Skip to main content

Table 2 Details of feline population size, seizure frequency, treatment time, doses of AED(s), seizure frequency reduction after AED initiation, 95% CI for the successful and affected cases and evidence statements for each study

From: Systematic review of antiepileptic drugs’ safety and effectiveness in feline epilepsy

References Wagner [38] Volk et al. [36] Boothe et al. [21] Boothe et al. [21] (retrospective part) Bertolani et al. [37] Volk et al. [28] Klang et sl. [39] Carnes et al. [42] Bailey et al. [40] Lowrie et al. [26] Dewey et al. [41] Cuff et al. [30] Barnard et al. [43]
AED evaluated Potassium Bromide LEV
2nd AED - - - PB (12) - - PB - PB (12)   PB (4) PB -
3rd AED - - - - - - LEV - -   - -  
4th AED - - - - - - Gabapentin - -   - - -
No of cats 26 9 7 17 7 5 1 10 (non-epileptic cats) 12 (10 completed the efficacy analysis) 34 (28 completed the efficacy analysis) 4 (3 had presumed IE) 1 7 (non-epileptic cats)
Age of cats at seizure onset (years) NA mean 4.1 NA mean 8.6 median 3; mean 3.2; range 1-8 NA 4 NA median 2; range 0.25-16 median 16; range 10-19 NA 10 NA
Period of treatment or follow-up (months) range 1.75-14 mean 13.63 2 mean 12.5 median 8; mean 18; range 1-96 NA 0.75 1 day median 9; mean 12; range 6-24 3 Minimum 3 months 2 0.06
Dose of AED(s) (mg/kg) NA mean 16.5 PO BID 15 PO BID 12 PO BID NA NA PBr 100 (total dose) PO BID; PB: 30 (total dose) PO BID; LEV: 50 (total dose) PO TID; gabapentin 100 (total dose) PO TID 20 mg/kg PO or IV SID (only one single dose) PB: median 3.02; range 0.75-4.9 PO BID; LEV: median 23.6; range 17.2-34.7 PO TID median 62.5; range 60-93.75 PO SID 20 mg/kg PO TID PB: 4.5 PO BID; LEV 50 PO TID 500 mg PO single dose (extended release)
Serum levels of AED(s) NA mean 1.15 mg/ml mean 1.1 mg/ml PBr: mean 1.5 mg/ml. PB: range, 13-47 μg/ml NA NA NA median 26.77; mean 25.54; range 13.22-37.11 μg/ml PB: median 29; range 5.6-75 μg/ml; LEV: median 25.5 μg/ml NA PB: mean 35.8 μg/ml; LEV: mean, 16.5; range: 6.9–24.3 μg/ml NA 89.7 + /−25.7 μg/ ml
Pre-treatment SF (seizures/month or year) NA mean 4/month (recorder over a period of 6-12 months) NA NA NA NA NA NA median 2.1; range 0.8-42.4/month (recorder over a period of median 4.5; range 0.3-46 months) 65/month NA continuous NA
Post-treatment SF (seizures/month or year) NA 0.52/month NA NA NA NA NA NA median 0.42; range 0-1.25/month NA NA 0 (recorded over a period of 2 months) NA
No of cats that were failures NA 1/9 (11%) NA - NA 0 NA NA 0% 0/28 (0%) 1/4 (25%) - NA
No of cats with >0% - <50% reduction in SF NA - NA 8/15 (53%) NA 0 NA NA 3/10 (30%) 0/28 (0%) 3/4 (75%) - NA
No of cats with ≥50% - <100% reduction in SF NA 3/9 (33%) NA - NA 0 NA NA 4/10 (40%) 14/28 (50%) 0 - NA
No of cats with 100% reduction in SF NA 5/9 (56%) NA 7/15 (47%) (available for 15 cats only and 3/7 were receiving also PB) NA 5/5 (100%) NA NA 3/10 (30%) 14/28 (50%) 0 1/1 (100%) NA
95% CI of successfully treated cases NA 56-98% NA 25-70% NA 100% NA NA 40%-90% 100% 0% 100% NA
Prevalence of adverse effects 11/26 (42%) 6/9 (67%) 0% 8/17 (47%) NA 4/5 (80%) NA 10/10 (100%) 2/12 (17%) 5/34 (18%) 2/4 (50%) NA 0%
95% CI of cases that developed adverse effects 26-61% 35-88% 0% 26%-70% NA 38-96% NA 100% 4-45% 6-30% 15-85% NA 0%
Body system affected and adverse effects Respiratory (cough(11), dyspnea(2)) Respiratory (cough(6)), dermatological (dermatitis/bromoderma(1)) NA Respiratory (cough (6)), GI (vomiting (1)), Neurological (sedation/ataxia (2)), weight gain (1), PD (1) Respiratory (cough(7), dyspnea(2), tachypnea (2)) Respiratory (cough, dyspnea) Respiratory (cough, tachypnea) GI (hypersalivation) Neurological (sedation(1)), GI (anorexia(2)) Neurological (sedation (4), ataxia (2), GI (anorexia (3)), PD (1) ClinPath (increased ALP(2)) NA NA
Most common adverse effects Cough Cough NA Cough Cough Cough NA hypersalivation (after PO administration only) anorexia sedation, anorexia increased ALP NA NA
Adverse effect type II II NA I & II II II II I I I I NA NA
Proportion of specific adverse effects for each AED based on all study reports Type I: sedation, ataxia, vomiting, weight gain and PD (1/7; 14%) Type I: sedation (2/5; 40%), anorexia (2/5; 40%), ataxia (1/5; 20%), hypersalivation (1/5; 20%), elevated serum ALP (1/5; 20%) and PD (1/5; 20%)
Type II: cough (6/7; 86%), dyspnea (3/7; 43%), tachypnea (2/7; 29%), dermatitis/bromoderma (1/7; 14%)
One study reported that there were no adverse effects.
Proportion of specific adverse effects for each AED based on the total affected population Cough (35/72; 49%), dyspnea (9/72; 12%), tachypnea (3/72; 4%), sedation (2/72; 3%), ataxia (2/72; 3%), dermatitis/bromoderma (1/72; 1%), vomiting (1/72; 1%), weight gain (1/72; 1%) and PD (1/72; 1%) Hypersalivation (10/67; 15%), sedation (5/67; 7%), anorexia (5/67; 7%), ataxia (2/67; 3%), elevated serum ALP (2/67; 3%) and PD (1/67; 1%)
Overall level of evidence supporting the efficacy and safety profile of an AED Weak level of evidence for potassium bromide’s efficacy and safety profile Weak level of evidence for levetiracetam’s efficacy and safety profile
  1. AED(s) anti-epileptic drug(s), BID bis in die (twice daily), CI confidence interval, GI gastrointestinal, IE idiopathic epilepsy, LEV Levetiracetam, m month(s), NA Not Available, PB phenobarbital, PD polydipsia, PU polyuria, PP polyphagia, PBr potassium bromide, PO per os, SID semel in die (once daily), TID ter in die (three times daily), w week(s), y year(s)