Abstract
BackgroundLevetiracetam can be used for seizure control alone or in combination with other antiepileptic medications. A previous study achieved the minimum targeted serum drug concentration after rectal administration of levetiracetam in healthy dogs. The purpose of the present study was to determine the pharmacokinetics of rectal LEV in dogs presented for cluster seizures or status epilepticus and potentially in treatment with other anti-epileptic drugs. Furthermore, preliminary information on response to this treatment as add-on to the standard treatment protocol is reported.ResultsEight client-owned dogs were enrolled. Plasma levetiracetam concentrations (measured at 0, 30, 60, 90, 120, 180, 240, 360, 720, and 1440 min after drug administration) reached the minimum target concentration (5 μg/ml) at 30 min in all but one patient. At T1 (30 min) the mean concentration was 28.2 ± 15.5 μg/ml. Plasma concentrations remained above the targeted minimum concentration in all patients until 240 min and in 7/8 until 360 min. Six out of eight patients experienced no seizures in the 24-h period after hospitalization and were classified as “responders”.ConclusionsMinimum plasma levetiracetam concentration can be reached after rectal administration of 40 mg/kg in dogs affected by cluster seizures and status epilepticus and concurrently receiving other antiepileptic drugs. These preliminary results may encourage the evaluation of rectal levetiracetam as an additional treatment option for cluster seizures and status epilepticus in a larger number of dogs.
Highlights
Levetiracetam can be used for seizure control alone or in combination with other antiepileptic medications
A total of 36 dogs were presented for Cluster seizures (CS) or status epilepticus (SE) to the Veterinary Teaching Hospital (VTH) between September 2016 and April 2017
The other 28 patients were excluded because: body weight less than 20 kg (16/28), no consent given by the owners for inclusion in the study (7/28), long-term oral LEV administration for seizure control (3/28), and diagnosis of reactive seizures (2/28)
Summary
Levetiracetam can be used for seizure control alone or in combination with other antiepileptic medications. The purpose of the present study was to determine the pharmacokinetics of rectal LEV in dogs presented for cluster seizures or status epilepticus and potentially in treatment with other anti-epileptic drugs. CS and SE are potentially life-threatening neurological emergencies and are considered risk factors for spontaneous death or euthanasia of dogs affected by epilepsy [3,4,5,6,7]. As such, these conditions are a frequent reason for presentation to emergency veterinary services [8, 9]. Due to its favorable therapeutic profile, LEV has been increasingly used for seizure control either alone or in combination with other
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