More Seizures

Today started as a better day for Max... but he ended up having 2 seizures one after the other... He tried to stand through both.  His right side was affected by both, more so the 2nd one... and his right front paw is now curling under when he tries to walk (...some of the time.  I did catch him walking across my office a little while ago when he was supposed to be sleeping!)

He only had two but I think this qualifies as a cluster seizure... both lasting about 45 seconds.. his tongue turned blue - the whole 9 yards...  but he knew what was going on and was trying to walk out of both seizures. He could breath through his nose.. his mouth foamed up and he was gasping for air when he started to recover.. He pooped during his 2nd seizure... He was afraid during the 2nd seizure - I could definitely see it in his eyes... his tongue actually turned bluish grey on that one. 

Unlike his previous seizures where he got up and started walking around like a crazy man for a few hours.. he actually lay down and took a nap (which is what my other dogs and cat did when they had seizures)

After his nap I managed to get him to take 1000mg of keppra and 10mg of prednisone with a little raw organic pumpkin.  (I was able to talk with Dr. Bush, our original veterinary neurologist from http://www.bvns.net who was able to tell me what do to.. ( always check with your vets before administering any drugs!)  It took him 10 seconds and he passed out after that... and he's been asleep mostly since then..

Keppra & Prednsone and 5...4...3...2...zzzzzzzzzz

His right front paw still curls under when he gets up and tries to walk, but hopefully it'll improve some by tomorrow so he can at least walk on his own.

I was away over the weekend and Max didn't get any keppra while I was gone... I'm hoping that is all that is going on.. but I suspect there's a little more to it..

Shortly before the seizures I was emailing with Dr. Joseph about his thoughts on a repeat cyber knife treatment.  For anyone thinking about doing it.. he said they wait at least 1 year after the first treatment to do any follow up treatments. He said the results are typically 1/2 of what they were the first go around.. so if it worked well for 12 months, a 2nd treatment will typically give you about another 6 good months.  He also mentioned that there is the possibility that there could be some kind of delayed damage from the radiation to blood vessels and his suggestion was to increase the prednisone to deal with either issue (tumor growth or blood vessel issues).  The only way to tell what's going on is an MRI.  Max is scheduled for one on June 5th.  Depending on how he's doing tomorrow though, we may run him up a little early.

On an emotional front... UGGGGHHHH... I really don't want to deal with this again!  It's been a rough year between Max's tumors, Tulsa and Buster's passing, and assorted other health issues..  but as much as I've been hoping I didn't need to face it.. it's right in my face right now and it's time to get to work on dealing with it... and seeing what we can do.. whether we go the hydroxyurea route, stay the course with just the prednisone, look at alternatives... who knows.. I suppose first we need to find out what's really going on... is it tumor growth or is it edema or blood vessel issues.. or is he just not responding to the medicine the right way... or was it just because he wasn't getting the right dose of the right thing?!

Heck (I said heck.. that's right!) each time he's had a seizure I had just finished dremmeling his nails... maybe the stress from that is what triggered it... although.. in this case.. after I finished dremmeling his nails I actually was picking a bugger out of his nose when he started to seize (not sneeze... seize)!  That old addage about not picking anyone else's nose rings true here.. apparently it could be dangerous! 

Is it the Drugs?

Today Max had an acupuncture appointment.  We've had him on 10mg of prednisone 3x / week - essentially every other day, as well as his normal dose of Keppra (125mg 2x day). It's been a few weeks but Max is still seeming foggy when he's on those doses.  The plan is to keep him on the prednisone at the 3x / week for the next week (2 additional weeks total) to see how he does and then reduce him back down to a low dose..

On his prednisone days he gets his prednisone between 8-9am at breakfast... around 2pm he starts drinking water and then the water works start and we have a good solid 4 hours of peeing every 1/2 hour or so... sometimes in the house, sometimes out... the door is open... Not so pleased with the indoor peeing.   His regular vet has suggested dropping him down to 5mg of prednisone every other day - we don't know if that will work - but since he was on such a low dose before it may keep him from having the issues with additional thirst and peeing... worth a try - we'll know what to look for if it's too low a dose.

Kids... this is what happens when you pass out on drugs

And when you wake up you have a funny face!

We're going to start giving Keppra with meals to see if that slows down the absorption as well. He's been getting it with snacks but maybe not enough food in his belly.

He's still active and walking  - pacing when he's on the meds.. walking when he's not. He can hear, comes when he's called, he's started to chase #2 when he runs by, he'll also follow him. Today he jumped up with the other dogs and got into the morning scrum and thought about wrestling with them.. Then thought twice about it.. (smart boy - he's still a little weak and sensitive. He fell in a ditch and off his ramp when he was loopy on the meds and his shoulders are stuff and his back legs... ) 

He has not had any medication yet today - he'll have Keppra in a little bit, but at his vet appt this morning he chased a tennis ball and tried to catch it in the air and then walked around with it for a while.. which was a great sign!  He also jumped up when the rest of the dogs started barking at the FedEx truck and ran with them to see what was going on.  I am now realizing that his foggyness is most likely more drug related than anything else.. It's amazing to me that the same dose isn't working the same way it was before and he's more sensitive to it... but maybe you just have to monitor and adjust to the patient.  Body chemistry changes over time... I suppose another argument as to why all patients should be dealt with as individuals vs. all treated the same.. 

Max NOT on drugs at vet getting acupuncture and playing ball

Max and his ball

Difference A Day Makes

What a difference a day makes... I think.   Yesterday was Max's first day back on his regular dose of Keppra.  He was still a man in motion...  The below video is only 4 minutes.. but when Max starts moving.. he's moving CONSTANTLY for hours..  Last night he woke up at 1:45AM and didn't start to tire out until 4AM. I finally had to grab him and put him in bed.  As soon as he lay on his side and finally put his head down, he was out cold until 8:45AM... but while he's walking around the house he's waking EVERYONE up, including the other dogs who try and hide from him so they can get some sleep too!  (the video below is of Max yesterday)

Today I wanted to get him back on his old keppra schedule so I waited until late afternoon to give him his 125mg.  He was much more alert than I've seen him in a while. He had his last 125mg of Keppra at 11pm and around 11AM he started to chase #2 when he was playing with a squeeky football and he even tried to nip at him and herd him!  Rex was flinging stuffed animals by Max and Max went over and tried to join in for a minute.. Then Rex body slammed Max (He has a bad habit of body slamming everyone - he really does think he's the King of the world). This is the best part! Max was not going to have any of it and actually jumped Rex, growling and teeth out and nipped at him and told him to back off!  Max went for a ride in the car and did well. He was able to stop the constant movement and run into the kitchen when he heard someone in there so he could see if there was food to be had. He was sniffing things outside in the garden, coming when called, sitting when asked,  checking to see what everyone was doing and even came over for a few snuggles! - pretty normal.   The only thing he did that drove me nuts today was step in his water bowl and flip it 4 times (so far) today.   I have now moved it and hopefully he won't do it again in it's new place..   He's even been able to come in for a landing and lie down and just sit and watch things vs. pacing  and then passing out.

I did give him his keppra at 5:30.. and he fell asleep right before dinner!  Something I haven't seen in a LONG time!  He did wake up and got upset he had been forgotten - but did eat his dinner and then helped Rex finish off Buttercups dinner (which probably means we have another issue to deal with - she doesn't normally NOT eat)

Rex & Max eating Buttercups Dinner

So he's been moving constantly since he finished dinner (7:30 until now 9pm) and just lay down to zonk out.  I'm hoping he will get up, go potty, go to bed and then stay asleep without pacing for the rest of the night... It would be nice to be back to normal.  I'm beginning to believe that this has been tied more to the keppra than anything else. I was worried yesterday and this AM.   I'll still be watching carefully the next week or so, but hopefully we'll keep seeing improvement!  and Hopefully Buttercup is ok!

Keppra

Today we finally get to start to wean Max down to his regular dose of Keppra... Oh how I do not like Drunk dogs!!!  And I'm sure Max does not like being drunk...

Max posing by the door during a pace.

He had a mild seizure 2 fridays ago 4/27 after running around like a mad man.  We upped his Keppra dose from 125Mg 2x / day to 500 mg once a day and he was sleeping 17-18 hours of the day, which was fine.  He would pace around the house for about 1/2 hour -45 minutes after taking his dose until he passed out.  On Thursday of last week we split his dose down to 250mg 2x day to see if he'd be less loopy and less sleepy.  He only slept for about 6 hours at a time, and then paced around the house for a good 3 hours! and then was normal for 3 hours before his next dose... Then he'd start the pacing again until he passed out.  The 250mg doesn't make him as sleepy, but still kind of agitates him that he has a buzz so he just wants to walk it off.  Yesterday he started his pacing at 3:30pm and didn't stop until 9pm!  At 4AM, Buster #2 came into my bedroom to tell me that Max was up and pacing on the other side of the house and I needed to make him stop!!!    Easier said than done... He went out for a bit, came in, paced some more until I finally grabbed him and put him on his bed and made him lie down at 5am.

He woke up today around 8AM and was a little wobbly at first, got himself stuck behind the toilet in the bathroom for about 10 minutes before I found him... Reverse apparently wasn't working!  He had breakfast, and then went for a walk down to the end of the road (about 1/4 mile and back) and seems much more coherant now and CAN now go in reverse... but is still making his rounds. He's always been one of those dogs who doesn't sit still very well.. Out of 35 commands he knew when he first came to me, Stay was not one he every followed! Fortunately Lie Down is one he still remembers... but then he gets back up!

The other thing he started to do when we cut his dose down to 250mg 2x a day was go outside to pee and he's been pooping in the house - even though the door is open. He has always pooped while on the move. I've never been too sure what that was about. My only guess was his previous owners used to run with him and never let him stop to go potty, so he just learned to go on the move.   I don't know if this is a result of being buzzed or something else.. but we'll watch it.. He's done it 2 days in a row. Thankfully they are solid and easy to clean. When he was on the higher dose he slept all day so the first thing he wanted to do when he woke up was go out and he took care of his business all at once.. Maybe being buzzed is affecting it??? We shall see.  Today we start him back on his regular dose of Keppra 125mg 2x / day.

The twitching seems to have diminished quite a bit, ever so often I'm seeing some twitch - but maybe once a day vs. frequently so that's good.  He can hear when you call him and will turn around, but he seems a little foggy still so I'm guessing that's from being drugged up still. When he is asleep he's not waking up when the other dogs are barking unless they are standing right over him.. but again - probably because he's drugged up.

I'll report back after we see how he does with the regular dose.. but all in all - so far so good. No more seizures, he can still turn right and left, still can see and hear.  I think he's just drugged and foggy.

Post Seizure Update

Well... today is Thursday and Max had his 2nd seizure last Fri...(he has only had 2 seizures in 7+ months and both times he wasn't on anti-seizure meds. He did not have seizures before CK but we were told it could be a side effect)...  so we're 6 days out and no repeat seizure.  He has been on 500Mg of Keppra once a day and I've noticed over the last 3-4 days the twitching he had right before his seizure seems to be frequent after he takes the keppra, starting about 1 hour after.  It stops when he goes to sleep but when he wakes up and is awake, it will continue until  4-5 hours before he's due to take his next pill. At that point his groggyness has worn off and he's much more alert and the twitching has stopped.

After talking with his neurologist, we're going to split his dose in to 2 doses (250mg every 12 hours) vs. 1 dose and see how he does..  (Max is also on Chinese herbs, specifically ones that can carry stuff through the blood brain barrier so he is affected by medication differently than the average dog his size / weight who aren't on these prescription herbs)

Drunk Max

Drunk Max

Drunk Max

Drunk Max

Max on the move! I think this is what he sees...

If anyone else is dealing with similar stuff. Max has always been a pacer and has always needed to be in constant motion.  When he's "drunk" and groggy and on the keppra he walks a lot. He's trying to walk it off. This is pretty normal for him.  Sometimes he bangs into walls, but usually he just follows them. Not sure if this also has to do with his decreased vision in his right eye.   Max doesn't want to be a substance abuser!

Other than that, he's doing well, still foraging for food when he can and trying to sneak poop if he can get away with it... He's been attempting to play a little with the other dogs and their toys... but it doesn't last too long.  And he can still hear very well and follows commands.

Up until tonight we haven't gone for any walks, not because Max wouldn't go, but because it's horsefly season and they are out in force.  Even #2 refuses to go outside!!! I ran #2 yesterday and had no less than 20 horseflies on my back and no matter how fast I ran.. the were right there... #2 had plenty on him as well.. We have both decided to hide out until they disappear!

Tonight I took him out and he tried to run up the street, then down the street, then over to our neighbors house.. then he saw his cat and wanted to run at him! Once he saw who it was he stopped..  Right now he's doing his evening walk about the house.. (He's had 250mg tonight)

Max at about 4pm after his keppra dose has worn off from the night before

Below is Max about 1/2 hour after he took his 500mg of Keppra.. lots of walking..