Meland Tessa, Carrera-Justiz Sheila, Buckley Gareth J
From the Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida.
J Am Anim Hosp Assoc. 2019 May/Jun;55(3):138-143. doi: 10.5326/JAAHA-MS-6795. Epub 2019 Mar 14.
This study used a cross-sectional survey designed to inquire about antiepileptic drug (AED) use in newly diagnosed idiopathic epileptic dogs among board-certified emergency and neurology specialists. Results were obtained from 300 completed surveys by 128 board-certified neurologists and 172 board-certified emergency and critical care (ECC) specialists. Case volume was slightly different between groups, with 36% of neurologists and 18% of ECC specialists managing >50 cases of first-time canine seizure patients yearly. The initial AED of choice was similar between the groups, with 66% of neurologists and 64% of ECC specialists using phenobarbital and 16% of neurologists and 26% of ECC specialists using levetiracetam. Although most respondents gave a loading dose of phenobarbital, roughly one-fourth of neurologists did not load the drug versus 6% of ECC specialists. The total loading dose was similar between respondents (16 mg/kg) but varied in administration protocol. Approximately half of neurologists and nearly two-thirds of ECC specialists gave a higher initial dose of levetiracetam than recommended. Almost all the respondents who gave a higher initial dose of levetiracetam used 60 mg/kg IV once. Understanding the common practices in AED use may promote future discussions regarding best practices in the management of canine idiopathic epilepsy.
本研究采用横断面调查,旨在询问获得认证的急诊和神经科专家对新诊断的特发性癫痫犬使用抗癫痫药物(AED)的情况。结果来自128名获得认证的神经科医生和172名获得认证的急诊与重症护理(ECC)专家完成的300份调查问卷。两组的病例数量略有不同,36%的神经科医生和18%的ECC专家每年处理超过50例首次发作的犬癫痫患者。两组首选的初始AED相似,66%的神经科医生和64%的ECC专家使用苯巴比妥,16%的神经科医生和26%的ECC专家使用左乙拉西坦。虽然大多数受访者给予了苯巴比妥负荷剂量,但约四分之一的神经科医生未给予该药物负荷剂量,而ECC专家中这一比例为6%。受访者的总负荷剂量相似(16mg/kg),但给药方案有所不同。约一半的神经科医生和近三分之二的ECC专家给予的左乙拉西坦初始剂量高于推荐剂量。几乎所有给予较高初始剂量左乙拉西坦的受访者均静脉注射一次60mg/kg。了解AED使用的常见做法可能会促进未来关于犬特发性癫痫管理最佳做法的讨论。