Evaluation of therapeutic phenobarbital concentrations and application of a classification system for seizures in cats: 30 cases (2004-2013).

ABSTRACT

OBJECTIVE: To determine the percentage of cats with a phenobarbital (PB) concentration between 15 and 45 µg/mL that had a ≥ 50% reduction in the number of seizures and to investigate applicability of the 2011 International League Against Epilepsy (ILAE) classification system in cats. DESIGN: Retrospective case series. ANIMALS 30 cats with suspected or confirmed epilepsy. PROCEDURES Medical records for 2004 to 2013 at 3 veterinary hospitals were searched. Information collected included signalment, duration of observation before treatment, frequency of seizures before PB administration, seizure phenotype, dose of PB, serum PB concentration, number of seizures after PB administration, duration of follow-up monitoring, and survival time. A modified 2011 ILAE classification system was applied to all cats. RESULTS: Seizure control was achieved in 28 of 30 (93%) cats with a serum PB concentration of 15 to 45 µg/mL. This comprised 10 of 11 cats with structural epilepsy, 14 of 15 cats with unknown epilepsy, and 4 of 4 cats with presumptive unknown epilepsy. Thirteen cats had no additional seizures after initiation of PB treatment. CONCLUSIONS AND CLINICAL RELEVANCE Seizure control was achieved in most cats with a serum PB concentration between 15 and 45 µg/mL, regardless of the cause of the seizures. A modified 2011 ILAE classification was applied to cats with seizures and enabled classification of cats without specific genetic testing and without identified structural or inflammatory disease. This classification system should be incorporated into veterinary neurology nomenclature to standardize communication between veterinarians and improve comparisons among species.