PDE Treatment Guide

Because of Payton and her blog, I’ve had the opportunity to talk with many pet parents who have found themselves in the scary place I was when Payton was first diagnosed with PDE.  In the vast majority of cases, the pets having the best success with treatment had three similarities.  Supported by the discoveries of PDE research, there seems to be three primary categories of medicines that when combined have proven to be effective in combating the progress of PDE for months…and even years!  Please make sure you consult your veterinarian – all animals are different.

Anti-seizure medicines will help to combat the seizures associated with the disease.  Various (more than one) drugs in this category are needed because they each work differently and on different parts of the brain.  Examples include Keppra/Levetiracetam, Phenobarbital, Zonisamide, and Gabapentin (which also has pain relief properties).

Immunosuppressive medicines should combat the misguided attack on the brain. A common example, used often in the treatment of cancer, is Cyclosporine.

Anti-inflammatory medicines will help reduce the swelling and pressure on the brain allowing it to function more normally.  A steroid, such as Prednisone, is common.

Liver supplements will also be useful as many of the drugs listed above are metabolized through the liver which can cause damage over time.  Examples include Ursodial, Denamarin, and Vitamin E.  An antacid, such as Pepcid AC, may be beneficial for upset stomach and related symptoms that might result from all the various other medications.

NO vaccines!  Any kind of vaccine, even rabies, can put a pug with a compromised immune system at severe risk and should be avoided.

NO potassium bromide!  Payton’s neurologist believed it is more harmful than good, and no dog really should take it when there are so many other better options available.  Ask your vet.

Dr. Michael Podell was Payton’s neurologist and the person who prescribed the treatment that gave her a wonderful and unexpected long life with us.  The exact medications that worked for Payton are described on one of her blog posts, http://pugnaciousp.blogspot.com/2011/05/paytons-battle-with-pdetreatment.html.  Dr. Podell’s neurology practice is at the Chicago Veterinary Emergency and Specialty Center in Illinois.  His contact information can be found on his webpage, http://michaelpodelldvm.com/Home_Page.html.  He has consulted on other cases around the world after being contacted from someone who found this blog.

Just recently, I found out about a neurologist in Boston who has apparently had remarkable success with his treatment protocol, http://www.mspca.org/vet-services/angell-boston/neurology/treatment-of.html, even achieving remission (not needing medication) in some dogs after a year or two of therapy.  Dr. Allen Sisson is working at the Angell Animal Medical Center, which is part of the Massachusetts Society for the Prevention of Cruelty to Animals (MSPCA).

Be hopeful but realize there are still so many unknowns.  With your veterinarian’s help, you will likely have to test different combinations and dosages and there are no guarantees that any drug regimen will work.  As destructive as the disease is, the medication that helps can have some bad long term side effects. So many drugs, at such high levels, can take its toll on the rest of the body. The key is to finding the lowest levels of drugs to minimize the impact on the body’s other organs (specifically the liver) yet keep the disease from further deteriorating the brain.