Govendir M, Perkins M, Malik R
Faculty of Veterinary Science, Building B14, The University of Sydney, New South Wales.
Aust Vet J. 2005 Oct;83(10):602-8. doi: 10.1111/j.1751-0813.2005.tb13269.x.
To assess whether there is a change in seizure activity in dogs with refractory epilepsy that are receiving appropriate doses of phenobarbitone and/or potassium bromide, when gabapentin is added to the therapeutic regimen.
A prospective study of 17 dogs with a refractory seizure disorder, 16 of which have idiopathic epilepsy.
Patients were stabilised using phenobarbitone and/or potassium bromide to produce tolerable therapeutic serum concentrations and dosed additionally with gabapentin at 35 to 50 mg/kg/d (divided twice or three times daily) for 4 months. Owners recorded seizure activity and side effects during this period in a standardised diary. Patients underwent monthly physical examinations and venepuncture to assess selected serum biochemical analytes, as well as phenobarbitone and bromide concentrations. Patients were further monitored for long-term response to adjunctive gabapentin therapy.
There was no significant decrease in the number of seizures over the study period for the entire cohort, however three dogs stopped seizuring completely. There was a significant increase in the number of patients who showed an increase in the interictal period (P > 0.001). Serum alkaline phosphatase activity and triglyceride concentrations were elevated at baseline. There were no significant changes in biochemical analytes during the course of the study period. Side effects observed initially on addition of gabapentin included sedation and hind limb ataxia. The former resolved spontaneously after a few days; the latter after a slight reduction in bromide dose. Long-term, a further two patients became seizure free and ten patients remained on gabapentin indefinitely. No long-term side effects have become apparent.
Addition of gabapentin to phenobarbitone and/or potassium bromide increased the interictal period and shortened the post-seizure recovery in some canine epileptics. In some dogs, seizures were prevented completely, while in others there was an increase in interictal period. The short-half life of gabapentin has advantages for seizure control, however its present high cost may prohibit therapy in large dogs.
评估在接受适当剂量苯巴比妥和/或溴化钾治疗的难治性癫痫犬中，当加用加巴喷丁至治疗方案时，癫痫发作活动是否有变化。
一项对17只患有难治性癫痫障碍犬的前瞻性研究，其中16只患有特发性癫痫。
使用苯巴比妥和/或溴化钾使患者达到可耐受的治疗血清浓度并稳定病情，另外以35至50mg/kg/d（每日分两次或三次给药）的剂量加用加巴喷丁，持续4个月。在此期间，主人在标准化日记中记录癫痫发作活动和副作用。患者每月接受体格检查和静脉穿刺，以评估选定的血清生化分析物以及苯巴比妥和溴化物浓度。进一步监测患者对加巴喷丁辅助治疗的长期反应。
在整个研究期间，整个队列的癫痫发作次数没有显著减少，然而有3只犬完全停止发作。发作间期延长的患者数量显著增加（P>0.001）。血清碱性磷酸酶活性和甘油三酯浓度在基线时升高。在研究期间，生化分析物没有显著变化。最初加用加巴喷丁时观察到的副作用包括镇静和后肢共济失调。前者在几天后自发缓解；后者在溴化物剂量略有减少后缓解。长期来看，又有2例患者无癫痫发作，10例患者无限期使用加巴喷丁。没有明显的长期副作用。
在苯巴比妥和/或溴化钾中加用加巴喷丁可延长某些犬癫痫患者的发作间期并缩短癫痫发作后的恢复时间。在一些犬中，癫痫发作被完全预防，而在另一些犬中，发作间期延长。加巴喷丁的短半衰期对癫痫控制有优势，然而其目前的高成本可能会使大型犬无法接受治疗。
