levetiracetam and Cat-Diseases

Seizures occur commonly in cats and can be classified as idiopathic epilepsy, structural epilepsy, or reactive seizures. Pursuit of a diagnosis may include a complete blood count, serum biochemistry, brain MRI, and cerebrospinal fluid analysis as indicated. Antiepileptic drugs should be considered if a cat is having frequent seizures, or any 1 seizure longer than 5 minutes. Phenobarbital is often the drug of choice; however, levetiracetam may be more useful for certain types of epilepsy in cats. Long-term prognosis depends on the underlying diagnosis and response to therapy.

Topics: Animals; Anticonvulsants; Cat Diseases; Cats; Epilepsy; Levetiracetam; Phenobarbital; Piracetam; Prognosis; Risk Factors; Seizures

A 7-month-old, spayed female, domestic longhair cat with L-2-hydroxyglutaric aciduria (L-2-HGA) was investigated. The aim of this study was to investigate the clinical signs, metabolic changes and underlying genetic defect. The owner of the cat reported a 4-month history of multiple paroxysmal seizure-like episodes, characterized by running around the house, often in circles, with abnormal behavior, bumping into obstacles, salivating and often urinating. The episodes were followed by a period of disorientation and inappetence. Neurological examination revealed an absent bilateral menace response. Routine blood work revealed mild microcytic anemia but biochemistry, ammonia, lactate and pre- and post-prandial bile acids were unremarkable. MRI of the brain identified multifocal, bilaterally symmetrical and T2-weighted hyperintensities within the prosencephalon, mesencephalon and metencephalon, primarily affecting the grey matter. Urinary organic acids identified highly increased levels of L-2-hydroxyglutaric acid. The cat was treated with the anticonvulsants levetiracetam and phenobarbitone and has been seizure-free for 16 months. We sequenced the genome of the affected cat and compared the data to 48 control genomes.

Topics: Alcohol Oxidoreductases; Animals; Anticonvulsants; Brain Diseases, Metabolic, Inborn; Cat Diseases; Cats; Female; Genetic Testing; Levetiracetam; Mutation, Missense

Objectives Currently, there are no published randomised, controlled veterinary trials evaluating the efficacy of antiepileptic medication in the treatment of myoclonic seizures. Myoclonic seizures are a hallmark of feline audiogenic seizures (FARS). Methods This prospective, randomised, open-label trial compared the efficacy and tolerability of levetiracetam (20-25 mg/kg q8h) with phenobarbital (3-5 mg/kg q12h) in cats with suspected FARS that experienced myoclonic seizures. Cats were included that had ⩾12 myoclonic seizure days during a prospective 12 week baseline period. This was followed by a 4 week titration phase (until a therapeutic serum concentration of phenobarbital was achieved) and a 12 week treatment phase. Results Fifty-seven cats completed the study: 28 in the levetiracetam group and 29 in the phenobarbital group. A reduction of ⩾50% in the number of myoclonic seizure days was seen in 100% of patients in the levetiracetam group and in 3% of patients in the phenobarbital group ( P <0.001) during the treatment period. Levetiracetam-treated cats had higher freedom from myoclonic seizures (50.0% vs 0%; P <0.001) during the treatment period. The most common adverse events were lethargy, inappetence and ataxia, with no difference in incidence between levetiracetam and phenobarbital. Adverse events were mild and transient with levetiracetam but persistent with phenobarbital. Conclusions and relevance These results suggest that levetiracetam is an effective and well tolerated treatment for cats with myoclonic seizures and is more effective than phenobarbital. Whether it will prevent the occurrence of generalised tonic-clonic seizures and other forebrain signs if used early in the course of FARS is not yet clear.

Topics: Animals; Anticonvulsants; Cat Diseases; Cats; Epilepsies, Myoclonic; Epilepsy, Generalized; Female; Humans; Levetiracetam; Male; Piracetam; Prospective Studies; Seizures

Mediastinal lymphoma with neoplastic invasion into the heart was diagnosed in a 9-year-old castrated male domestic short hair cat. The neoplastic infiltrate was seen throughout the atria and atrial septum, surrounded the aortic root, and resulted in narrowing of the right ventricular outflow tract. Chemotherapy resulted in resolution of the echocardiographic abnormalities and the cat's clinical signs until the patient was euthanized 58 days later following development of neurologic signs. Mediastinal lymphoma with myocardial invasion and response to chemotherapy has not been documented previously in the veterinary literature.

Topics: Animals; Anticonvulsants; Antineoplastic Agents; Asparaginase; Cat Diseases; Cats; Drug Therapy, Combination; Echocardiography; Euthanasia, Animal; Fatal Outcome; Heart Neoplasms; Levetiracetam; Lomustine; Lymphoma; Male; Mediastinal Neoplasms; Neoplasm Invasiveness; Piracetam; Seizures

A 4.5-year-old spayed female domestic shorthair cat was evaluated because of a generalized seizure disorder that developed after an anesthesia-related hypoxic event.. Following administration of phenobarbital, the seizures stopped but the cat developed severe generalized lymphadenopathy. Results of a CBC and serum biochemical analysis were unremarkable. Cytologic examination of the lymph nodes revealed a reactive lymphocyte population. Differential diagnoses included neoplasia and infection, but results of related diagnostic tests were all negative.. Treatment was changed from phenobarbital to levetiracetam. Ten days following discontinuation of phenobarbital, the lymph node enlargement resolved, and the cat remained free of seizures with levetiracetam as treatment.. Pseudolymphoma and anticonvulsant hypersensitivity syndrome are recognized potential sequelae to anticonvulsant administration in humans. However, a pseudolymphoma-like reaction to anticonvulsants in veterinary species has not previously been reported. This case highlighted a potentially serious yet reversible sequela to phenobarbital treatment that may have been mistaken for more severe illness such as neoplasia.

Topics: Animals; Anticonvulsants; Cat Diseases; Cats; Epilepsy; Female; Levetiracetam; Phenobarbital; Piracetam; Pseudolymphoma

To assess pharmacokinetics, efficacy, and tolerability of oral levetiracetam administered as an adjunct to phenobarbital treatment in cats with poorly controlled suspected idiopathic epilepsy. DESIGN-Open-label, noncomparative clinical trial.. 12 cats suspected to have idiopathic epilepsy that was poorly controlled with phenobarbital or that had unacceptable adverse effects when treated with phenobarbital.. Cats were treated with levetiracetam (20 mg/kg [9.1 mg/lb], PO, q 8 h). After a minimum of 1 week of treatment, serum levetiracetam concentrations were measured before and 2, 4, and 6 hours after drug administration, and maximum and minimum serum concentrations and elimination half-life were calculated. Seizure frequencies before and after initiation of levetiracetam treatment were compared, and adverse effects were recorded.. Median maximum serum levetiracetam concentration was 25.5 microg/mL, median minimum serum levetiracetam concentration was 8.3 microg/mL, and median elimination half-life was 2.9 hours. Median seizure frequency prior to treatment with levetiracetam (2.1 seizures/mo) was significantly higher than median seizure frequency after initiation of levetiracetam treatment (0.42 seizures/mo), and 7 of 10 cats were classified as having responded to levetiracetam treatment (ie, reduction in seizure frequency of >or=50%). Two cats had transient lethargy and inappetence.. Results suggested that levetiracetam is well tolerated in cats and may be useful as an adjunct to phenobarbital treatment in cats with idiopathic epilepsy.

Topics: Animals; Anticonvulsants; Cat Diseases; Cats; Drug Therapy, Combination; Epilepsies, Partial; Epilepsy; Epilepsy, Generalized; Female; Half-Life; Levetiracetam; Male; Phenobarbital; Piracetam; Treatment Outcome