03243-A: Comparison of Clorazepate and Levetiracetam as Pulse Therapy for the In-Home Management of Cluster Seizures in Dogs with Idiopathic Epilepsy: A Pilot Study

Idiopathic epilepsy is the most common chronic neurological disorder in dogs. Approximately half of all dogs with idiopathic epilepsy have cluster seizures, defined as 2 or more seizures within a 24-hour period. Cluster seizures are considered a medical emergency, as dogs with cluster seizures are at increased risk of both medical complications and death. Therapeutic regimens are commonly prescribed that include in-home administration of emergency medication for cluster seizures, but there is a lack of evidence on which to base those treatment recommendations.

The aim of this pilot study is to evaluate and compare the use of two oral treatment protocols for the in-home management of cluster seizures in dogs with idiopathic epilepsy. The researchers hypothesize that an in-home emergency treatment protocol that includes intermittent, or pulse therapy, with either oral clorazepate or oral levetiracetam is effective in controlling cluster seizures in dogs with idiopathic epilepsy. Thirty idiopathic epileptic dogs with a history of cluster seizures will be enrolled in this randomized clinical trial. Dogs will receive oral pulse therapy with either clorazepate or levetiracetam, in combination with intranasal midazolam, for the in-home emergency treatment of cluster seizures. Owners will record data on seizure frequency, medication administered, and adverse effects. The primary outcome measurement will be the number of dogs that respond with no additional seizures over a 24-hour period. The information gained from this study will help guide treatment recommendations for cluster seizures and serve as a basis for future studies, with the goal of improving management strategies for cluster seizures in dogs with idiopathic epilepsy.