Veterinary 2025 Guide: Levetiracetam (Keppra®) for Seizures in Dogs & Cats 🐾🩺

Hi! I’m Dr Duncan Houston BVSc. In this detailed 2025 guide, we cover the safe and effective use of levetiracetam—commonly known as Keppra®, Elepsia® XR, Spritam®—for managing seizures in dogs and cats. This evidence-based article explores its pharmacology, indications, dosing options, side‑effect profile, monitoring, and practical tapering advice, with support from Ask A Vet tools 😊.

🔍 1. What Is Levetiracetam?

Levetiracetam is an anticonvulsant used off‑label in veterinary medicine for refractory epilepsy and seizure management in pets :contentReference[oaicite:3]{index=3}. It’s cleared via the kidneys, making it a good choice for pets with impaired liver function :contentReference[oaicite:4]{index=4}.

⚙️ 2. Mechanism of Action

Levetiracetam modulates neurotransmitter release by binding to the SV2A synaptic protein, preventing the cascade of seizure activity :contentReference[oaicite:5]{index=5}.

🎯 3. Clinical Uses in Veterinary Medicine

• Adjunctive therapy for idiopathic epilepsy, cluster seizures, status epilepticus, and hepatic encephalopathy-related neurologic signs :contentReference[oaicite:6]{index=6}.
• Monotherapy in pets unable to tolerate phenobarbital or bromides :contentReference[oaicite:7]{index=7}.

💊 4. Formulations & Dosing Schedules

• Immediate-release tablets/liquid: Typically 20 mg/kg PO every 8 hours (TID) in dogs; adjust per vet recommendation :contentReference[oaicite:8]{index=8}.
• Extended-release tablets (XR): May allow twice-daily or once-daily dosing; do not split or crush :contentReference[oaicite:9]{index=9}.
• Cats: Typically dosed Q8–12h; common signs are sedation, appetite changes, drooling :contentReference[oaicite:10]{index=10}.

⏰ 5. Missed Doses & Discontinuation

• Give dose when remembered unless it's near the next scheduled time—don’t double up :contentReference[oaicite:11]{index=11}.
• Never stop abruptly: Taper off slowly to avoid rebound seizures :contentReference[oaicite:12]{index=12}.

⚠️ 6. Adverse Effects

• Common: drowsiness, ataxia, vomiting, diarrhea, appetite changes; more frequent at higher or pulse doses :contentReference[oaicite:13]{index=13}.
• Behavioral changes—anxiety, aggression—can occur in both animals and humans :contentReference[oaicite:14]{index=14}.
• Rare but serious: hypersensitivity (DRESS syndrome: fever, rash, lymphadenopathy)—be alert, especially weeks after starting :contentReference[oaicite:15]{index=15}.

📋 7. Monitoring & Safety

• No standard blood monitoring needed, but baseline CBC and renal function are prudent :contentReference[oaicite:16]{index=16}.
• Watch for neurologic signs, GI upset, or systemic reactions—adjust dose or discontinue as needed.
• Adjust dose for renal impairment—since it’s renally excreted; less adjustment needed for hepatic disease :contentReference[oaicite:17]{index=17}.

🔄 8. Drug Interactions

Minimal drug–drug interactions, but caution when co-administering with antihistamines, benzodiazepines, gabapentin, opioids, and methotrexate :contentReference[oaicite:18]{index=18}.

📊 9. Clinical Tips & Case Use

• Use as part of polytherapy to reduce doses of liver-metabolizing drugs :contentReference[oaicite:19]{index=19}.
• Consider pulse dosing (loading then taper) for cluster seizure control—persistent mild effects noted :contentReference[oaicite:20]{index=20}.

🔚 10. Vet Takeaways for 2025

• Safe, kidney-cleared anticonvulsant ideal for liver-impaired patients.
• Supports both monotherapy and adjunct use in chronic seizure management.
• Common side effects are mild; monitor for behavioral or severe systemic signs.
• Ensure consistent dosing and safe tapering to prevent rebound seizures.
• Minimize drug interactions; adjust dosage in renal patients.
• Use Ask A Vet app for dosing reminders, seizure tracking, behavior logs, and direct veterinary support 😊.

At Ask A Vet, we offer seizure log tracking, medication reminders, and 24/7 veterinary access—supporting both clinicians and pet parents in achieving safer seizure control and improved quality of life. Download the app today! ❤️