Keppra For Dogs – Side Effects Of Keppra On Dogs

Medical review by K9 Healthcare Council of America (K9HCA). Intended for educational purposes only. Always seek medical advice from your veterinarian.

Keppra For Dogs

Even though seizures are a frequently reported neurological condition in dogs, it’s never easy to see your beloved pup be affected by a convulsive fit or seizure.

A seizure is any sudden and uncontrolled movement of the animal’s body caused by abnormal brain activity. Seizures may be very severe and affect all of the body–or–quite mild, affecting only a portion of your pet.

When it comes to managing seizures in dogs, veterinarians still rely on the anti-seizure medications phenobarbital and potassium bromide in the majority of maintenance regimens for these dogs. But managing seizure disorders is a challenge, especially when a dog does not respond to standard phenobarbital or bromide therapy.

In 25-30% of refractory cases of epilepsy (where dogs are unresponsive to traditional AE drugs), veterinarians will prescribe Keppra to manage canine seizures.

Keppra For Seizures in Dogs

Keppra belongs to a class of drugs called Anticonvulsants. Keppra is a popular choice for veterinarians because it is not metabolized by the kidneys, which makes it a safer option for dogs with pre-existing liver or kidney diseases.

But there can be profound adverse effects of Keppra for dogs–namely, behavior changes including increased aggression!

When is Keppra Prescribed to Dogs?

Keppra, also referred to by the generic name Levetiracetam, is a prescription medication used to treat the symptoms of partial onset seizures, tonic-clonic seizures and myoclonic seizures in dogs.

side effects of keppra
Keppra can be used alone, or in conjunction with other anticonvulsants such as phenobarbital or potassium bromide; and more recently, used successfully with natural plant extracts containing Phyto cannabinoids from hemp.

Keppra is relatively safe for dogs, but studies are still looking into other possible side effects. Unlike phenobarbital or potassium bromide, it does not seem to affect the liver or liver enzymes. It does, however, require a higher dosage than other medicines.

As with any anticonvulsant medication, Keppra should never be cut off suddenly–doing so may lead to a life-threatening seizure. When discontinuing this medicine, a gradual withdrawal is always suggested to prevent possible withdrawal seizures.

Keppra For Dogs Side Effects

Levetiracetam (Keppra®) is a popular medicine for refractory epilepsy in dogs because it has been shown to be fairly reliable and has minimal side effects potential compared to other anti-convulsive medications.

However, all seizure control medications have potential adverse effects. Based on experience in human medicine, levetiracetam generally is well tolerated in dogs with the most-likely side effects include changes in behavior, drowsiness and GI upset, including vomiting or diarrhea.

Keppra for dogs side effects.
Keppra for dogs. Sedation, drowsiness and coordination problems are potential side effects of Keppra in dogs.

In one study of 84 client owned dogs, canine patients were observed with behavioral abnormalities after LEV treatment, it was hypothesized that levetiracetam induces behavioral changes or causes an intensifying of pre-existing behavioral abnormalities in dogs with epileptic seizures.

Approximately half of the dogs in the study population were reported to have preexisting behavioral changes before treatment with LEV, and some of these dogs were reported to experience a worsening of behavioral changes or the emergence of new behaviors after initiation of LEV therapy.

One quarter of the dogs without pre-existing behavioral abnormalities developed behavioral changes associated with the administration of LEV.

Based on these results, the authors conclude that behavioral changes (hyperactivity, aggression, somnolence) can occur in dogs being administered LEV, and this should be taken into consideration when discussing holistic treatment options with your dog’s pet care professional.

Primary Side Effects of Keppra Include:

  • Sedation / drowsiness
  • Ataxia
  • Behavioral Changes (aggression)
  • Allergic Reaction (anaphylaxis)
  • Dizziness / Coordination difficulties
  • Gastro-intestinal symptoms (vomiting, diarrhea).
  • Embryonal and fetal changes during pregnancy

Disadvantages of Keppra for Long Term Use

The chief disadvantage of levetiracetam is that tolerance can develop when it is used long term, which means that it will not work as well over time.

Studies suggest that 60% of dogs respond initially; however, after 4–8 months, there is a loss of effect in two-thirds of previous responders because of development of tolerance.

Another drawback to Keppra is it must be given three times daily (TID) in most veterinary patients. The more inconvenient a drug’s dosing schedule is, the easier it is to skip doses which, in this case, could mean uncontrolled seizing for your dog.

There are extended-release formulations that can be used twice daily but the tablets cannot be cut or even chewed without interfering with absorption into the body, thus they may not be an option for smaller K9 patients.

There is also an injectable formulation that could be useful for stopping unexpected seizures at home, but this is for select situations and the majority of pet owners are not comfortable with this mode of application.

Keppra For Dogs Dosage

Therapeutic levels have not been established for levetiracetam; however, some experts recommend checking levels after a patient’s seizures have stabilized for a week or two so as to get the ‘therapeutic range’ for that individual canine patient.

In dogs, Keppra is administered by mouth three times per day beginning at 10-20mg/kg.

The initial dosage can be increased every 2 weeks in increments of 20 mg/kg if therapeutic benefit has not been noted.

On the high end of dose range, adverse effects of salivation, restlessness, vomiting, and ataxia at dosages greater than 400 mg/kg/day have been seen experimentally in dogs but resolved within 24 hr of discontinuing the drug.

Phenobarbitol for dogs overdose
Do not use anti-convulsive medications in pets that have kidney inflammation/infection, severe breathing problems, or severe liver disease.

Levetiracetam appears to work best in combination with other seizure medications rather than as a sole therapy, but many dogs are able to use Keppra as a single anti-seizure agent.

So, adding levetiracetam along with other vet recommended treatments may allow doses of other seizure control medications like phenobarbital to be reduced…but there’s a caveat–

There is new information that over time, phenobarbital may “teach” the body to remove levetiracetam more quickly, possibly necessitating higher dosages to maintain the same blood levels. In this event, it may become necessary to add or change seizure medications to achieve the same anti-seizure effect.

Further, the phenomenon of tolerance occurs with levetiracetam such that after a long time, an effective dose may simply no longer be effective as the body becomes tolerant.

As with any anticonvulsant medication, Keppra should never be cut off suddenly. Doing so may lead to a life-threatening seizure. When discontinuing this medicine, a gradual withdrawal is always suggested to prevent possible withdrawal seizures.

Keppra has excellent oral bioavailability with a half-life around 4 hours and is primarily excreted unchanged in the urine without undergoing hepatic metabolism.

The extended-release tablets can be used for twice daily (instead of the conventional three times daily) dosing but extended-release tablets must be given intact and cannot be split or crushed. This means they are only useful for appropriately sized animals.

Is Keppra Safe for Dogs?

In certain cases, Levetiracetam is safer for pets to use than other anticonvulsant medications because it passes through the urine instead of being broken down by the liver or metabolized by the kidneys.

Even though Levetiracetam isn’t metabolized by the kidneys, it is not recommended for dogs with decreased kidney function, so tell your veterinarian if your pet has kidney disease–your dog’s dosage may have to be reduced as a precaution. Also, exercise prudence and caution with pregnant or lactating dogs.

Keppra for dogs safe
Taking care of a pet with seizures is a life-long responsibility.

Laboratory tests show that Keppra can cause an increase in embryonal and fetal losses. If your dog is pregnant, talk to your vet about possible alternatives. Your vet may still prescribe it should the benefits outweigh the possible risks.

A final precautionary reminder, due to its potential for tolerance, do not stop giving Levetiracetam suddenly unless directed by your veterinarian. Suddenly removing Keppra can result in your pet experiencing a seizure.

Alternatives To Traditional K9 Seizure Medications

Improvement in epilepsy treatments is urgently needed, especially for dogs with drug-resistant epilepsy or where side effects of currently available drugs are not tolerated.

For pet parents seeking a more natural way to reduce their dog’s seizure activity without the negative side effects frequently found in prescription drugs such as Levetiracetam & Phenobarbital, natural hemp oil offers a potential therapeutic option.

Cannabidiol from hemp is a Phyto cannabinoid which mimics the naturally occurring chemicals in the body that has been shown to be well tolerated by dogs even at very high doses.

keppra side effects in dogs
Studies have found that hemp oil can be a successful adjunctive therapy used alongside AE medications like Keppra to produce a consistent, measurable reduction in the frequency of canine seizures–And offers a potential long-term treatment for dogs with Idiopathic Epilepsy.

One major clinical trial to study the use of cannabidiol to treat drug resistant epilepsy in dogs was led by Stephanie McGrath, MS, DVM, DACVIM (Neurology), at Colorado State University’s College of Veterinary Medicine and Biomedical Sciences.

Known as the “Efficacy of Cannabidiol for the Treatment of Canine Epilepsy”, Dr. McGrath intended to determine if hemp oil is effective for treating epilepsy in dogs and measure the potential adverse side-effects of full spectrum hemp oil as an anti-convulsive medication.

She studied 16 dogs with greater than 2 seizures a month and found that using a full-spectrum hemp oil extract in a carrier oil of MCT oil showed positive clinical results with a statistically significant reduction in the FREQUENCY of canine seizures with ZERO adverse side effects–even when combining hemp oil and Keppra for the management of canine epilepsy.

A study of this scope proved the efficacy of plant-based cannabinoid therapy for dogs with uncontrolled epileptic seizures.

Quality Of Life for Dogs with Epilepsy

As with all anti-convulsive medications, what works for one dog may not be as effective for another.

But for those dog owners who want to decrease seizure activity and give their furry friend a better Quality of Life without the unsettling side effects and organ damage from a lifetime of use of prescription medications, hemp oil is proven to be an effective treatment alternative to traditional anti-epileptic medications like Keppra for dogs.

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2 thoughts on “Keppra For Dogs – Side Effects Of Keppra On Dogs”

  1. I have a 165 lb Great Dane who has been on Keppra, 4 pills of 750 for a year and increased Keppra, Levetiracetam ER, 6 pills 750MG tablets, twice a day now but this has caused two side effects. I need assistance with #1 is diarrhea and #2 increase aggression.
    Based on your research with the CBD will it decrease both or either of these side effects?
    I need information for his veterinarian to prescribe this if it will help his issues.
    I would appreciate your assistance with this.

    Reply
    • Hi Virginia, thank you for your inquiry. I’m sorry about your pups’s health challenges. It sounds like you’ve taken exceptional care of your furry friend.

      First, in 2019, a randomized, blinded, placebo-controlled study was published evaluating CBD in dogs with refractory epilepsy. https://pubmed.ncbi.nlm.nih.gov/31067185/
      This study provided some evidence that CBD might be useful in refractory epilepsy in dogs with the major outcome being a change in the monthly seizure FREQUENCY (a decrease from 4.0 to 2.7 on average).

      What I found interesting from this particular university based study was that canine participants that were currently on AE meds (Keppra) were still positively impacted by the addition of full spectrum CBD oil with no adverse reactions. Thereby indicating the use of BOTH conventional treatments and natural CBD helped to reduce the frequency (and to a lesser extent, the INTENSITY) of seizures in dogs.

      More specific to your question and application to your dog’s condition, CBD (and CBDA) are also known to have anti-emetic properties. https://pubmed.ncbi.nlm.nih.gov/32488349/
      This particualr study suggests that these cannabinoids may be useful anti-nausea and anti-emetic treatments for chronic conditions, without the development of tolerance.

      Secondly, a well known side-effect of Keppra is a change in your dog’s behavior (Eg. increased aggression). https://www.frontiersin.org/articles/10.3389/fvets.2020.00169/full
      The addition of Canine Support Formula (CBD+CBDA) can possibly help offset this negative side effect by reducing anxiety through 5-HT1A receptor activation. https://pubmed.ncbi.nlm.nih.gov/30157131/

      Finally, CBD oil is sold without a prescription. However, the correct dosage and application should be a primary consideration along with your dog’s current medications to ensure the most positive clinical outcome.
      Hopefully, your vet will review these studies and givs you the go-ahead to start your dog on a consistent regimen of natural CBD pet care. Let me know how it goes. All the best!

      Reply

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