Can Seizures in Dogs Be Controlled with Progesterone?

Controlling Dog Seizures with Progesterone

“My 5 year old dog has been having seizures for years. She still has a seizure about every 4 weeks or so, and there is no obvious trigger. She has been on Keppra with her phenobarbital, but it does not seem to help, so I am no longer giving that.

I’m interested in trying progesterone as an adjunct therapy with her 90mgBID phenobarb. I’ve read that it’s useful in women’s catamenial epilepsy?” – Jennifer

Epilepsy and the Ketogenic Diet

The first thing to do in a case of epilepsy that does not respond to the conventional treatments is a ketogenic diet. This diet will provide an alternative energy source for your dog’s brain and has been shown to be effective in cases of canine epilepsy. You can read about how to make this diet at home in this article. In some cases, the seizures stop, and in others, there is a decreased frequency of seizures.

You are correct in that the relative balance of hormones alters the seizure frequency. If your female dog is not spayed, there is a possibility that progesterone will be beneficial since it lowers the seizure threshold. In one study, 38% of dogs had their first seizure during their heat, and 13% had their seizure within 1 to 3 months of coming out of heat. (1) Estrogen has proconvulsive effects, and progesterone has a protective effect against seizures.

If your dog is spayed, however, I do not see that giving any additional progesterone has any benefits. Hormone fluctuations have been measured in humans, but if she no longer produces estrogen, then there is going to be no change in the relative progesterone/estrogen levels that will provoke seizures in some dogs.

My main concern with using the progesterone therapy is the side effects. I have actually dealt with a lot of progesterone side effects since medroxyprogesterone acetate is sold OTC here at almost all feed stores. People who cannot afford to take their dog to a vet to be spayed use it as a birth control method. Some of the problems of giving progesterone (2) include:

• pyometra
• mammary hyperplasia
• mammary tumors
• weight gain
• liver failure
• kidney failure
• diabetes (insulin resistant)
• adrenal cortex suppression

Monitor Your Dog Closely

If for some reason you are against having her spayed and you still want to try this since she is not responding to medications, do not do so for more than 3 months, so you can monitor it closely. If your dog has a seizure during the progesterone trial, I would recommend you stop using it.

Progesterone Dosage for Dogs

Because of the potential side effects, the dose needs to be very low. In humans, one dose tried was about 1 milligram per kilogram, but this was only used for 6 days of each monthly cycle. (3) In dogs, it has been used short-term to maintain pregnancy in pets with a history of pregnancy failure, at 5 to 10 mg per kg, but there are few controlled studies. One study that compared very low dose progesterone to other doses (0.83, 0.25, and 0.75 mg per kg) noticed obesity and uterine changes at all doses. Some of the dogs on the higher dose also developed mammary tumors. (4)

In some countries, an injectable form of progesterone is available in feed stores. A safer alternative is to get an oral prescription from your regular veterinarian, the person who prescribes the phenobarbital. You can print this article and take it in so that they can see the dose recommended and read the references.

As I mentioned above, I do not think this is going to help. If you decide to do so, however, and your dog responds, please let us know so we can update this article and make it more useful to readers with epileptic dogs.

Sources

1. Van Meervenne SA, Volk HA, Van Ham LM. Association between estrus and onset of seizures in dogs with idiopathic epilepsy. J Vet Intern Med. 2015 Jan;29(1):251-3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4858085/
2. Wiebe VJ, Howard JP. Pharmacologic advances in canine and feline reproduction. Top Companion Anim Med. 2009 May;24(2):71-99. doi: 10.1053/j.tcam.2008.12.004. PMID: 19501345; PMCID: PMC7104932. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7104932/
3. Motta E, Golba A, Ostrowska Z, Steposz A, Huc M, Kotas-Rusnak J, Łuszczki JJ, Czuczwar SJ, Lasoń W. Progesterone therapy in women with epilepsy. Pharmacol Rep. 2013;65(1):89-98. doi: 10.1016/s1734-1140(13)70967-8. PMID: 23563027. https://pubmed.ncbi.nlm.nih.gov/23563027/
4. Capel-Edwards K, Hall DE, Fellowes KP, Vallance DK, Davies MJ, Lamb D, Robertson WB. Long-term administration of progesterone to the female beagle dog. Toxicol Appl Pharmacol. 1973 Mar;24(3):474-88. https://www.sciencedirect.com/science/article/abs/pii/0041008X73900549

This article is not meant to substitute for diagnosis, prognosis, treatment, prescription, or formal and individualized advice from your veterinarian. Animals exhibiting signs and symptoms of distress should be seen by a veterinarian immediately.

© 2024 Mark dos Anjos, DVM