Suggested guidelines for canine phenobarbital treatment

STEPs | CANINE PHENOBARB
Suggested guidelines for canine phenobarbital treatment
Algorithm
Canine patient receiving
phenobarbital
(e.g. for epilepsy)
Routine check every 6
months*
CBC, Chem, BAST,
trough phenobarb levels
(12hrs post pill)
Adjust phenobarb dose
accordingly*
Seizures well controlled,
CBC, chem and BAST
unremarkable & phenobarb
within therapeutic range
Maintain current dose
Seizures poorly controlled,
and/or significant CBC,
Chem or BAST abnormalities +/- phenobarb out-with
therapeutic range
Re-evaluate anti-epileptic
treatment
Sick dog
CBC, chem, lytes, BAST.
[peak (5hrs post-pill) &
trough phenobarb levels
(12hrs post pill) may
be appropriate if animal
over sedated or poorly
controlled respectively]
Significantly increased Bile
Acids >60mmol/l
Bile acids >30 but
<60mmol/L
Consider alternative anti-epileptic treatments
Consider alternative
anti-epileptic treatments
or investigate for
additional illnesses
Bile acids <30mmol/l
Continue with
phenobarbital and
investigate other
reasons for illness
STEPs | CANINE PHENOBARB
Suggested guidelines for canine phenobarbital treatment
Applicable – IDEXX Products & Services
Event
Suggested Protocol
IDEXX Workflow Key:
 In-Clinic or Ref-Lab  Ref-Lab only In-Clinic Only
Diagnosis
CBC
Chemistry profile
Electrolytes
Bile Acid Stim
Phenobarb
Chemistry Profile:
Chem17
ALB, ALB/GLOB, ALKP, ALT, AMYL, BUN, BUN/CREA, Ca, CHOL
CREA, GGT, GLOB, GLU, LIPA, PHOS, TBIL, TP
Electrolytes:
Lyte 4
Cl, K, Na, Na/K
Haematology:
Comprehensive Haematology – (Code FBCS)
LaserCyte® CBC or ProCyteDx® CBC
Bile Acid Stim:
SNAP® BileAcids x2
Bile Acid Stimulations Test – (Code BAS)
Phenobarb:
Catalyst Dx Phenobarbital Slide
Phenobarbital – (Code PHEN))
Monitoring
CBC
Chemistry profile
Bile Acid Stim
Phenobarb
Chemistry Profile:
Chem17
ALB, ALB/GLOB, ALKP, ALT, AMYL, BUN, BUN/CREA, Ca, CHOL
CREA, GGT, GLOB, GLU, LIPA, PHOS, TBIL, TP
Haematology:
Comprehensive Haematology – (Code FBCS)
LaserCyte® CBC or ProCyteDx® CBC
Bile Acid Stim:
SNAP® BileAcids x2
Bile Acid Stimulations Test – (Code BAS)
Phenobarb:
Catalyst Dx Phenobarbital Slide
Phenobarbital – (Code PHEN))
VetConnect™ PLUS – Client communication suggestions
• Show your client the diagnosis results
• Discuss next STEPs
• Discuss the requirement to monitor phenobarbital levels (As per Pharmaceutical Data Sheet)
•Use Client Friendly Summary to outline future monitoring requirement
· Discuss organ functions  Use Notes function to add in details specific to the Pet 
Use the calendar function to set date for next check-up / monitoring visit
•When monitoring phenobarbital levels use the tabulation of results to
communicate to your client:
· Changes in stability  Changes in dosage 
Great News! – “your pet is doing great. Continue the good work”
If you have questions regarding diagnostics or treatment for any of your patients, please contact our Internal Medicine team on
00800 1234 33 99 (option 1, option 2)
© 2014 IDEXX Laboratories, Inc. All rights reserved. 1406050-0614-UK
All ®/TM marks are owned by IDEXX Laboratories, Inc. or its affiliates in the United States and/or other countries.
The protocols / information presented in this document are a general overview to help guide the diagnosis and treatment of
routine cases. Diagnostic and treatment decisions for an individual animal remain the responsibility of the attending veterinary
surgeon and decisions should never be based solely on laboratory results or general literature.
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