Table 6 Details of numbers of dogs, pre- and post- treatment seizure frequency, period of treatment, doses of AED(s), seizure frequency reduction/response after the initiation of treatment and efficacy statements for each study
References | Volk et al.[16] | Volk et al.[16](retrospective) | Steinberg M[23] | Muñana et al.[12] | von Klopmann et al.[20] | Dewey et al.[19] | Chung et al.[24] |
|---|---|---|---|---|---|---|---|
AED evaluated | Levetiracetam | Zonisamide | |||||
2 nd AED | PB (14 dogs) | PB (8 dogs) | PB (15 dogs) | PB (33 dogs) | PB (11 dogs) | PB (33 dogs) | - |
3 rd AED | PBr (14 dogs) | PBr (8 dogs) | PBr (15 dogs) | PBr (29 dogs) | PBr (4 dogs) | PBr (29 dogs) | - |
4 th AED | - | - | - | Gapa (2 dogs) | - | Felb (1 dog) or Gaba (1 dog) or Cloraz (1 dog) | - |
No of dogs | 14 | 8 | 15 | 22 | 11 | 12 | 10 |
Period of treatment (months) | 2-6 or more | Approx. 2-3 | median, 38; range, 13.8-95.5 | 9 (during the 5th m no AED was administered) | range, 4-17 | mean, 8; median, 9; range, 2 -18 | median, 12; mean, 11.2 |
Dose of AED(s) (mg/kg) | LEV: 10 for 2 m, 20 for further 2 m, 10–20 until 6 m and then 10–20 long-term PO TID; PB and PBr: NA but were within normal reference values | LEV: median, 22.15; mean, 21.7; range, 10–32.8 PO TID; PB and PBr: NA but were within normal reference values | LEV: range, 7.1-23.8 PO TID; PB and PBr: NA | lEV: median, 20.6; range, 17–23.1 PO TID; PB: median, 8.7; range, 2.9-17.2; PBr: median, 39.1; range, 13.6-133.3 PO SID) | Zonisamide: mean, 8.9; range, 5–11. PO BID; other AED doses were NA but continued unchanged or reduced | Zonisamide: mean, 8.9; range, 5–11. PO BID; other AEDs doses were NA but reduced or eliminated in 9/12 dogs | median, 9.5; mean, 8.65; range, 2.5-12 PO BID |
Pre-treatment SF (seizures/month) | median, 7.25; mean 8.2 (recorded over a period of 2 m) | median, 8; mean 9.7 +/− 7.6; range 1–25 (period not recorded) | mean, 4.3 (recorded over a period of median 17 m) | median, 8.4+/−10; mean, 7.6 – 7.6 (recorded over a period of 2 m) | median 6.5; range 1–72 (over a period of 4 m) | median 19.8; mean 33 (recorded over a period of 2.5 to 82 m) | median, 3; mean, 4.4; range, 2–10 (period not recorded) |
Post-treatment SF (seizures/month) | 4 m: median 3.5; mean 3.7. 6 m: median 4.25; mean 4.8 | median, 0; mean 3.9 +/−6; range 0–15.5 | mean, 1.96 | mean, 4.4+/−5.2 | median, 1.63; range, 0-9 | mean, 1.8; median 3 | median, 1.5; mean, 2.5; range, 0-10 |
No of dogs that were failures | 4 m: 2/14 (15%) 6 m: 2/11 (18%) | - | - | - | - | 5/12 (42%) | 4/10 (40%) |
No of dogs with >0% - <50% reduction in SF | 4 m: 3/14 (21%) 6 m: 1/11 (9%) | - | - | - | 2/10 (20%) | - | - |
No of dogs with ≥50% - <100% reduction in SF | 4 m: 6/14 (43%) 6 m: 7/11 (64%) | 3/8 (37.5%) | 15/15 (100%) | 12/22 (56%) | 6/10 (60%) | 5/12 (42%) | 2/10 (20%) |
No of dogs with 100% reduction in SF | 4 m: 3/14 (21%) 6 m: 1/11 (9%) | 5/8 (62.5%) | - | 4/22 (17%) | 2/10 (20%) | 2/12 (16%) | 4/10 (40%) |
No of dogs with >30% reduction in SF | 4 m: 11/14 (79%) 6 m: 8/11 (73%) | 5/8 (62.5%) | 15/15 (100%) | - | 8/10 (80%) | 7/12 (58%) | 6/10 (60%) |
95% CI successfully treated cases | 4 m: 39% - 89% | 100% | 100% | 54% - 92% | 56% - 100% | 30% - 86% | 30% - 90% |
6 m: 50% - 96% | |||||||
Overall evidence for/against recommending the use of an AED | Fair evidence for recommending the use of levetiracetamas an an adjunct AED. | Insufficient evidence for recommending the use of zonisamide as a monotherapy AED. Insufficient evidence for recommending the use of zonisamide as an adjunct AED. | |||||