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Idiopathic epilepsy

JoannC

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On 4/14 at 2 am, my sweet Teddy had cluster seizures, 4-5 in a short duration, and I tried to give pet rescue on first seizure but he continued to seize lying down, paddling, salivating, then ran in corner crying, then laid down and had another seizure. On the way to the veterinary specialists and emergency he began to have another seizure. He was given mannitol because he was unresponsive and stayed that way for almost 6 hrs after seizures.

At 8:30 that morning a Cornell neurologist, Dr. Dewey, who happened to be there for his scheduled day saw him, noting he was demented and flailing, cranial nerves: abscent menace bilaterally, appears to be blind.. Nociception> very reactive but appears to resist head/neck palpating. Neuroanatomic localization: forebrain(seizures and dementia)
The neurologist recommended an mri and cerebral spinal fluid tap but warned that due to his u responsiveness he may die on the table so that sad no, I think I regret that decision now, because the next four days they tested him for EVERYTHING. All blood work, normal, fasting post bile test, normal, toxoplasmosis, normal(however he was started on Iv Clindamycin and continued that antibiotic on po meds until Friday when the test came back negative. Urine C&s normal, ( the internal medicine vet wanted to add bacitrel but I said no not until tests come back she was thinking sepsis or liver issues]. Also insulin resistant test normal, he developed hypoglycemia after being in there for 2 days, and so now at home I have to feed him every 4 hrs. Bottom line, he is on phenobarbital 0.25 go a day which is making him sleepy, and he walks gingerly, sometimes will interact with his brother but for the most part sleeps. His sight has fully returned. I have been giving him belladonna very day and he is now on DMG from DaVINCHI labs a liquid. He just recently has started to play but only for a minute or two and loses interest. Staff tell me his symptoms will get better once blood level is normalized but I want to take him off as soon as possible.

He has a good appetite and I am working with his homeopathic vet. I am discouraged because I worked so hard to get him to an almost raw state but because he needs to eat every 4 hrs I ordered some cornucopia organic canned food. Timmy is also on this schedule but I worry because I know frequent feedings are not good for cats???

If anyone has had a similar experience and weaned off your cat from phenobarbital or maybe they are still on it, how will this effect the rest of his life. He goes back to see neurologist on 5/14 and I was told that if I do decide to do an mri after the fact it may not show anything anymore unless he has a huge tumor. So his dx is idiopathic epilepsy and hypoglycemia of unknown origin.

Next week I am taking him to the vet for a spot check glucose to see if I can try feeding 3 x a day instead of 5 or 6.?
 

Dr. Jeff

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Hi JoAnn-

I'm sorry about Teddy's epilepsy diagnosis, but am relieved to hear that he's alive and hanging in there. (When you shared about him during the Empower Hour, things were still touch and go).

The "good" news is that frequent small feedings are fine for him.

In fact, lots of small meals is a more natural way for kitties to eat.

Did your vet say why he needs to eat so frequently?
 

JoannC

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Hi Dr Jeff, both neurology and internal medicine do not know why while he was in the hospital that he developed hypoglycemia. I have a theory but there is not research to back it up. I think somehow some way the phenobarbital is causing it. He was placed on 16 mg a day on 4/15, and now I have tapered him to 8 mg a day split in divided doses. His appetite I think left him because he contracted a cold while in there and after 13 days isover it andnow Timmy has it! He is holding his own but I will ask on forum for this weekend outcomes on phenobarbital and when trying to wean the ups and downs of vitality for the cat, because it is definitely happening to Teddy. He is holding his own and. Have a great homeopathic vet that puts up with all my questions and fears! See you this weekend. I may not have pic shown because I will be listening and doing things while the workshop is going on.
 

Dr. Jeff

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Great thinking JoAnn!

Absolutely, the hypoglycemia may be an unintended drug effect, associated with Teddy's unique physiology.

Heres one article that confirms that (in rats):

Phenobarbital reduces blood glucose and gluconeogenesis through down-regulation of phosphoenolpyruvate carboxykinase (GTP) gene expression in rats.

No worries about the video as it won't be used during the seminar.
 

Dr. Christina

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JoAnn,
You are doing (along with your Homeopathic vet) such a wonderful job with Teddy. He is truly blessed to have you in his corner.

Celebrate the playful moments and relax when he seems less happy. You are definitely making progress. Patience is so needed when you have very ill animals.

Most animals, with good holistic care, are able to stop phenobarb.

One cat I treated with diabetes was on super high insulin and still (for no apparent reason) was having hypogylcemic attacks so she bought an automatic timed feeder that had ice pack under it since she worked and could not be there to feed him. (No brain problems). With homeopathy we decreased the insulin to just one drop in the tiny syringe, but for 4 years could not stop it completely and he still needed frequent meals during the day (maybe 4). When 16, he developed a tooth root abscess which we treated with homeopathy. After a month we found the homeopathic medicine that matched his total vital force and the abscess resolved, then we discovered he no longer needed any insulin. At 18, his family moved to Australia and we found a new home for him, and he continued to do well for several more years. His owner needed a lot of patience over those many years.
Dr. Christina
 

JoannC

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Great thinking JoAnn!

Absolutely, the hypoglycemia may be an unintended drug effect, associated with Teddy's unique physiology.

Heres one article that confirms that (in rats):



No worries about the video as it won't be used during the seminar.
Thank you! I am moving forward to wean him off of phenobarbital because the owners of KINGKALMCBD a Greenroads product talked about p450 enzyme and to not give their product together with cbd but to give 4 hours after. I started to do some research on this and found this article which I copied the summary and will post here. Teddy started with hypoglycemia while in the hospital the same time he was placed on phenobarbital? There seems to be a correlation between phenobarbital and a glucocorticoid response. Teddy is on 8 mg a day now in divided doses plus DMG 50mg a day plus belladonna once a day and just a drop of this cbd for now. I know DMG does have to do with methylation but I am not sure if it can actually increase a negative effect if thehypoglycemia is a side effect of the drug? Here is the summary but I know you will understand this better than me.

Hepatic cytochrome P450s play a critical role in the metabolism of hydrophobic xenobiotics. One of the ma- jor unsolved problems in xenobiotic metabolism is the molecular mechanism whereby phenobarbital induces hepatic enzymes, particularly CYP2B1 and CYP2B2 in rat liver. By using primary rat hepatocytes for transfec- tion analyses, we previously identified in the CYP2B2 5?-flank a 163-base pair Sau3AI fragment that confers phenobarbital inducibility on a cat reporter gene and that has the properties of a transcriptional enhancer. Transfection experiments with sub-regions of the Sau3AI fragment now indicate that a central core to- gether with an upstream or downstream accessory ele- ment within the fragment can confer phenobarbital re- sponsiveness. One such accessory element, AF1, was identified and localized. DNase I footprinting analysis revealed the presence of a footprint overlapping this AF1 element. It also identified three other major pro- tected regions, two of which are putative recognition sites for known transcription factors. Site-directed mu- tagenesis indicated that a putative glucocorticoid re- sponse element as well as a nuclear factor 1 site and an associated nuclear receptor hexamer half-site are essen- tial for conferring maximal phenobarbital inducibility. Taken together, the results indicate that phenobarbital induction of CYP2B2 requires interactions among mul- tiple regulatory proteins and cis-acting elements consti- tuting a phenobarbital response unit.

I know the neurologist will frown on DMG, and CBD. This company is working with a Dr Khoury on NASC certification. They do full panel analysis on this product too. Any comments will be appreciated but I Teddy has to get off this drug.
 

JoannC

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JoAnn,
You are doing (along with your Homeopathic vet) such a wonderful job with Teddy. He is truly blessed to have you in his corner.

Celebrate the playful moments and relax when he seems less happy. You are definitely making progress. Patience is so needed when you have very ill animals.

Most animals, with good holistic care, are able to stop phenobarb.

One cat I treated with diabetes was on super high insulin and still (for no apparent reason) was having hypogylcemic attacks so she bought an automatic timed feeder that had ice pack under it since she worked and could not be there to feed him. (No brain problems). With homeopathy we decreased the insulin to just one drop in the tiny syringe, but for 4 years could not stop it completely and he still needed frequent meals during the day (maybe 4). When 16, he developed a tooth root abscess which we treated with homeopathy. After a month we found the homeopathic medicine that matched his total vital force and the abscess resolved, then we discovered he no longer needed any insulin. At 18, his family moved to Australia and we found a new home for him, and he continued to do well for several more years. His owner needed a lot of patience over those many years.
Dr. Christina
Thank you Dr Christina, please see my response to Dt Jeff, I think there is a correlation between the phenobarbital and his low blood sugar. Teddy is ok during the night, I feed him at midnight but 2 hrs later he is up and about, almost like he is trying to hunt inside and Timmy is the victim! I have not had a goodnight sleep I hope this early morning anxiety settles down because he rouses his brother and then they are both up. If I separate them, they cry until I open the door?????. I know I have to wean him without the support of his neurologist but I believe the low blood sugar and Teddy genotype are related to this drug!
 

Dr. Jeff

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Yes, JoAnn, his response is *related* to (but not caused by) his genes (and genotype).
No the methylation that DMG promotes should not worsen the hypoglycemia.


Here's the video from that page (about human methylation defects and hypoglycemia):

 

JoannC

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This s very good. I can’t help but wonder if feeding Teddy every 12 hrs before the seizures and not having maybe enough B vitamins could have caused the seizure but he was nothypo glycemic when the first drew his blood on admission. He developed low blood sugar during the hospitalization same time as phenobarbital was starteed. Either way. Am feeding now very 4 hrs while awake and he seems to be doing ok. Timmy loves the new schedule too. Thank you!
 

Dr. Jeff

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You're welcome JoAnn! :D ?
 

JoannC

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Dr Jeff, yesterday Teddy saw the neurologist, and his exam from neurology point of view normal. He wants to transfer Teddy back to internal medicine because he cannot explain the hypoglycemia. They did a serum glucose check and he was 37. It had been 5 hrs since he ate. Basically, he said stop DMG that might be worsening it, up the CBD and if I want to wean off phen I am on my own. It was a nightmare. He also suggested while upping the CBD to add
consider Di Tan Tang, the dosage he suggested was 0.5g per 10 to 20 lb body wt 2x a day. What do you think.
He also said his semi raw diet could be adding to low blood sugar not enough calories. A total opposite of where I was going.

I do not think DMG is adding to low blood sugar, can you confirm that thought. Also I have KINGKALMCBD CBD 150mg/30 ml. Can you please look at this one and see what you think of it. The company says they do a full panel analysis on the product and the patent is pending for NASC certification? The neurologist wants CBD 5 mg 2x a day. When a vet writes this order am I correct to think that it means for any CBD product of my choice as long as it equals the 5mg????? Thank you. This Friday I am working with Dr Judy too but I wanted you insight as well.

Lady question. Would cellbio help me know if Teddy has an insulinoma, not detected by and ultrasound or the serum insulinoma test?
 

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