Keppra, the brand name for levetiracetam, is a newer medication that can be used for treating seizures in dogs and cats. Seizures and epilepsy are commonly diagnosed conditions in dogs. A seizure happens when the brain's neurons are quickly and continuously discharging, causing increased electrical activity. Seeing your dog go through a seizure can be upsetting, but it's not usually life-threatening. Medications traditionally used to treat seizures and epilepsy include phenobarbital and potassium bromide.
However, in some pets, these medications alone may not always adequately control seizures. Also, some animals are not able to tolerate phenobarbital or potassium bromide well, or the pet owner may wish to avoid the potential side effects associated with them. In these instances, an alternative anticonvulsant medication may be necessary, and Keppra may be a good choice.
Keppra as an Anticonvulsant
Keppra can be used by itself as an anticonvulsant medication. It can also be used in conjunction with phenobarbital or potassium bromide to alleviate symptoms more effectively. Less of those other medications may be needed when using Keppra, which can reduce the side effects they may cause. Side effects of phenobarbital or potassium bromide in dogs may include sedation, ataxia (loss of coordination), and behavioral changes.
Keppra is available in different dosages, including 500-milligram and 750-milligram extended-release tablets. It does need to be dosed more frequently than other anticonvulsant medications. In many cases, the medication must be given three times daily or the extended-release tablets given twice a day. This is because it is rapidly broken down in the body, with an elimination half-life between four and six hours. It also has a wide margin of safety, so overdoses are less likely. It doesn't require monitoring of blood levels.
Levetiracetam appears to be relatively safe for dogs, but studies are still ongoing to investigate any adverse effects it may have. It does not appear to affect the liver or liver enzymes (measured in the blood) as phenobarbital and potassium bromide can. It is not broken down by the liver but instead passes into the urine. This is why it is safer for pets who may have impaired liver function, including those whose seizures are due to liver damage from other medications such as phenobarbital.
Potential Side Effects
Most dogs seem to tolerate levetiracetam quite well. Side effects in dogs may include drowsiness, changes in behavior, and gastrointestinal symptoms such as vomiting or diarrhea.
Extended-release tablets must be given intact, not split or crushed, or too much of the medication will be released at once. If your pet is likely to chew them, it is better to use the regular formulation rather than the extended-release formulation.
It's important to remember that levetiracetam has been used to date only in a limited number of pets, and only some of the effects in dogs are known.
As with any other anticonvulsant medication, levetiracetam should never be stopped suddenly. Doing so may place your pet at risk of life-threatening seizure activity.
Beasley, M.J., and D.M. Boothe. Disposition Of Extended Release Levetiracetam In Normal Healthy Dogs After Single Oral Dosing. Journal Of Veterinary Internal Medicine, vol 29, no. 5, 2015, pp. 1348-1353. Wiley, doi:10.1111/jvim.13588
Maintenance Anticonvulsant Or Antiepileptic Therapy - Pharmacology - Veterinary Manual. Veterinary Manual, 2020