Keppra is a commonly used brand name for levetiracetam, an antiseizure medication prescribed to dogs and cats. It is often used alongside other seizure medications and can be particularly helpful in managing seizures.
This article explains how levetiracetam works, when your veterinarian might recommend it, and what you should know when giving it to your dog.
Important: never change your dog’s medication dose or stop treatment without veterinary guidance.
Is your pet having a seizure right now?
Keep them safe and time it. Seek urgent veterinary advice after a first seizure, and go to the nearest emergency vet now if it continues for several minutes or repeats within 24 hours.
Why is Keppra prescribed to dogs?
Levetiracetam helps reduce abnormal electrical activity in the brain that causes seizures. Your veterinarian may prescribe it when:
- Additional seizure control is needed alongside medications such as phenobarbital.
- Your dog experiences cluster seizures and needs a short-term treatment plan.
- A medication with minimal liver metabolism is preferred.
The choice depends on your dog’s seizure pattern, medical history and response to treatment. [1]
How does levetiracetam work?
Levetiracetam works differently from many traditional antiseizure medications.
Its main recognized mechanism involves binding to a protein called synaptic vesicle protein 2A (SV2A). This protein helps nerve cells release chemical messengers that allow them to communicate. By influencing this process, levetiracetam helps reduce abnormal electrical activity associated with seizures.
Levetiracetam has also been investigated for possible anti-kindling effects. Kindling describes a process in which repeated stimulation makes the brain increasingly susceptible to seizures. However, the clinical significance of this effect in dogs remains uncertain. [1,2]
How quickly does Keppra work, and how is it given?
Levetiracetam is absorbed rapidly after oral administration, allowing useful drug concentrations to be reached relatively quickly. This makes it valuable in certain seizure-management plans, particularly when prompt treatment is needed. Note: oral levetiracetam is not a substitute for emergency treatment of an ongoing seizure.
The exact dose and schedule must be determined by your veterinarian. The oral medication comes in regular and extended-release forms, which are given every 8 hours and every 12 hours respectively. Extended-release tablets should not be crushed, split or chewed.
Some extended-release tablets may leave a tablet-shaped remnant in the stool, sometimes called a ghost tablet. This consists of the insoluble empty outer structure of the tablet after the medication has been absorbed. Check with your veterinarian if you are unsure about your dog’s particular product. [2]
Giving medication on time is important. Because levetiracetam has a short elimination half-life of approximately three to four hours in dogs, missed or delayed doses may reduce drug concentrations and contribute to breakthrough seizures. If you miss a dose, ask your veterinarian what to do rather than doubling the next dose. [2,3]
Is Keppra safe? What side effects should I watch for?
Levetiracetam is generally well tolerated and has a relatively wide safety margin. However, side effects can occur, particularly when treatment is first started or the dose is changed.
Possible side effects include:
- Sleepiness or sedation: your dog may seem more tired than usual.
- Unsteadiness (ataxia): your dog may appear wobbly or less coordinated.
- Restlessness or behavioral changes: some dogs may become unusually restless or excitable.
- Vomiting or reduced appetite: gastrointestinal signs can occasionally occur.
Mild effects may improve as your dog adjusts to treatment. Contact your veterinarian if your dog develops significant unsteadiness, persistent vomiting, marked behavioral changes or other concerning signs.
Levetiracetam undergoes minimal liver metabolism and is eliminated primarily through the kidneys. This can make it useful in some dogs where liver metabolism is a concern. Importantly, the dog’s overall health should still be considered. [1]
Why might Keppra become less effective over time?
Some dogs initially respond very well to levetiracetam, but its effectiveness appears to diminish with continued use. This is sometimes called the “honeymoon effect” and may reflect the development of tolerance.
However, a return of seizures does not automatically mean tolerance has developed. Other possibilities include missed doses, progression of the underlying epilepsy or interactions with other medications.
If your dog’s seizures become more frequent, keep a record of the episodes and contact your veterinarian. Do not increase the dose or discontinue medication yourself.
Why is Keppra used for cluster seizures?
Cluster seizures occur when a dog experiences two or more seizures within a 24-hour period.
Levetiracetam is often included in cluster-seizure treatment plans because it acts relatively quickly and can provide lasting seizure control. Veterinarians may prescribe a specific short-term or pulse treatment plan to be started when a cluster begins. This approach can also help limit concerns about tolerance developing with continuous long-term use. [3]
The plan should clearly specify when to start treatment, how long to continue and when to seek emergency care.
When to seek emergency care
Seek emergency veterinary care immediately if your dog has a seizure lasting five minutes or longer, experiences repeated seizures without recovering consciousness between them, or has rapidly recurring seizures.
Do not attempt to give oral medication to a dog that is unconscious or unable to swallow safely.
Does my dog need blood tests while taking Keppra?
Routine measurement of levetiracetam blood concentrations is not usually performed. Your veterinarian will generally assess effectiveness by reviewing your dog’s seizure frequency, drug dose and side effects. Serum level testing can, however, be performed in some circumstances. [1]
Keeping a seizure diary can be extremely helpful. Record the date and duration of each seizure, what happened during the episode, whether your dog recovered fully, any missed doses and any changes in behavior.
References
- De Risio L, et al. (2015). ACVIM Small Animal Consensus Statement on Seizure Management in Dogs. Journal of Veterinary Internal Medicine, 30(2), 477–490. Read the full consensus statement
- Moore SA, Muñana KR, Papich MG, Nettifee-Osborne JA. (2011). The pharmacokinetics of levetiracetam in healthy dogs concurrently receiving phenobarbital. Journal of Veterinary Pharmacology and Therapeutics, 34(1), 31–34. Read the research abstract
- Charalambous M, Muñana K, Patterson EE, Platt SR, Volk HA. (2024). ACVIM Consensus Statement on the Management of Status Epilepticus and Cluster Seizures in Dogs and Cats. Journal of Veterinary Internal Medicine, 38(1), 19–40.
This article is for education only and doesn’t replace advice from your veterinarian. Never start, stop or change your dog’s medication without veterinary guidance.
Related guides
Phenobarbital for dogs with epilepsy
How it works and what to expect.
Cluster seizures in dogs
What they are and when they are an emergency.
When will your veterinarian start seizure medication?
The guidelines veterinarians follow.
Diagnosis and treatment
Tests, medication and living with epilepsy.