THE USE OF DIAZEPAM PER RECTUM AT HOME FOR THE ACUTE MANAGEMENT OF CLUSTER SEIZURES IN DOGS

The use of diazepam per rectum (RDZ) in the home to control generalize d cluster seizures in 11 dogs diagnosed with idiopathic epilepsy was e valuated over a 16-month period. All dogs had a prior history of clust ers of generalized seizures and were treated with multiple antiepilept ic drugs. Owners were instructed to administer diazepam injectable sol ution (5 mg/mL) per rectum to their dogs at a dose of 0.5 mg/kg when a n initial generalized seizure occurred and when a second or third gene ralized seizure occurred within 24 hours of the first seizure. Seizure activity was recorded by owners in a daily log before the onset of RD Z use and for the duration of RDZ use, which ranged from 57 to 464 day s (median = 157 days). The median age at which the first seizure occur red and the median age at the time of enrollment in the study were 19 and 42 months, respectively. All 11 dogs were treated with phenobarbit al, with 10 dogs receiving concomitant bromide therapy. No significant correlation between the duration of the first, second, or third antie pileptic drug therapy and the change in the number of cluster seizure events before or after use of RDZ was found. Comparisons of seizure ac tivity were done for the same time interval before and after the onset of RDZ availability. A significant decrease in the total number of se izure events and the total number of cluster seizures events was found after RDZ availability. Similarly, a significant difference in the av erage number of seizures per cluster seizure event and the total numbe r of isolated seizure events occurred before and after RDZ therapy. Ei ght of the 11 dogs (73%) that received RDZ for 1 or more times after t he first or second seizure had a 100% success rate in prevention of fu rther seizure activity after the first dose. In 3 dogs, success and co mpliance rates were both equal at 100%, thus suggesting 100% efficacy of RDZ in blocking further seizure activity over the next 24 hours in these dogs. Owners had a large cost-savings because of the decrease in emergency clinic visits after initiating treatment with RDZ. Before R DZ use, the average number of emergency clinic visits was 3, with an a verage cost of $308 per dog. After RDZ use, the average number of emer gency clinic visits was 1, with an average cost of $81 per dog. The re sults of this study suggest that RDZ may be an effective method of hom e treatment of generalized cluster seizures in dogs with idiopathic ep ilepsy, regardless of prior antiepileptic drug history.