Abstract
In human medicine, doses of levetiracetam (LEV) are individualized for patients with epilepsy, depending on the status of the patient’s renal function. However, there are not reports on the individualized dosing of LEV for small animals. The aim of this study is to investigate whether a dose adjustment of LEV is needed in dogs with chronic kidney disease (CKD). Patient databases were searched, and 37 dogs with seizures or epilepsy were retrospectively included in this study. Based on pre-existing CKD, patients were divided into a CKD group (n = 20) and a non-CKD group (n = 17). We collected kidney panels before and after LEV treatment. Side-effects were monitored for 1 month after the start of LEV administration. In the CKD group, more dogs developed adverse effects (85%) than in the non-CKD group (52.94%). After LEV administration, an increase in blood urea nitrogen and/or serum creatinine was more often reported in the CKD group than it was in the non-CKD group. Our data indicate that in dogs with seizures or epilepsy with pre-existing CKD, an LEV dose-adjustment is needed. During LEV treatment, CKD patients should be monitored for side-effects and may require laboratory evaluation of renal function.
Highlights
Epilepsy, which affects 50 million people around the world, is the most common neurological disorder [1]
In patients with normal or low baseline blood urea nitrogen (BUN) values, a relevant increase in serum BUN was defined as a 25% increase over the upper normal limit, and for patients with initially greater than normal BUN values, a 25% increase higher than baseline was considered [15,16]
We investigated whether chronic kidney disease (CKD), defined by the International Renal Interest Society (IRIS) CKD diagnostic guidelines, had been diagnosed before starting LEV administration
Summary
Epilepsy, which affects 50 million people around the world, is the most common neurological disorder [1]. Epilepsy is the most common neurological disorder [2]. The key treatment for this condition is antiepileptic drugs (AEDs), of which the most commonly used are phenobarbital and potassium bromide [3]. Seizures are not well controlled in 20–30% of dogs with epilepsy [4]. Dogs can experience severe adverse effects with conventional AED treatment [4]. For these patients, the assessment of new AEDs for the management of epilepsy is essential [5]
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