{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T03:31:38Z","timestamp":1785382298194,"version":"3.55.0"},"reference-count":31,"publisher":"American Veterinary Medical Association (AVMA)","issue":"7","license":[{"start":{"date-parts":[[2023,7,1]],"date-time":"2023-07-01T00:00:00Z","timestamp":1688169600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["javma"],"published-print":{"date-parts":[[2023,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>To investigate caregivers\u2019 assessments of outcome in dogs with idiopathic epilepsy (IE) administered levetiracetam (LEV), zonisamide (ZNS), or phenobarbital (PB) monotherapy.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>ANIMALS<\/jats:title>\n<jats:p>100 dogs with IE administered LEV (n = 34), ZNS (31), or PB (35) monotherapy between January 1, 2003, and February 6, 2019, and survey responses from their caregivers.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>PROCEDURES<\/jats:title>\n<jats:p>Information on duration of therapy, adverse effects (AEs), and outcome was obtained from medical record review and caregiver questionnaire.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A significant improvement in mean quality of life score was reported during monotherapy (7.7; SD, 2.14) compared to before treatment (6.25; SD, 2.63; <jats:italic>P<\/jats:italic> &lt; .0001), with no difference identified between monotherapy groups. Compared to ZNS monotherapy, dogs prescribed PB monotherapy had a significantly younger median age at seizure onset (2.6 vs 4.3 years; <jats:italic>P<\/jats:italic> = .024). A significant relationship was identified between the occurrence of reported AEs and monotherapy group, with a higher prevalence in the PB group (77% [27\/35]) and a lower prevalence in the ZNS group (39% [12\/31]; <jats:italic>P<\/jats:italic> = .0066). Treatment failure rates for PB, LEV, and ZNS monotherapy were 51%, 35%, and 45%, respectively, with failure attributed most commonly to inadequate seizure control. No significant difference was identified between groups with respect to rate of or time to failure.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CLINICAL RELEVANCE<\/jats:title>\n<jats:p>Most caregivers reported a favorable outcome with administration of LEV, ZNS, or PB monotherapy to dogs with IE. Phenobarbital is associated with the highest prevalence of AEs but no difference in quality of life score. Prospective controlled studies are needed to further compare the efficacy and safety of these monotherapies in dogs with IE.<\/jats:p>\n<\/jats:sec>","DOI":"10.2460\/javma.22.10.0469","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T19:10:23Z","timestamp":1679598623000},"page":"1020-1027","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of caregivers\u2019 assessments of clinical outcome in dogs with idiopathic epilepsy administered levetiracetam, zonisamide, or phenobarbital monotherapy"],"prefix":"10.2460","volume":"261","author":[{"given":"Bryanna R.","family":"Gristina","sequence":"first","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rennie J.","family":"Waldron","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie A.","family":"Nettifee","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen R.","family":"Mu\u00f1ana","sequence":"additional","affiliation":[{"name":"Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1272","reference":[{"issue":"13","key":"ref1","series-title":"Vet Rec","first-page":"338","article-title":"Prevalence and risk factors for canine epilepsy of unknown origin in the UK","volume":"172","author":"Kearsley-Fleet L","year":"2013","unstructured":"Kearsley-Fleet L, O\u2019Neill DG, Volk HA, Church DB, Brodbelt DC. Prevalence and risk factors for canine epilepsy of unknown origin in the UK. Vet Rec. 2013;172(13):338. doi:10.1136\/vr.101133"},{"issue":"3","key":"ref2","series-title":"Vet J","first-page":"471","article-title":"A cohort study of epilepsy among 665,000 insured dogs: incidence, mortality and survival after diagnosis","volume":"202","author":"Heske L","year":"2014","unstructured":"Heske L, N\u00f8dtvedt A, J\u00e4derlund KH, Berendt M, Egenvall A. A cohort study of epilepsy among 665,000 insured dogs: incidence, mortality and survival after diagnosis. Vet J. 2014;202(3):471-476. doi:10.1016\/j.tvjl.2014.09.023"},{"issue":"5","key":"ref3","series-title":"J Vet Intern Med","first-page":"1665","article-title":"Seizure occurrence in dogs under primary veterinary care in the UK: prevalence and risk factors","volume":"32","author":"Erlen A","year":"2018","unstructured":"Erlen A, Potschka H, Volk HA, Sauter-Louis C, O\u2019Neill DG. Seizure occurrence in dogs under primary veterinary care in the UK: prevalence and risk factors. J Vet Intern Med. 2018;32(5):1665-1676. doi:10.1111\/jvim.15290"},{"issue":"4 suppl 1","key":"ref4","series-title":"Epilepsy Curr","first-page":"1","article-title":"American Epilepsy Society Treatments Committee. Summary of antiepileptic drugs available in the United States of America","volume":"18","author":"Vossler DG","year":"2018","unstructured":"Vossler DG, Weingarten M, Gidal BE; American Epilepsy Society Treatments Committee. Summary of antiepileptic drugs available in the United States of America. Epilepsy Curr. 2018;18(4 suppl 1):1-26. doi:10.5698\/1535-7597.18.4s1.1"},{"issue":"2","key":"ref5","series-title":"J Vet Intern Med","first-page":"477","article-title":"2015 ACVIM Small Animal consensus statement on seizure management in dogs","volume":"30","author":"Podell M","year":"2016","unstructured":"Podell M, Volk HA, Berendt M,  2015 ACVIM Small Animal consensus statement on seizure management in dogs. J Vet Intern Med. 2016;30(2):477-490. doi:10.1111\/jvim.13841"},{"issue":"1","key":"ref6","series-title":"BMC Vet Res","first-page":"257","article-title":"Treatment in canine epilepsy-a systematic review","volume":"10","author":"Charalambous M","year":"2014","unstructured":"Charalambous M, Brodbelt D, Volk HA. Treatment in canine epilepsy-a systematic review. BMC Vet Res. 2014;10(1):257. doi:10.1186\/s12917-014-0257-9"},{"issue":"9","key":"ref7","series-title":"J Am Vet Med Assoc","first-page":"1073","article-title":"Comparison of phenobarbital with bromide as a first-choice antiepileptic drug for treatment of epilepsy in dogs","volume":"240","author":"Boothe DM","year":"2012","unstructured":"Boothe DM, Dewey C, Carpenter DM. Comparison of phenobarbital with bromide as a first-choice antiepileptic drug for treatment of epilepsy in dogs. J Am Vet Med Assoc. 2012;240(9):1073-1083. doi:10.2460\/javma.240.9.1073"},{"issue":"9","key":"ref8","series-title":"J Am Vet Med Assoc","first-page":"1117","article-title":"Serum concentrations and efficacy of phenytoin, phenobarbital, and primidone in canine epilepsy","volume":"184","author":"Farnbach GC","year":"1984","unstructured":"Farnbach GC. Serum concentrations and efficacy of phenytoin, phenobarbital, and primidone in canine epilepsy. J Am Vet Med Assoc. 1984;184(9):1117-1120."},{"issue":"2","key":"ref9","series-title":"J Vet Pharmacol Ther","first-page":"113","article-title":"Therapeutic efficacy of phenobarbital and primidone in canine epilepsy: a comparison","volume":"8","author":"Schwartz-Porsche D","year":"1985","unstructured":"Schwartz-Porsche D, L\u00f6scher W, Frey HH. Therapeutic efficacy of phenobarbital and primidone in canine epilepsy: a comparison. J Vet Pharmacol Ther. 1985;8(2):113-119. doi:10.1111\/j.1365-2885.1985.tb00934.x"},{"issue":"2","key":"ref10","series-title":"J Vet Pharmacol Ther","first-page":"160","article-title":"Clinical efficacy and safety of imepitoin in comparison with phenobarbital for the control of idiopathic epilepsy in dogs","volume":"38","author":"Tipold A","year":"2015","unstructured":"Tipold A, Keefe TJ, L\u00f6scher W, Rundfeldt C, de Vries F. Clinical efficacy and safety of imepitoin in comparison with phenobarbital for the control of idiopathic epilepsy in dogs. J Vet Pharmacol Ther. 2015;38(2):160-168. doi:10.1111\/jvp.12151"},{"key":"ref11","series-title":"Vet J","first-page":"44","article-title":"A single-blinded phenobarbital-controlled trial of levetiracetam as mono-therapy in dogs with newly diagnosed epilepsy","volume":"208","author":"Freds\u00f8 N","year":"2016","unstructured":"Freds\u00f8 N, Sabers A, Toft N, M\u00f8ller A, Berendt M. A single-blinded phenobarbital-controlled trial of levetiracetam as mono-therapy in dogs with newly diagnosed epilepsy. Vet J. 2016;208:44-49. doi:10.1016\/j.tvjl.2015.10.018"},{"issue":"1","key":"ref12","series-title":"BMC Vet Res","first-page":"79","article-title":"Antiepileptic drugs\u2019 tolerability and safety-a systematic review and meta-analysis of adverse effects in dogs","volume":"12","author":"Charalambous M","year":"2016","unstructured":"Charalambous M, Shivapour SK, Brodbelt DC, Volk HA. Antiepileptic drugs\u2019 tolerability and safety-a systematic review and meta-analysis of adverse effects in dogs. BMC Vet Res. 2016;12(1):79. doi:10.1186\/s12917-016-0703-y"},{"issue":"1","key":"ref13","series-title":"BMC Vet Res","first-page":"148","article-title":"International veterinary epilepsy task force consensus proposal: diagnostic approach to epilepsy in dogs","volume":"11","author":"De Risio L","year":"2015","unstructured":"De Risio L, Bhatti S, Mu\u00f1ana K,  International veterinary epilepsy task force consensus proposal: diagnostic approach to epilepsy in dogs. BMC Vet Res. 2015;11(1):148. doi:10.1186\/s12917-015-0462-1"},{"issue":"3","key":"ref14","series-title":"J Am Anim Hosp Assoc","first-page":"138","article-title":"Antiepileptic drug use patterns in suspect epileptic dogs among neurology and emergency specialists","volume":"55","author":"Meland T","year":"2019","unstructured":"Meland T, Carrera-Justiz S, Buckley GJ. Antiepileptic drug use patterns in suspect epileptic dogs among neurology and emergency specialists. J Am Anim Hosp Assoc. 2019;55(3):138-143. doi:10.5326\/JAAHA-MS-6795"},{"issue":"1","key":"ref15","series-title":"Vet J","first-page":"15","article-title":"The influence of sex hormones on seizures in dogs and humans","volume":"201","author":"Van Meervenne SA","year":"2014","unstructured":"Van Meervenne SA, Volk HA, Matiasek K, Van Ham LM. The influence of sex hormones on seizures in dogs and humans. Vet J. 2014;201(1):15-20. doi:10.1016\/j.tvjl.2014.05.008"},{"issue":"6","key":"ref16","series-title":"J Small Anim Pract","first-page":"275","article-title":"Genetic aspects of idiopathic epilepsy in Labrador Retrievers","volume":"39","author":"Jaggy A","year":"1998","unstructured":"Jaggy A, Faissler D, Gaillard C, Srenk P, Graber H. Genetic aspects of idiopathic epilepsy in Labrador Retrievers. J Small Anim Pract. 1998;39(6):275-280. doi:10.1111\/j.1748-5827.1998.tb03650.x"},{"issue":"3","key":"ref17","series-title":"J Vet Intern Med","first-page":"262","article-title":"A cross-sectional study of epilepsy in Danish Labrador Retrievers: prevalence and selected risk factors","volume":"16","author":"Berendt M","year":"2002","unstructured":"Berendt M, Gredal H, Pedersen LG, Alban L, Alving J. A cross-sectional study of epilepsy in Danish Labrador Retrievers: prevalence and selected risk factors. J Vet Intern Med. 2002;16(3):262-268. doi:10.1892\/0891-6640(2002)016<0262:acsoei>2.3.co;2"},{"issue":"6","key":"ref18","series-title":"N Z Vet J","first-page":"357","article-title":"Zonisamide monotherapy for idiopathic epilepsy in dogs","volume":"60","author":"Chung JY","year":"2012","unstructured":"Chung JY, Hwang CY, Chae JS,  Zonisamide monotherapy for idiopathic epilepsy in dogs. N Z Vet J. 2012;60(6):357-359. doi:10.1080\/00480169.2012.680855"},{"key":"ref19","series-title":"Vet J","first-page":"53","article-title":"Epileptic seizure frequency and semiology in dogs with idiopathic epilepsy after initiation of imepitoin or phenobarbital monotherapy","volume":"249","author":"Stabile F","year":"2019","unstructured":"Stabile F, van Dijk J, Barnett CR, De Risio L. Epileptic seizure frequency and semiology in dogs with idiopathic epilepsy after initiation of imepitoin or phenobarbital monotherapy. Vet J. 2019;249:53-57. doi:10.1016\/j.tvjl.2019.05.007"},{"issue":"8","key":"ref20","series-title":"Vet Rec","first-page":"203","article-title":"Responses to successive anti-epileptic drugs in canine idiopathic epilepsy","volume":"176","author":"Packer RMA","year":"2015","unstructured":"Packer RMA, Shihab NK, Torres BBJ, Volk HA. Responses to successive anti-epileptic drugs in canine idiopathic epilepsy. Vet Rec. 2015;176(8):203. doi:10.1136\/vr.102934"},{"issue":"10","key":"ref21","series-title":"J Small Anim Pract","first-page":"574","article-title":"Idiopathic epilepsy in dogs: owners\u2019 perspectives on management with phenobarbitone and\/or potassium bromide","volume":"47","author":"Chang Y","year":"2006","unstructured":"Chang Y, Mellor DJ, Anderson TJ. Idiopathic epilepsy in dogs: owners\u2019 perspectives on management with phenobarbitone and\/or potassium bromide. J Small Anim Pract. 2006;47(10):574-581. doi:10.1111\/j.1748-5827.2006.00203.x"},{"issue":"3","key":"ref22","series-title":"J Am Anim Hosp Assoc","first-page":"143","article-title":"Evaluation of the impacts of epilepsy in dogs on their caregivers","volume":"53","author":"Nettifee JA","year":"2017","unstructured":"Nettifee JA, Munana KR, Griffith EH. Evaluation of the impacts of epilepsy in dogs on their caregivers. J Am Anim Hosp Assoc. 2017;53(3):143-149. doi:10.5326\/JAAHA-MS-6537"},{"issue":"9","key":"ref23","series-title":"Vet Rec","first-page":"229","article-title":"Quality-of-life aspects in idiopathic epilepsy in dogs","volume":"179","author":"Wessmann A","year":"2016","unstructured":"Wessmann A, Volk HA, Packer RMA, Ortega M, Anderson TJ. Quality-of-life aspects in idiopathic epilepsy in dogs. Vet Rec. 2016;179(9):229. doi:10.1136\/vr.103355"},{"issue":"6","key":"ref24","series-title":"J Vet Intern Med","first-page":"1782","article-title":"Risk factors for survival in a university hospital population of dogs with epilepsy","volume":"28","author":"Freds\u00f8 N","year":"2014","unstructured":"Freds\u00f8 N, Koch BC, Toft N, Berendt M. Risk factors for survival in a university hospital population of dogs with epilepsy. J Vet Intern Med. 2014;28(6):1782-1788. doi:10.1111\/jvim.12443"},{"issue":"4","key":"ref25","series-title":"J Vet Intern Med","first-page":"754","article-title":"Premature death, risk factors, and life patterns in dogs with epilepsy","volume":"21","author":"Berendt M","year":"2007","unstructured":"Berendt M, Gredal H, Ersb\u00f8ll AK, Alving J. Premature death, risk factors, and life patterns in dogs with epilepsy. J Vet Intern Med. 2007;21(4):754-759. doi:10.1892\/0891-6640(2007)21[754:pdrfal]2.0.co;2"},{"issue":"8","key":"ref26","series-title":"Vet Sci","first-page":"140","article-title":"How owners of epileptic dogs living in Italy evaluate their quality of life and that of their pet: a survey study","volume":"8","author":"Masucci M","year":"2021","unstructured":"Masucci M, Di Stefano V, Donato G, Mangano C, De Majo M. How owners of epileptic dogs living in Italy evaluate their quality of life and that of their pet: a survey study. Vet Sci. 2021;8(8):140. doi:10.3390\/vetsci8080140"},{"issue":"1","key":"ref27","series-title":"BMC Vet Res","first-page":"54","article-title":"A prospective observational longitudinal study of new-onset seizures and newly diagnosed epilepsy in dogs","volume":"13","author":"Freds\u00f8 N","year":"2017","unstructured":"Freds\u00f8 N, Toft N, Sabers A, Berendt M. A prospective observational longitudinal study of new-onset seizures and newly diagnosed epilepsy in dogs. BMC Vet Res. 2017;13(1):54. doi:10.1186\/s12917-017-0966-y"},{"issue":"1","key":"ref28","series-title":"J Vet Intern Med","first-page":"171","article-title":"Epilepsy in Border Collies: clinical manifestation, outcome, and mode of inheritance","volume":"24","author":"H\u00fclsmeyer V","year":"2010","unstructured":"H\u00fclsmeyer V, Zimmermann R, Brauer C, Sauter-Louis C, Fischer A. Epilepsy in Border Collies: clinical manifestation, outcome, and mode of inheritance. J Vet Intern Med. 2010;24(1):171-178. doi:10.1111\/j.1939-1676.2009.0438.x"},{"issue":"3","key":"ref29","series-title":"Am J Vet Res","first-page":"337","article-title":"Levetiracetam pharmacokinetics in healthy dogs following oral administration of single and multiple doses","volume":"71","author":"Moore SA","year":"2010","unstructured":"Moore SA, Mu\u00f1ana KR, Papich MG, Nettifee-Osborne J. Levetiracetam pharmacokinetics in healthy dogs following oral administration of single and multiple doses. Am J Vet Res. 2010;71(3):337-341. doi:10.2460\/ajvr.71.3.337"},{"issue":"8","key":"ref30","series-title":"Am J Vet Res","first-page":"719","article-title":"Pharmacokinetic evaluation of immediate- and extended-release formulations of levetiracetam in dogs","volume":"76","author":"Boozer LB","year":"2015","unstructured":"Boozer LB, Platt SR, Haley AC,  Pharmacokinetic evaluation of immediate- and extended-release formulations of levetiracetam in dogs. Am J Vet Res. 2015;76(8):719-723. doi:10.2460\/ajvr.76.8.719"},{"issue":"5","key":"ref31","series-title":"J Vet Intern Med","first-page":"1677","article-title":"Population pharmacokinetics of extended-release levetiracetam in epileptic dogs when administered alone, with phenobarbital or zonisamide","volume":"32","author":"Mu\u00f1ana KR","year":"2018","unstructured":"Mu\u00f1ana KR, Otamendi AJ, Nettifee JA, Papich MG. Population pharmacokinetics of extended-release levetiracetam in epileptic dogs when administered alone, with phenobarbital or zonisamide. J Vet Intern Med. 2018;32(5):1677-1683. doi:10.1111\/jvim.15298"}],"container-title":["Journal of the American Veterinary Medical Association"],"original-title":[],"link":[{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/261\/7\/javma.22.10.0469.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/261\/7\/javma.22.10.0469.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/261\/7\/javma.22.10.0469.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,25]],"date-time":"2024-09-25T22:01:07Z","timestamp":1727301667000},"score":1,"resource":{"primary":{"URL":"https:\/\/avmajournals.avma.org\/view\/journals\/javma\/261\/7\/javma.22.10.0469.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,1]]},"references-count":31,"journal-issue":{"issue":"7"},"URL":"https:\/\/doi.org\/10.2460\/javma.22.10.0469","relation":{},"ISSN":["0003-1488"],"issn-type":[{"value":"0003-1488","type":"print"}],"subject":[],"published":{"date-parts":[[2023,7,1]]}}}