Daytime and nocturnal activity in treated dogs with idiopathic epilepsy compared to matched unaffected controls

Abstract

Background: In dogs, antiepileptic drugs (AED) cause lethargy but quantitative data regarding the effects of AED on activity levels are not available, and little is known about how AEDs affect sleep quality.

Objective: To quantitatively compare activity levels and nocturnal activity in dogs previously diagnosed with idiopathic epilepsy (IE) receiving AEDs compared to age- and breed-matched control dogs.

Animals: Sixty-two dogs with IE and 310 control dogs.

Methods: This is a 3-month prospective parallel observational study. An activity monitoring device for dogs was used to measure daily activity levels and sleep scores in all dogs.

Results: Dogs with IE treated with AEDs had an 18% average lower baseline activity level compared to control dogs (P = .005; point estimate = 0.82, 95% confidence interval [CI], 0.75-0.90). The combination of phenobarbital and potassium bromide (KBr) was associated with an average 28% decrease in activity in dogs with IE compared to control dogs (P = .03; point estimate = 0.72; CI, 0.62-0.82). Mean sleep scores were not significantly different in dogs with IE receiving AEDs compared to control dogs (P = .43). However, higher dosages of KBr were associated with lower sleep scores (P = .01).

Conclusions: Dogs with IE receiving AEDs have lower activity levels, but no difference in sleep scores, compared to controls. The combination of phenobarbital and KBr had the largest decrease in activity between groups. Higher doses of KBr may affect nocturnal activity in epileptic dogs.

Keywords: antiepileptic drugs; canine activity monitoring device.

FIGURE 1

Scatterplot of 3‐month averaged daily activity levels in 62 treated dogs with idiopathic epilepsy (IE) assessed with accelerometry collars, compared to data from 310 breed‐ and age‐matched unaffected, untreated control dogs from the manufacturer's database (P = .005 between groups). Dogs with IE had a mean activity level of 6710 activity points compared to a mean of 8208 activity points for control dogs

FIGURE 2

Slope chart displaying subgroup analysis of activity levels for different antiepileptic drugs (AED) combinations in dogs with idiopathic epilepsy (IE) compared to control dogs. Each line represents 1 dog with IE and the average activity of the 5 matched control dogs. Blue lines correspond to the dog with IE having a lower activity level than the controls. Pink lines correspond to the dog with IE having a higher activity level than the controls

FIGURE 3

Scatterplot of 3‐month averaged nightly sleep scores in 62 treated dogs with idiopathic epilespy assessed with accelerometry collars, compared to data from 310 breed‐ and age‐matched unaffected, untreated control dogs from the manufacturer's database. The mean sleep scores of epileptic dogs receiving antiepileptic drugs (AED) therapy (84.6%) was not significantly different than sleep score of age‐ and breed‐matched control dogs (83.6%; P = 0.49)

FIGURE 4

Linear regression model of dogs with idiopathic epilepsy showing relationship between dosage of potassium bromide (KBr) and the 3‐month average sleep score. This model includes covariates for age, sex, and all antiepileptic drugs (AED) dosages. The green line shows sleep score predictions for a range of KBr dosages, averaged over the other covariates, and indicates higher dosages of KBr are associated with lower sleep scores (ie, more restlessness)