6:30, 2:30, 10:30; Life With Keppra Vito

Right now, subject to change without notice, it appears Keppra is key in managing Vito’s seizures.  It’s been hypothesized that the stress caused by the side effects of the KBr counteracted the Keppra that time he had seizures while on both drugs.  We don’t have the side effects, other than the constant hunger, on NaBr.  2 attempts to remove Vito from the Keppra after therapeutic blood levels of Br were reached resulted in seizures in 22 hours or less.  Thus, Keppra is a permanent fixture barring any unforseen complication or a better treatment comes out.

How can such a wee little, rodent like dog control us?
How can such a wee little, rodent-like dog have such power over us?

Here’s the rub with Keppra:  It has a half-life of 4 hours, meaning at the end of 8 hours, it is gone, finished, no longer detectable, leaving the patient open to the possibility of a seizure. Even worse, a missed dose may actually cause a seizure.  It must be given every 8 hours to ensure maximum effectiveness. Not 3 times a day at the most convenient hours, shifting depending on outside activities, but every 8 hours.  This little factoid is why Keppra is rarely the drug of choice for dogs.  Compliance is nearly impossible except for stay at home pet parents.

Vito is a great laundry helper!
Vito is a great laundry helper!

Think about it:  the average day job is at least 8 hours.  Factor in commuting and you’ve already blown the timing of one dose.  Add 8 hours to the already late dose, and you’re looking at the next one occurring in the middle of the night, long after bedtime.  In order to get to work, the morning dose would have to be given hours early.  See the problem?

How does a mere mortal stick with a Keppra dosing schedule?  With great planning and forethought.

I leave for work so early, it’s practically the previous day.  Crabby gets up at 5:30.  He has a 6:30 alarm for Vito’s morning dose.  No chance of forgetting if his pre-work chores get out of hand, the alarm will remind him.

I have a regular alarm set for 2pm.  If I’m working, and the alarm goes off, I drop what I’m doing and go home for Vito’s 2:30pm dose (yup, I have a 2:30pm alarm too).  If my work was not finished before the 2pm alarm goes off, after Vito gets his Keppra, I go back and finish.

After a post-seizure bath.
After a post-seizure bath.

Both Crabby and I have alarms set for 10:30pm.  That’s way past my bedtime, and though Crabby usually stays up at least until 10:30, he has been known to fall asleep on the couch.  The dual alarms insures one or both of us is up to give the 10:30 dose.

In the event one of us can not make our appointed dose, the other gets a call.  Whoever can break away from work the easiest goes home for Vito.

If Crabby or I were to get hit by a truck or  contract some fatal disease, the availability of the other to go to the hospital to visit or claim the body is contingent on how close we are to one of Vito’s dosage times.  For example; if I were hit by a truck at 12:30pm, and Crabby were to receive notification of my impending demise, he is to immediately go home, wait for the 2:30pm dose, and then go to the hospital.  He will time the commute, schedule his miscellaneous emotions and other pertinent tasks and then set an alarm on his phone signaling when he has to leave the hospital to make it home in time for Vito’s 10:30 dose.

A couple weekends ago, Crabby and I painted the town one evening.  But not before I calculated the mileage to our destination, factored in weekend traffic, then gave a 15 minute buffer just in case, and set an alarm telling us when we had to head for home.

To make sure Vito’s schedule is strictly adhered to, we have a white board listing day and dosage time.  After each dose, a check mark goes in the appropriate place.  This keeps Crabby and I from ever having to wonder if the other goofed. Additionally, the snack reminder for Vito’s 2:30 and 10:30 doses are duly noted (Vito insisted on that).

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Photo taken the first time we tried to stop the Keppra.  Vito had a seizure 22 hours later.

Because no medication stops all seizures, and because Crabby has a tendency to freak just as much now as he did when Vito had his first seizure, to the right of the seizure board from a kitchen cabinet hangs the Vito Emergency Bag (VEB, since everything has an acronym now).  In it are a syringe pre-filled with a loading dose of Keppra, 2 syringes of rectal diazepam and Vito’s “chewing” toothbrush (hey, it soothes him to chew it, so who are we to deny him?).  At first twitch, my job is to go to Vito.  Crabby’s job is to bring me the VEB.  Vito gets both the Keppra and 1 syringe of diazepam at the end of the seizure.  He then gets his toothbrush to gnaw on until he’s fully back with us.

DSC_4946

To help us feel this is all worth it, all seizures past April (some occurring between January and April are missing) are noted on the Horde Board in the hallway by the back door.   That way every time we come home, we can count another day off the ticker from the last seizure.   As of right now, Vito hasn’t had a seizure since June 8, the longest he’s gone since we started medicating.

The plan had been, if we ever reached a significant gap between seizures again, to try to wean Vito off his NaBr.  We’ve decided not to go there.  Something is working and we just want it to keep working.  If we do a Br check and find it has dropped below therapeutic levels, we will know the seizures are being controlled by the Keppra alone. Until then, we change nothing.

And so is our lives until the day we die (the dogs are expected to outlive us after all).  There are those, even in the dog ‘community’ who don’t understand the short leash we have to home right now.  I’ve stopped trying to explain.

The only thing I can say is this:  Vito is not a sacrifice.  He was, is and always will be, a gift.  In other words, he’s worth it.

It's not fair that Vito has to go through so much.
It’s not fair that Vito has to go through so much.
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24 thoughts on “6:30, 2:30, 10:30; Life With Keppra Vito

    1. A bester dog parent would have a greater people to dog ratio. With as much attention as we give him, Vito, and the others for that matter, should have more. But we do the best we can.

      I guarantee you any of the Run A Muck Ranch dogs, well, maybe not Marcy or Pablo, but the others, would trade places with Easy in a heartbeat!

  1. Of course he is worth it. Look at that face. What a brave boy and what BRAVE AND SMART parents. You can’t argue with success. This is success. Prayers to tick off many more seizure free days. xoxo

  2. If Vito had two legs instead of four and no fur people would understand. They are simply too narrow minded to believe that these are our furry, four legged children.

    1. You would be amazed at how many dog people aren’t as committed as they say they are. They bail at the first sign of trouble. I soooo don’t understand that.

  3. Totally understand. We too have “charted” Ray for health issues which are thankfully now resolved, and we have shopped around for meds pricing to minimize the financial impact and, after 2-1/2 yrs ……. still no life for us outside our home! Would we do it again? In a heartbeat after all, Ray is one of the family. 🙂

  4. Poor VIto, then poor mom and dad. Have you tried anything but Keppra? The reason I ask, they put my sister on that stuff and all she could do was lay in the bed. It completely made her dysfunctional. Now she’s on another seizure medicine, lamictal. It’s not as bad as keppra – that stuff should be outlawed. I just worry about people and animals on that after I watched it effect my sister. She takes the lamictal only at night, or at the on-set of a seizure, which Vito can’t tell you he’s going to have one.

    I just hope you have all the dogs pictures, with names, conditions, and medical info. Now I’m worried if something happens to one or both of you no one will know what to do with them.

    I love you guys for taking on Vito and his medical issues. The things we do for our ‘fur-babies’. I always tell my mom, I spend more money and time with my fur-babies, then I would ever spend on human babies. smile.

    Keep us up-to-date regarding Vito. I’ll be praying for him.

    1. Maintenance doses of Keppra have no effect, or maybe the NaBr counter acts it, because Vito still gets the zoomies just fine.

    1. Vito would pass on the butt scratch for an extra ear scritch, if you don’t mind. Perhaps a cat like face rub if you are short on ear scritches.

  5. I had a brain stimulation last night, lol. Is Vito people friendly? Does he like to go places with you and/or Crabby? If so, take him with you then you can worry about how to medicate him when you are both gone and he’s not with you, smile.

    Give Vito hugs. I know what he’s going through having a sister with seizures.

    1. I used to take Vito to rental dog. I would do the property Vito was visiting last. Problem was, once he heard my engine, he desperately wanted to be with me. OK to have him as a helper in cooler weather, no so good in the heat.

      When push comes to shove, neither Crabby nor I have dog friendly jobs.

  6. I don’t think any of us have dog friendly jobs, but I have herself at home most of the time so I could rely on that. These last few days I have looked at the clock and thought of Vito and Medication. I think about you, Crabby and Vito each day. Chienne and I send Vito hugs and warm thoughts.

    1. If there weren’t 2 of us working such staggered schedules, we couldn’t do it.

      Thank you for the good thoughts and hugs!

  7. I loved this article. We recently started our epileptic Vizsla, Huckabee, on Keppra. He is also on 2 other medications, but we were still having break through seizures so we decided to make the commitment to try Keppra every 8 hours. You described our life perfectly. We even adhere to the same exact time schedule as you do, 6:30, 2:30, 10:30. The only difference is that I don’t work – which makes it much easier for me and my husband to be kept on that “short leash”. I do a lot of running around as we have 2 kids, but I always find a way to be home at 2:30. It’s crazy, but like you said, Huckabee is a gift and he is worth it.

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