# Phenobarbital



## Countryboy (May 16, 2011)

I'd like to talk to y'all abt Phenobarbital... and then ask a question.

Tonka has had seizures, diagnosed as Epilepsy. My vet pretty much insisted on meds when he went into seizure on the operating table. So... it was The Pills for him . . . not much choice. 

Ever since he started them last February I've been wondering how they might affect him. 'Specially since, in this last couple of months, I've been noticing just a touch of clumsiness abt him. Little things... nothing that anyone but a constant companion would see.

Anyway . . . long story short . . . I was a teenager in the '60's . . . this is only a sedative . . . I'm over three times his body weight . . . how bad can it be? So I took one myself... 30mg.

Well I'll tell ya... Half an hour after I took it I was zonked. V-e-r-y r-e-l-a-x-e-d . . . . 

So . . . if yr dosing yr dog for any reason with these meds, don't give them a pill, even the half one in the morning, and half an hour later drag them out for a walk. They may not very energetic.

But my question... The vet told me that these meds would build up a tolerance. A tolerance by him to the good/desired effects of the meds... so he will eventually need more. But I wonder if he also builds a tolerance to the bad effects of the meds . . . the lethargy.

Where's our Biology prof these days? I know there's one in here somewhere.  Or would anyone else have any clue . . or a rational guess?


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## sarahmurphy (Mar 22, 2012)

My actual human daughter is on psychotropic meds, and I don't think she has developed a tolerance to them as much as she has learned to operate in slow motion, and we've come to expect that to be her normal speed... 

I think the "Adjusting" is more about forgetting what "Normal" looked like, and less about coming back up to speed once you adjust to the dose.

My fairly uneducated guess is that. 

sarah


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## CharismaticMillie (Jun 16, 2010)

When did you take this? So you're telling me I am trying to have a rational conversation with someone zonked out on their dog's phenobarbital?


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## MaryLynn (Sep 8, 2012)

I'm a child of the 80's, and I can tell you that there is more to taking a sedative than your body weight vs the body weight of the person the prescription is for, such as not having the symptoms that a sedative is needed for 

If you were actually epileptic you would need much more than your dog. The amount your dog taking is likely a maintenance amount, and by cutting up the doses I'd carefully monitor your dog to make sure it's enough to have the desired effect.

There are more tolerated medications for humans, perhaps they're also available for dogs? They're likely much more expensive though.

The tolerance just means that he will need more, eventually-not that he will harden to the side effects of the medication.


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## Countryboy (May 16, 2011)

Well there have been no seizures since he's been on the meds, MaryLynn. 

But yr thinking that he may not get used to the effects? That I should continue to be careful not to dose him and then expect him to be active?


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## lily cd re (Jul 23, 2012)

Here are the biology prof's thoughts. Any time one starts a new medication there can be side effects. Often they go away as your body adjusts to the med (tolerance to the side effects if you want to think of it that way). When the side effects do not fade and are incompatible with normal function you have to change medications or see if a lower dose will give the desired benefit without the side effects. For phenobarbitol, you cannot withdraw cold turkey (at least not in humans, I assume same for dogs). The dose has to be tapered down to withdraw the drug (otherwise you can have seizures worse than before med), so don't stop giving it without asking the vet.

It is not uncommon for the dosing of drugs to be based on different parameters in humans vs. dogs. For example if you needed mild sedation to get into an MRI machine a doctor might tell you to take a benadryl or two since it makes most people sleepy. It is my understanding that benadryl has virtually no sedating effect on dogs however. You should also be aware that some individuals will have paradoxical reactions to certain drugs. For example, benadryl wakes me up, and I have always been hard to anesthetize (woke up from sodium pentathol in the middle of having my wisdom teeth extracted).

I hope this sheds some light on your concerns Countryboy.


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## MaryLynn (Sep 8, 2012)

Quite honestly I think if you're concerned that the side effects are abnormal (there is usually some types of side effects that we have to deal with for at least a short amount of time, you just have to weigh the good with the bad I guess?) that you should speak with your vet again, or go to another vet for a second opinion.

There are other seizure medications on the market, I know my aunt's golden has been on anti-seizure meds for about 6 years and she is full of happiness and energy. The most laying around she does is beside the pool deck to tan with my aunt (silly girls!). I am not sure what type she takes though.

He probably won't really get a chance to completely shake the side effects, they could lessen to some degree, but then at that point his tolerance level to the meds will have increased and your vet will likely increase the dose. Unfortunately they can't tell us if it's too much or too little, all we can do is keep an eye on them and try and measure the negative changes vs the positive changes (in your case no more seizures).

Edit: Lily cd re's post is much more articulate than mine, I would go with her response. She knows way more than me!


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## Meg (Aug 1, 2010)

Sorry, I'm not a biology professor but I do work in a pharmacy. I would say that the sedating effect of phenobarbital is always going to be present and will manifest itself in direct proportion to the dose. Higher dose = more sedation and lower dose = less sedation. But the sedation level may not remain the same on one dose. So at the initiation of the med/new dose, sedation would be high. After six months on current dose, the sedation level may be low to moderate. Your body would eventually adjust to sedation and just like a functioning alcoholic, you would learn to live with it. 

Your body will eventually work its way back to at/near your normal activity level. I've seen lots of little old ladies on high doses of opiates and barbituates that would flatten a football player. Because thier dose was titrated over a period of time they are functioning well, or as well as can be expected, given thier disease state. Not sure if this was a clear answer or not.


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## Rayah-QualitySPs (Aug 31, 2010)

Countryboy said:


> I'd like to talk to y'all abt Phenobarbital... and then ask a question.
> 
> Tonka has had seizures, diagnosed as Epilepsy.
> 
> ...


Dear Countryboy *you are very BAD*. Tonka is not happy you experimented with his medication!!!!!

You should *never take another persons or dogs medication*. What would you have done if you had an allergic reaction? How would Tonka feel if you were in the hospital or maybe even suffered physical harm from a fall. 

Besides all that the manufacturers website states: _Dosage should be reduced in the *elderly or debilitated* because these patients may be more sensitive to phenobarbital. Dosage should be reduced for patients with impaired renal function or hepatic disease._

Aren't you what some people, not me of course, would call elderly? How is your renal or liver functions? 

You are supposed to have learned from the things you were doing in the sixties and not keep repeating them. VBG 

When you first give a dog Phenobarbital the dogs blood level should be taken to establish that he is on the right amount. If it has been a year maybe you should *have the blood redrawn*, (check the Phenobarb blood level), to make sure he is not being given too much medication. 

Is it possible that his liver or kidneys could be impaired? Many poodles are being diagnosed with liver disease nowadays. (CAH - chronic active hepatitis)

If the liver is impaired it effects how much of the drug is removed from the drug stream and could mean a *buildup of the Phenobarb* in his bloodsteam.

There may be something else wrong with him if the blood levels are ok. I can not remember how old he is but aging can slow down a dog. So can a low grade infection. Often the dog is just not 100% right with a low grade infection.

In relation to the tolerance effect usually the side effects go away not become stronger. I am glad to hear that you did put Tonka on medication for his seizures.

If you think something is not quite right with your dog you are probably *correct*. Take Tonka to a vet you trust not to run tests just to pay the rent. Maybe run liver enzymes to be on the safe side.

Keep us posted!


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## Countryboy (May 16, 2011)

Actually, I am somewhat intolerant of barbiturates and(?) narcotics. *If they're not one and the same...* But my intolerance manifests itself only by my stomach simply rejecting them . . almost immediately.  And my gkids and DD are right upstairs. 

"Elderly or debilitated"?... "very BAD"?... Moi???? U must be thinkin' of some different Countryboy.  lol And I'm functioning within normal parameters. My endocrinologist keeps me that way. 

But yr sayin' that roughly once a year we should be drawing blood. That's good to know.

I love my Pharmacist!  He's far and away my BEST source of information on drugs and their interactions and their side effects. I talk to him more often than I do my specialists. And it's good to know that dogs who have been on meds for years still have no noticeable drop in energy!

Thanx, Prof!  It's sooo good, in this forum, to have so much outside expertise. Not just Poodles, I think it's important to remember that we all have lives, and specialized knowledge, outside of our common interest here. 

And the great thing is that all this knowledge, as it relates to Poodles, is now here for me to re-read and re-assimilate in the morning. Also searchable to anyone in the future. Thanx all for yr time to encode it here. 

I hope there wasn't anybody I missed thanking, eh?


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## Carley's Mom (Oct 30, 2011)

I can tell you were a teenaager in the sixties....lol


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## lily cd re (Jul 23, 2012)

Narcotics and barbiturates are separate drug classes although there are some overlapping effects.

Don't take your dog's medicine again!

We should all also remember to consult our veterinarians before giving our dogs any OTC medications or using anything off label. The same applies to us. Just because you can pick a drug off a pharmacy shelf by yourself doesn't mean you should use it any old way you want. Look at the warning labels on "tylenol" for a good example.

Stay well everybody.


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## Countryboy (May 16, 2011)

lily cd re said:


> Don't take your dog's medicine again!
> 
> Stay well everybody.


I hear ya . . . both statements. 

There is no need to repeat this experiment. But may I explain some of my reasoning?

I have never put an E-Collar on a dog. But! . . if I had to, I would first test it on the back of one hand, or on my arm. This test was similar. A slight risk of harm... but I had to know what I was putting my dog thru.


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## lily cd re (Jul 23, 2012)

Ok, so now I will confess that I tasted a tiny bit of Peeves ivermectin liquid that I had to give him when he was younger. I did it because he made a horrible face every time I gave it to him and I was curious how bad it was. It was vile and I spat out the taste as best I could and then rinsed and spat. I understand wanting to get what your dog is feeling. However to use an analogy to some other famous disclaimers about drug use, "I didn't inhale.":stoned::wink:


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## pgr8dnlvr (Aug 7, 2011)

I work at a vet clinic and have seen a number of dogs through diagnosis, initial phenobarbitol doses, regulation and long term treatment. 

We have more than once had owners call us in a terrible panic over the initial lethargy in their dogs. Complaining "it's not the same dog anymore", "I don't want him on drugs if he'll lose his personality"... 

We usually just counsil them to keep up for two weeks and judge the difference, after that if they STILL feel the dog is too lethargic, we gently cut back the doses, but it's really shocking how quickly they return to much of their old "personality". I definitely believe they build a tollerance...

As for the blood tests, we usually test at two months, if the levels still seem good, we try for quarterly to bi-annual tests. If the dog is consistanly in the high range of theraputic dose we may try to cut the dose if possible. 

There are three common pill doses, 15mg, 30mg, and 60mg. With those sizes we can usually "tweak" the amounts prescribed to each dog. 

I can tell you my doctor would be horrified to hear of a client taking any of their dogs meds, particularly one that is a "controlled" drug. When we dispense pheno, right on the bottle it has a warning about it being illegal to allow anyone other than the patient to take the prescribed the drug. 

The BC Veterinary Medical association will not accredit your clinic if you do not have a security system (often on top of bars on large windows) and keep your phenobarb and other narcotics, locked in a safe, in a seperate locked room in the clinic overnight. Every pill is accounted for. 

Hope your pal is "regulated" soon and the pheno continues to do what it's supposed to do 

Rebecca


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## outwest (May 1, 2011)

Not a biologist, not a pharmacist, but an RN. 
Phenobarbital works, but isn't given nearly as much as it used to be. You are absolutely correct, Countryboy, it knocks you on your butt. Most antiseizure meds do, but some newer ones not so much. Other drugs are more popular because the side effects are less. Keppra is the current favorite and approved for use in dogs, too.

If you aren't happy with how he is acting you should ask for a trial with a different med, but don't be surprised at the cost. My guess is phenobarb is CHEAP CHEAP CHEAP compared to newer drugs like Keppra. The vet can make some decent money on it and people don't want to pay more than they have to for a pet. Phenobarb works- stops seizures and easy to regulate. Since it isn't a person, the dog can't complain about side effects. 

I think with what you describe, you should ask your vet about trying a different medication, but please don't take any yourself again. 

I am sorry Tonka has to deal with this in the first place.


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## outwest (May 1, 2011)

In addition to Keppra, there's also Neurontin, Topomax, Vimpat and Lamictal (and a couple more I can't remember). As an RN, I see all of these given today far more than good old Phenobarbital and mostly because they don't knock you for a loop the way Phenobarbital does.


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## georgiapeach (Oct 9, 2009)

Phenobarb is potent - please don't take it again! My son, who has a seizure disorder, was first put on phenobarb a long time ago at 4.5 months, but it didn't work. He was taken off of it, cold turkey, while in a specialized children's hospital in ATL. It was NOT pretty - and he'd only been on it for a week. He screamed and cried day and night for 2 days straight (withdrawals), and I cried right along with him. The nurses finally made me go home for a few hours, b/c I was getting so upset. Don't play vet with your dog and discontinue/change the medicine w/out medical advice/support!

Not sure about dogs, but phenobarb is known to lower a person's mental functioning, with prolonged use, which is why it's not used so much in humans anymore. It is the cheapest anti-seizure drug, which is why it's usually tried first. Like I said, I don't know the effects on dogs - ask your vet.


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## vicky2200 (Feb 14, 2012)

Dakota has been on phenobarbital for years. He did need an increased dose after awhile. He can, and is active after taking those pills and he is on a high dose and a high dose of potassium bromide. Ask your vet about other drug options because other drugs have fewer serious side effects.


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## flyingpoodle (Feb 5, 2012)

*Not a neurologist*

But am a pharmacist... 

Insert some disclaimers and stuff here, k? 

Answer to direct question 1 as I remember it at this point- do the side effects (drosiness and dizziness) fade? Yes. Direct Q 2 do the beneficial anti-seizure effects fade- not generally. Seizure disorders can progress and get worse despite medication. 

Pharmacodynamics of tolerance development to the... [J Pharm Sci. 1990] - PubMed - NCBI

This article says it is probably because the anti-epileptic activity and the drowsiness dizziness are from different actions of the drug. Different receptors. 

I highly recommend you listen to the advice to get Tonka tested for blood levels of the phenobarbital, and if he starts getting more drowsiness or unsteadiness instead of less, also get thee to the vet.

not all meds are metabolized the same by dogs and people, some meds are metabolized a lot faster by dogs so they need much higher doses. Some 13lb doggie doses of some human meds would knock you out for 2 days! 

And thanks for loving your pharmacist!


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## Countryboy (May 16, 2011)

Wow! And thanx... 

Some varied expertise in here , eh? And good insight from all!

I gave him his 15mg of dose half an hour ago. Tested him with a bit of a 'wrestle' and he seemed normally alert and energetic. 

From fourty-five minutes to an hour 'post' he's charging around after squirrels on the retractable leash. 

So from the general understanding in here, and a bit of 'experimental' evidence from the mad scientist, it seems that they will, at least, acclimatize to the 'clumsiness' side effect. 

And we'll deal with any potential necessary increase in meds as it comes...


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## ArcadiaX (Sep 17, 2012)

lili cd re's Benedryl remark is right on the money... I had to give Sadie, our Rhodesian Ridgeback mix of 70 lbs., *6* Benadryl every 6 hours (per the vet) for a mysterious rash-hives outbreak over the course of 2 months (on and off). It scared the bejeebers out of me the first couple of times. I watched her like a hawk until I was sure she wouldn't have a negative reaction... Dog and human medication doses definitely do not jibe.


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## Sawyersmomma (May 28, 2012)

I know you already solved your dilema or whatever, but just thought I'd add my experience.
Piko my American Eskimo was being tested for Alopecia X since he's losing all his hair. The vet said to give him a melatonin everyday and try for six months since there are no side effects, and it's cheaper than the actual test.
For humans melatonin is used as a natural sedative, that's it's only purpose, but for dogs it apparently helps with the alopecia x.
So the first week or so I gave it to him, he was so out of it, sleeping like a log and just lazing around, but eventually his body adapted to it and he was back to his old self.


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## Locket (Jun 21, 2009)

Matrix has been on potassium bromide the past 6 years, and while it took time to find his ideal dosage, he's done so well on it.


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## Countryboy (May 16, 2011)

Tonka just had a new blood test. I actually got to talk to the vet this time, rather than just a technician. And it was his vet! The one who operated on him at 10:00 at nite. 

According to her, he's slightly under-medicated. I think she called it 'less than therapeutic levels'. But gave me the choice of upping his dose by 15mg *33%* per day or keeping him at the same levels. Hmmmmmm....

Regardless, the next step is to test him twice a year, and try to avoid a 'breakthrough'... where the seizures overcome the meds dose. But "it will happen", she told me. 

I asked her abt Potassium Bromide and was assured that she 'had that in her toolbox', if and when we need it.


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