Compounded Diazepam Rectal Gel

Why is home treatment necessary for some dogs?

Most dogs with idiopathic epilepsy suffer isolated seizures that stop spontaneously within one to three minutes. However, some dogs with epilepsy tend to suffer cluster seizures or status epilepticus. Status epilepticus is defined as (1) a continuous seizure lasting at least 5 minutes or (2) two or more discrete seizures without full recovery of consciousness between seizures. Cluster seizures (serial seizures, acute repetitive seizures) are two or more seizures occurring over a brief period (minutes to hours) but with the patient regaining consciousness between the seizures.

While a single seizure of short duration is rarely life threatening, status epilepticus is a medical emergency requiring prompt treatment. Continuous seizure activity lasting 30 to 60 minutes can lead to profound, life-threatening abnormalities and brain damage. Although cluster seizures do not fulfill the definition of continuous seizure activity, they nevertheless represent a serious condition that can progress to status epilepticus. The goal of treatment is to quickly stop the seizure and provide support for the patient. Typically, this involves urgent veterinary care, including administering anti-seizure medication by vein. The financial and emotional distress of repeated emergency treatment is a common reason for a client to have their epileptic pet euthanized.

Why is rectal administration of diazepam recommended?

Rectal administration of diazepam (valium) by the client is a safe method of home treatment of cluster seizures in dogs with idiopathic epilepsy. Diazepam belongs to the class of drugs known as benzodiazepines. Benzodiazepines are the treatment of choice for the emergency treatment of seizures because they are safe, work quickly, and are effective against many types of seizures. Veterinarians typically administer diazepam by vein to quickly stop a seizure, but most clients are not adept at intravenous injections. Absorption of diazepam after injection into the muscle is variable and unpredictable and may cause muscle damage. Giving diazepam by mouth is difficult and hazardous when the dog is actively seizing, and absorption after oral administration is slow and unpredictable On the other hand, rectal administration of diazepam results in higher and earlier blood levels compared with either oral or intramuscular routes, making this route of administration ideal for home treatment of cluster seizures.

Information on this medication quoted from canine-epilepsy.com