Liver Enzymes

Goofiness after having a bath.

Well, this post will be about not so fun medical stuff, so feel free to skip it.  I got the results of Zephyr's blood work on Wednesday and unfortunately they showed that his liver enzymes have increased again.  About three weeks ago the Alkaline Phosphate had increased from 100 to 800, and now it's at 1,300.  The Dr. says this is probably from the phenobarbital.  Although all of the medicine he is taking, procarbazine and prednisone, can effect the liver.  I don't think 1,300 is really bad, but there seems to be continuous increase.  I just can't risk damaging his liver so, I am now transitioning him from phenobarbital to levetiracetam (Keppra).  Keppra doesn't harm the liver like phenobarbital.  This will be a slow transition over many weeks with decreases of 7.5 mg every four to seven days.  He is on his full dose of phenobarbital and full dose of Keppra until tomorrow morning when I'll make the first decrease.  He seems a little sedated from the addition of Keppra.  There is a chance that the Keppra won't control his seizures and they'll start again, which I'm very worried about.

I am a happy clean boy.

In fact we had an episode today.  Zephyr had his second dose of Keppra this morning, it's given every eight hours.  He was seeming pretty normal.  He and Astro played this morning and we took a short walk.  About 12:00 they were in the yard running and playing like normal.  They stopped and I called Zephyr up the stairs to go in.  As he came up he started holding his right front foot and walking funny.  I thought it was from pain, but realized it wasn't as he came in.  He was walking really different and it looked like that leg was contracting and kind of stiff and his head and neck was now tilted to one side and looked stiff.  I immediately thought it was a seizure but was confused because he's never had any like this, they have always been when he's sleeping and he loses consciousness.  When I saw the head tilt I of course also thought the encephalitis was back.  He laid down and I saw that his eyes were dilated too.  That always happens when he has a seizure.  I went to get the diazepam and he followed me.  I had him lay down and he started to get better so I didn't give the diazepam.  I think this happened in less than two minutes.  I sat with him a few more minutes and then had him get up.  He was still a little dazed and confused, but better.  I think he had what is called a simple partial(focal) seizure.  And, on the lengthy info page that came with the Keppra it says that changes in seizures can occur.  Online I found many things about people and dogs taking it that said they had partial seizures or more seizures from Keppra.  I do think the Keppra had something to do with this.  I also think that Zephyr is pretty sensitive to medications in general.  I always worry that rowdy play will cause a seizure, but he has played like that countless times and not had any problems. 

Enjoying some yummy fresh beef bones that I got at the Farmers Market last weekend.  Hopefully I'll get more tomorrow.

Zephyr was fine the rest of the day.  He did get pretty tired, and he seems sedated from the Keppra.  I had to leave twice for about 1 1/2 hours each time, which I hate.  Sara's mom said she always hated leaving her too.  I spent too much time today searching for info on partial seizures and Keppra.  If you all haven't noticed I'm a bit of a worrier.  Spending hours reading about and watching videos of seizures trying to figure out if that's what it was, how seizure meds. might not work, how they might work at first and then stop working, etc., etc, doesn't really help.  This is why I usually don't spend a lot of time reading the forums about encephalitis, epilepsy, chemotherapy, etc.  It just scrambles my mind.  Oh, and dreaming that Zephyr has liver failure, repeatedly, last night didn't help.   Welcome back stress.  Oh, that's right, you never really left did you.