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The serum zonisamide concentration was close to the upper limit, which raised a suspicion of adverse effects of zonisamide. This is the first report showing that the fractional excretion of bicarbonate after compensation for the plasma bicarbonate concentration by a sodium bicarbonate infusion was approximately 5%, indicating distal renal tubular acidosis (RTA). The serum zonisamide concentration decreased, and adverse effects were abated by reducing the zonisamide dosage. Diagnostic therapy with bicarbonate served as a means of compensating for bicarbonate deficiency and contributed to the clinical diagnosis of the condition in zonisamide\u2010associated RTA in dogs.<\/jats:p>","DOI":"10.1002\/vms3.905","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T12:11:59Z","timestamp":1659442319000},"page":"2256-2260","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Distal renal tubular acidosis and lethargy associated with zonisamide treatment in a dog with idiopathic epilepsy"],"prefix":"10.1002","volume":"8","author":[{"given":"Takamasa","family":"Itoi","sequence":"first","affiliation":[{"name":"Veterinary Medical Teaching Hospital Faculty of Veterinary Medicine Okayama University of Science  Imabari Japan"},{"name":"Department of Veterinary Medicine Faculty of Veterinary Medicine Okayama University of Science  Imabari 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