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Old 01-07-2013, 04:08 AM   #1 (permalink)
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Name: Vinh & Ann
Dog's Name: Biscuit (@Rainbow Bridge), Pork Chop, and Emmie
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Location: San Jose, CA
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Default Happy New Year! Biscuit's Latest Status

Hello SM Family!

Wishing everyone a Happy New Year! Sorry but we have been so busy with Biscuit and celebrating with New Year with our family that we have not been able to post any new update. It is also unfortunate and sad that this latest post is not so good for Biscuit as he just experience another relapse of seizure just a couple of hours ago. However we were fortunate that Dr. Sisson was actually up and he responded to us right away with an immediate response of increase doses. Below are the email communication threads starting from latest to our initial email to Dr. Sisson.

From: Sisson, Allen
Sent: Monday, January 07, 2013 12:25 AM
To: Vinh Le
Subject: RE: Biscuit

Do not do what I just said to do. After looking at your record I saw that Biscut is also taking phenobarbital. You should give of a tablet ( 12.15 mg) of phenobarbital now and raise the regular dose of phenobarbital every 12 hours. Give an extra tablet of phenobarbital after every seizure Biscuit has and do not give extra levetiracetam doses. Keep the levetireacetam as 50 mg every 8 hours for now. If you have already given the 1 ml extra of levetiracetam that is fine, but still give the extra tablet of phenobarbital. Do everything else I said but use an increased phenobarbital dose not an extra levetiracetam dose. Allen Sisson

From: Sisson, Allen
Sent: Monday, January 07, 2013 12:16 AM
To: Vinh Le
Subject: RE: Biscuit

You should give another 50 mg (one-ml) of the levetiracetam now. You should increase his regular dose of levetiracetam to 100 mg (two mls) every 8 hours. Any time he has a seizure you should give an extra 100 mg (2 mls) of levetiracetam after every seizure until they stop. It does not matter when the last dose of regular medicine was. If he is due for a regular dose when a seizure occurs double the dose to 4 mls and give that after the seizure. There are no too many extra doses just too few. You would only take him to an emergency clinic if he has seizure that lasts longer than 10 minutes or if he has more than 3 seizures in one hour despite giving three extra doses of medication. It is more than three seizures in one HOUR not one day. Three seizures in a day would not be an emergency. I would not give medication until after the seizure is over not when you just suspect one. The ER would know how to stop the seizure they will not want instructions about that. You do not need to change the prednisone dose due to the seizure. The anticonvulsant dose is just not high enough. Allen Sisson

From: Vinh Le
Sent: Monday, January 07, 2013 2:42 AM
To: Sisson, Allen
Subject: RE: Biscuit

Hi Dr. Sisson,

At around 11:00PM tonight, Biscuit had a more violent seizure. The seizure lasted about 4-5min from the point we notice it to it actually stop. It started with Biscuit circling tightly to the right clockwise very rapidly, then I notice his head started to lightly jerks to the right in slow motion. So my wife rush over and started to sooth him and hold him lightly and jerking continue still in light motion. Within a matter of 30sec to 1min, the seizure starts to increase with Biscuit’s mouth starting to twitch and claps on controllably. At around 4min.30sec or so, the seizure seem to stop and Biscuit seem a bit disoriented. When we put him down, he started to pace slowly and seem confused and his legs seem a bit weak.

Since 11PM is his routine interval for 1 Ml, 50mg LEVETIRACETAM (Keppra) we immediately gave him this dose but nothing else. Before the seizure, we notice today that he seem a bit not himself and a bit weary and tire. Before the seizure he was pacing about very rapidly and I had a hunch that something was bugging him.

During our visit, you had mention that unless Biscuit had a seizure lasting more than 10min, and/or twice in the same day, then there is no major reason to rush him to the emergency but to immediately increase some of his med. I don’t recall exactly which so if you could kindly repeat the instruction it would be helpful.

Secondly, if we can see the signs again which could indicate Biscuit is could possibly experience a seizure, should be then apply the higher dose of medication?

If we had to rush him into the ER, do you have any specific instruction for us to pass on to the staff? Like what meds should Biscuit be given and what should not?

Biscuit started to switch over to a lower dose of Prednisone 7.5mg once per day starting on 1/5/13 which has been only two days and the seizure relapse. Does this mean we should go back to the higher dose 7.5mg twice per day right away?

I have recorded the seizure but the file is very large, too large to send in one file. I’ll try to split it up to send you a brief viewing if that helps.

Kindly advise us on what we need to do next.

Thank you Doctor.

Biscuit (@Rainbow Bridge), Pork Chop, and Emmie

Vinh & Ann
San Jose, California

Last edited by vinhle68; 01-07-2013 at 04:12 AM.
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Old 01-07-2013, 05:39 AM   #2 (permalink)
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Name: Bridget
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I am so sorry to hear that Biscuits seizures continue. I wish I had words to ease your fears. Please know that you are in our thoughts. Big hugs to little Biscuit.

"A weed is just a plant whose virtues have not yet been discovered."
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Old 01-07-2013, 05:58 AM   #3 (permalink)
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Vinh, I am so sorry Biscuit is having a relaps in his seizures. Will continue prayers for him.
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Old 01-07-2013, 06:54 AM   #4 (permalink)
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Vinh & Ann, thank you so much for the up-date, even if the news is not all great! Please know that you continue to be on our hearts & in our prayers. I know you suffer each time Biscuit has a relapse---unfortunately it is the nature of the beast when we love so deeply. Bless you both.
I feel you are in the best possible care. Little Biscuit is giving it a good hard try and we can't ask for more than this for now. He seems to have a strong will to keep trying which will help as much as the meds.
I am so sorry that there are not more comforting words. Language falls short in many areas & words on paper can seem quite shallow, but know that we are here w/you for the duration of this journey. Big hugs to you both.
Qui me amat, amet et canem meum. (Who loves me will love my dog also.), - St. Bernard
"Life without a maltese is like summer without ice-cream." - St. Edelweiss

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Old 01-07-2013, 09:45 AM   #5 (permalink)
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I'm really really sorry that you,your wife and especially biscuit are going through this.you are great parents to biscuit and I pray for all of you.
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Old 01-07-2013, 11:52 AM   #6 (permalink)
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I'm so sad that Biscuit is doing well.
MiMi & Sylvie
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Old 01-07-2013, 12:22 PM   #7 (permalink)
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My prayers are with you! I am so sorry that sweet little Biscuit is going through this but praise God that he has you and your wife for such wondeful, caring and committed owners. Keeping good thoughts for you...
Hope and Bella Breeze
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Old 01-07-2013, 12:25 PM   #8 (permalink)
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So sorry Biscuit had a set back. I know how hard it is to watch a fluff go through an illness. Praying that things will stabilize for him. Hoping that the New Year will bring comfort and joy to you and Biscuit will recover quickly. Please keep us posted!! Hugs to you all!
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Old 01-07-2013, 12:37 PM   #9 (permalink)
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I have been anxiously waiting for some news on Biscuit:

don't be discouraged: at this stage I suppose the dosage of medications to be administered is in the trial and error level according to Biscuit's weight and reaction to the treatment.

Eventually his body will respond to the correct amount of medications and he will be back his own self.

Dr. Sisson is there for you day and night for inquiries, which is very encouraging. Know that you are doing all and the best you can, and God will deliver the rest.

We are all thinking of little Biscuit and praying for him that he will get through this difficult stage of his illness.
Malteses are angels on earth
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Old 01-07-2013, 04:07 PM   #10 (permalink)
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Vinh and Ann, I know that the ups and downs must be heartbreaking. Please know that we are thinking of you guys and biscuit ::hugs::
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