cbd oil for horses with epilepsy

Cbd oil for horses with epilepsy

Table of Contents

In recent years it has come to light that CBD oil is extremely effective in treating seizures in humans. In fact, there have been documented cases where seizures have been reduced by as much as 50% by the judicious administration of CBD. But what about our 4 legged friends? And in particular, horses. Can CBD help horses struggling with seizure disorders?

Happily, the answer is “yes.” Although the causes of equine seizures vary and are sometimes hard to pin down, horses often respond positively to CBD treatment. It’s an exciting development and one that promises to open new avenues of low-impact, high-effectiveness treatment for these most noble of animals.

Equine Seizures: The Big Picture

As we mentioned, there is more than one cause of equine seizures. According to veterinarian Dr. Joyce Harmon, seizures in horses have a variety of possible causes, including tumors, chemical toxins, head trauma, rabies and more. But in some instances – as is often the case with humans – the cause will remain a mystery for the duration of the horse’s life.

Another thing to keep in mind is that seizures can sometimes be confused with other disorders, including but not limited to, narcolepsy and cataplexy. In a general sense, however, equine seizures can be divided into two broad categories: epileptic and non-epileptic. Let’s take a closer look at those different categories now:

Epileptic Seizures

According to Doctor of Veterinary Medicine Robert Ogelsby, equine epilepsy is actually a fairly common affliction. Epileptic seizures in horses vary in intensity, and if the horse does not receive adequate treatment, they may wind up injuring themselves or others during a seizure.

In extreme cases, horses will actually collapse to the ground, stiffen, shake and lose consciousness, much like people do. In other cases, the ears or tail of the horse may begin to tremble, its jaw may stiffen, and its eyes may seem to glaze over and stare into the distance. No matter the severity, it’s a disturbing thing to see.

Non-epileptic Seizures

A horse may experience other types of seizures as well. In some cases, these may have some of the characteristics of epilepsy, but actually be caused by something else. During these episodes, the horse will likely not lose consciousness, but may be unsteady on their feet. Make sure you take careful note of everything the horse is going through, and relay the symptoms to the vet. This will help them make a more accurate diagnosis. Here are some of the symptoms to look for:

  • Shaking or trembling as if they’re cold.
  • A glazed look in their eyes.
  • A firmly clenched jaw for no apparent reason.
  • Excessive sweating.
  • Abnormal mouth activity.
  • Tensing up of the leg muscles.
  • Loss of bowel control.
  • Loss of bladder control.
  • A sense of confusion or being lost.
  • Shaking or trembling of the head.

To see what it looks like when a horse suffers a seizure, take a look at this YouTube video. We must warn you though, the video may be disturbing for some viewers.

The Role of Diet in Seizures

Some owners suspect that the seizures their horse is experiencing is somehow related to diet. And there may be something to that, according to Dr. Kathleen Crandaell, an equine nutritionist. According to Dr. Crandell, horses, like people, can experience the phenomenon known as being “hangry” (hungry and angry) when they’re blood sugar levels crater. In some horses, seizures may accompany the blood sugar crash.

The EES (Equine Endocannabinoid System) In Horses

In the late 20th century, a series of breakthrough discoveries confirmed the existence of the endocannabinoid system (ECS) in humans. At the time, however, restrictive laws related to all manner of hemp products made it difficult to get funding to explore the potential of the ECS. Nonetheless, that discovery got animal lovers wondering if their dog or cat or even their horse also possessed a similar system. And the answer is that it does.

Science Weighs in on the Issue

A wide-ranging study published in 1999 looked at the role of the ECS in animals. It was found that only insects lacked some version of an ECS, and that this regulatory system could be traced back hundreds of millions of years in the fossil record. The study concluded that all animals are designed, so to speak, to be receptive to cannabinoids. And that cannabinoids play a role in modulating movement, enhancing memory, and controlling pain in animals, including horses.

This landmark study sent ripples across the medical and veterinary landscapes. But again, because the laws of the day were very restrictive when it came to hemp and hemp derivatives (i.e. marijuana), all vets could do was wonder about the potential of CBD for animal disorders and health conditions.

The Dawn of a New Day

As we turned the page into the new century, however, those narrow-minded and restrictive laws began to fall by the wayside. As fresh data began to roll in, professionals like Dr. Juliet Getty recognized that the endocannabinoid system of the horse responded to CBD in much the same way the human ECS does. This had implications for the treatment of myriad health conditions afflicting horses, including seizures.

The Dosing Issue: A Step by Step Process

So now we know horses have their own version of the ECS, referred to by vets as the EES. We also know that CBD is effective in treating seizures in humans and other animals. What we still need to determine is the right dose for treating equine seizures.

While it may seem that the age-old maxim of basing a dose on the animal’s size and age should apply, unfortunately that is not the case. Also, potency in CBD products can be somewhat hit or miss, according to Professor of Neurology Dr. Jerzy Szaflarski. “The concentrations in products are only approximate, and I don’t know how well they’re tracked,” he says. So with that in mind, let’s go through the dosing procedure one step at a time:

  • Step 1: Determine a baseline – Regardless of the size, sex or age of your horse, it is suggested that you start with 40mg of CBD per day.
  • Step 2: Determine your step size – That is, decide how much of a step upward you will take during the process. Generally, it is recommended each step be in 20mg increments.
  • Step 3: Begin administration at baseline dosage – Begin administering the baseline amount of 40mg CBD per day. Administer this dosage for one week, while carefully monitoring your horse and noting any changes. 7 days is necessary because CBD has a cumulative effect.
  • Step 4: Step up the dosage – If, after 7 days, you are not satisfied with the results, it will be time to increase the dosage by 20mg. Continue with this dosage (now 60mg per day) for 3 days this time. Again being careful to note any changes in your horse.
  • Step 5: Increase again if necessary – If after 3 days at 60mg per day your horse is still not experiencing the benefits of the CBD therapy, increase the dosage again by another step. Stay at this new baseline level (80mg) for another 3 days, carefully monitoring your horse. If after 3 days you need to increase the dose again, take it up another 20mg and keep it there for a further 3 days.

Continue on this path until you reach the dosage at which your horse shows improvement. And be patient. It’s possible that it may take several weeks to find the right dosage for your horse. Don’t lose patience and overload their system with an enormous dose.

  • Step 6: Refining the dosage – When you reach that happy point where your horse is responding the way you hoped to the CBD, your job then becomes one of refinement. For the sake of your horse, you can and should take your time with this step. Leave things where they are for a while and then, if you think a smaller dose is called for, back off in 5mg increments, 3 days at a time until you find the right balance.

Best CBD Oil for Horses with Seizures At The Moment Is Green Flower Botanicals

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Conclusion

The days of having to watch helplessly as your horse endured the pain and stress of equine seizures are behind us. Thanks in no small part to advances in treatment made possible by products such as Green Flower Botanicals CBD Oil. The above step by step guide will allow you to determine the precise amount of this remarkable substance that’s needed to bring relief to your horse. So don’t delay. Get started with CBD therapy today.

Therapeutic Use of Cannabidiol (CBD) for Equine?

Cannabidiol (CBD) is one of many cannabinoid compounds found in the cannabis plant. Cannabis includes three species: Cannabis sativa, Cannabis indica, and Cannabis ruderalis. “Hemp”, a variety of Cannabis Sativa, is the common name for cannabis that is cultivated not only for CBD products, but for other non-drug uses such as fiber for clothes, ropes, and paper. Hemp is not to be confused with marijuana, which includes all cannabis species and cultivated for high levels of the cannabinoid tetrahydrocannabinol (THC). THC is the cannabinoid responsible for the psychoactive effect that causes the user to feel ‘high’, and while both hemp and marijuana produce CBD and THC, only small amounts (typically <0.3%) of THC are found in hemp. CBD does not have the same psychoactive effects as THC.

CBD Supplementation and Uses

CBD supplements come in many different forms, and can be administered through various routes such as oral ingestion, inhalation, sublingual, rectal, or topical application to the skin. CBD products may be supplied as a CBD-only oil, a full-plant extract oil, dried plant, in liquids, creams, ointments, or capsules, among many other forms. Currently, these CBD products are aggressively marketed online and in print for the use in horses, making exaggerated and unproven health claims including the promise of chronic pain relief, reduction in anxiety and depression, lowering inflammation, increased neuroprotective properties (brain health), aiding gut health, treating seizures, and protecting against bone disease. The effects of CBD in horses is unknown! There are no studies or scientific research into the effect of CBD in horses.

The Industry Lacks Published Studies

Given the increasing interest of health claims associated with the therapeutic uses of CBD, more rigorous studies are needed to substantiate and validate these claims, as well as to understand the potential health risks associated with both short-term and long-term CBD use. In humans, CBD, THC, and other cannabinoids interact in the body as part of the endocannabinoid receptor system. Horses also have endocannabinoid receptors, so similar effects are possible, though it is unknown due to the lack of scientific data or published studies (pharmacodynamics). Additionally, there is no information on the equine metabolism (pharmacokinetics) of CBD, thus it is impossible to estimate or determine withdrawal times in horses.

CBD Regulation

Over the last several years, interest and research has focused on the potential therapeutic use of CBD. The US FDA (Food and Drug Administration) has approved a CBD drug, Epidiolex, for the treatment of two epilepsy disorders in humans. Only this CBD drug has a Schedule V classification, while all other CBD products remain a Federal Schedule I drug prohibited for any use. Many states have laws allowing medical use of cannabis and/or products that are high in CBD and low in THC (<0.3%) with varying degrees of restriction, so care must be taken to cross-reference state and local laws. Despite diverse regulation for human consumption, at present there are NO cannabidiol products approved for use in horses, and the Association of Racing Commissioners International (ARCI) has designated CBD as a penalty Class 3B drug and THC a Penalty Class 1A drug.

While the FDA-approved CBD drug Epidiolex is regulated for efficacy and is produced under good manufacturing practices (GMP) to ensure the safety, quality and sterility of the product, CBD products sold on the internet or at dispensaries are not manufactured to these same FDA and GMP standards. Though state laws and regulations for CBD supplements may require content labeling and quality manufacturing controls, they are inconsistent and sometimes nonexistent.

Artisanal (homemade) extracts and supplements are also not required to be tested CBD or THC content, or for parameters such as microbial safety, residual solvents, or contaminants such as pesticides and herbicides. How does one effectively use a product when there may be significant variance in production, content, and safety? Even though supplements are required to contain less than 0.3% THC, the small quantity found in hemp will ultimately be extracted and concentrated alongside the CBD. Without laboratory testing and labeling requirements of the finished product, THC may then be inadvertently ingested, and a positive finding for THC from a hemp-derived CBD product may occur. Since microbial testing is also not a regulated requirement, pathogens such as Salmonella, E.coli, Listeria, and consumption of other harmful compounds are a major concern. It is difficult, if not impossible, to know exactly what you are getting.

Unknown Side Effects of CBD Usage

Besides the health and safety concerns, there are noted side effects in humans such as diarrhea, changes in appetite, fatigue, drowsiness, light headedness and low blood pressure. Although the majority of the science indicates that CBD is safe for use, CBD may interact with the cytochrome P-450 system, an enzyme in the liver responsible for metabolizing most drugs and toxic compounds, which could result in either faster or slower metabolism times for other drugs. Other foods or supplements such as grapefruit, watercress, and St. John’s Wort have similar effect on the cytochrome P-450 system. Unwanted side effects and potentially an overdose could be the impact of CBD’s inhibition of the cytochrome P-450 system.

Due to the lack of regulation, unsubstantiated claims without published studies, and unknown health effects and potential side effects, be cautious of all of the CBD oil and supplement claims for novel pain relief, athlete performance and recovery statements. There are numerous dosage and safety concerns around these unregulated CBD supplement products, so using prescribed drugs from a licensed veterinarian to treat all equine health issues is the best approach in the care and welfare of your animal.

Cannabis oil ?

CBD oil inhibits the P450 enzyme in the liver and affects the metabolism of other drugs. It should not for instance be used alongside steroids.

There are different strengths and it would be easy to give too much if you didn’t read up on the exact dose and measure dose accurately, to a fraction of a ml.

THC toxicity is a very real risk.

CorvusCorax
Actually made out of cups
bonny
Well-Known Member

CBD oil inhibits the P450 enzyme in the liver and affects the metabolism of other drugs. It should not for instance be used alongside steroids.

There are different strengths and it would be easy to give too much if you didn’t read up on the exact dose and measure dose accurately, to a fraction of a ml.

THC toxicity is a very real risk.

skinnydipper
Well-Known Member

No, I looked into it to use for my last dog. He was on multiple drugs including steroids. After doing lots of "homework" I decided it wasn’t worth the risk.

You need to do a lot of research before you use it. Everything has to be considered, including the carrier oil as this affects absorption. MCT is considered the best.

bonny
Well-Known Member
skinnydipper
Well-Known Member

Has your dog been investigated to find the cause of the seizures?

I would recommend following your vet’s advice before trying to treat this yourself.

I had a dog with idiopathic grand mal epilepsy. She survived many years on daily veterinary prescribed medication and I administered rectal Diazepam for prolonged seizures. The medication controlled but did not eliminate the fits. She had cluster seizures and on medication could have a couple of weeks free between clusters.

She was a happy, bright dog and I never considered euthanasia as she enjoyed life to the full.

She was eventually put to sleep due to status epilepticus. She was 6 when diagnosed and 12 when she died.

Please feel free to ask me anything, I’ll try to help if I can.

ETA. Annie was taking Epiphen and potassium bromide daily – these did not affect her quality of life – she was not drowsy on them. There was no evidence for using Pexion for cluster seizures so this wasn’t tried.

PurBee
Well-Known Member

The law on CBD oil is that it cannot contain more than 0.2% THC cannabinoid.

CBD is an excellent anti-inflammatory. I’ve known a few cases, including myself, where it helped.

I dont know of reports on dogs, but it could be useful for arthritic conditions.
Ask your vet if they have any cases using CBD oil for the condition youre wanting to treat.

Although for the cost of CBD oil, there’s alot of other effective anti-inflammatory natural options to try that are far cheaper. turmeric/msm/chondroitin/probiotics etc.

In the future the whole range of cannabinoids will be studied even moreso than now and will become a commonplace remedy for various ailments, at a reduced price than the highly inflated price it is today.
Its a shame that the drug world bred ‘super high THC hybrid cannabis’ Which has given the indigenous plant botanical healing qualities a skewed understanding by the majority.

P.s ‘hemp oil’ is not the same as CBD oil.
Hemp oil is from the hempseeds, containing high omega 3 and 6. (I wouldnt use hemp oil for inflammatory conditions anyway as it contains an inverted omega index. Much higher pro-inflamm. Omega 6 content compared to anti-inflamm omega 3)
CBD is not contained in hemp seeds.
CBD cannabinoid is found in the trichomes of the flower of hemp plant.
So if the bottle doesnt say ‘CBD OIL’ on the front, it’s just hemp oil. There’s some unscrupulous sellers on ebay and amazon pulling a fast one on people by selling hemp oil as cbd oil.

bonny
Well-Known Member

Has your dog been investigated to find the cause of the seizures?

I would recommend following your vet’s advice before trying to treat this yourself.

I had a dog with idiopathic grand mal epilepsy. She survived many years on daily veterinary prescribed medication and I administered rectal Diazepam for prolonged seizures. The medication controlled but did not eliminate the fits. She had cluster seizures and on medication could have a couple of weeks free between clusters.

She was a happy, bright dog and I never considered euthanasia as she enjoyed life to the full.

She was eventually put to sleep due to status epilepticus. She was 6 when diagnosed and 12 when she died.

Please feel free to ask me anything, I’ll try to help if I can.

ETA. Annie was taking Epiphen and potassium bromide daily – these did not affect her quality of life – she was not drowsy on them. There was no evidence for using Pexion for cluster seizures so this wasn’t tried.

PurBee
Well-Known Member

My friends akita age 6 ish suddenly developed grand mal seizures, that involved urinating everywhere too. The vet gave medication which reduced the number of seizures, and i found online a recommendation that someone said worked for seizures a recipe of cooked courgette and sweet potato, which i made for it and friend fed daily, along with usual dried kibble (prob grain based). and the combo stopped the seizures.

This was some years ago and i cant recall what it was that was in the potato and veg mix specifically but it was recommended for seizures. Google this, hopefully now yrs have passed there could be more dietary advice.

Their akita lived for many yrs after this seizure free, while on medication.

skinnydipper
Well-Known Member

It isn’t easy watching your dog have a fit but it isn’t the end of the world. Don’t panic and don’t be frightened to reassure your dog as he is recovering. Please watch that he doesn’t come to harm in the post ictal period when he is likely to be confused.

As the fits have increased I would suggest going back to your vet for further advice. MRI would rule out a brain tumour and might put your mind at rest that there isn’t a sinister cause. Your vet will have ruled out metabolic causes with the blood tests. Your dog could be like mine and have idiopathic epilepsy which basically just means that no cause was found.

With the guidance of your vet I would try prescription medication and forget the CBD oil as a first line of treatment, it is always something to consider if all else fails. Annie died in 2015, there may be newer treatments available now.

Prescription medication may stop the fits or reduce them to a frequency that you feel you can cope with.

Only you and your vet can decide if your dog’s quality of life is impaired and if PTS would be kindest.

I never once regretted my decision to treat Annie with anticonvulsants, she didn’t let epilepsy get in the way of enjoying life.

Don’t hesitate to contact me if you feel I can help.

CorvusCorax
Actually made out of cups
skinnydipper
Well-Known Member

. and don’t do as I did when Annie’s first fit started – I didn’t realise she was fitting, I thought from the sound she was making that she was choking and was going to clear her airway when she bit down hard on my fingers I soon realised what was going on when the tonic/clonic movements started and she was incontinent. It came as a shock the first time. She had been asleep in the chair.

One of my other dogs got excited the first time she saw Annie fitting but didn’t bother after that. My first GSD would come and gently reassure her as she was recovering.

Annie was never aggressive when she was coming round but would crash about or stand with her head in the corner of the room. I found she was calmer and recovered more quickly if I gently held her.

She must have had an aura when she was awake and tried to find me if she knew she was going to fit and I always slept with one ear open so I knew when a fit started at night.

missmatch
Well-Known Member
skinnydipper
Well-Known Member

I know its tough for you right now Bonny and you are trying to do what you feel is best for your dog. I was just sharing my experience of epilepsy in my dog. Sometimes she would have a cluster only once a month, sometimes only a couple of weeks would go by but if we were lucky we could have a stretch of 6 weeks between episodes. I am sure it was not painful for her. Between episodes she was the same dog with the same zest for life.

Why don’t you go back and have another chat with your vet. Explain how you are feeling, that you are worried about the increase in fits and ask about treatment options and whether it would be a good idea to have a treatment trial. When on treatment your vet will check bloods to see if the drugs are at a therapeutic level and monitor liver and kidney function.

It really doesn’t matter if we or our pets are on drugs for life, I am on more than one and it certainly beats being dead

Here is more information about CBD which I hope will help you make an informed decision on treatment.

I’ll start with this link:

I think vets in the UK can prescribe CBD using the prescribing cascade when usual treatments for the condition have not been effective.

I could only find one small study, led by Dr McGrath at Colorado State University, which looked at CBD for dogs with epilepsy. 16 dogs in the study, 9 were given CBD in addition to their usual medication. Dr McGrath is a shareholder of the company which provided the product used in the study.

CBD for humans is an unregulated, non standardised supplement.

It is illegal for CBD supplements to be sold for animal use (see first link)

Studies have found that label claims frequently do not match bottle contents.

CBD oil has been found to contain fungus and pesticides and other toxins such as heavy metals and high levels of ethanol.

It is advisable to buy a pharmacy grade product with a certificate of analysis.

You would need to check for drug interactions, CBD may interfere with other medications processed by the liver.

CBD elevates liver enzymes and you would be unaware of this without blood testing.

THC causes toxicity in dogs and has been found in higher levels than those stated on the label.

I would want to know that the person advising on dosage was medically qualified.

bonny
Well-Known Member
PaintPonies
Active Member

When you see your vet make sure you ask about what you should/shouldn’t do when your dog is having a fit and coming out of the fit. Having as much information as you can should make it less scary for you and you will feel more prepared. As skinnydipper has said apart from some confusion after the fit they really don’t know anything about it, it will be worse for you watching than for him.

I’m not up to date with current treatment options but in my experience the preventatives were usually very effective. I know you say you don’t want the dog on life long medication but surely the cannabis oil would be life long too? If the fits seem to be increasing in frequency then it would be good to get to the vet and get started on medication sooner rather than later.

SusieT
Well-Known Member
bonny
Well-Known Member
skinnydipper
Well-Known Member

You stated on another thread "we seem to have become a nation of animal owners that can’t do anything without a professional holding our hands". That should not apply to epilepsy which needs the expertise of a veterinarian.

Epilepsy is not something that you should be trying to treat yourself with OTC dubious supplements.

The dogs in the study were taking conventional veterinary prescribed proven epilepsy treatments, the same drugs that my dog was on. CBD was given in addition to those. Larger studies are needed.

I was not advocating treating with CBD when I linked to the study.

I had hoped that my post would highlight the dangers of buying CBD and trying to treat your dog yourself. Aside from giving something which could potentially be harmful (THC, contaminants, CBD content not consistent with labelling) – you would be committing an offence.

Please make an appointment to see your vet without delay. Your vet needs to be aware that the situation has changed and advise you accordingly. There is no advantage in waiting.

From what you have said, he is having frequent fits and they are severe.

A prolonged fit (lasting more than 5 minutes) can cause brain damage and requires treatment to stop it.

50% reduction in fits is good. Any reduction is good.

He won’t come to any harm by taking medications prescribed by your vet.

Your vet may have made the decision not to treat initially because your dog had only had one fit or occasional fits. If your dog is having multiple fits then your vet needs to know ASAP.

Your vet may wish to carry out further investigations to elicit the cause of the seizures.

If your dog needs medication it takes time for it to reach therapeutic levels.

Your vet will not prescribe CBD without first prescribing tried and tested anticonvulsants and not all vets will be familiar with its use.

Well-Known Member

If you don’t want to medically treat your dog for what sounds like worsening epilepsy then that’s your call but to be quite frank it’s a bad one.

one seizure has a very different recommendation on management to multiples and clusters of seizures. You really need to talk to your vet again. Increasing frequency changes the treatment plan completely.

Those increasing seizures need treatment and are likely to worsen. The longer you delay treatment the less likely you are to be able to control this if it is true epilepsy.

Cluster seizures are where you have mutlipe seizures together so the body never gets a chance to recover or cool down after all that movement. Clusters or excessively long seizures are the biggest risk in this condition as these can lead to death due to hyperthermia from the excessive muscle movement.
Any reduction is better then ongoing seizures and the risk they entail if they have started to increase in frequency.

Generally over 5 minutes of nonstop fitting and you’ve essentially cooked the internal parts if the dog and it will be brain dead when the seizure eventually stops. The body shuts down after. That’s what the medications trying to avoid.

It makes 0 sense to use cannabis instead of trialling the medications with known efficacy for this condition. If all else fails then by all means it’s worth a go..but as a first line of defence it’s a bad call until we learn more about that drug in dogs.

There are multiple recognised and quite reliable treatment options for canine epilepsy. The aim of treatment is generally to reduce frequency and length of seizures in the hopes of avoiding the fatal clusters seizures. It’s rarely 100 percent perfect few medications are. but many dogs respond very well once correctly medicated at the right dose.

At 3 his treatment will be lifelong but if he responds well to medication it could be quite a long and otherwise normal life.

bonny
Well-Known Member

If you don’t want to medically treat your dog for what sounds like worsening epilepsy then that’s your call but to be quite frank it’s a bad one.

one seizure has a very different recommendation on management to multiples and clusters of seizures. You really need to talk to your vet again. Increasing frequency changes the treatment plan completely.

Those increasing seizures need treatment and are likely to worsen. The longer you delay treatment the less likely you are to be able to control this if it is true epilepsy.

Cluster seizures are where you have mutlipe seizures together so the body never gets a chance to recover or cool down after all that movement. Clusters or excessively long seizures are the biggest risk in this condition as these can lead to death due to hyperthermia from the excessive muscle movement.
Any reduction is better then ongoing seizures and the risk they entail if they have started to increase in frequency.

Generally over 5 minutes of nonstop fitting and you’ve essentially cooked the internal parts if the dog and it will be brain dead when the seizure eventually stops. The body shuts down after. That’s what the medications trying to avoid.

It makes 0 sense to use cannabis instead of trialling the medications with known efficacy for this condition. If all else fails then by all means it’s worth a go..but as a first line of defence it’s a bad call until we learn more about that drug in dogs.

There are multiple recognised and quite reliable treatment options for canine epilepsy. The aim of treatment is generally to reduce frequency and length of seizures in the hopes of avoiding the fatal clusters seizures. It’s rarely 100 percent perfect few medications are. but many dogs respond very well once correctly medicated at the right dose.

At 3 his treatment will be lifelong but if he responds well to medication it could be quite a long and otherwise normal life.