Hello everyone. Today I’m barking about the follow up phone calls between my huMom & my vet Dr. Jodi. My huMom had lots of questions & Dr. Jodi was herself doing research on my behalf. Both wanted to plot the best way forward for yours truly.
We left off last week waiting to hear back from Dr. Jodi to discuss a schedule strategy for lowering my phenobarbital medication. When she called we were told that the best approach was to go as slow as possible. A 25% reduction was the plan. What that would mean for me is that my 60mg dose every 12 hours would go to 45mg every 12 hours for a minimum of 4 weeks. At the 2 week mark we would touch base & discuss how things were going. If all goes well we would decrease my dose another 25% for an additional 4 weeks with another 2 week check in point. That would reduce my dose from 45mg to 30mg every 12 hours; half of the dose I currently take. From there 25% would take us to 22.5mg & that would be difficult to administer. For that reason Dr. Jodi would have to look into other possible means of meeting a closer range, i.e. 20mg. I should bark that if we were to see breakthrough seizures we would have to readdress lowering the dose any further.
Since we were coming into a full moon cycle we decided to wait until after April 29th to begin this reduction; that is, as long as there was no unsettling weather.
During the wait for our projected start date Dr. Jodi called again. She wanted to share some new information she had learned regarding Phenobarbital & ALP levels & the risk involved in decreasing phenobarbital to sub therapeutic levels especially for a Epilepsy Warrior like myself who experiences cluster seizures.
Dr. Jodi informed us that certain medications can turn on the production of ALP & phenobarbital happens to be one of those drugs. Phenobarbital can benignly cause an elevated ALP (Alkaline phosphatase) but it can also cause liver damage. She felt that my ALP level was not of great concern at this point.
Dr. Jodi also shared her concerns around breakthrough seizures if we were to lower my dose of phenobarbital to sub therapeutic levels. She had read that after reducing phenobarbital, if I were to have breakthrough seizures it could be difficult for me to regain management with this drug. With my history of cluster seizures she was concerned that this was a possibility. HuMom & Dr. Jodi discussed quality of life & how seizure management is of the upmost importance. Her recommendation is to stay at my current dose & retest in 2-3 months.
HuMom explained that I am currently using a CBD product that we feel is responsible for the increase in my seizure free days; today I am at 82 days. HuMom went on to say she understood that CBD could increase the efficacy of AEDs (anti epileptic drugs) & that it was our hope when we started our CBD journey to reduce some of my AEDs; more so my phenobarbital. However, we were looking for a greater number of seizure free days; more like 6 months to a year before having this discussion. With that said, huMom agreed to continue my dose at it’s current 60mg every 12 hours & we would recheck my ALP levels again July 13th.
There are many reason that a dog could have elevated ALP levels & I intend to do a blog post on this topic in the future.
I of course will also keep everyone pupdated about my next blood tests in July.
💜 nose nudges 💜
CEO Olivia ❤