Been a long time

Wow, been ages since I came and updated this.

Mainly because there's been so little to say. Things have been going as they always have. Seizures still kicking around at about once a month. But that's nothing new. That said I turned 11 years old yesterday, happy birthday to me. The seizures really are nasty horrible things, but so far I've the strength to handle them. Takes some getting over as I get older, I have to sleep it off a bit more.

Late last year dad weaned me off the KBr completely. It's been no change at all for the seizures in terms of frequency or impact. So I guess it did little for me and only drained dad's wallet faster. After telling the vet that's what we'd done he was surprised, but couldn't argue with the fact that they obviously did nothing for me.

The vet still wanted to do blood tests. They do this every visit. I'm convinced it's just a way of topping up their revenue as the results are never meaningful. Dad explained that I'm an old girl now and it's a bit too late to be worried about any impact the epiphen may be having on my liver and there seemed less of a point to checking that the levels of the drug where still at a medicinal value in my blood.

Nothing's changed. No more regular, less regular, bigger or lesser impact - they're just seizures. We just deal with it these days.

Ahh well time for another trip to the vet

Nothing bad, just the regular medication review so we can buy another prescription and get sold some more blood tests.

This weekend I had another cluster. First time for a while really. The seizures were unpredictable as ever. Most of them were the jump up and run blindly into walls type. These are the worst as getting mum or dad to catch me before I clatter into things is almost impossible. I flooded the living room by knocking over a full mop bucket that was stood by for the seizures.

Dad had to work from home as I started having seizures through Monday and into Tuesday night. So on Tuesday night I was so hyper I was up and down stairs constantly. Then pacing around the bedroom until Dad finally gave in and took me downstairs and stayed with me. All I wanted was him to be there so I could sleep. I don't think he slept too well on the sofa as he then took the day off to catch up with some sleep.

As we'd run out of tablets dad had arranged a visit to the vet on Tuesday anyhow. So I got a bath before we went and then he had to help me into the new car. So much for it being a bigger car. The rear floor is higher off the ground and that means the roofspace is also a bit lower. Dad has to help me in because it's higher.

The vet played their usual game. Wanting us to have blood tests for kidney performance, but more importantly KBr and epiphen levels. We know this is just a money making scheme for them as quite often we never get any results. Or when we do everything is at the right levels and as high as they can be. So I can't have any more medication even if  they wanted me to. The tests are pointless.

So dad played the game too. Oh, dear we ran out of tablets and I never had any this morning. So the vet can't do a blood test if I've missed my tablets (which I hadn't).

I also continue to be on half the dosage that the vet prescribes. I've been on the half dosage for 6 months now and there is no difference in the regularity or length of the seizures. All that's happened is I'm a bit more steady on my feet. The most important difference is we now don't pay the vet so often for prescriptions and consultations as the tablets last twice as long - I'm sure they'll cotton on at some point.

But by way of demonstration we ordered 1 week of tablets from the vet to cover me until the online ones get shipped. Here's how the prices worked out:

Price per tablet
30mg Epiphen - vet price = £0.50, online price = £0.10
60mg Epiphen - vet price = £0.53, online price = £0.14
325mg KBr - vet price £0.66, online price = £0.31

So for the price of ONE weeks medication from the vet I could by two and half weeks worth online. In just one week we save £35.62 over vet prices.

It's been a while

It's been a while ... and that's a good thing. For some time now I've not really had much to write about. Since getting back on the medication in February I had a couple of seizures last month that we thought were the start of a cluster, but were just single episodes. It's not until this week when things started to go a little south. But then again that may be down to running out of tablets. So annoying.

Dad got two prescriptions for me last month. He talked nicely to the vet and they wrote two separate prescriptions thinking that we'd then be able to buy one months medication and then renew the following month. So rather than laying out two months of cash he'd be able to spend monthly to lighten the load.

Well, you know how the best laid plans go. Dad placed the order for the second month and paid for them. As there was no major rush left the postage as second class. So Friday last week things are getting tight and still no tablets. Well turns out that the legislation has changed (or so we are told) so that a prescription must be filled within 28 days of writing, which is impossible for monthly amounts. So whilst the order was accepted nothing was shipped as they are waiting on a new prescription. Communication failure! We are not mind readers :(

So Monday there are no Epiphen tablets and it takes a day off work to go get another prescription and some tablets to last until the ones we're waiting for get shipped.

Of course this means Monday a seizure starts. Maybe a one off? Sadly not. Wednesday there were a few seizures and then sometime Wednesday night/Thursday morning I have the seizure that scrambles my brain. It reverts me back to a puppy state. Dad says it "puppyfies" me. I lose my house training and I'm all wired and hyper. Add to that not wanting to be left alone dad ends up sleeping on the sofa (well lying on it whilst I keep waking him up) so I can be in the same room.

It's hard to say for sure if it's related to missing some tablets or it's coincidental. But it is annoying that we end up unsure. It's cost dad two days off work this week as he's was far too tired to go in today. Not that I noticed because I'm busy being bouncy and wanting attention and putting my nose in everyone's face :)

Battling Back Up the Hill

Well dad's having to admit to making quite a big mistake, and one that's cost us rather a lot of anguish.

Back in November a few things conspired to make life a bit difficult. With Christmas coming up dad's car decided to self destruct. This would be the second replacement engine this year. So there was the cost of that and having to use alternate transport for work.

Dad's boss decided to be a dick and decided that he shouldn't bring me in to work anymore. That wouldn't have been so bad if he hadn't used the excuse that his boss didn't approve and it was under his instruction that I shouldn't go to work anymore. So having asked directly in front of a number of he said that he hadn't suggested any such thing and it was fine to take me to work. So we all know what a two faced lying git dad's boss is now then.

Not being able to take the dog to work, not having a big enough car to take me in, and not really having the funds it resulted in me taking a break from my medication. We knew this wasn't going to be too smart so we at least did it gradually, until the pills ran out.

The effect wasn't that dramatic at first. Seizures were just the same as they always were and about as regular. That was up until late January. Then things got worse. The seizures were more frequent and I spent more time recovering from them that life really wasn't worth living.

We finally organised a visit to the vet local to home and planned on getting a prescription sorted as soon as possible. Just before getting in the car to go to the vets off I went into another seizure. When I got there I was all panty and out of breath.

The vet was very helpful and didn't over complicate matters, simply gave me the once over and sorted out the prescription I was on previously. We also got a weeks supply of tablets there and then, so we could start straight away and wait for the larger delivery later in the week.

I guess now we know the drugs and quantity that I was on where doing something and were pretty high doses. Day one dad gave me some Diazepam to immediately suspend the seizures. We expected that to make me dopey. But over the next 3 days the Epiphen and KBr just about knocked me out. I couldn't stand and even ate my dinner lying down with my head in the bowl. I spent most of the time sleeping.

After the initial 3 days I began to get a bit more active. I'd try to stand but was very clumsy walking into walls, doors and furniture. The picture is of me giving up on getting into bed. I'd climbed half in and just decided to stay there.

7 Days later and I'm much better. It's hard work standing up, but once I'm up I can get around. So dad's been taking me out for walks first up and down the driveway and then out to the park to get me moving my legs some more.

Things are going well. I'm getting better every day.

Walking my Legs Off

Well things are going well since the last round of seizures. I guess we're waiting on the next cluster as it's over due. But let's not worry about that until it happens. A bit of a medication increase in the KBr to 5 x 325mg tablets twice a day and still with 180mg Epiphen twice a day - that's 8 tablets! Then dad's also got me on 1500mg of Glucosamine HCL too - and that tablet is huge.

Now that Blaine's found a girlfriend who also has dogs in their family he's always taking me out for a walk with them. Sometimes I can be gone all day when he's away from college. I then have to sleep off all the fresh air as soon as I get home. In fact sometimes it's taken a couple of days for me to recover. But I can't complain I getting out an having fun with other dogs.

Since getting the new bed I'm now able to stay on it without sliding off. I still use all my other places for naps around the house, but the bed is still for my main snooze.

Back to the Vet

After the vet phoned dad with the results of the blood test - no big surprises, the KBr and Epiphen levels are well within the therapeutic range. The vet also said she was reluctant to increase my dosage on either drug as I'm taking a relatively high dose already. The risk is we then start getting negative side affects that outweigh the required effects of the drugs anyhow.

So the outcome was another blood test. This time a more general set of test to investigate liver and kidney function. Just to be sure that they are metabolising the drugs properly to make sure that even though the drugs are in my blood that my body is making proper use of them. As the vet is otherwise at a loss as to why the drugs aren't as effective in seizure control as she thinks they should be.

So we got there in plenty of time even though dad left late. When we saw the vet it was the same routine. They took me away from dad and off into a back room to take the blood. They had some trouble getting enough as they wanted quite a bit for these tests. So they took some from my neck too. So I have a nice bandage on my leg for an hour and a shaved part on my neck.

I'm sure dad wonders why they take me out the back to take blood, maybe he thinks they're vampires?

Edit: Here's what they shaved on my neck!

Winning

Following on from Yesterday dad and I got a good nights sleep. Maybe that has something to do with my Diazepam and dad's exhaustion. Still feeling spaced out like first day in rehab, but a whole lot better than yesterday.

Dad got up to give me the last of the Diazepam this morning and found I'd left mum a big pile at the bottom of the stairs (don't know why it was for mum, but dad didn't want it). This isn't unusual as after a cluster and I'm in recovery I lose some of my training and forget how things work. Like going upstairs right now is out of the question, and getting in the back of the car - my favourite place in the whole world - needs some help.

But the good thing about this morning was two breakfasts - winning! Dad gave me my tablets and breakfast, then let me out. Then when mum got up for work she gave me breakfast too, and I didn't waste any of it.

Later we went off to the vets and dad had to lift me into the back of the car. I couldn't figure out how to get in. At the vets he had to help me out to as it seemed awfully high in the air.

The vet checked me over and spoke with dad and we arranged to go back next week for a blood test. The irony of which isn't lost on dad, since the previous Friday he refused to have one done at our usual vets because a) they aren't cheap, b) no one reports any of the results and c) the medication hasn't changed since the last three blood tests.

So the vet was very nice and I really think they must hate the Internet because it gives everyone access to so much information. The vet said they could do blood today, but dad asked about the effect of the Diazepam on the results as "Diazepam increases the serum levels of phenobarbital" and Epiphen (phenobarbitone) falls into this category. So instead we're going back on Tuesday night.

The vet also said she wasn't charging us for this visit, which was nice as it really was a flying visit. In, quick listen to my chest, a chat with dad and out again in 5 minutes.

So things are definitely looking positive. I'm in my usual recovery situation, timid, a bit confused and slow, but as expected. This being the biggest scariest most stressful episode, but not unique - we still remember back to January 2010, when we thought the Epilepsy had run it's course then too.

Just Mad About Snow

Mum and dad took me out for a walk in the snow yesterday. It was great fun. We went all along the road to the shops and then went around to the park where dad filmed me eating snow. I just can't get enough of it.

I like snow so much that when dad took me out today, he decided to clean the cars off first. I just stood and watched and this is how I ended up! Dad just stood laughing at me and had to take this goofy picture.

Yesterday was quite an anniversary for me. 3 months since my last seizure. That's something we're all very happy about.

Dad called the vets to arrange a repeat prescription for the medication. With money being tight at the minute I know we weren't looking forward to the having to make a chargeable visit to see the vet, then having to pay for a blood test and then having to pay for the prescription. Well I think we caught them on a good day. They didn't demand we had an appointment or blood test, yay! They just charged us for the prescription and off we went.

It's still not great as the prescription charge is £18.75, but it's much cheaper than buying the drugs from the vet. In total the drugs come to around £250 per quarter if we buy them online with the vets prescription. The vet will waive the prescription charge if we buy the drugs from them, but they are exactly double the price! We pay 7p and 14p for the 30mg and 60mg Epiphen respectively. The vet wants 14p and 28p for the same tablets. So to save £1,000 per year I must spend £80 on prescriptions. That seems like a deal to me!

You Know What Comes Next...

I would say it's obvious really, as it's been a while and posting something is bound to be the kiss of death. But so far so good. It's been a while since the last episode, but we're expecting a visit anytime soon.

We were thinking "Today's the day" a couple of times this week. I haven't had a full seizure, but I've had a couple of new small episodes of "falling". By that I mean episodes that resemble the moment when you're asleep and for no reason you suddenly jump awake trying to grab onto something as if you're falling. Well there's been a few times when I've startled dad with similar sort of actions.

After some "falling" I've been a little off. Not quite right and one day just seemed to forget about how to go down stairs! It was like I just thought you walked straight out over them, not focussing on the fact they go down as well as forwards, yikes! I ended up in a heap at the bottom after sliding down quite a few of the steps. So mum and dad are extra vigilant when I'm not looking quite right.

Unfortunatley it's not as easy as stopping me going upstairs. I'm pretty strong willed and when I want to go upstairs I will. Mum's even put stuff on the bottom of the stairs in my way to stop me going up, but that proved just as dangerous as just letting me go up anyway.

One good thing though. We went to the vets for a blood test, to update the prescription... again. Thankfully the results show the epiphen and KBr are within the range required. Money's real tight at the minute, so adding more tablets is always hard. September saw a £60 vet bill for the blood test, £253 for the drugs (epiphen and KBr for 3 months) and another £30 for Glucosamine and Milk Thistle (for a year thankfully).

My diet's taking too long. I got weighed whilst at the vets. It came in at 56kg, so mum and dad have cut my food down quite a bit. From the 2 meals a day I'd get out of 1200g of food they've now made that equal to 3 meals, so I'm down to 800g per day. Now I don't get chance to eat half my breakfast and save the rest for later in the day whilst they're out at work. Now I eat my breakfast and dinner in one go and eagerly want more. Totally different when a few years ago I didn't want food at all.

Back to the Regular Vet Visits

Dad took me into work again today. It was the first time in ages since I've been there. At first I wondered where we were going as it's unusual to get up so early and leave the house without breakfast!

Once we got to work dad gave me my breakfast. Just as usual these days I polished the lot of in one go. Mum and dad reckon I've turned into a normal dog now. Since the last set of seizures I now eat anything and everything. I'm always on the scrounge and have also been bad in going in the kitchen bin for scraps. Up until the last seizures, even when offered something, I'd let it fall to the floor to give it a sniff before deciding if I want to eat it or not. Now I don't seem to be so fussy. If it's being offered or left lying around, I'm eating it!

We saw the vet in the afternoon. Dad walked me down there which is always fun. Dad 'fessed up about weaning me off the drugs and me having a big seizure. The vet wasn't too harsh, but dad said in future we'll stick to the drugs and talk to him first next time.

It's still not a fun day for dad's wallet. £91 for blood test and £150 for 3 months worth of drugs. Still at least by buying them on-line we're still paying effectively half what the vet wants to charge for their drugs!!!

Taking blood was as easy as ever. The usual shaved off patch and I was so good I almost offered him my paw to let him do it. Even with the needle in there's no reaction and I sit there all good  and looking like butter wouldn't melt in my mouth. We'll find out early next week if I'm on the right dosage of Epiphen and KBr.

As good as I am, whilst dad's writing this I'm going in the kitchen bin for scraps!

A Much Better Week

Over the last week things have gotten much better. With the seizures stopped I'm gradually getting back to my old self. Every day that goes by I get a little better.

The seizures have definitely caused some brain damage, more memory loss than anything else. Dad's having to retrain me so I can at least get back to the basics of Sit and Down. I've been doing pretty good though.

The worst affect seems to be my coordination. I've always been clumsy, but now I seem to misjudge distance and will walk into the corner of the table or edge of a doorway. I've lost count of the number of cups I've knocked over or broken. This may be due to the reintroduction of the drugs.

Dad's put me back on the Epiphen and KBr. At least if they don't have any affect on prevention, maybe they'll at least minimise the duration and effects of the seizures. We're willing to try anything after this last really scary bout.

On Tuesday when dad got in from work I was in a right state. I'd poohed on the floor and walked in it. Then lay down in it. I was all matted with dry slobber from from the weekends seizures and so was really smelly. Normally that would mean a trip outdoors and a hosing down with the garden hose and a good shampooing. But dad felt sorry for me and decided to put me in their bath and give me a warm shower.

Well that meant going upstairs, and I don't do that yet. They're still too scary. So dad picked me up and carried me upstairs - I'm a big girl, so I'm surprised I didn't put his back out! He put me in the bath and turned on the shower and I just lay there and let him wash me.

When we've been out for walks dad's taken me on the extending lead so he can keep in touch. But yesterday he let me off on my own as I'd been so good. In fact even when on the extending lead I wont go further than the normal lead, so dad figured I needed some freedom.

It was good to be off the lead as then I could go sniff and play everywhere. I even had a go at chasing my own shadow, but it kept teasing me by always running a bit faster than me and staying out of reach.

So things are getting better, but just one day at a time.

A Drug Free Life

Over the past few months dad's decided that we're going to come off the Epiphen and Potassium Bromide. We've gradually weaned it down to zero and for the last few months I've been drug free.

Why? Well the drugs obviously weren't doing anything they were supposed to at the dosages I was taking them. The seizures still occurred with the same frequency, duration and intensity with them. So by taking the medication I was no better off and without it I certainly don't seem any worse off.

If anything it means the effects on my liver caused by Epiphen won't exist.

It's an awkward decision and not one I'd advise anyone else to take. Just personal choice. In case you're wondering, no I have not become a Scientologist - I may be a  crazy, but I'm not THAT crazy!

We could have consulted the vet, but to be honest the expected answer would have been to stay on the profitable medication. So for now I'm living without the daily tablets and just getting on with living with seizures.

Another Day at Work

Dad made an appointment at the vets so they could repeat my prescription and checkout my ears. We should have gone back about my ears a few weeks ago but as they were no longer giving me any trouble since the medication had run out it's just a problem of getting the time to do it. With dad being off work last week it seemed a waste to drive the 70 miles into Loughborough and back just to get my ears checked.

So today I got to go into work with dad again! Dad even took in my new squeaky ball so I'd have something to do, even if it drove everyone mad with all the noise.

As it was market day in Loughborough, at lunchtime dad even picked me up a couple of bones from one of the pet stalls there. I made a bit of a mess in the office though, so hopefully the cleaners will forgive me.

The vet checked out my ears and gave me the all clear as far as infection goes. But there's still some wax that'll need sorting by giving my ears a good clean twice a week. As I'm not at all bothered by this any more, in fact being an attention seeker I kind of  like it.

After talking about my latest cluster the vet suggests we raise the dosage of the Epiphen to 150mg twice a day, from 120mg. The Potassium Bromide stays the same. So the vet drew up prescriptions for the Epiphen that includes additional 30mg (tiny tablets) so we don't have to worry about splitting them anymore.

I have to go back in a month for yet another blood test - this time to check the Potassium Bromide levels. The Epiphen levels should be fine as the dosage isn't significantly increased and the last test was considered on the lower end of the therapeutic range.

Damn it, damn it, damn it!!!

We ran out of Epiphen yesterday as the prescription was delayed in arriving and then was not received properly to allow the pharmacy to ship the drugs on time.

11:00 The outcome was almost guaranteed and today I started having seizures. Luckily the kids were off school and Chris was around when I had the first one. It was the usual full on seizure whilst I was asleep in bed.

15:00 Later in the afternoon Blaine was around to see me have another full seizure whilst in bed again.

I'm so annoyed at myself for letting it come to this. There was a miscount on the tablets and what with changing the dose I didn't leave enough of a buffer between getting the prescription, ordering and delivery.

It was such a frustration arranging with the vet for the prescription, to be told I couldn't collect it the same day. This pushed it to Friday and that meant my order wouldn't be shipped until Monday.

Then to have the pharmacy call to say they hadn't received one of the prescriptions, well that was it. Another day later.

Only myself to blame I guess. I must make sure I don't let this happen next time, as now we're not going to be sure if the additional dosage or the KBr are working.

Blood Test Results

Dad spoke with the vet today and they gave him the results of the blood test. The results show the Phenobarb levels to be with the therapeutic range. But we'll be going to see the vet tomorrow to find out what the actual reading was. It should be between 15 - 45µg/ml.

It's also time to get a repeat prescription for the Epiphen and Previcox. Although the current vet doesn't have experience of Previcox they are willing to maintain the prescription, but have spoken of Rhimadyl (Carprofen) which is one of their preferred products. Unfortunately as the Previcox is working very well and has made such a difference, it's debatable whether I want to change it - even though it is relatively expensive. After reading the wiki and other sites this quote gives me a little cause for concern:

Although most dogs respond well to carprofen, it is capable of causing liver toxicity in some animals, and in the early days of introduction there were significant anecdotal reports of sudden animal deaths arising from its use.

Source: wikipedia

So that's the last thing we want to add. More risk of liver damage when there is already an increased risk caused by the Epiphen. So dad will certainly have to query the vet in more detail about this.

We have to accept the last significant part of the statement, reporting of sudden deaths, as the same has been proven of Previcox. So whilst there is a reluctance to change it is only in regard to the liver damage.

There's also some really good news on the ears. Now the Canaural has run out the problem has gone away. No more head shaking and scratching at my ears. But we've been asked to see the vet just to take a proper look and make sure.

UPDATE: After talking with the vet she suggested that possible liver damage is a risk with all NSAID's even with Previcox.

Minimising Liver Damage

One of the worrying side effects of the Epiphen (Phenobarbital) drug that I've been prescribed to counter my seizures, is that the higher the dosage and duration the higher the risk of liver damage.

In order to respond to this there are really only two courses we could take at this stage. As it's not an option to reduce the dosage and the duration is going to be life time we can introduce another drug, Potassium Bromide, which would allow the Epiphen dosage to be lessened.

However, at this relatively early stage in the treatment we're still trying to figure out what the dosage of Epiphen is required in order to be within the therapeutic serum range (15 - 45µg/ml) ie. to be effective in controlling my epilepsy. Hence the need for regular blood tests. So mixing the medication at this stage is not a good idea.

The other option is to look towards a "Complimentary or Alternative" medicine to try to minimise the effects on my liver.

Milk thistle is believed to have protective effects on the liver and improve its function. It is typically used to treat liver cirrhosis, chronic hepatitis (liver inflammation), and gallbladder disorders.

Source: nccam.nih.gov

Dad's gone back to the Internet and ordered up a supply of tablets from a previous source of supplements and we're now going to add these tablets to my medication. If we add many more I will rattle when I walk!

Worst 24 Hours to Date

So far the past 24 hours has been horrendous. Initially thinking that a series of seizures (the previous 3) would see an end to it fell far short of the actual count.

In all I've had another five seizures since those!

22:45 (12 Jan) I was acting all excited as if I wanted something. Dad thought I was after going for walkies as I wouldn't settle and ran upstairs and down between him and mum. Eventually the seizure hit as I was at the bottom of the stairs thankfully. Dad came down and took care of me.

02:55 (13 Jan) Whilst sleeping in with mum and dad I woke them up with another full blown seizure. Dad tried to get me safely downstairs afterwards and nearly ended up paying a trip to hospital after I tripped him up at the bottom.

After this one dad slept downstairs on the sofa to keep an eye on me. For a long time afterwards I couldn't get comfortable and was very restless. I'm sure dad didn't get any sleep.

07:00 Dad didn't get up for work, so was still lying on the sofa when I had another seizure in my bed.

Thankfully the new vet was able to reschedule our 17:00 appointment to 10:10 this morning. So mum and dad took me for a long drive over to see them.

09:15 On the way to the vets I started a seizure. Dad noticed I was drooling a lot and just as I started chomping he pulled over to take a look at me. It turned out to be the shortest seizure so far. After the jaw chomping and gallons of slobber the seizure stopped. Less than a minute, but I was still a little confused afterwards.

The New Doctor

The new vet wasn't so nice. Not for me anyhow. He took a good look at me and spoke with mum and dad about my problems. As expected he advised the Epiphen should be increased to 2 x 60mg twice a day (240mg per day).

The new doctor did a good job on talking with reassuring mum and dad that whilst this is not a pleasant condition, it's not as bad as it could be. The seizures certainly are scary so I'm glad I'm not aware of them at all.

Following the conversation dad asked about Valium and the doctor also prescribed something called "a tube of rectal Valium" to be used in emergencies if the seizure goes on much longer than usual. Now I think that sounds like taking my temperature, so I better not be awake when that happens!

He also gave my ears a really, really good clean. This is why I didn't like him much. When dad cleans my ears it's not as thorough as the doctor did. The doctor was really vigorous in using cotton wool over his finger and getting as far in as he could. Even though dad cleaned my ears only the other day the doctor came out with lots of wax and dirt, yeuch! I guess now dad's seen how the doctor did it, I've got this to look forward to from now on.

I got to go in to dads work with mum, just to say hello as we'd driven all that way just to see the doctor. Before we left they took me around the park so I could get some exercise and see if I could catch one of them pesky squirrels.

11:55 After we got home and mum and dad where having a cup of tea I started twitching and chomping. After clearing the area expecting and full blown fit it turned out to be another small one like earlier.

Mum and dad then both joined me in a nap in front of the TV. It's been a long night/day.

Oh, and Dave and grandma came round just to see how I was. They'd been reading my blog so knew I wasn't doing so good, so thought they'd call in. I just wish I wasn't so slobbery and so happy to see them.

Updated

15:40 As dad was upstairs writing this Blaine came in from school and after shaking my head started antother small seizure.

18:45 Another small seizure whilst lying in bed.

21:40 Whilst lying in the front room.

Veterinary Value

Sounds like dad's had some fun over the past few days. Seems getting prescription drugs online is a a battle of pedantics.

Placing an order with an online pharmacy couldn't be easier. After choosing one of the many online it was simple to complete the order and make payment.

After receiving the order confirmation simply replying with the scanned copies of the two prescriptions, one for Epiphen and one for Previcox, the order part was complete.

Now this is where common sense leaves the room. The prescription for 90 x 60mg  tablets of Epiphen for a months supply means that each time I take the 1.5 tablet dose I'm prescribed, a small 60mg tablet must be broken in two. This isn't an accurate science as it often means the tablet crumbles into 3 or more parts.

So why not order 60 x 60mg and 60 x 30mg - the half size tablets? This equates to exactly the dosage on the prescription, but is more accurate and convenient.

Well it turns out that my current vet wont allow the tablets to be supplied in this way. The online pharmacy calls up my vet and asks if they can supply pills of the correct size and the vet says no!

I suspect that if dad were to ask the vet they would then say I need 3 separate prescriptions to do this. So the vet would charge more and profit more each month.

Dad nor I can see the sense in having to continue breaking pills - where it is not a recommended practice as the dosage can not be precisely controlled. But it would appear that for nothing other than protecting their profits, my current vet insist we must stick to the prescription tablet size and quantity exactly, despite them having supplied half size tablets when they themselves have had them in stock.

Well that appears to be the last straw. Dad got on the phone a called a few more veterinary surgeries and was advised by his boss to call one local to where he works. After a very helpful conversation with the veterinary nurse it turns out that they are willing to assist and can provide a 3 month prescription - either as monthly repeats or as a single 3 month quantity - for £12!!! Yes, that's right, a saving of £6 per month.

Of course this means that I must come under their care and be seen by one of their surgeons, but the savings in prescription charges more than compensates for this. Other parts of the conversation relating to consultancy charges and prices for blood tests suggest even more savings.

So in February we're going to go pay this new veterinary surgery a visit. The extra good news for me is that I get to go to work with dad whenever I need to go see the doctor. It does mean dad would have to drive 35 miles each way if he wasn't going in to work, but as he's in work most every day, it seems like a reasonable trade off.

In all it pays to shop around. You can never ask too many questions and it pays to do some research online so you can get as much information as possible.

Prescription Drugs

Dad's been speaking to the doctor today and trying to find a more cost effective way of continuing my treatment. Not being insured turns out to be rather costly after all, but it's all about accepting certain risks. In my case it hasn't really paid off.

Insurance quotes for me ranged from £28-£33 per month, which is rather a lot of cash. I guess until mum and dad got really attached to me, they thought that a little too much to take on. Hopefully in hind sight they now see it as a small price to pay for a lovable monster like me.

Now with my current condition over the past few months the vet bills have grown more than mum and dad can afford - dad's been looking at some other options. It's not about the doctor, as I know dad's really pleased with them, the service is great, it's just about the money.

The two drugs that I'm taking (Epiphen and Previcox) work out at £69.35 per month when supplied by the vet.  This is made up of:

Description	Quantity	Price	Per Tablet
Epiphen (60mg)	90	£23.12	£0.256
Previcox (227mg)	30	£46.23	£1.541
	Total	£69.35

Now if dad goes online to many of the online pet pharmacies - and you too can just simply Google for almost any of them you'd see prices like this:

Description	Quantity	Price	Per Tablet
Epiphen (60mg)	90	£10.80	£0.12
Previcox (227mg)	30	£24.80	£0.826
	Total	£35.60

Can you believe that? Half the price that my friendly and so very helpful vet is charging! And I do mean friendly and helpful, as they are.  But the huge difference in price really has to be considered - especially with no insurance.

But things are not that straight forward. Since October 2008 veterinary practices can now charge for prescribing these drugs - which in itself isn't unfair, there has to be a cover for the administration of writing and recording prescriptions, or the vet would lose out. But the law now allows vets to charge anywhere up to £60 per prescription. Not that many do or would charge that much - but the law allows for it.

Thankfully my vet has set it's prescription charge at £7.20 per prescription. But that charge increases as I need two prescription drugs, so works out at £9.99. However, they will not provide a 3 month prescription, meaning this will require monthly prescriptions at £9.99 each month. Quite a money spinner as my medication is for a lifelong ailment, my vet is guaranteed £120 per year, for as long as I live.

Taking the vets prescription charges into account
there is still a huge saving of £23.76 per month (£285.12 per year)!

I'll still need to visit the doctor regularly for tests and checkups, so they'll still make money on my visits, but it still seems like there's £120 per year that they are making without any real effort.  I guess they have to protect themselves from people taking advantages of free prescriptions and not taking any of the vets services, but as we're paying for every consultation and test, it seems a better way would be to either offer repeat prescriptions or free prescriptions only where a contract of care between surgery and owner exists.

If a prescription were only issued at the time of consultation and valid only until the next, surely it would be fairer? As I must visit the vet every three months it doesn't sound unreasonable to have a three month prescription - instead I must get a prescription each month.

Dad did phone around other local vets and whilst very, very helpful the feedback was that the prices my vet are charging are typical of the industry. In fact the information regarding the change since October 2008 came from speaking to other practices.

Some very frank responses to the questions regarding drug costs expressed that veterinary surgeries often have high prescription charges simply to ward off bargain hunters, like myself, and attempt to keep the drug revenue within the practice. But if Internet sellers can supply and make money at the prices they charge I find it hard to believe that veterinaries aren't obtaining drugs at better prices and making huge mark ups.

There certainly seems like a large element of self preservation where practices are attempting to hold their market share simply by making the legislation work in their favour. No drugs without prescription, means cheap drugs only if you buy an expensive prescription. I feel certain that in some cases the cost of prescription means cheap drugs are not a viable alternative. In my case it seems there is an option - but how many could benefit by a fairer prescription process?

So far that's the best deal we've got. It's a good saving, but still an awful lot of money year on year. I'll update as we learn more.

UPDATE: Sad to say I missed the deadline in 2008 where the government were petitioned in regard to prescription charges. The governments response can be found here [http://www.number10.gov.uk/Page16942]

The Government is committed to delivering free and fair markets, with greater competition, for businesses, consumers and employees.

That is why the Government introduced the Supply of Veterinary Medicinal Products Order in 2005 to create a market for veterinary medicines away from veterinary surgeries. The Order was introduced following a Competition Commission report which found that the veterinary profession tended to understate the true cost of their professional services and offset this in their medicines pricing. This practice can allow two detrimental effects:

· Veterinary surgeons can hide excess profits in drug prices; and

· Inadequate pressure on manufacturers to maintain competitive drug prices.

The Competition Commission felt strongly that a three-year moratorium on prescription charges was essential to allow animal owners to become used to the availability of free prescriptions and encourage them to shop around. The availability of prescriptions was seen as the key element in opening up the prescription-only veterinary medicines market, increasing competitive pressure and driving prices down. High prescription charges had been a barrier to customers doing this in the past, but the three-year prohibition would kick-start the market.

The independent Office of Fair Trading (OFT) will be monitoring developments after the prohibition on charging for providing prescriptions comes to an end in October 2008 and will consider when and whether any further regulatory action may be needed to ensure effective competition in the supply of veterinary medicines.

Back to see the Vet

Well following the seizures over the past few days dad took me to see the Doctor today.

As usual I was on my best behaviour. There were plenty of other dogs there this time and one strange white fluffy thing that reminded me of a fluffy Christmas star. It was very odd because it smelled like a dog and when it turned round it had eyes and a nose! Strangest dog I've ever seen.

Dad put me on the scales which now I know what they are makes them not scary at all. I just hopped right on and sat down with no fuss. That was until dad called me a fat dog... I'd put on a kilo and was nearly 42kgs today - I put it down to my winter coat. Dad says it might be the tablets (but not sure which ones) as I've certainly got an appetite these days. I eat all my breakfast and dinner usually in one sitting which isn't like me.

The vet did the usual stuff checking my eyes and listening to my heart - and the thermometer bit which I'd rather not talk about.

With nothing else to do for it the dosage of the Epiphen was raised to 90mg in the morning and 120mg in the evening to see if this provides better control. This effectivley increases by half a tablet in the evening.