Levetiracetam (Keppra) for Dogs: A Treatment Option for Seizures

Canine epilepsy is the most common chronic neurological disorder in dogs. Some dogs who have seizures may require treatments other than common medications, like phenobarbital. One such medication, levetiracetam (Keppra) for dogs, may be a good option for your canine companion.

Learn about levetiracetam for dogs, including what it’s used for, how it’s given, and side effects to be aware of.

Levetiracetam for dogs at a glance

What is levetiracetam for dogs, and what is it used for?

Levetiracetam is an anticonvulsant medication that can stop or prevent seizures in dogs. The exact mechanism for how levetiracetam prevents seizures is not fully understood. But it appears to work by interfering with the release of neurotransmitters.

Most dogs with ongoing seizures are treated with phenobarbital or levetiracetam. But these medications don’t work well enough for some dogs. They might also not work for dogs with certain underlying health conditions. In these cases, levetiracetam may be used as an add-on treatment or an alternative to other seizure medications.

Dogs taking levetiracetam for seizures may develop resistance to levetiracetam over time. They may require higher doses or additional medications to maintain seizure control.

Levetiracetam can also be given to stop an active seizure in dogs, though other medications like diazepam are more common. Options for using levetiracetam to stop a seizure include administering a dose rectally or giving a shot under the skin. Pet owners should follow their veterinarian’s precise instructions if levetiracetam is being used in this way.

EXPERT PICKS: WHAT TO READ NEXT

• Seizures in dogs: Learn the signs that your dog may be having a seizure, along with what to do next.

• Phenobarbital for dogs: Phenobarbital is another common seizure medication for dogs. Here’s what to expect if your dog takes this medication as well.

• Dog anxiety: Dogs may show a variety of signs that they’re anxious, and some may be unexpected. Read all about them.

What is the dosage of levetiracetam for dogs, and how is it given?

Levetiracetam comes in immediate-release and extended-release tablets (levetiracetam ER). Levetiracetam is not FDA approved for use in veterinary medicine, but its off-label use is common.

Immediate-release levetiracetam

For immediate-release tablets used to prevent seizures, the dosage is 20 mg per kilogram of body weight given every 8 hours. The dosage may be increased up to 60 mg/kg every 8 hours if needed, as long as your dog doesn’t have side effects. Increase the dosage only with veterinary guidance.

Giving the medication 3 times a day can be a problem for some pet owners. Talk to your veterinarian if you’re concerned about being able to do this for your dog.

Extended-release levetiracetam

For levetiracetam ER, the standard dosage is 30 mg/kg every 12 hours. The dosage can be increased up to 60 mg/kg every 12 hours if needed. Increase the dosage only with veterinary guidance.

This twice-daily dosage may be more convenient for dog owners who struggle with giving the medication 3 times daily.

Tablets cannot be split or crushed, so levetiracetam ER may not be an option for small dogs. 

What should you do if your dog misses a dose of levetiracetam?

If you miss a dose of your dog’s levetiracetam, give the missed dose as soon as you remember. Make sure to give the next dose 8 hours after you give the missed dose. Do not double up on your dog’s dose to account for missed doses.

Seizure medications stop preventing seizures as soon as they wear off. This puts your pet at higher risk of seizures. So it’s very important to give your dog levetiracetam on time. Try setting reminders or alarms to help you remember when it’s time for your pup’s next dose.

What are the common side effects of levetiracetam in dogs?

Side effects for levetiracetam in dogs aren’t common.

The most common side effects in dogs are sedation and clumsy gait (ataxia). Some dogs may develop changes in behavior while taking levetiracetam. Vomiting is a potential side effect as well.

What are the most serious risks of levetiracetam for dogs?

Levetiracetam doesn’t carry many serious risks for dogs. It’s considered one of the safest anti-seizure medications for dogs.

For dogs experiencing changes in behavior, anxiety and depression are common. Levetiracetam could also increase existing behavior problems such as:

• Anxiety

• Attention seeking

• Depression

• Aimless behavior

• Aggression

These behavior changes may hurt the human-animal bond. It could also result in injuries to people or animals, as well as destruction of property.

Does levetiracetam interact with other dog medications?

Levetiracetam has few known interactions with other dog medications. But it can interact with the following medications:

• Antihistamines, such as diphenhydramine (Benadryl)

• Benzodiazepines like midazolam or alprazolam

• Gabapentin

• Opioids, such as butorphanol

• Methotrexate

When given with phenobarbital to control seizures, levetiracetam may need to be given in a higher dosage than usual to work well. Phenobarbital increases how rapidly levetiracetam is cleared from the body in dogs.

Why trust our experts?

Written by:

Rhiannon Koehler, DVM, MPH

Rhiannon Koehler, DVM, MPH has been involved in veterinary medicine for over a decade. Her clinical practice has mostly revolved around providing care to shelter animals, low-cost services to underprivileged families, and wellness care for pet parents.

Edited by:

Renée Fabian, MA

Renée Fabian is the senior pet health editor at GoodRx. She’s worked for nearly 10 years as a journalist and editor across a wide range of health and well-being topics.

Reviewed by:

Ghanasyam Bey, DVM

Ghanasyam Bey, DVM, is from Cleveland, Ohio, and attended Princeton University for undergraduate studies. After a year of biology research at Duke University, he attended Ohio State College of Veterinary Medicine.

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