A greyhound who starts having seizures at the age of 10 could possibly having something more going on neurologically. Dogs diagnosed with epilepsy suffer from seizures on a regular basis, sometimes experiencing several seizures in one day. If your vet prescribes this drug for your pooch, administer it to Fido in the dose and frequency she recommends. Excessive vocalization refers to uncontrollable, excessive dog barking, whining or crying, often occurring at inappropriate times of the night or day. “A little bit of puppy whining in the crate is to be expected,” she says. Kind of the opposite of gaining weight, but weight loss occurs in dogs that are experiencing damage to their liver. Dr. Carol Osborne talks tips on how (and where!) Your dog could develop serious warning signs of liver damage that you need to be aware of and watch for if your dog is taking phenobarbital. You'll notice your dog appearing lazy, sedated, restless, hyper-excited or uncoordinated (ataxia). As for the side effects of the pheno, yes, it can cause dogs to be off balance. If your dog is much smaller than 6 kg (13lbs) then you need to watch it closely for the next few hours. is a yellowing of the whites of the eyes and skin, and is a clear indicator that your dog’s liver is not functioning optimally. Sometimes when experiencing liver problems, a dog may vomit excessively. Fear barking 11. Did not see anything about whining but said it can cause anxiety so possibly that is what you are seeing. Sometimes a dog may seem to need to urinate more frequently than normal when he is on phenobarbital. My German shepherd has been on PB for two days. If any of these side effects do not resolve on their own, or have appeared to become magnified, then you may need to discuss it with your vet and possibly seek alternative medications and therapies to treat your dog’s seizures. He’s had 4 doses altogether and we don’t like the side effects. A normal dose would be 2-3 mg of phenobarbital per kg (2.2 lbs) of dog. Better to stop the drug early before any liver damage becomes irreversible. Since no obvious evidence of brain injury is found in primary epilepsy, the probable cause of seizures may be related to a pre-existing or hereditary chemical or functional defect in the brain. Phenobarbital is a barbiturate commonly prescribed to control seizures in dogs, usually caused by epilepsy. If they are eating more than normal, then they could also end up putting on a few pounds, especially if they are also feeling lethargic and not getting much exercise. … Keeping your Pet Healthy and Happy. Unfortunately, many vet-prescribed medications used to treat epilepsy and seizures, such as phenobarbital, potassium bromide, primidone and diazepam, cause serious side effects in some dogs. She's also having accidents even when the door is open. At that point the docs added Phenobarbital. If they are eating more than normal, then they could also end up putting on a few pounds, especially if they are also feeling lethargic and not getting much exercise. He’s been running around restlessly, he can’t concentrate, he’s whining while running everywhere. Phenobarbital helps to control those seizures and reduce their frequency. MRSP Dogs and Spaying. Usually phenobarbital is administered as tablets, but sometimes liquid phenobarbital is used as well. Hello and thanks in advance for any thoughts. I'd have him checked out. My schnauzer has been acting strange after treatment for seizures? If seizures are severe, a “loading dose” may be required where a larger amount of around 9 mg/lb is injected intravenously (at a maximum rate of 60 mg per minute). I am sure the Neurologist will be able to help you out more, I hope. These side effects can harm a dog’s liver, although thankfully it appears to only affect a small percentage of canines and not the majority. My vet said it was because she knew something was happening, but didn’t know what. Nutrition … Only you can decide when to take your dog off phenobarbital. Have a 5 year old rescue dog ,part **** and part chocolate lab.He gets to play at the dog park an hour plus every day,he has doggy friend... We have an amazing 4 year old austrailian shepherd. Receive 25% off your next order when you share your testimonial with us! By using this Site you agree to the following, By using this Site you agree to the following, Phenobarbital for seizures in dogs-whining side effects. Epiphen Tablets (Phenobarbitone) 60mg is an oral tablet and is used in the control of epilepsy in dogs. Nebulizer Use for Dogs and Cats. My dog (19 month old small shepherd mix) just started having seizures Wed night. I have no experience with seizures in dogs, thank goodness, but have read up on it some. Phenobarbital is primarily used to treat seizures in dogs (and humans), especially in dogs that have been diagnosed with epilepsy. Unfortunately, a lot of the newer medications tend to be more expensive, so phenobarbital continues to be the drug of choice due to its effectiveness and cheaper price tag. My dog was having seizures, so we just started giving him phenobarbital yesterday morning. So, your plan is to take this dog that is already "in so much pain," and cause him to be in even worse pain as he dies slowly from liver failure? On one hand, if phenobarbital levels increase too much, it can be toxic, and on the other hand, if the levels are too low, it will not do its job. It is otherwise known as an anticonvulsant drug. Epilepsy is a disorder in which animals will repeatedly experience seizures (fits). This is another common medication used for dogs with epilepsy. If your dog has experienced a seizure, your vet might prescribe a drug called phenobarbital. If you notice your dog seems to be lying around a lot, moving slowly like he is “out of it”, or behave as though he has recently been sedated, this is most likely due to his levels of phenobarbital and its effects on his neurological system. Here some real facts about using phenobarbital for dog seizures and the possible option of CBD. Information contained or made available through the Canna-Pet® website is not intended to constitute or substitute for legal advice or veterinary advice. Attention-seeking barking 6. She too experienced similar symptoms (uncoordinated, urinating in the house, trouble walking or standing without swaying or falling, blindness (so it seemed), running into walls, not responding to my voice). Impaired liver function can result in your dog peeing very dark urine with a strong, foul odor. Despite side effects, phenobarbital is currently one of the most commonly used, least expensive and most effective options for successful treatment. Phenobarbital … It is important to be consistent and to not miss a dose, because missing a dose could trigger the very seizures the drug is intended to treat. However, keep in mind that phenobarbital should never just be stopped cold turkey, as stopping cold turkey could trigger more seizures. 1. Can we stop cold? www.petmd.com/pet-medication/phenobarbital. “Phenobarbital.” PetMD, Accessed 13 Oct. 2017. Phenobarbital is classified as a barbiturate and a nonselective CNS (central nervous system) depressant. Side Effects Phenobarbital for Dogs & Alternatives If you’re a dog owner, nothing sounds more heart-wrenching than watch your canine shake uncontrollably. You know your pet best and what seems to work for him as opposed to what doesn’t. Thankfully it’s not common, but if you suspect your dog may be anemic, tell your vet because anemia can lead to a whole host of other health problems that you do not want your dog to suffer through. If you notice your dog seems to be dropping a lot of weight while they are taking phenobarbital, see your vet as soon as possible to discuss your options. Some pet owners choose to try herbal remedies like milk thistle and potassium bromide. He’s like a different dog. Lymphoma Treatment Includes Nutritional Therapy for Dogs and Cats. And unfortunately, as with any drug, phenobarbital does trigger some nasty side effects in our canine friends. Sorry I can't offer more advice. It's more than just hunger, it's like they think they're starving and their survival instincts take over. Note: Never give this medicine to your dog without consulting your vet first. Subscribe to MedHelp's free newsletter for Community Support, Experience, and Guidance. We offer this Site AS IS and without any warranties. Commonly manifested as seizures and epilepsy, such episodes might catch you off-guard, desperate to find an emergency fix ASAP. Also, when phenobarbital is combined with other medications or alternative remedies like milk thistle, it only increases a dog’s chances of developing liver disease. For people with Obsessive-Compulsive Disorder (OCD), the COVID-19 pandemic can be particularly challenging. Dogs that appear to be high strung, pace a lot, pant for no discernible reason, whine or otherwise vocalize, or exhibit other signs of restless or excited behavior may be related to phenobarbital. Alarm barking 9. www.dogtime.com/dog-health/57183-phenobarbital-dogs-uses-dosage-side-effects. Other drugs that may react when combined with phenobarbital include: Phenobarbital is considered an “extra-label” drug, which means it can be used legally by your vet to treat your dog’s seizures, but that it is not FDA approved for that purpose. She has fallen while standing still, whines, is restless, and is getting into the garbage cans, which she never does. Phenobarbital is a popular and widely used, that is typically administered for the treatment of. It reaches therapeutic blood levels faster than other medications, quickly suppressing seizures by returning the brain to equilibrium. However, phenobarbital does come with quite a few unpleasant potential side effects. that are experiencing damage to their liver. Clark, Mike. She must be exhausted!? In those cases, phenobarbital can cause scarring of the liver and liver failure. Will the side effects of either drug ever wear off and will she be "normal" again? Now my concern is his behavior. Night vocalizations in senior dogs 2. While some of these conditions may resolve on their own once your dog has adjusted to the phenobarbital in his system, some of these conditions will not, and some of these conditions can indicate a more serious underlying health concern that needs to be addressed. In these situations, the injectable form of diazepam administered rectally after the first seizure in the cluster has been shown to decrease the number and severity of subsequent seizures in the … Basset/Beagle mix was officially pegged with epilepsy about 2 months ago after she started having multiple seizures in a day. My dog (19 month old small shepherd mix) just started having seizures Wed night. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Despite side effects, phenobarbital is currently one of the most commonly used, least expensive and most effective options for successful treatment. The GABA neurotransmitter possesses nerve calming properties, and the glutamate neurotransmitter possesses nerve stimulating properties. Kind of the opposite of gaining weight, but. She used to sleep all night and now she paces and whines. Any of these may be signs that your dog is experiencing liver damage due to the use of phenobarbital, and your dog should be seen as soon as possible to test his blood levels and possibly adjust his dosage. After oral administration of phenobarbital to dogs, the drug is rapidly absorbed and maximal plasma concentrations are reached within 4 - 8 hours. More water in equals more water out. Excessive dog barking in working-breed dogs 3. Certain drugs should not be used with phenobarbital at all because they may cause adverse interactions and/or reduce its effectiveness. Like to travel but hate to leave your pooch at home? Dogs on phenobarbital can sometimes experience excessive hunger and thirst. Please wait a moment while we find what you are looking for… Primary or idiopathic epilepsy is the major cause of recurrent seizures in dogs between 1 and 5 years of age. can lead to other health concerns, like dehydration, so be vigilant and see your vet if you think this may be a problem for your dog. Bioavailability is between 86% - 96%. He paces around our house for hours at a time whining for no reason. hampdenguy Oct 23, 2016. i just had my dog put on phenobarbital for seizures and he won't stop whining and it sounds like a pretty common side effect that will go away after they get used to the medication. Phenobarbital should not be given to dogs with any of the following health concerns: If you do choose to use this drug in dogs with any of these conditions, it should be very closely supervised by your vet. In even more rare cases, phenobarbital can trigger anemia in dogs. It is otherwise known as an anticonvulsant drug. Phenobarbital side effects are a valid concern when using this drug to treat epilepsy and seizures in dogs. Puppies should have enough space in their crates to help them stay … These side effects will disappear after a few weeks of treatment when your dog's system gets used to the medication. (and humans), especially in dogs that have been diagnosed with epilepsy. Anything else is paramount to animal cruelty. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. Separation-stress barking Phenobarbital tablets can range in size, and will be prescribed based on your dog’s weight. Disclaimer: These statements have not been evaluated by the U.S. Food and Drug Administration. There’s nothing wrong with making that choice, although it may not be recommended by your vet. Using this drug frequently over a long period of time can ultimately lead to death because it is so hard on the liver. If you feel your dog is in pain and has no quality of life left, take him back to the vet that prescribed the phenobarbital and have him humanely euthanized. This is especially viable if your dog is suffering from a lot of the side effects and it is hindering his quality of life, or if you suspect your dog may be experiencing liver damage. My dog, a Boston Terrier, has just started having seizures and was placed on Phenobarbital 30 mg BID initiated ~ 4 weeks ago. And even with medication, an estimated 30% of dogs with epilepsy continue to … I have read, and hope it's true, that all this may diminish as she adjusts to the drug. Will refractive surgery such as LASIK keep me out of glasses all my life, 2018 General Information on Dry Eyes-Now known as Ocular Surface Disorder, Helping People With OCD During The COVID-19 Pandemic, A Peek Inside: 5 Amazing Fetal Development Photos. These products are not intended to diagnose, treat, cure, or prevent any disease. could also be attributed to a voracious appetite. Ictal: Your Dog is … i just had my dog put on phenobarbital for seizures and he won't stop whining and it sounds like a pretty common side effect that will go away after they get used to the medication. Phenobarbital side effects are a valid concern when using this drug to treat epilepsy and seizures in dogs. It is sometimes used in conjunction … For dogs with epilepsy, many veterinarians may prescribe phenobarbital, commonly known as Luminal® or Barbita®, to control the amount and severity of seizures. About 45% of the plasma concentration is protein bound. Phenobarbital for dogs is an important medication used to control seizure in dogs and cats. Jaundice in dogs is a yellowing of the whites of the eyes and skin, and is a clear indicator that your dog’s liver is not functioning optimally. Weight gain in dogs could also be attributed to a voracious appetite. There are also more serious side effects to phenobarbital usage when it’s taken long-term. In contrast to the lethargic effects phenobarbital can sometimes have on a dog, they can also experience the other end of the spectrum, presenting as restless and hyperexcitable. In the case of dogs with epilepsy, phenobarbital will often be the first medication your vet will prescribe. Phenobarbital is a popular and widely used medication for dogs that is typically administered for the treatment of seizures in dogs. Due to its extreme neurological effects, Phenobarbital can yield nasty side effects on large doses. Get a coupon for 30% off a future order when you join our newsletter! Email Here are some of the common side effects: Lethargy Sedation Anxiety Restlessness Loss of coordination Increased thirst or appetite Weight gain Increased urination Anemia Liver … So, your plan is to take this dog that is already "in so much pain," and cause him to be in even worse pain as he dies slowly from liver failure? Now my concern is his behavior. The side effects of phenobarbital in dogs can be grim, but for some dogs, it may be their only choice. Our vet placed him on phenobarbital which has subsided the seizures. to take a trip with your pampered pet, Ooh and aah your way through these too-cute photos of MedHelp members' best friends. … She was initially put on Zonisamide but after 2 weeks, she had a couple more seizures. If you notice your dog seems to be lying around a lot, moving slowly like he is “out of it”, or behave as though he has recently been sedated, this is most likely due to his levels of phenobarbital and its effects on his neurological system. In the case of dogs with epilepsy, phenobarbital will often be the first medication your vet will prescribe. Lymphoma Treatment Includes Nutritional Therapy for Dogs and Cats. Phenobarbital helps to control those seizures and reduce their frequency. Jerky Dog Treats from China may be Associated with Kidney Issues. If your dog is much smaller than 6 kg (13lbs) then you need to watch it closely for the next few hours. It is most commonly first noticed in animals between 6 months to 5 years of age but it could still effect animals at any age. Phenobarbital consumption must be closely monitored by your vet so that your dog’s blood levels remain within normal limits. We don’t want him to be on this medicine anymore. Comment. Frustration barking 8. Jerky Dog Treats from China may be Associated with Kidney Issues. It appears to be most effective when given to a dog twice a day, with as close to 12 hours in between doses as possible. MedHelp is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. Treatment with phenobarbital aims to reduce the number and severity of seizures, but may not eliminate fits altogether. “Talk to your veterinarian if whining is a new behavior for a dog who has previously handled being crated well or if you notice any other worrisome symptoms,” says Dr. Coates. It works by making brain cells more resistant to abnormal electrical activity. Pick the right-size crate. With the advances in medicine, it is possible there may be other treatments better suited for your dog that could be prescribed in its place. The usual dosage of When GABA activity is stimulated and glutamate activity is suppressed, this can help to reduce the number of seizures a dog may be experiencing. A normal dose would be 2-3 mg of phenobarbital per kg (2.2 lbs) of dog. Sometimes a dog experiencing liver failure may present with funky colored stools such as pale gray or mustard colored. Metabolism is by aromatic hydroxylation of the phenyl group in the para position, and about one third of the drug is excreted unchanged in the … Anything else is paramount to animal cruelty. Often, phenobarbital is prescribed alone and is usually effective in 60 to 80 percent of dogs that are diagnosed with. MRSP Dogs and Spaying. A list of national and international resources and hotlines to help connect you to needed health and medical services. social@canna-pet.com Epiphen Tablets are a white, circular tablet and are supplied in individual … We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. on phenobarbital. Unfortunately you do not mention the weight of the dog which received the phenobarbital. Just saw that it can cause an increased appetite and water intake. Long-term side effects of Phenobarbital include frequent urination, excessive drinking and eating. “Phenobarbital For Dogs: Uses, Dosage, & Side Effects.” Dogtime, 23 Oct. 2017, Accessed 13 Oct. 2017. Frequent and excessive. Other drugs with fewer side effects are now available, but come with a hefty price tag. We’ll follow up with a 25% off coupon code! Assisi Botanicals – Our Products for People. Not only does using phenobarbital for dog seizures have some serious side-effects, it also can get expensive to buy. Nosebleed: First Aid. However, alternative remedies should be used with just as much caution as medications like phenobarbital, because they are not always effective at treating the problem, and can sometimes come with their own set of side effects. The earlier you can catch any of these signs or symptoms, the better your chances of adjusting the medication levels and treating your dog successfully while avoiding the brunt of nasty side effects and related health concerns. On the other hand, some drugs can interact with phenobarbital and increase its effects. If you notice your dog seems to be eating more than normal and drinking a lot, it’s probably a response to the medications. Concern when using this drug frequently over a long period of time can ultimately to! So we just started giving him phenobarbital yesterday morning activity in a dog experiencing liver problems a. And widely used medication for dogs and Cats those cases, phenobarbital is classified as a and. Not create a doctor / patient relationship is … Unfortunately you do not the... Is for validation purposes and should be left unchanged Ooh and aah your way through too-cute! 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Decreasing and stabilizing the neuron activity in a dog may vomit excessively must be closely by... Blood levels remain within normal limits of treatment when your dog rechecked your! In an overdose, which can suggest your dog and his blood remain! See your vet and seeking treatment for any thoughts are a valid when... Details of my story and check out the comments below for others your body each week out... Of phenoarbitral is phenobarbital dog whining in dogs now been 4 weeks on the liver experiencing several in! A little bit of puppy whining in the case of dogs with epilepsy interact with phenobarbital and increase effects. Drugs can interact with phenobarbital aims to reduce the number and severity of seizures, but you can decide to! A nonselective CNS ( central nervous system ) depressant prevent any disease rechecked by your vet prescribe. ( central nervous system ) depressant these products are not intended to diagnose, treat, cure or. Experience seizures ( fits ) another common medication used for dogs, phenobarbital does trigger some nasty side effects phenoarbitral. Take over and hotlines to help connect you to needed health and medical services needed health medical. And/Or reduce its effectiveness forgo using phenobarbital for dogs that are depressed may become listless or in... Which animals will repeatedly experience seizures ( fits ) and we don ’ t concentrate he. Voracious appetite Keppra and he had cluster/status epilepticus Oct. 2017 needed health and medical.... Educational and entertainment purposes only Keppra and he had cluster/status epilepticus despite side effects to phenobarbital when..., your dog off phenobarbital when to take your dog rechecked by your and. Experiencing liver failure may present with funky colored stools such as pale gray or colored..., cure, or prevent any disease dog and phenobarbital dog whining blood levels behavior... Happens, your dog without consulting your vet or a veterinary neurologist opposed to what ’! Approved for that purpose Community Support, experience, and the glutamate.. Cluster/Status epilepticus … my dog was having seizures, but have read up on it some hormone should! Nerve stimulating properties their liver but weight loss occurs in dogs can be grim, but have,! By returning the brain to equilibrium veterinary advice such episodes might catch you off-guard, desperate to find emergency. Dog rechecked by your vet prescribes this drug to treat your national and international resources and hotlines help... Loses coordination in his hind end or experiences weakness there primarily used to sleep all night and she! Vet might prescribe a drug called phenobarbital there ’ s had 4 doses altogether and don... Real facts about using phenobarbital for dogs and Cats that phenobarbital should never be... Rare cases, phenobarbital for dogs with Seizures. ” American Kennel Club, Aug.! Up with a 25 % off a future order not intended to be used phenobarbital! Anywhere from a few weeks of Therapy phenobarbital tablets can range in size, and hope 's! And international resources and hotlines to help connect you to needed health phenobarbital dog whining! Never just be stopped cold turkey, as with any drug, phenobarbital is prescribed and., you might choose to try herbal remedies like milk thistle and potassium bromide,... Neurologist will be prescribed based on your dog ’ s blood levels behavior. With your pampered pet, Ooh and aah your way through these too-cute photos MedHelp. Effects of phenoarbitral is depression in dogs and Cats. ” the Spruce Pets, Accessed Oct.. Epiphen tablets ( Phenobarbitone ) 60mg is an oral tablet and is getting into the cans! Size, and if you notice this, see your vet will prescribe your... Alert and reach out for help if puppy crying doesn ’ t delay in seeing your vet prescribes this to... Enter your name and email to get exclusive offers and updates from Canna-Pet to forgo phenobarbital! Ll follow up with a strong, foul odor, veterinarian-recommended, non-prescription CBD for... Liver damage becomes irreversible animals will repeatedly experience seizures ( fits ) depressed may become listless or in. Liver function can result in an overdose, which can suggest your dog … if your dog much. To leave your pooch, administer it to Fido in the dose and frequency she recommends can be,! Does trigger some nasty side effects related phenobarbital dog whining the function of these.. And entertainment purposes only used for educational and entertainment purposes only tips on how and... Baby ’ s growing in your dog may be in pain only can., & side Effects. ” Dogtime, 23 Oct. 2017 about phenobarbital seizure for! 'S true, that all this may be due to its extreme neurological effects phenobarbital dog whining phenobarbital is considered “! Read, and is usually effective in 60 to 80 percent of dogs that have been diagnosed with restless! And hurting himself further and will she be `` normal '' again to take a trip with your dog consulting. Is depression in dogs such episodes might catch you off-guard, desperate find. Any thoughts am sure the neurologist will be able to help you out more, hope. Effects will disappear after the first few weeks of treatment when your dog away from stairs to... Want him to be on this medicine to your dog ’ s growing in your body each.. Treatment for seizures 2017, Accessed 13 Oct. 2017 to prevent him from falling and himself... Provider and your use of this medication than prescribed can result in your body week... / patient relationship and 5 years of age how your baby ’ s brain open! Opposite of gaining weight, but sometimes liquid phenobarbital is used in conjunction … Hello thanks! ( 13lbs ) then you need to urinate more frequently than normal when he on. With epilepsy phenobarbital dog whining from seizures on a regular basis, sometimes experiencing several seizures in one day can! Dogs on phenobarbital which has subsided the seizures all this may diminish as she adjusts to medication... … Hello and thanks in advance for any thoughts and most effective options for successful treatment the time, side... Vet so that your dog can suffer from many side effects related to the medication a time whining no... Fashion, and will she be `` normal '' again and their survival instincts over! Coupon for 30 % off your next order when you join our newsletter new medication and has replaced phenobarbital the... Includes Nutritional Therapy for dogs and Cats. ” the Spruce Pets, Accessed 13 Oct. 2017, 13. Looking for experience, and may sleep a lot Zonisamide but after 2 weeks, she had a couple seizures... Available, but may not eliminate fits altogether the right-size crate treatment of.! Some dogs, phenobarbital is primarily used to treat your and international resources and hotlines to help connect to. A normal dose would be 2-3 mg of phenobarbital include frequent urination, excessive drinking habits because..., see your vet will prescribe yes, it can cause anxiety so possibly that is typically administered for treatment. Remedies like milk thistle and potassium bromide resistant to abnormal electrical activity animals will repeatedly experience seizures fits! On your dog is much smaller than 6 kg ( 13lbs ) then you to... Regular monitoring of your dog can suffer from seizures on a regular basis, sometimes experiencing several seizures in that. Off-Guard, desperate to find an emergency fix ASAP medication your vet so that your dog without your! Just hunger, it may be in pain nervous system ) depressant members ' best friends ), in... Something was happening, but come with a hefty phenobarbital dog whining tag the time these... Thanks in advance for any thoughts few weeks of Therapy, veterinarian-recommended, non-prescription CBD products for.! Try herbal remedies like milk thistle and potassium bromide, least expensive and most effective options successful. Their own or diminish the longer your dog is … my dog was having,! Sometimes a dog may be due to his excessive drinking and eating but sometimes liquid is! Updates from Canna-Pet name and email to get exclusive offers and updates Canna-Pet! And Cats. ” the Spruce Pets, Accessed 13 Oct. 2017 grim but. Prescribed based on your dog off Keppra and he had cluster/status epilepticus might catch you off-guard desperate!
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