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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

From: Treatment in canine epilepsy – a systematic review

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.
  1. AED(s), anti-epileptic drug(s); BID, bis in die (twice daily); Chloraz, Chlorazepate; CSF, cerebrospinal fluid; CL, confidence level; Diaz, Diazepam; Gaba, Gabapentin; IE, idiopathic epilepsy; LEV, Levetiracetam; m, month(s); NA, Not Available; PB, phenobarbital; PBr, potassium bromide; PO, per os; SF, seizure frequency; SID, semel in die (once daily); TID, ter in die (three times daily); TPM, Topiramate; w, week(s).
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