Keppra for Dogs With Seizures or Brain Tumors

Name: Keppra for Dogs With Seizures or Brain Tumors
Creator: Dr. Zubair Khalid

By Dr. Zubair Khalid, DVM, MS, PhD · 2026-10-03

Keppra for dogs with seizures is a prescription anticonvulsant that veterinarians use most often as an add-on to other seizure medicines, and sometimes for emergency seizure control or for dogs with brain tumors. It is generally well tolerated, has few drug interactions, and does not usually require the same liver monitoring as older seizure drugs. It is not a cure, and it works best as part of a plan your veterinarian builds for your dog.

This article is educational and is not a substitute for veterinary diagnosis or treatment.

Quick Answer

Keppra (levetiracetam) is an antiepileptic drug with a mechanism of action distinct from other seizure medicines, and it has minimal drug-drug interactions [1].
It is most often used as an add-on (adjunctive) drug in dogs already taking another anticonvulsant, though its role as a first-line solo treatment in dogs is still being determined [1].
It can be given by injection or by mouth in emergencies such as cluster seizures or status epilepticus, which is a seizure lasting more than 5 minutes or two or more seizures with incomplete recovery of consciousness between them [2].
Seizures from a brain tumor or other cause of increased intracranial pressure should be treated aggressively, because one seizure can raise pressure further and lead to brain herniation [3].
Never change, add, or stop a seizure medicine on your own. Your veterinarian calculates the dose from your dog's weight, health, and other medicines.

What Is Keppra and What Do Veterinarians Use It For?

Keppra is the brand name for levetiracetam, an anticonvulsant (antiepileptic) drug. Anticonvulsants are used to stop an ongoing seizure, to reduce how often seizures happen, or to make future seizures less severe [2]. Some of these drugs are only for emergencies, some are only for long-term maintenance, and some can do both [2]. Levetiracetam falls into that flexible category.

In dogs, levetiracetam is used in three main situations.

As an add-on drug for epilepsy. Most dogs on Keppra are already taking another anticonvulsant, often phenobarbital, potassium bromide, or zonisamide. Levetiracetam's value here is that it works through different pathways than those drugs and has minimal drug-drug interactions, so it can be layered on without disrupting an existing regimen [1]. Its use in small animals is growing, but whether it should replace older drugs as a first-choice solo treatment is still an open question [1].

For seizures caused by a brain tumor. A brain tumor raises pressure inside the skull. Seizures in that setting are dangerous because each seizure can push intracranial pressure even higher and risk brain herniation, so they need to be treated aggressively [3]. Levetiracetam is attractive in these dogs partly because it has minimal interactions with the steroids and other drugs they often take, and because it may have wider applications in patients with brain injury [1]. If your dog has a tumor, imaging follow-up matters as much as the drug itself. You can read about that in MRI Monitoring of Brain Tumor Response to Therapy in Dogs.

For emergency seizure control. Cluster seizures and status epilepticus are emergencies. Treatment is essential to prevent death from hyperthermia, acidosis, poor perfusion, and hypoxia, and to prevent permanent brain damage [3]. Injectable levetiracetam is one option veterinarians use in that setting, alongside benzodiazepines and other drugs [3]. A newer option being studied is intranasal levetiracetam, which in healthy dogs reached target blood concentrations after a single dose, though this is still research instead of routine practice [4].

Levetiracetam has also been used successfully in dogs with suspected myoclonic seizures, a type of generalized seizure marked by brief jerking movements. In one case series, all five dogs were treated with levetiracetam and two became free of those seizures long term [5].

How Keppra Works in Dogs

Levetiracetam's mechanism of action is distinct from that of other anticonvulsants [1]. That matters in practice. Many older seizure drugs work by dampening sodium channels or boosting GABA, the brain's main calming signal. Levetiracetam takes a different route, which is one reason it stacks so well with those drugs instead of competing with them.

The drug also behaves predictably in the body. In people and small animals, levetiracetam shows linear kinetics, meaning blood levels rise in proportion to the dose, and it has excellent oral bioavailability, meaning a pill delivers a reliable amount of drug into the bloodstream [1]. It is excreted largely unchanged by the kidneys, which is why serious side effects are rarely reported across species [1].

That kidney route has one practical consequence. Dogs with kidney disease clear the drug more slowly, so your veterinarian may adjust the dose or interval. Tell your vet about any kidney problems, past or present.

Dosing Basics for Dogs on Keppra

Who decides the dose?

Your veterinarian does, every time. There is no safe home dose chart for levetiracetam, and the right amount depends on your dog's weight, kidney function, seizure pattern, and what other drugs are on board. Doses used in hospital emergencies are calculated and given by the veterinary team, not by owners at home.

How is it given?

Levetiracetam comes as oral tablets, oral liquid, and injectable forms. In the hospital, it may be given intravenously for a seizure emergency [3]. At home, most owners give it by mouth, usually two or three times a day because the drug clears fairly quickly. An intranasal compounded version has been studied in healthy dogs and reached target blood levels, but that is not yet a standard at-home product [4].

A few practical tips:

Give the medicine with or without food, whichever your dog tolerates. Consistency matters more than timing relative to meals.
If your dog spits out a pill or vomits soon after a dose, call your veterinarian for instructions instead of guessing at a repeat dose.
Keep a seizure log with dates, times, duration, and what the seizure looked like. This is the single most useful thing you can bring to follow-up visits.

What about a missed dose?

Call your veterinarian's office and ask. In general, the safest approach with anticonvulsants is not to double up, because a double dose raises the risk of sedation and wobbliness. Missing doses, on the other hand, can lower blood levels and trigger breakthrough seizures. If you miss doses often, tell your vet. A different schedule or formulation may fit your life better.

If your dog has a seizure while you are figuring out a missed dose, follow your emergency plan. What Can You Do For Dog Having Seizures walks through what to do and what not to do in the moment.

Side Effects of Keppra in Dogs

Levetiracetam is considered well tolerated, and serious side effects are rarely reported in dogs or cats [1]. That said, no drug is free of effects, and the ones that do occur are usually manageable.

Side effect	How common or serious	What to do
Sleepiness, wobbliness, unsteady walking	Common when starting or after a dose increase. Usually mild and settles.	Note the timing and severity. Call your vet if it does not improve or if your dog cannot stand or walk safely.
Mild stomach upset (vomiting, soft stool, poor appetite)	Uncommon and usually mild.	Offer small bland meals. Call your vet if vomiting repeats or your dog stops eating.
Behavior change (agitation, restlessness, unusual clinginess)	Uncommon.	Report it. Your vet may adjust the dose or timing.
Marked sedation or profound weakness	Uncommon but serious.	Call your veterinarian the same day.
Allergic reaction (hives, facial swelling, trouble breathing)	Rare but an emergency.	Go to a veterinary emergency hospital immediately.
Changes on blood work	Antiepileptic drugs as a group can shift lab values, most often liver-related, and these changes are often adaptive in dogs instead of true disease [6].	Keep scheduled monitoring appointments. Do not interpret lab results on your own.

One thing to understand about monitoring: levetiracetam is not the drug most likely to cause liver enzyme changes. Older anticonvulsants are. Still, because many dogs on Keppra also take phenobarbital or another drug, your veterinarian will likely check blood work periodically to separate drug-related lab shifts from real organ problems [6]. That distinction is exactly why the monitoring schedule exists.

Who Should Not Take Keppra, and What Interacts With It?

Levetiracetam has minimal drug-drug interactions, which is one of its main selling points in veterinary medicine [1]. That does not mean interactions are impossible. It means Keppra is less likely than older drugs to interfere with everything else your dog takes.

Dogs who need extra caution include:

Dogs with kidney disease, because the drug is cleared by the kidneys and may build up.
Dogs already very sedated from other anticonvulsants, since adding any seizure drug can deepen sedation.
Dogs with known sensitivity to levetiracetam or to ingredients in the tablet or liquid.
Dogs on multiple anticonvulsants at once. This is common in hard-to-control epilepsy, and it is a situation where your veterinarian needs the full medication list, including supplements and over-the-counter products.

Tell your veterinarian about every product your dog receives, including flea and tick preventives, joint supplements, and any CBD product. CBD is being studied as an add-on for dogs with drug-resistant epilepsy, and in one small study it reduced seizure frequency when added to existing anticonvulsants [7]. Even when a product seems natural, it can change how the body handles prescription drugs, so your vet needs to know.

If your dog's seizures are not controlled on two or more drugs, that is called refractory epilepsy, and it is a signal to revisit the whole plan. Canine Epilepsy: Diagnosis and Antiepileptic Drug Management explains how veterinarians work through those decisions.

Overdose and When to Call for Help

If your dog gets into the pill bottle and takes too much levetiracetam, call for help right away. Do not wait for symptoms.

Call your veterinarian or a veterinary emergency hospital first. If they are closed or you cannot reach anyone, call poison control. In the United States, you can reach the ASPCA Animal Poison Control Center at (888) 426-4435 or the Pet Poison Helpline at (855) 764-7661. Both may charge a consultation fee.

Signs that worry veterinarians after an overdose include heavy sedation, inability to stand, vomiting, tremors, and unusual breathing. Bring the bottle with you so the team knows the drug, the strength, and how many pills might be missing.

Limitations and When to Contact a Veterinarian

Keppra is not a standalone fix. It reduces seizure activity in many dogs, but it does not address the underlying cause of seizures, whether that is epilepsy, a brain tumor, or a metabolic problem. Reactive seizures from toxic or metabolic causes need their own treatment, and long-term anticonvulsants are often not needed once the cause is corrected. In one study of dogs with seizures caused by insulin-induced low blood sugar, only a small minority needed ongoing seizure drugs [8].

Every dog is different, and only your veterinarian can judge your dog's case.

Contact your veterinarian the same day if:

Your dog seems more sedated, wobbly, or weak than usual after a dose.
Your dog vomits repeatedly or refuses food for more than a day.
Seizures are becoming more frequent or more severe than your dog's normal pattern.
You missed doses and are unsure how to get back on schedule.

Go to an emergency hospital now if:

A seizure lasts longer than 5 minutes [2].
Your dog has two or more seizures without fully recovering consciousness in between, which defines status epilepticus [2].
Your dog has a cluster of seizures in a short period, especially if that has happened before [3].
Your dog has trouble breathing, collapses, or does not wake up normally after a seizure.

Frequently Asked Questions

Is Keppra safe for long-term use in dogs?

Yes, levetiracetam is generally considered well tolerated for extended use, and serious side effects are rarely reported in dogs and cats [1]. Most dogs stay on it for months or years alongside another anticonvulsant. Your veterinarian will still schedule periodic checkups and blood work, mainly to watch the whole medication plan instead of Keppra alone.

Can Keppra be used alone for seizures?

Sometimes, but it is most often prescribed as an add-on to another anticonvulsant. Its role as a first-line solo treatment in dogs has not been settled [1]. If your dog is newly diagnosed, ask your veterinarian why a particular drug or combination was chosen for your dog's seizure type and pattern.

Does Keppra help dogs with brain tumors?

It can help control the seizures that tumors cause, and seizure control matters a great deal in these dogs because each seizure can raise intracranial pressure and risk herniation [3]. Keppra's low interaction profile makes it easier to combine with steroids and other tumor-related treatments [1]. It does not shrink the tumor. Tumor-directed care is a separate conversation with your veterinarian or veterinary oncologist, and nutrition support may be part of that plan, as described in Cancer Diet for Dogs: Ketogenic Omega-3 and Antioxidant Protocol.

Can Keppra be given during a seizure emergency?

Yes. Injectable levetiracetam is one of the drugs veterinarians use for cluster seizures and status epilepticus, alongside benzodiazepines and other anticonvulsants [3]. This is hospital-level care, not something to attempt at home. If your dog is seizing now, get to a veterinary emergency hospital.

What if my dog's seizures are not controlled on Keppra?

That is common in hard-to-control epilepsy, and it usually means the plan needs revisiting instead of the drug being useless. Your veterinarian may adjust doses, add a third drug, or recheck the underlying diagnosis. If you are facing a poor prognosis or considering quality-of-life decisions, Dog Seizures Put Down discusses how owners and veterinarians approach that conversation with care.

References

A review of the pharmacology and clinical applications of levetiracetam in dogs and cats. Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001), 2024.
Anticonvulsants for Treatment of Animals - Pharmacology. Merck Veterinary Manual.
Anticonvulsants for Emergency Treatment of Seizures in Dogs and Cats - Pharmacology. Merck Veterinary Manual.
Single-Dose Pharmacokinetics of Intranasal Levetiracetam in Healthy Dogs. Journal of veterinary pharmacology and therapeutics, 2026.
Use of levetiracetam for the successful treatment of suspected myoclonic seizures: five dogs (2016-2022). The Journal of small animal practice, 2024.
Antiepileptic drug therapy in companion animals: New perspectives on clinical pathology monitoring. Veterinary and animal science, 2026.
An Exploratory Study of Cannabidiol as an Adjunctive Treatment for Refractory Epilepsy in Dogs. Animals : an open access journal from MDPI, 2025.
Long-term antiepileptic therapy is often not required in dogs with insulin-induced hypoglycemic seizures: a multicenter retrospective study of 49 dogs. Journal of the American Veterinary Medical Association, 2026.