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Ask Dr. Michael Salkin Your Own Question
Dr. Michael Salkin
Dr. Michael Salkin, Veterinarian
Category: Dog
Satisfied Customers: 33334
Experience:  University of California at Davis graduate veterinarian with 45 years of experience.
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I have a shih Tzu male dog 2 years old. He has been having

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I have a shih Tzu male dog 2 years old. He has been having fits since Christmas. Our vet has put him on Pexion 150 mg twice a day. Since starting on this medication Alfie (the dog) hasn't had any more attacks until .... TODAY. The first fit started at 8.oo this morning and several others have followed during the day. At the last count he has had 8. We have of course taken him back to our vet who has advised us to increase his Pexion to 200 mg.per day.
Can you advise me what is likely to be the maximum number of cluster fits he could have in one day.

Yours sincerely XXXXX XXXXX
Aloha! You're speaking to Dr. Michael Salkin
Gabrielle, clustering is defined as more than one seizure within a 24 hour period. I would be concerned that my patient was in status epilepticus should so many seizures have occured as you reported. Status eilepticus is the state in which seizure activity never abates and is thus life-threatening. These dogs need to be heavily sedated or anesthetized.

The initial recommended dose of Pexion is 10 mg/kg twice daily. If seizures aren't adequately controlled after one week, Alfie's vet may increase the dose weekly - if necessary - to as much as 30 mg/kg. Here's a good review of this drug for you:

Please respond with further questions or concerns if you wish.
Customer: replied 3 years ago.

Thanks for your reply. Alfie weighs 10.5 kilos, so it appears he is on the right dose. I am just so worried about the number of seizures he has had today (so far 8) and both my husband and myself have witnessed them and you can imagine how very upsetting it is. The last seizure was the very worst, it took him some time to 'come round'. I just hope he can sleep now through the night. Would you advise I give him some medication ? I have some herbal dog travelling sickness pills.

If Alfie can't see a vet at this time, I would immediately administer a dose that would bring his last dose to a total of 30mg/kg. In other words, If he received 150mg as his last dose, he should receive another 150mg and then his vet should be consulted concerning increasing his dose as I mentioned above.

The herbal traveling sickness pills should be avoided at this time. I don't know how they would interact with the Pexion. Please continue our conversation if you wish.
Customer: replied 3 years ago.

I know its an impossible question to answer but have you any idea what is likely to be the maximum number of seizures he could have in one day?


Once obvious seizures exceed two daily, we assume that many of our dogs are in a constant state of seizure (even if not clinically evident) and so your question can't be answered properly.
Dr. Michael Salkin and other Dog Specialists are ready to help you
Thank you for your kind accept. I appreciate it.

I'm going to check back with you in a few days for an update. Feel free to return to our conversation - even after rating - prior to my contacting you if you wish.

Please disregard the info request.
May I have an update on Alfie, please?