Potassium Bromide for Seizures
Potassium bromide is frequently helpful in treating refractory seizures in animals. Because potassium bromide is excreted renally, it may also be preferable for use in animals that have developed hepatotoxicity while on other anticonvulsants. My compounding pharmacist prepares this as a liver flavored solution, which can easily be administered to dogs. I feel that it is important to inform my animal owners that potassium bromide solution is compounded from a reagent grade chemical, and is not a commercially available "drug."
KBr is dosed on a weight basis. Maintenance doses range from 20-100 mg/kg body weight/day, and can be given as a single or divided dose. I usually dose at 30-40mg/kg/day as a single dose with food. Due to its long half-life, KBr can take up to four months to reach steady state; therefore, a loading dose may be required if therapeutic blood levels must be reached quickly. The loading dose is 400-600 mg/kg body weight and is administered orally over 30 to 60 minutes to avoid vomiting. A loading dose is not necessary if it is possible to keep the animal on other medications (as in a case of emerging hepatotoxicity) until levels of bromide are therapeutic (0.5-1.5 mg/ml), when the other anticonvulsant can be tapered off.
Potassium Bromide Chewable "Treats" for Seizure Control
Case Report: 5 y.o. male Golden Retriever with seizure disorder. The owners called our compounding pharmacy to see what we could do as they were having difficulty administering medications to their dog. We suggested medicated canine treats that we have compounded many times with a 100% success rate. The veterinarian was consulted and we prepared potassium bromide (KBr) 150 mg treats coated with liver and beef flavored powder. The owner administers two treats two times daily, and the dog now loves to take his medicine!
Note: Chewable treats can be compounded to contain a variety of medications and flavored for the specific breed or pet. This dosage form has high patient acceptance and a low risk of owner misdosing.
Potassium bromide (KBr) can be also compounded as an oral solution which is easy to flavor and convenient for use as a loading dose. However, the risk of owner misdosing is greater than with a chewie or capsule.
Phenobarbital: Problems and Solutions
While phenobarbital is often used in veterinary medicine to treat seizure disorders, there are several concerns with its use:
- Hormone Replacement Therapy for Men
- Hormone Replacement Therapy for Women
- Athlete’s Foot
- Chemical Peels
- Diaper Rash/Incontinence
- Head Lice and Scabies
- Molluscum Contagiosum
- Nail Infection/Removal
- Pigmentation Abnormalities
- Plantar Warts/Warts
- Scarring and Keloids
- Topical Anesthetics
- Sun Protection/Photoaged Skin/Wrinkles
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- Palliative Care
- Sports Medicine
- Veterinary Compounding
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