I've tried a few times to write a "seizure update," but it seems like I only think of writing one after Iris has had a couple seizures. Problem with that is I am tired after "seizure day" (or two days, as has been her recent pattern).
At the end of 2010, Iris went 15 weeks without any seizures. I was hoping she might do the same this past winter, but unfortunately, that was not the case. She continued right along on her every-four-weeks schedule. Even more stressful is that her clusters had been getting gradually more severe. Rather than having 3-4 seizures per episode and being done after a few hours, she was up to around 10 seizures over a 24-36 hr period. I talked it over with her vet and we made the decision to increase her phenobarbital dose (again) on Feb 7th.
Iris' seizures almost always start in the middle of the night, although lately they've been starting closer to morning. In the past, she would have one bad night of 3-4 seizures and then by the next night, she'd be starting to feel better. Starting last November, she's been continuing into the second night. She was up to 4-5 seizures during the first night, maybe 1-2 over the course of the next day, and another 2-3 the following night. Which means 48 hrs or so of postictal crazy dog.
After increasing her meds in Feb, it seems like the total number of seizures she's having is better. Yesterday she had 4 seizures starting around 5am (all fairly close together) and then had one more around 6am this morning. Definitely better than the ~10 seizures she was having before increasing her meds. But two nights of seizures means two days of postictal dog. And honestly, I'm more worried about her doing something crazy and hurting herself when she's postictal than hurting herself during a seizure.
Sometimes I feel like it's hard to determine what is an "acceptable" level of control for Iris. Ten seizures is definitely unacceptable. Is 5 seizures per episode ok? Is two nights in a row as "acceptable" as we're going to get? She's due for her annual exam and bloodwork in May, so I guess we'll reevaluate then.