Bram's Epilepsy Diary 1999
January 1999
Went to NC State CVM and had a complete neuro work up including bloodwork, bile acids, lumbar puncture and MRI scan. On exam the neurologist thought she'd find a right sided brain tumour but all the tests came back negative. Bram continued to have severe ataxia and twitch/jerk when resting. We decidied to stop his PB to see if this could be the cause. We reduced it and 2 days later the GM's started. Over the next 3 days he had 3 episodes, two singles and onle cluster of 2. We restarted him on PB immediately.
February 1999
Repeated PB this month and found the trough to be only 17 (normal 15-45). Why he metabolises the Pb so fast we don't know, also don't know what effect raising the doseage would have n his liver. Had a lot of partials this month and 2 episodes of GM's, both clusters of 2. Also had an episode when, while lying quietly he started thrashing and screaming. It lasted 5-10 mins and was terrifying. Additionally Bram's being losing weight, 7lbs in literally a few days. My vet is concerned about this and his continued deterioration. She broached the subject of euthanasia, something I'm not at all prepared for.
March 1999
The worst month yet. Bram's deterioration has progressed. He is still losing weight,stumbling, pacing and at times has been barely able to walk. He had 4 seizure episodes, 2 singles, one set of 3 and a wopping episode of 10 in one night. and had been twitching almost all the time. Again Kate broached euthanasia and this time we made an appointment. As a last ditch attempt to save him we started him on Anipryl. Amazingly 2 days before we were to let him go he started to pick up, amazing all of us.
This month we also raised his bromide to 1250mg to try to gain more control of the clusters.
April 1999
Bloodwork time again! This time PB was 28.3 which was perfect although bromide was high at 3.2 (normal 1.0-3.0). Up to April 19th had 3 seizure episodes, 2 of 2 seizures and one of 7. April 20th disaster struck. I took him to get more meds for the valium protocol and whilst at the vets he had a GM. He was given 7.5mg IV diazepam which stopped the seizure. I took him back to work but he had more on the way back. Over the next 4 days he had lots of IV diazepam and IV phenobarb but remarkably again pulled himself around.
May 1999
May has unfortunately been quite active seizure wise with 2 singles, 2 doubles and one cluster of 3. Again his neurological status has been changing with the unsteadiness and ataxia getting worse. Additionally his CP's have deteriorated now affecting all his limbs.
June 1999
This has been ear infection month! despite intense cleaning his ear will not seem to resolve itself. On the seizure front again it has been an active time with 5 clusters, one lasting a full 30 mins. Also we reduced his bromide as his levels are still high. He is now on 1000mg.
July 1999
A great month! We have gone 38 days seizure free. We repeated bloodwork and found PB=17 and KBr=2.5 which was great.
August 1999
Back to day 0! Had 12 seizures in one day and was hospitalised for 2 days as a result. had another four episodes, all clusters of 3 or more seizures. One had 19(!) and required a visit to the ER.
September 1999
The month started off well but by mid month I made an appointment to see Dr Munana again. She agreed he has deteriorated and also determined hehas vision problems and is likely going blind. There is nothing more she can do for him now, just advised to keep him comfortable.
October 1999
Started the month off OK but beame increasingly agitated and unstable as the days passed. On the 21st he had 2 seizures and didn't recover well. He went to the vets where he needed diazepam every 45 mins. Was almost unrousable by the end of the day so he spent the night at the ER. The next day he spent at the vets and I took him home that evening. unfortunately he didn't do well and we had to return to the ER that night. Thankfully a vet from my practice was on. The next day he remained ill and the ER doc recommended he stay there the rest of the weekend. The end of the month was a real up and down time and again we were thinking of euthanasia.
November 1999
Not eating well this month and his condition dropped off fast. We repeated his PB and KBr and found the PB to be in range but the KBr to be way out at >4.0. Neurologist suggested reducing bromide to 2/3rds of doseage to try to reduce the level. Now on 650mg once daily. bram struggled again this month requiring another stay at the ER where he's become very well known! Had 2 seizure episodes this month, both clusters of 2.
December 1999
Seizure month! Had seizures almost every other day for the first half of the month, two singles and seven clusters of 3. Thankfully the later half of the month was quieter. We repeated the bromide which was still higher than 4.0. We'll remeasure next month when hopefully levels will have gone down.
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