Dietary protein levels have some effect on the half-life of phenobarbital, with a lower half-life of the medication reported in dogs on protein or protein and fat reduced diets .
There is a dietary approach to seizure control in humans that is referred to as a ketogenic diet. In this diet, a patient is kept off food for several days to induce a ketoacidotic state (a situation in which fats are being broken down and producing more acidity in the blood than normal). After this state has been induced it is maintained by feeding a high fat, low carbohydrate diet. I think that protein levels are usually higher with this sort of diet than normal, not lower, though. This diet is not utilized much in dogs because it is hard to induce a ketoacidotic state in dogs by withholding food so it is questionable whether it is possible to get any benefit from the diet, in dogs.
There are dogs that are reported to have improvements in seizure control when fed diets that contain novel proteins (diets meant to rule out food allergies) and the new hypoallergenic diets with hydrolyzed proteins (HA (tm) and z/d (tm)) may be helpful in this situation. I am not sure these claims have ever really been proven, since that is hard to do because of natural variations in seizure activity. In a dog that also seems to show sensitivity to foods by vomiting or diarrhea, it really seems worthwhile to consider trying one of these foods, just to see if food sensitivity does play a role in the seizure activity or digestive problems. Truthfully, this approach hasn't produced much benefit in our patients, that I can remember, but it doesn't hurt to try.
The only other reason that I can think of to control dietary protein in a pet with seizures is to control seizures associated with liver disease. Reduction of dietary protein is a really important part of treatment for seizures and other central nervous system disorders associated with an inability of the liver, for whatever reason, to process ammonia properly. If this is part of the problem with your dog's seizures, then restriction of dietary protein is important.
Phenobarbital Overdose
Treatment of phenobarbital overdose consists of removal of ingested product from the gut if appropriate and offering respiratory and cardiovascular support. Activated charcoal has been demonstrated to be of considerable benefit in enhancing the clearance of phenobarbital, even when the drug was administered parenterally. Charcoal acts as a "sink" for the drug to diffuse from the vasculature back into the gut. Forced alkaline diuresis can also be of substantial benefit in augmenting the elimination of phenobarbital in patients with normal renal function. Peritoneal dialysis or hemodialysis may be helpful in severe intoxications or in anuric patients.
Adverse Effects/Warnings
Dogs may exhibit increased symptoms of anxiety and agitation when initiating therapy. These effects may be transitory in nature and often will resolve with small dosage increases. Occasionally dogs will exhibit profound depression at lower dosage ranges (and plasma levels). Polydipsia, polyuria, and polyphagia are also quite commonly displayed at moderate to high serum levels; these are best controlled by limiting intake of both food and water. Sedation and/or ataxia often become significant concerns as serum levels reach the higher ends of the therapeutic range. Increases in liver enzymes and anemias are more rare, but these potentially serious adverse effects have been reported in dogs.
Alternative Method for Dog epilepsy
Dog Acupunture
Gold bead implants are a permanent form of acupuncture. The gold beads are implanted on the acupuncture points on the dog's back and head. The gold beads are very tiny, about the size of a pinhead or tip of a fine ball point pen. They provide a long-term stimulation of the points. This form of treatment was pioneered in the 1970's. As with all forms of treatment, it will work for some and not for others. The first gold bead implants performed in the US was done in the early 1970's by Dr. Grady Young. Dr. Terry Durkes in Marion, IN began doing clinical research on using the implants in 1975, and initially used them to treat seizure disorders and hip dysplasia.
Success Rates
Dr. Durkes lists the following as his success rates for epilepsy:
60 % of dogs are "cured". They no longer have seizures and will no longer need any Phenobarbital. If the dog is on Potassium Bromide (KBr), they will have to continue its use.
20% of dogs will "no longer have seizures", but are required to take Phenobarbital but at a reduced dose.
20 % of dogs will "continue to have seizures". Some of these will at least have fewer seizures and will have less severe seizures. Some of course will not be helped at all
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