Managing Epilepsy in dogs

Managing Canine Epilepsy: Medication, Monitoring & Long-Term Control

Canine epilepsy is one of the most common chronic neurological conditions in dogs in the UK. It is typically managed with long-term anti-epileptic medication including phenobarbital, Pexion (imepitoin), and potassium bromide. In more complex or refractory cases, veterinary surgeons may prescribe levetiracetam, zonisamide, or rectal diazepam under the UK prescribing cascade.

What Does a Seizure Look Like?

Generalised seizures (previously called “grand mal” seizures) are the most common presentation in idiopathic epilepsy.

  • Sudden collapse and loss of consciousness
  • Limb paddling or rigid extension
  • Jaw chomping or facial twitching
  • Salivation or foaming
  • Urination or defecation during the episode
  • Disorientation, pacing or restlessness after recovery (post-ictal phase)

Most seizures last between 30 seconds and 2 minutes. Seizures lasting longer than 5 minutes, or multiple seizures within 24 hours (cluster seizures), require urgent veterinary attention.
 
                                       

Treatment Goals in Canine Epilepsy

The goal of treatment is not always complete elimination of seizures. Instead, therapy aims to:

  • Reduce seizure frequency
  • Reduce seizure severity and duration
  • Prevent cluster seizures
  • Maintain quality of life with minimal adverse effects

Most epileptic dogs require lifelong medication once treatment is initiated.

Although seizures are distressing to witness, many dogs achieve stable, meaningful control with structured therapy and appropriate monitoring.

Licensed Long-Term Anti-Epileptic Medications

Phenobarbital tablets for dogs epilepsy management

Phenobarbital for Dogs

Phenobarbital enhances GABA-mediated inhibition within the brain and remains one of the most established treatments for canine epilepsy.

Common side effects:
  • Increased thirst and urination
  • Increased appetite
  • Sedation (often transient)
  • Ataxia during dose adjustments
Monitoring:
  • Serum phenobarbital levels
  • Liver enzyme monitoring
  • Routine blood tests
View Phenobarbital
Pexion tablets for dogs imepitoin epilepsy treatment

Pexion (Imepitoin) for Dogs

Pexion is licensed in the UK for reduction of generalised seizures in dogs with idiopathic epilepsy. It modulates GABA receptors to stabilise abnormal electrical activity.

Common side effects:
  • Mild sedation
  • Transient ataxia
  • Increased appetite

Blood monitoring is not routinely required in the same way as phenobarbital.

View Pexion
Potassium bromide for dogs epilepsy adjunct therapy

Potassium Bromide for Dogs

Potassium bromide is licensed in the UK as adjunctive therapy for canine epilepsy. It is commonly prescribed alongside phenobarbital where seizure control is incomplete or where additional stabilisation is required.

Different licensed veterinary medicines containing potassium bromide are available. The specific product supplied must match the prescribing veterinary surgeon’s instructions.

Common side effects:
  • Sedation
  • Ataxia
  • Gastrointestinal upset
Monitoring:
  • Serum bromide levels
  • Stable dietary salt intake

Off-Label (Cascade) Medications for Refractory Epilepsy

When seizures remain poorly controlled despite licensed medication such as phenobarbital, Pexion or potassium bromide, veterinary surgeons may prescribe additional anti-epileptic drugs under the UK prescribing cascade.

Levetiracetam tablets for dogs epilepsy UK cascade prescription

Levetiracetam for Dogs

Levetiracetam is commonly prescribed as adjunctive therapy in dogs with refractory epilepsy or cluster seizures. It acts on synaptic vesicle protein SV2A to reduce abnormal neuronal firing.

Why it is used:
  • Inadequate seizure control on first-line drugs
  • Cluster seizure management
  • When liver enzyme elevation limits phenobarbital escalation

It is generally well tolerated and does not induce hepatic enzymes.

Zonisamide tablets for dogs epilepsy UK cascade prescription

Zonisamide for Dogs

Zonisamide may be prescribed in cases where seizure control remains suboptimal despite appropriate first-line therapy.

Why it is used:
  • Adjunctive therapy in refractory epilepsy
  • Alternative option when other medications are not tolerated

Dosing and monitoring are determined by the prescribing veterinary surgeon based on clinical response.

Rectal diazepam for dogs seizure emergency UK prescription

Rectal Diazepam for Dogs (Emergency Use)

Rectal diazepam may be prescribed for at-home emergency interruption of prolonged seizures or cluster events while urgent veterinary care is arranged.

It is intended for emergency management and does not replace long-term maintenance therapy.

Enquire about purchasing Off-License Epilepsy Medication

Supplying Long-Term Epilepsy Medication Safely

Anti-epileptic medications are prescription-only veterinary medicines and must be supplied against a valid veterinary prescription.

All anti-epileptic medications for dogs are prescription-only veterinary medicines and must be prescribed by a registered veterinary surgeon following appropriate clinical assessment. Treatment decisions, dose adjustments and blood monitoring are overseen by your vet to ensure safe and effective long-term seizure control. In the UK, supply of these medicines is regulated by the Veterinary Medicines Directorate (VMD) and dispensed under Royal College of Veterinary Surgeons (RCVS) standards, ensuring continuity, accuracy and responsible prescribing.

For dogs requiring ongoing anti-epileptic therapy in the UK, understanding how repeat prescriptions work is essential to ensure continuity of medication and avoid missed doses.

Understanding Repeat Prescriptions for Pets

If you are comparing providers, it may help to understand how online veterinary pharmacies operate and what regulatory standards apply.

How to Choose an Online Veterinary Pharmacy

Frequently Asked Questions About Canine Epilepsy

How long does phenobarbital take to work in dogs?

Phenobarbital typically reaches therapeutic blood levels within 10–14 days. Blood testing is usually performed around two weeks after starting or adjusting the dose to ensure safe and effective control.

Can dogs live a normal life with epilepsy?

Many dogs with epilepsy live full and happy lives with appropriate long-term medication and monitoring. The goal of treatment is meaningful reduction in seizure frequency while maintaining good quality of life.

What triggers seizures in dogs?

In many cases of idiopathic epilepsy, no specific trigger is identified. However, stress, sleep disruption, illness, medication changes or missed doses can sometimes lower the seizure threshold.

What are cluster seizures in dogs?

Cluster seizures occur when a dog has multiple seizures within a 24-hour period. These cases often require urgent veterinary assessment and may involve emergency medication such as rectal diazepam.

Do dogs need lifelong epilepsy medication?

Most dogs require lifelong treatment once anti-epileptic therapy has started. Dose adjustments are guided by seizure frequency, clinical response and blood monitoring results.


← Back to all articles