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MP having lots of seizures :(

Posted: Mon Sep 12, 2016 2:05 pm
by MaisyPancakes
Hey guys, we could use some good thoughts and any advice. :) Bear with me while I try to get the history out.

MP’s had occasional seizures that began 7/9/14. After that, she’d had another 4 months later, then nothing for 10 months. Another 7 months went by, then possibly one on 4/22/16 (didn’t see—just came home and saw her sleeping in pee, which she’s just never done except when she was very sick long time ago). Then, one on 5/6, 7/17, 8/28, TWO on 9/10 (one at midnight, then 10 hrs later), then again today 9/12. When I show vets my videos, they call them mild seizures. Some of them, they thought could be partial or even syncope, but some vets are sure that the last few have been true seizures.

My regular vet wants to do x-rays of chest and abdomen, just to make sure. We ran blood test on Saturday because we just so happened to be at the vet doing laser when it happened again. Waiting on results.

I’ve been loosely following GARD protocol for diet, and have tried to eliminate things that are supposedly high in glutamates, like chicken neck broth that she used to get all the time.

Most of her seizures have happened when she was hopping (because gimpy) into the kitchen to come see me cooking her meals, or to come eat it. She’d arrive, lose balance, and have seizure. But recently, like the 9/10 midnight one and today—she had just eaten (9/10 was full dinner; today was a small morning snack because she was supposed to go to hydrotherapy and eat the rest there), and once she got back to her bed, she’d tumble and seize. They’ve ranged from about 8-45 seconds from the moment she falls over to the time she is unambiguously “back”—but, my counting is not always so great, and she might be done sooner. She sometimes pees or poops. The only time she vigorously paddled was her very first one—that was the most fierce one where she was breathing frantically and squealing. The other ones have been very quiet, mild twitchy, knock movement type stuff. She is immediately “OK” afterwards, although over the weekend she has been pretty low-key. I give her ice cream right after because I read it uses up so much energy that they need to replenish glucose. Vet didn’t have ice cream so she just got some more banana after the Saturday one. She eats 3 meals a day: 1) 8:30-ish; 2) 3:30-ish; 3) 8-ish.

She has been getting gabapentin for pain, which we increased this weekend due to seizures. She now gets 200 mg AM + 100 mg Afternoon + 200 mg bedtime. (Before, 100 + 100 + 200). She gets a ton of other supplements on rotation for pain and general maintenance, and my vets and I are pretty on top of them all, and none of them should be causing seizures—most of them are actually supposedly helpful for raising the threshold (e.g., GABA, theanine, DLPA, DMG).

She’s been pretty clumsy lately, even before the gabapentin++. It’s become a bit of a new normal that she tips over easily, but it really has been more frequent these last few days, for sure. She tipped over twice on Saturday, and she did it just before her seizure this morning, and also a few hours following (although this one could have been a misstep—I rarely see why she tipped over, but most times it’s obvious, like something in the way, or she tried to turn a certain way and just couldn’t.)

Another thing I have been noticing on occasion is her eyes seem kind of flat/dead, and it seems like a precursor to a seizure. (But might be confirmation bias!) Sometimes she’d sort of do a shudder, which my rehab vet described it as “old folks falling asleep in their spaghetti during lunch”—which does makes sense, but sometimes she seems to do it when I don’t expect her to be so fatigued. Nevertheless, the shudders do seem more like knee buckling after standing a while or something more muscle/nerve fatigue, though.

OK, starting to ramble so will try to stop! She is turning 14 in October for her fake birthday, and currently weighs 41.4 lb—I like her at 42+, but she’s lost muscle here and there, and I’m upping calories again. (We slacked a tiny bit because I was trying to give less fatty things when her poops were weird, and she got skinner. :S )

Thanks so much for reading, friends! ❤️ I appreciate any input!

Re: MP having lots of seizures :(

Posted: Mon Sep 12, 2016 3:38 pm
by UpwardDog
I'm so sorry, Nana. Seizures really suck. My only experience with them within my family was with Ben.
For him, it was really sedating (also super effective for nerve pain), but within a month or maybe 6 weeks of an increase, he'd have a noticeable decrease in the side effects. It would certainly seem reasonable to think some of the tippiness could be chalked up to the gabapentin.
Did MP already have the x-rays? Do you have the blood results?

Re: MP having lots of seizures :(

Posted: Mon Sep 12, 2016 4:00 pm
by MaisyPancakes
Thanks so much, Heather. My rehab vet (who Rx-ed the gaba) said to expect wobbliness to increase, and we're hoping she'll get used to it. I was afraid that some other scary thing was making her wobby, but she didn't have a reason to think so, so that's good. I messed up the calendar and didn't actually have acupuncture + x-rays scheduled for Wed—so the receptionist booked us for 9/20 unless the vet says to do it sooner. Blood results are apparently in, but they didn't see anything urgent, so one of the drs is supposed to call me later today for an update. They don't usually send me the PDF until I talk to someone.

I've been in this bucket list mode for a bit and cramming in a bunch of fun trips and stuff, because she LOVES walks and becomes just overjoyed when I bring her some place (especially with Acorn), and I'm certain that it's good for her (even if bad for my mental health, but who cares). ;) But then, I saw a dog being pulling in a wagon the other day, and realized that I could still bring her places if she gets too gimpy to do the walks, and we could go a lot further that way, too. So, that made me feel a little better. :) ANYWAY, the point of my mentioning these trips was to say that they can lower the seizure threshold despite being positive things, so they may have contributed to the sudden increase in seizures. I am supposed to take it easy (no trips to parks, really) for the next few days, which is probably good because I'm clearly hormonal and beginning to unravel a bit. :crazy: :whistle:

Thanks again!

Re: MP having lots of seizures :(

Posted: Tue Sep 13, 2016 8:53 am
by emmas_mom
I've dealt with a number of old dogs who have had seizures, including some of my own or my fosters, and it can be really hard to pinpoint the cause. Sadie used to just collapse with only minor tremors - she turned out to have insulinoma and recovered quickly from each one when I rubbed honey on her gums. Eddie was the scariest - due to a brain tumor - he was only 11 (should have had several more years of life given breed and overall health) - but even there the vets thought it could be syncope until they got so severe that there was no doubt what was happening. Most of the seniors I've seen had seizures had very minor, short ones, and eventually died of natural causes or of something completely unrelated to the seizures.
I know how stressful it becomes - you watch them every second, you fear this will be the end, you worry they are in pain.....I hope the cause of MP's seizures is NBD. She has such a great mama, and riding in a wagon (or a doggy stroller - I've seen several people with their senior dogs in strollers around here) will provide her with mental stimulation and happy times with you if a time comes that she can't walk well.
If you become unravelled, your ODO friends will all help knit you back up again! :)

Re: MP having lots of seizures :(

Posted: Tue Sep 13, 2016 10:42 am
by MaisyPancakes
Thank you so much, Jean! <3 *tears*! (Hormones, fatigue, some kind of Mercury effery going on!!!)

I'm kind of taken aback by how seemingly suddenly the frequency ramped up in the last few months. I guess it's a gradual-ish increase starting 2 years ago, but 2 in a day seriously kicked my ass. My regular vet is still the leaset 100% about syncope vs seizure—she feels like there's some kind of vagal nerve dealio that's involved, at least in some of the collapses, anyway; she thinks that the last few are likely seizures, though. Everyone else (rehab vet, my old vet, my other vet whom I see when my main vet is gone) had been more certain that they're seizures, but they don't know her entire history as well as my regular vet.

They thought there's no reason to wait for x-rays, especially if the seizures continue, so my 2nd regular vet found an open spot with my regular vet and put me down for tomorrow afternoon to see her. We're going for acupuncture, but we'll talk about doing x-rays, then. The 2nd vet also told me that the blood tests looked normal except for the 2 liver values, which he'd consider "moderately high" and not high enough to warrant changes at the moment, like meds or other tests—he said they're not high enough to be involved in the causing of the seizures, although the seizures (which had happened within 30 min of blood draw) could have caused the spike, too, from momentary loss of blood flow, etc. He didn't say which ones (I was just kind of coping as I was listening) but I'm guessing they were AST and ALT. Her ALT had gone up once last November, just beyond the lab's range. Her new normal is high-ish normal, whereas her old normal had been lowish on the range. (No one really seems concerned about that trend.) She's never had anything shoot up more than just a bit beyond the range, so I'm kinda sad. After saying that "there's something going on there," he reassured me and said it indicates just that the liver was upset about something at that very moment, but nothing really suggests urgent action at the moment. :S

Anyway, we see my regular vet tomorrow, so we'll see how that goes. I was reading a neurologist's blog (almost a terrible idea) and this Toxoplasma gondii thing sounded kinda like how she is, but I think I'm just making up answers. ;)

Re: MP having lots of seizures :(

Posted: Tue Sep 13, 2016 12:43 pm
by Sabine
:sad: Oh MP

I hope you'll be able to stabilize her soon, Nana :(

Re: MP having lots of seizures :(

Posted: Wed Sep 14, 2016 3:49 am
by SherriA
Seizures are scary, especiallyclusters. I think you're doing everything (and more) that I would. I hope you can find a way to lessen them. You and MP are on my mind

Re: MP having lots of seizures :(

Posted: Wed Sep 14, 2016 10:02 am
by connie
Oh, I'm sad to read this. Hoping it gets worked out for MP, Nana. The Boyz and Dee and I send all our best wishes to you two. :love:

Re: MP having lots of seizures :(

Posted: Wed Sep 14, 2016 11:45 am
by MaisyPancakes
Thanks so much, everyone!! :) I just got back from the vet and the liver values that were high were indeed ALT and AST, but my vet doesn't think we need to address it any way right now at this moment. However, she did start crying and said that it's looking likely that MP would have a brain tumor or something like that, given the way things have progressed. We could do MRI at the U, or just let her be. Info would mostly be for peace of mind, and possibly to have a better targeted way of keeping her comfortable—but, the treatment plan is likely not significantly different from what we are doing now. I was thinking we just had to keep the seizures under control with upped gabapentin and stuff, so I was a little bit surprised. She hesitated to give a timeline but I asked, so that I have an idea, and she thought 6 months, maybe, maybe not, and a year is highly unlikely. She'll be 14 next month for her fake birthday, so I'd like to think she's had a good full life so far. But boy, despite her gimpies and all the stuff, we were really, really enjoying her old girl years together.

I see the rehab vet tomorrow, so we'll talk about next steps and what she thinks we should do. MP isn't a huge fan of pool parties but our goal was to help her keep doing what she loves.

The good thing is that I see her rehab and regular vets (and their staff) all the time, so they can all help keep me honest and realistic. And I know I'll be asking a lot of you guys, too, as we sort of navigate through this a bit more quickly than I expected.

Re: MP having lots of seizures :(

Posted: Wed Sep 14, 2016 3:24 pm
by Amanda
Seizures are so tough. I don't have anything to add to what you are already doing, but I feel for you. Seizures are emotionally and physically exhausting for both of you as you worry and are on edge thinking another one could come at any time. Hang in there and try to give yourself grace for the stress of it. I hope she can stabilize and still have many good times ahead together.

Re: MP having lots of seizures :(

Posted: Wed Sep 14, 2016 8:05 pm
by UpwardDog
I'm glad you have a close relationship with your vets and are in good hands.
I think at her age, or in any situation where a firm diagnosis won't change the treatment plan, not knowing is kind of nice, because it allows you to think maybe it's not a tumor, maybe it's some kind of old lady thing and the seizures will settle back down because that's still a possibility (and it is!)
Rosie, who is most likely 14-15 has some lumps and things that I'm turning a blind eye to because at her age I'm not doing anything surgical or invasive to her at this stage. So, I'm going with 'ignorance is bliss,' spoiling the heck out of her and keeping her happy as I can knowing things could change in the blink of an eye. Old dogs are heartbreaking, but so so special.

Re: MP having lots of seizures :(

Posted: Wed Sep 14, 2016 10:24 pm
by LisaT_II
Oh no, I'm so very sorry :(

I understand little about seizures, though jazz has had her episodes that we think were seizures.

I will throw out a few random thoughts which are probably not helpful at all.

Although it's usually really high liver values that do this, high liver values can contribute to seizures.

Gaba made my mom wobbly enough to fall a lot and have to come off the med. Seems some people don't have that issue.

This is not the norm, but jazz's IMS doesn't completely disagree, but I have a list of things I use doxycycline for, and seizures are one of them. Doxy helps with inflammation, brain tumors, (undiagnosed) tick disease, some heart disease, vascular deficiency, and other things. It helps stop jazz's tremors and that is one reason she is on it. With the liver and gimpy and the seizures, there certainly could be an underlying infection.

Low acetylcholine is one thing that may be an important issue for the nervous system. Jazz didn't do well on acetylcholine supplements, but she does very well on non-gmo sunflower lecithin. Amazing to me was that Huperzine A stopped her tremors in their tracks several times, which slows the use of acetylcholine in the body. To me that's a quick test to see if this stuff is a factor in the episodes.

Trivia - if GABA helps, that means that there is "leaky brain", the blood-brain barrier has been compromised. Some studies have shown that after a head injury occurs, within hours, there will also be leaky gut. Not really relevant here, but kinda weird.

Some dogs don't do well with an MRI and it can make them worse.

I think the vagus nerve is hugely important, but tough to know if it's a cause or an effect.

This part is so hard, I know. I'm sorry. She knows what a champion she has in you, but be sure to take care of yourself.

Re: MP having lots of seizures :(

Posted: Fri Sep 16, 2016 5:55 pm
by MaisyPancakes
Thank you, friends, so much! <3

MP didn't have a seizure since Monday morning (and after increasing her gabapentin by 100 mg in the AM) but she had two this morning. :bawl: I didn't really see it coming because she was bright-eyed and nothing seemed amiss. Although, I was getting ready to go to a morning concert and saw her watching me put on "non-dog clothes" and she was doing the usual sad face, and I thought, "Uh oh..." (Regret and confirmation bias are my middle names.) :tongue: She had a very low-key pool party yesterday, although I really don't know if that mattered. (Excitement/stimulation seems to lower threshold, but belatedly so, so it's hard to tell.)

Her first one was a relatively typical one these days, although she squeak/whined this time, like she did during the seizure she had at the vet on Saturday. The 2nd one (about 40 min after) was just like one of her very first ones where she'd cough/hack a few times, then fall over. 2nd one was much shorter, although having watched the crappy video I took, it seemed worse and longer than it felt in real life.

Sent notes to both regular and rehab vets, and rehab vet said to increase gabapentin another 100 mg (for afternoon dose), so that she now gets 200 mg TID. If continuing to up the gabapentin doesn't work, then we might try something else (zonisamide), but sticking to gabapentin for now. All vets agree.

Thanks, Lisa, for the list—my regular and rehab vet both thought it'd be worth testing for toxoplamosis, just in case. I don't think the regular bloodtest we did showed signs of infection, per se, but we'll see. Not sure when we are going to do it, though.

BTW, I sent an update to the the rehab vet after my sad appt with the regular vet, and she called me right away (BLESS HER SOUL FOREVER) to assure me that 1) we don't know what's going on in the brain; 2) even if it's a tumor, they are usually very slow growing; 3) finding out for sure w/MRI won't likely change outcome nor course of action; 4) aside from increase in seizures we are really not seeing any other neuro signs; 5) she is 14, and that's kinda old, so we can continue to help her stay healthy and fit so that she can keep walking and doing stuff she loves. So, no real change in our rehab plan, except taking it easier at pool parties.

Thank you all for reading, and for your support!!

Re: MP having lots of seizures :(

Posted: Fri Sep 16, 2016 9:01 pm
by MaisyPancakes
Another one. :((((( I had hoped she'd go 24 hrs. :((((

Re: MP having lots of seizures :(

Posted: Sat Sep 17, 2016 2:02 am
by LisaT_II
I'm glad that she has been more stable, but wish they would stop completely.

Yes, jazz's IMS had us check for Toxo as well as neospora, but there are so many tick disease that we don't have tests for :-( On the tick list, we've seen infection and symptoms sometimes with little changes in blood values, so you have to go by other things, and sometimes a hail mary.

Fingers crossed for you guys.

Re: MP having lots of seizures :(

Posted: Sat Sep 17, 2016 9:12 am
by emmas_mom
Oh Nana, how stressful and how sad! The frequency reminds me so much of Eddie's experience. Once a brain tumor was suspected, he was put on prednisone, if I recall, but he reacted badly to the prednisone so we had to pull him off it. We chose not to do an MRI because, as your vets pointed out, it likely wouldn't change anything about the treatment. Had he been a young dog, I would have gone for it as surgery or chemo might have been an option if I wanted to go that route.
I hope the increased gaba dose helps and that both you and MP get more time between seizures.

Re: MP having lots of seizures :(

Posted: Sat Sep 17, 2016 9:49 am
by UpwardDog
I'm so sorry, Nana. I wish I could bring you some chocolate chop banana bread and hunks of beef heart for MP.

Re: MP having lots of seizures :(

Posted: Sun Sep 18, 2016 6:50 pm
by PofiMia
Oh, Nana. I am so sorry.

Our aging cats had seizures due to BP issues, but in the end the BP was probably secondary to cancer; but hypertension meds completely controlled the seizures. Iggy cat also had the flat, blank look in his eyes immediately prior, when I witnessed the seizures up close. His also were varied. There was one where he flopped over and not too much else and one where he sort of yowled as it started and two that featured very dramatic paddling.

Pofi was pretty tolerant of Gabapentin - he took it for 6 weeks total. On the Tripawds forum, there are a few dogs that seem to get a bit of a sedative effect, but most get past it. Pofi was taking 300 mg 3x daily for four weeks (two weeks before and after amputation). He is 70 lbs and was taking for nerve pain rather than seizures. I do know my surgeon said we could safely go up from that amount if needed.

Do you want some of our Gaba stash????

Re: MP having lots of seizures :(

Posted: Sun Sep 18, 2016 7:22 pm
by MaisyPancakes
Thanks so much, everyone!! After the OMG-three-in-a-day on Friday, we are approaching the 48-hr seizure-free mark!!! Sheesh. I used to be glad when they were months apart. :( I'll take it, though! :) I downloaded a nice seizure tracking app that launches quickly and tapes/times it. I should've gotten it a long time ago! I've also been wearing my plastic Casio watch that has a stopwatch on it, and just have it on the 0:00:00 (instead of the time). It is dope-ass! I might be a bit of a catastrophizer. ;)

My regular vet was really thinking vagal nerve thing for a while, but after the last few (and the increase in frequency, I think) made her think seizures, too. We measured BP a couple of times (1x @ the U and 1x @ reg vet); not sure how successful the U was at it, but the one we did at the regular vet took FOREVER (the machine kept pooping out), she got really hot, and the whole thing was really effing stupid. :/ I think she tended to be high-ish for both readings, but they always said it's probably attributable to the environment, etc. I might ask about it again when we go for acupuncture next time—but it seemed like it would always read inaccurately, anyway! :rolleyes:

LM, MP was initially put on gabapentin for pain—it's the only real meds that she's on for her owies. Rehab vet chose it because it also doubles as anti-seizure, and thought we could up the dosage if we need to (which we did). They think her wobbliness and the general "deflated look" is from the gabapentin, and she seems to be getting used to the increase and perking up a bit now. :) It scares me sometimes because side effects look just like if she were worsening (both in terms of lameness [clumsiness] *and* whatever is causing her seizures [mentation]!). Thanks for the offer for the gabapentin, LM! Does Pofi not need his anymore? If you really don't need it, we'd gladly take it—we're on it for the long haul—but I don't want you to be without it if you ever use it again!

Re: MP having lots of seizures :(

Posted: Sun Sep 18, 2016 7:44 pm
by PofiMia
Nana - the 100 mg was given to me by a friend of a friend whose Greyhound lost her osteo battle. I have 56 of those left and giving at least some away seems like paying it forward. I also still have 14 of the 300 mg left from his original prescription, but the gift of the 100 mg capsules allowed us to ease off week 5 and 6. We certainly have no immediate need. Pofi takes Rimadyl 1 x a day as part of Metronomic Chemo protocol so if he is having any pain, that seems to be covering it. I might hang on to some in case there seems to be some as yet unanticipated need, but I think you and MP should take at least the bulk of it. If you took 35, that would cover MP for a week and we would have enough left if it seemed like he needed some Gaba for a few days.

Re: MP having lots of seizures :(

Posted: Wed Sep 21, 2016 3:49 pm
by MaisyPancakes
Thanks so much, LM! <3 The Pancakes would happily take what you don't need. :)

Re: MP having lots of seizures :(

Posted: Fri Sep 30, 2016 5:43 pm
by Amanda
I'm so sorry that she isn't pulling out of them completely with the increased meds. I know how stressful it can be living on pins and needles of when the next one could happen. Hoping for good things for MP and you.