Optimal management canine seizures

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AC/1623/17

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1. Which one of the following is NOT an ACVIM panel recommendation to initiate treatment with antiepileptic drugs (AED’s)? *

1 point

Identifiable structural brain lesion or prior history of brain disease or trauma

Acute repetitive seizures (≥3 generalised seizures within 24hrs)

status epilepticus ( ≥5 min of seizuring)

≥ 2 seizure events in a 6-month period

Cluster seizures

2. Which one of the AED’s listed has been shown to be as effective as phenobarbitone but with less side effects ? *

1 point

Imepitoin

Zonisamide

Levetiracetum

Potassium Bromide

Diazepam

3. Which one of the AED’s listed indiced microsomal enzyme induction? *

1 point

Imepitoin

Potassium Bromide

Phenobarbitone

Levetiracetam

Gabapentin

4. Which of the AED’s listed below will cause euthyroid sick syndrome if use for extended periods? *

1 point

Phenobarbitone

Zonisamide

Bromide

Levetiracetum

Imepitoin

5. Which one of the following statements regarding loading of potassium bromide is INCORRECT? *

1 point

High doses can cause vomiting due to irritation of the gastric mucousa

The loading dose is 600 mg/kg in 24 hours

The loading dose is 630mg/kg in 24 hours

The loading dose can cause drowsiness and ataxia

The loading dose will reach therapeutic levels in most cases within 48 hours

6. Which one of the statements regarding bromide listed below is CORRECT? *

1 point

Bromide is excreted renally and via the bile

Bromide can cause bronchial disease in dogs

The rate of renal excretion dramatically increases with a high salt diet

Serum bromide levels should be between 1-2mg/ml as a sole treatment.

Prandial state affects absorption - if given with food you may get less absorption

7. Which one of the reasons listed below is not a factor in decision making with add-on therapy? *

1 point

Decreasing dosages of medications to reduce long term side effects?

Phenobarbitone may result in drug interactions due to altered hepatic excretion of add-on medications

Improved seizure management in cases with <50% seizure reduction on monotherapy

Unacceptable side effects at effective doses

To reduce dosage frequency

8. Which of the statements below regarding the induction of ALP by phenobarbitone is INCORRECT? *

1 point

A reversible increase in liver enzymes occurs.

Increases above pre-treatment values are seen from week 5

Increases were above the reference range by 2-3 months and could be up to 10 x baseline values.

The increase was related to high serum concentrations

The increase was related to high dose of phenobarbitone and a long treatment period

9. Which one of the statements regarding the elimination halflife of the AEDs is correct ? *

1 point

The relatively long elimination half- life of phenobarbitone (50 – 96 hrs) causes fluctuations in blood levels

Once the dog is on long-term treatment the elimination half-life of phenobarbitone becomes more variable, ranging from 20 – 140 hours.

The elimination half-life of bromide is 120 days.

Levetiracetum has a moderate plasma t ½ in dogs which will require only BID administration.

Zonisamide has a t ½ of about 15 hrs in dogs requiring TID treatment as an add-on therapy.

10. Which one of the following statements regarding AEDs and the thyroid gland is INCORRECT? *

1 point

KBR doesn’t affect serum thyroxine levels (TT4), fT4or cTSH.

Recent seizure activity (within 24hrs prior to blood collection) causes a significant decrease in T4.

Epilepsy is a cause of euthyroid sick syndrome (non-thyroidal illness)

The long-term use of phenobarbitone can decrease TT4and fT4 into the range seen with hypothyroid dogs, while cTSH generally remains unchanged.

The cTSH is likely to be normal with phenobarbitone induced euthyroid sick syndrome

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