIENTS IN TRIFEXIS, COMFORTIS, AND NEXGARD HAVE BEEN SHOWN TO INCREASE SEIZURE ACTIVITY"...

So WHY are Nexgard, Heartgard, and Vectra 3D being dispensed along with Phenobarbital? Perhaps there needs to be a red flag in the computer system that pops up when Phenobarb is dispensed that states "WARNING - DO NOT DISPENSE NEXGARD!"

This dog started seizuring in June. She was started on Nexgard in April. Let's connect the dots.

The first treatment advice given for this pet: Stop giving chemicals! In particular, stop the Nexgard, but all the chemicals are a problem here.

The last dose of Nexgard given to this dog was August 1st. She has had no seizures this month, so we will start weaning her off phenobarbital. She has been started on a clean, raw diet and the topical medications have also been discontinued. Perhaps this dog really does have epilepsy. My suspicion is that she does not. Only time will tell. If she has more seizures, we will work with acupuncture, diet, and herbs.

Be your pet's advocate. Read the large print notices on your invoices. If the veterinary staff can't see they are prescribing the wrong combination of medications, maybe you can point it out to them.

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