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A New Treatment for Canine Idiopathic Epilepsy: Pexion

A New Treatment for Canine Idiopathic Epilepsy: Pexion

We recently wrote about canine idiopathic epilepsy, a form of epilepsy where the cause remains unknown. Today we are looking at a new treatment; Pexion.

The severity of epilepsy can vary greatly between individual sufferers. Some dogs may experience a single, isolated seizure, whilst other can experience multiple seizures every week.

Recently Boehringer Ingelheim has announced their latest product for the treatment of canine epilepsy, Pexion® (Pexion) an alternative to the traditional phenobarbital or potassium bromide treatments given to epileptic dogs.

Are you using Pexion?

If you’re dog has been prescribed Pexion, let us know how your dog is getting on in the comments below. Join the discussion on how other dog owners are getting on with Pexion and keep the community updated with your progress. 

What Is Pexion?

Unlike other treatments for canine epilepsy, Pexion contains the active ingredient Imepitoin. Imepitoin acts in a similar manner to previous anti-epileptic medicines, potassium bromide and phenobarbital, in that it works to suppress electrical activity in the brain.

Imepitoin partially activates GABA receptors, which are responsible for reducing electrical activity between nerve cells. This partial activation of the GABA receptors is believed to reduce electrical activity and help prevent seizures. Specifically, Imepitoin also has a weak blocking effect on calcium channels that allow electrical signals to be propagated along nerve cells.

See here for more information about Pexion 

Does Pexion Work?

A study conducted on Pexion during its development compared it to the traditional anti-epileptic medicine phenobarbital. A 20 week study of 226 dogs taking the medications found Pexion matched phenobarbital in efficacy, reducing the occurence of seizures by around 50%. 1

Is Pexion a Better Alternative?

The Pexion study showed that it had an effectiveness equivalent to phenobarbital, however, Pexion may be considered a better alternative as it has less severe side effects.

Unlike phenobarbital, Pexion does not pose a hepatotoxicity risk (liver toxicity). This means the regular testing required to ensure that a dog’s liver remains healthy is not needed whilst being given Pexion.

Treating the Epileptic Dog

It is commonly cited that around 0.5 to 5% of dogs suffer from some form of epilepsy, the severity varying between breeds and individuals. In dogs where seizures occur infrequently  owners may consider not using any medication at all, avoiding the side effects associated with anti-epileptic medications.

In dogs where seizures occur more freqently, such as once a month or more, treatment should be considered.

The introduction of Pexion gives owners and vets a greater choice when it comes to treatment, but does not replace phenobarbital and potassium bromide.

Owners should consult their vet and explore all the possibilities when dealing with an epileptic dog.

Seizure Types That Require Immediate Veterinary Assistance

Cluster seizures – When multiple seizures occur in one 24 hour period
Status epilepticus – A persistent epileptic state that lasts for longer than 5 minutes

For more information about epilepsy, such as the causes, what to do during a seizure and more, see this article.

Disclaimer: This article was written as a response to the release of Pexion and as a follow up to a previous article concerning idiopathic epilepsy. I am not affiliated with the product (Pexion) or the manufacturer (Boehringer). 

Image Credit: Onkel_wart

About James Watts

BSc Bioveterinary Science. Editor of PetSci. When I'm not writing, learning, discussing, or reading about animals, you know it's the weekend!


  1. My staffy x has been on Pexion now for about six months, after being on phenobarb for two years. No discernible side effects and she’s been seizure free. the only slight difficulty with Pexion is that the pills are much larger than the phenobarb pills, so it’s not so easy to give them to her. Otherwise, no problems at all, although the overall cost of the medication is about two hundred dollars a year more than the phenobarb/blood test routine.

  2. My Chocolate has been under medication on phenobarb and pexion for almost 2 years. His condition becomes more stable and controlled. I want to thanks so much of my Vet introducing pexion to me.

  3. My Pomaranian is on Pexion for 10 months now, and he’s given 2 times 200 mg a day. He had several seizures before we started medicating him, because the seizures were rather mild when he started. But then the seizures came quicker and we started with Pexion.
    At that point, when he got a seizure he had clusters of 4 seizures within 24 hours. He never had clusters before. My vet neurologist added Levetiracetam, and now he is almost 4 months seizure free. We are going to try to ween him off the Pexion now.

    • My Springer clustered from the beginning and was put straight on Pexion. She went two months seizure free and the next clusters were slightly less. They upped the meds and we went 28 days and the next clusters were within minutes of each other but had reduced from 4 to 2. They upped the Pexion to 600mgs twice daily and added Keppra. So far we’re a few days short of 3 months seizure free. I’m not looking to reduce or change anything at the moment as this is the longest she’s gone.

  4. My Beagle, Daisy, is 8 years old. She had her first seizure at 6 yrs old, when she had a cluster of 5 within 36 hours. Each one left her very distressed, panting, crying and wanting close contact with us, but unable to settle. She would come to us then wander away for a few yards and immediately come back again for reassurance. This would sometimes last for more than an hour before she would eventually settle down and rest.
    The vet put her on Epiphen and she was fine for 6 months before she had another cluster. These seizures seemed more severe than the first cluster and the vet increased the epiphen from 1 1/2 to 2 tablets twice a day. The next cluster came after only 3 months at which point the vet added Pexion to her medication. She has (thankfully) had no more seizures since, but last year she became really ill and was diagnosed with pancreatitis. We now feed her a really low fat diet (Not that she was given a fatty diet before) but wanted to cut down on the Epiphen if possible because we feel that this is what causedf the pancreatitis. The vet however, says that Pexion is just as toxic as Epiphen. We really don’t know what to do for the best. She is not underweight, but is forever searching for food. She will do anything to reach anything edible, including quick snatch manoeuvres if you look away for a few seconds…..even a cup of tea…..or a pair of leather gloves. She has always been a bit of an opportunist, but has become so determined since being on the low fat diet. Any suggestions on the way forward?

    • Dear Anne
      A natural thing to use to help protect the liver is Milk Thistle, get it in a tincture and use half the dose for med and small dogs and full dose for larger dogs. It is completely natural but run it by your vets first. Good luck.

    • My Springer has been a disaster with food since being on Pexion. She’ll get into the bin bags, will jump at the kitchen surfaces to get food off a plate, and will bark constantly if not getting anywhere. She also steals food off our lab if she can. She’s also more thirsty. She is overweight so is on a diet but stealing food doesn’t help with the weight management. It’s my understanding that Pexion doesn’t cause the damage the most of the other drugs do so I’m not sure why your vet is saying its toxic. Since adding Keppra alongside the Pexion she’s had no seizures for three months. She clustered from the start but Pexion was the vets preferred choice even though it’s not been trialled in dogs that cluster. It might be worth getting a second opinion with the meds but the hunger is definitely a side effect.

      • my dog is on EPILEASE KBR does anyone else have any dogs on this? and how do they find it? my dog seems to fit once a month

        • Hi Carole – I have some Epliease that I’m not using – please email me and I can send to you if you are UK

        • Hello Carol.

          Shani is on kbr but she is oalso on phenobarbital and gabapentin. When the kbr was added she became very ataxic, nauseous and occasionally vomited. But giving it twice a day, always with food and separately from the pheno she has done wel on it. She is now 37 weeks seizure-free.

          It may br that your dog’s dose might need increasing a little.

  5. my 17 week old whippet has just had 3 seizures over the course of 2 weeks, 2 of which within 36 hours. The vet immedicatley prescribed 100mg Pexion x 2 per day based on his weight, nutritional supplements x 2 per day and emergency diazepam in case of another seizure. He has been on this medication for 4 days now. The main side affectes are increased hunger, thirst, excessive weeing and hyperactivity. I’m hoping that these side affects will settle in time which according to the drug information they should. He has so far not had another seizure but I find it hard to see these changes in him. Other than that he is just his normal lovable self.all of these side affects are however nothing compared to his seizures and at least aren’t causing potential harm so i’m very thankful for that.

    • Pexion is a good starting point but not recommended for clusters. Have you had tests to rule out shunts or infections . Seems very young . I have 5 whippets and Bo developed epilepsy after a vaccination. Love to you and your pup
      Please join Blu Tale foundation group on Facebook

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