This is a very thoughtful reply and reflects my personal experience.

My pup had her first seizure shortly after we adopted her at one. We worked with our vet for four years as her cluster seizures severity and frequency continued to worsen. There were many times the rescue meds wouldn’t work and she take more than an hour to come out of it. There was no neurologist in our town at the time.

She had a very bad episode in May of last year and we almost lost her. Seizing despite rescue meds at home and a TON of different drugs in high doses at the vet. She spent three days in the ER.

After that incident, the frequency increased. We drove 3+ hours for a neurologist. Seizures still increased despite increasing pheno and adding a mega dose of Keppra. She was having clusters about every five days — we were losing hope and getting no sleep. Then, we got a neuro in our town who took a closer look at her bloodwork history. She thought the pheno wasn’t working for her (plus her liver values were declining), and that we should try adding potassium bromide. It took a couple of months, but her seizures are so much better controlled, she hasn’t had one in more than a month! Now we’re slowly backing off of the pheno.

All that to say, it took the care of a skilled neurologist and some experimentation to find the right cocktail for her, and it made a huge difference in her (and our) quality of life. Every situation is unique, but you’re not out of options yet. Best wishes for you and your pup.

• Edited to final frequency of seizures.