Therapie epileptischer Anfälle bei Hund und Katze

Das Auftreten epileptischer Anfälle ist einer der häufigsten neurologischen Vorstellungsgründe bei Haustieren. Die Therapie dieser Patienten kann – je nach Ursache und Krankheitsverlauf – herausfordernd sein. Dieser Artikel gibt einen Überblick über die aktuell verfügbaren therapeutischen Ansätze bei Hunden und Katzen, die an Epilepsie leiden.

Publication History

Article published online:
06 March 2023

• Literatur

• 1 Berendt M, Farquhar RG, Mandigers PJ. et al. International veterinary epilepsy task force consensus report on epilepsy definition, classification and terminology in companion animals. BMC Vet Res 2015; 11: 1-11
• 2 Seppälä EH, Jokinen TS, Fukata M. et al. LGI2 truncation causes a remitting focal epilepsy in dogs. PLoS Genet 2011; 7: e1002194
• 3 Shih JJ, Ochoa JG. A systematic review of antiepileptic drug initiation and withdrawal. Neurologist 2009; 15: 122-131
• 4 Bhatti SF, De Risio L, Muñana K. et al. International Veterinary Epilepsy Task Force consensus proposal: medical treatment of canine epilepsy in Europe. BMC Vet Res 2015; 11: 1-16
• 5 Lewis CB, Adams N. Phenobarbital. StatPearls Publishing. Im Internet (Stand: Januar 2023): https://www.ncbi.nlm.nih.gov/books/NBK532277/
• 6 Finnerty KE, Heller HLB, Mercier MN. et al. Evaluation of therapeutic phenobarbital concentrations and application of a classification system for seizures in cats: 30 cases (2004–2013). J Am Vet Med Assoc 2014; 244: 195-199
• 7 Cochrane SM, Parent JM, Black WD. et al. Pharmacokinetics of phenobarbital in the cat following multiple oral administration. Can J Vet Res 1990; 54: 309
• 8 Ravis W, Pedersoli W, Wike J. Pharmacokinetics of phenobarbital in dogs given multiple doses. Am J Vet Res 1989; 50: 1343-1347
• 9 Levitski RE, Trepanier LA. Effect of timing of blood collection on serum phenobarbital concentrations in dogs with epilepsy. J Am Vet Med Assoc 2000; 217: 200-204
• 10 Dayrell-Hart B, Steinberg S, VanWinkle T. et al. Hepatotoxicity of phenobarbital in dogs: 18 cases (1985–1989). J Am Vet Med Assoc 1991; 199: 1060-1066
• 11 Schwartz-Porsche D, Löscher W, Frey HH. Therapeutic efficacy of phenobarbital and primidone in canine epilepsy: a comparison. J Vet Pharmacol Ther 1985; 8: 113-119
• 12 March PA, Hillier A, Weisbrode SE. et al. Superficial necrolytic dermatitis in 11 dogs with a history of phenobarbital administration (1995–2002). J Vet Int Med 2004; 18: 65-74
• 13 Jacobs G, Calvert C, Kaufman A. Neutropenia and thrombocytopenia in three dogs treated with anticonvulsants. J Am Vet Med Assoc 1998; 212: 681-684
• 14 Kantrowitz LB, Peterson ME, Trepanier LA. et al. Serum total thyroxine, total triiodothyronine, free thyroxine, and thyrotropin concentrations in epileptic dogs treated with anticonvulsants. J Am Vet Med Assoc 1999; 214: 1804-1808
• 15 Vaughan-Scott T, Taylor J. Drug choice and therapeutic drug monitoring in the management of canine primary epilepsy: continuing education. J S Afr Vet Assoc 1999; 70: 172-176
• 16 Baird-Heinz HE, Andrea L, Pelsor FR. et al. A systematic review of the safety of potassium bromide in dogs. J Am Vet Med Assoc 2012; 240: 705-715
• 17 Rossmeisl JH, Inzana KD. Clinical signs, risk factors, and outcomes associated with bromide toxicosis (bromism) in dogs with idiopathic epilepsy. J Am Vet Med Assoc 2009; 234: 1425-1431
• 18 Dedola C, Gallucci A, Ibba F. et al. Ulcerative neutrophilic dermatitis resembling human bromoderma in a dog. J Small Anim Pract 2022; 63: 331-335
• 19 Boothe DM, George KL, Couch P. Disposition and clinical use of bromide in cats. J Am Vet Med Assoc 2002; 221: 1131-1135
• 20 Bertolani C, Hernandez J, Gomes E. et al. Bromide-associated lower airway disease: a retrospective study of seven cats. J Feline Med Surg 2012; 14: 591-597
• 21 Rundfeldt C, Löscher W. The pharmacology of imepitoin: the first partial benzodiazepine receptor agonist developed for the treatment of epilepsy. CNS Drugs 2014; 28: 29-43
• 22 Engel O, von Klopmann T, Maiolini A. et al. Imepitoin is well tolerated in healthy and epileptic cats. BMC Vet Res 2017; 13: 1-7
• 23 Neßler J, Rundfeldt C, Löscher W. et al. Clinical evaluation of a combination therapy of imepitoin with phenobarbital in dogs with refractory idiopathic epilepsy. BMC Vet Res 2016; 13: 1-11
• 24 Gallucci A, Gagliardo T, Menchetti M. et al. Long-term efficacy of imepitoin in the treatment of naive dogs affected by idiopathic epilepsy. Vet Rec 2017; 181: 144
• 25 Dewey CW. Anticonvulsant therapy in dogs and cats. Vet Clin North Am Small Anim Pract 2006; 36: 1107-1127
• 26 Tipold A, Keefe T, Löscher W. et al. Clinical efficacy and safety of imepitoin in comparison with phenobarbital for the control of idiopathic epilepsy in dogs. J Vet Pharmacol Ther 2015; 38: 160-168
• 27 Lynch BA, Lambeng N, Nocka K. et al. The synaptic vesicle protein SV2A is the binding site for the antiepileptic drug levetiracetam. Proc Natl Acad Sci U S A 2004; 101: 9861-9866
• 28 Packer R, Nye G, Porter SE. et al. Assessment into the usage of levetiracetam in a canine epilepsy clinic. BMC Vet Res 2015; 11: 1-8
• 29 Sills GJ. The mechanisms of action of gabapentin and pregabalin. Curr Opin Pharmacol 2006; 6: 108-113
• 30 Shank RP, Gardocki JF, Streeter AJ. et al. An overview of the preclinical aspects of topiramate: pharmacology, pharmacokinetics, and mechanism of action. Epilepsia 2000; 41: 3-9
• 31 Kiviranta AM, Laitinen-Vapaavuori O, Hielm-Björkman A. et al. Topiramate as an add-on antiepileptic drug in treating refractory canine idiopathic epilepsy. J Small Anim Pract 2013; 54: 512-520
• 32 Leppik IE. Zonisamide: chemistry, mechanism of action, and pharmacokinetics. Seizure 2004; 13: S5-S9
• 33 Dewey CW, Guiliano R, Boothe DM. et al. Zonisamide therapy for refractory idiopathic epilepsy in dogs. J Am Anim Hosp Assoc 2004; 40: 285-291
• 34 Von Klopmann T, Rambeck B, Tipold A. Prospective study of zonisamide therapy for refractory idiopathic epilepsy in dogs. J Small Anim Pract 2007; 48: 134-138
• 35 Chung J, Hwang C, Chae J. et al. Zonisamide monotherapy for idiopathic epilepsy in dogs. N Z Vet J 2012; 60: 357-359
• 36 Ackermann AL, Frank LA, McEntee MF. et al. Erythema multiforme associated with zonisamide in a dog. Vet Dermatol 2015; 26: 391-392 e389
• 37 Schwartz M, Muñana KR, Olby NJ. Possible drug-induced hepatopathy in a dog receiving zonisamide monotherapy for treatment of cryptogenic epilepsy. J Vet Med Sci 2011; 73 (11) 1505-1508
• 38 Miller M, Center S, Randolph J. et al. Apparent Acute Idiosyncratic H epatic N ecrosis Associated with Z onisamide Administration in a Dog. J Vet Int Med 2011; 25: 1156-1160
• 39 Charalambous M, Gomes SA, Papageorgiou S. et al. Epileptic seizures versus syncope: pathophysiology and clinical approach. Veterinary Evidence 2017; 2
• 40 Han FY, Conboy-Schmidt L, Rybachuk G. et al. Dietary medium chain triglycerides for management of epilepsy: New data from human, dog, and rodent studies. Epilepsia 2021; 62: 1790-1806
• 41 Molina J, Jean-Philippe C, Conboy L. et al. Efficacy of medium chain triglyceride oil dietary supplementation in reducing seizure frequency in dogs with idiopathic epilepsy without cluster seizures: a non-blinded, prospective clinical trial. Vet Rec 2020; 187: 356-356
• 42 Robinson K, Platt S, Stewart G. et al. Feasibility of non-invasive vagus nerve stimulation (gammaCore VET^™) for the treatment of refractory seizure activity in dogs. Front Vet Sci 2020; 7: 569739
• 43 Muñana KR, Vitek SM, Tarver WB. et al. Use of vagal nerve stimulation as a treatment for refractory epilepsy in dogs. J Am Vet Med Assoc 2002; 221: 977-983
• 44 Shell L, Scariano R, Rishniw M. Features of stimulus-specific seizures in dogs with reflex epilepsy: 43 cases (2000–2014). J Am Vet Med Assoc 2017; 250: 75-78
• 45 Lowrie M, Bessant C, Harvey RJ. et al. Audiogenic reflex seizures in cats. J Feline Med Surg 2016; 18: 328-336