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A seizure lasting more than 5 minutes, or two or more seizures in 24 hours, is an emergency even if your dog is on Keppra — go to an emergency vet. Keppra wears off within hours, so missed doses matter more than with most seizure drugs. Do not stop it suddenly, and do not split or crush extended-release tablets.
The short answer: Keppra (levetiracetam) is a human anti-seizure drug that vets use off-label in dogs. The standard immediate-release dose is 20 mg/kg every 8 hours; extended-release tablets are usually 30 mg/kg every 12 hours. It is one of the gentlest seizure drugs — it barely touches the liver, is cleared by the kidneys, and its main side effects are mild sleepiness and wobbliness. The catch: its placebo-controlled evidence is thin (the only randomised add-on trial did not beat placebo), some dogs lose the benefit after a few months (the "honeymoon effect"), and phenobarbital sharply lowers Keppra levels, so dogs on both may need much higher doses. In a UK epilepsy clinic, 69% of dogs had at least a 50% drop in seizures on it, and 15% became seizure-free.
By Marc Brannigan and Natalie Mondine, co-founders of HempMy Pet · Published November 6, 2026 · Last reviewed November 6, 2026. We have grown and bottled full-spectrum hemp for pets on our own Colorado farm since 2016. We are not veterinarians — everything below comes from the published veterinary studies, consensus guidelines and drug labels listed at the end.
What Keppra Is
Levetiracetam, sold as Keppra and as cheap generics, is a human epilepsy drug that works differently from older drugs — it binds a protein (SV2A) involved in releasing nerve signals. It is not FDA-approved for dogs, but vets prescribe it off-label widely, as a first drug, an add-on, a short "pulse" for cluster seizures, and in emergencies. A 2024 review describes it as having linear kinetics, excellent oral absorption, minimal drug interactions and rarely any serious side effects in dogs and cats.
Its pharmacology explains both its strengths and its weaknesses:
- Minimal liver metabolism — it leaves the body mostly unchanged through the kidneys. That makes it useful for dogs with liver disease or liver shunts, and for dogs already stressed by phenobarbital. Dogs with kidney disease may need a lower dose.
- Short half-life (3–6 hours) — which is why the immediate-release form is given three times a day, and why late or missed doses matter.
- No blood-level target established in dogs — vets can measure levels, but a 2024 study of 69 dogs could not identify a therapeutic range.
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Keppra Dosage for Dogs
| Form | Typical dose | How often | Notes |
|---|---|---|---|
| Immediate-release tablets or liquid | 20 mg/kg (about 9 mg/lb) | Every 8 hours (sometimes every 6) | IVETF maintenance dose; your vet may go higher |
| Extended-release tablets (Keppra XR and generics) | 30 mg/kg | Every 12 hours | Must be swallowed whole — never split, crush or chew; often impractical for small dogs |
| "Pulse" for clusters | 60 mg/kg once at the first seizure, then 20 mg/kg every 8 hours | Until 48 hours seizure-free | IVETF protocol; more side effects than daily dosing |
| Rectal (vet-directed rescue) | 40 mg/kg | Single dose | Reached target levels within 30 minutes in most dogs in studies |
Sources: IVETF 2015 (PMID 26316233); Beasley & Boothe 2015 (ER, PMID 26290357); Peters 2014 and Cagnotti 2018–2019 (rectal). Doses are for illustration — your vet sets your dog's.
If a liquid is prescribed, ask the pharmacist to confirm the formulation contains no xylitol, which is toxic to dogs, and use the syringe that comes with it. Human generics are inexpensive — GoodRx lists about $13–25 for 30 tablets — though large dogs on three-times-daily dosing go through a lot of tablets.
Does Keppra Work? What the Studies Show
This is where Keppra's reputation outruns its evidence. The data, honestly:
- Randomised placebo trial (34 dogs, 2012): in dogs not controlled by phenobarbital and bromide, Keppra reduced seizures compared with baseline, but not significantly compared with placebo (P = .31). Only 22 dogs finished, so the study was underpowered. Owners did rate quality of life higher on Keppra.
- UK epilepsy clinic (52 dogs, 2015): 69% had a 50% or greater reduction in seizure frequency and 15% became seizure-free. No life-threatening side effects; mild ones in 46%, more often with pulse dosing.
- US referral hospital (100 dogs on one drug, 2023): treatment failure was 35% for Keppra, 45% for zonisamide and 51% for phenobarbital — not statistically different — and quality-of-life scores improved on all three.
- Systematic review (2014): rated the evidence for Keppra as "fair", below phenobarbital and imepitoin.
The Honeymoon Effect
Some dogs respond well to Keppra for a few months and then drift back toward their old seizure frequency, even at the same dose. In a study of 14 dogs resistant to phenobarbital and bromide, 9 responded — but 6 of those 9 saw their seizures increase again after 4–8 months.
This tolerance is the main reason neurologists developed pulse therapy: instead of giving Keppra every day, the dog takes a high dose only when a seizure happens (or the owner spots the warning signs), then a short course until 48 hours seizure-free. It is aimed at dogs whose problem is clusters.
Keppra and Phenobarbital Together
This is the interaction most owners never hear about. Phenobarbital speeds up Keppra's clearance:
- In epileptic dogs on extended-release Keppra, peak levels were 13.4 µg/mL with phenobarbital versus 33.0 µg/mL without it, and total exposure was less than half (Muñana 2018).
- A 2024 study of 69 dogs estimated that reaching a serum level considered effective in people (20 µg/mL) would take 99–216 mg/kg/day — far above the standard 60 mg/kg/day — especially in dogs also on phenobarbital.
So if your dog is on both and still seizing, ask whether Keppra levels have been checked before concluding it "doesn't work". Zonisamide, by contrast, did not affect Keppra levels.
How Keppra Makes Dogs Feel
Most dogs tolerate it well. The most common side effects are sleepiness and wobbliness (ataxia), usually mild and most noticeable in the first week or two or after a dose increase. Less often, owners report vomiting, reduced appetite, or behaviour changes — restlessness, anxiety, clinginess or irritability. Serious side effects are rare, and bloodwork changes were not seen in the placebo-controlled trial. Unlike phenobarbital, Keppra does not typically cause big increases in hunger and thirst.
How Long Until It Works, and How Long Until My Dog Adjusts?
Keppra is absorbed quickly and, with its short half-life, reaches steady levels within a day — which is why it is used as a pulse and in emergencies. Your vet will usually judge whether it is controlling seizures over 1–3 months, depending on how often your dog was seizing before. Mild sleepiness typically settles within about one to two weeks.
What Is the Safest Seizure Medication for Dogs?
A 2016 meta-analysis of side effects suggested imepitoin and levetiracetam may be better tolerated than phenobarbital, and phenobarbital better than bromide — though none of those differences reached statistical significance. "Safest" depends on the dog: Keppra is often chosen for dogs with liver disease, while dogs with kidney disease need dose adjustment. Gentler is not the same as more effective, and for many dogs the right answer is a combination.
Can You Give CBD With Keppra?
Keppra's lack of liver metabolism means CBD is less likely to change its levels than with drugs that share liver pathways. In the 51-dog Colorado State crossover trial, where dogs stayed on their existing seizure drugs, CBD did not change anti-seizure drug levels — but it did raise liver enzymes and caused more vomiting and reduced appetite than placebo. CBD is not a substitute for Keppra. See what the CBD seizure trials found and our hemp and dog medications guide.
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- Missed dose: give it as soon as you remember unless the next dose is nearly due; never double up. Because Keppra leaves the body within hours, a skipped dose can drop protection quickly — phone reminders help.
- Stopping: taper under your vet's direction. Stopping any anti-seizure drug suddenly risks withdrawal seizures.
- Extended-release tablets: if your dog chews or you need to split them, ask for immediate-release instead — breaking them releases the whole dose at once.
Questions to Ask Your Vet
- Is Keppra replacing or adding to my dog's current drug?
- Immediate-release three times a day, or extended-release twice?
- If my dog is also on phenobarbital, should we check Keppra levels?
- Would pulse dosing for clusters suit my dog better than daily dosing?
- Does my dog's kidney function need a dose adjustment?
Frequently Asked Questions
How does Keppra make dogs feel?
Most dogs tolerate Keppra well. The most common effects are mild sleepiness and wobbliness, mostly in the first week or two or after a dose increase. Some dogs have vomiting, lower appetite, or behaviour changes such as restlessness or clinginess. Serious side effects are rare, and it does not usually cause the large increases in hunger and thirst seen with phenobarbital.
What is the safest seizure medication for dogs?
A 2016 meta-analysis suggested imepitoin and levetiracetam may have better safety profiles than phenobarbital, and phenobarbital better than bromide, though the differences were not statistically significant. Levetiracetam is often chosen for dogs with liver disease because it is cleared by the kidneys. The safest choice depends on your dog's organs, seizure pattern and other medications.
Does Keppra eliminate seizures in dogs?
Sometimes, but not usually. In a UK clinic study of 52 dogs, 69% had at least a 50% reduction in seizures and 15% became seizure-free. The only placebo-controlled add-on trial found fewer seizures than baseline but not significantly fewer than placebo. Some dogs also lose the benefit after a few months.
How long will it take my dog to adjust to Keppra?
Keppra reaches steady blood levels within a day. Mild sleepiness and wobbliness usually settle within one to two weeks. Your vet will judge seizure control over one to three months depending on how often your dog was seizing before.
What is the Keppra dose for dogs?
The standard immediate-release dose is 20 mg/kg every 8 hours. Extended-release tablets are usually given at 30 mg/kg every 12 hours and must be swallowed whole. For cluster seizures, the IVETF pulse protocol is 60 mg/kg once, then 20 mg/kg every 8 hours until 48 hours seizure-free. Your vet sets the exact dose.
Can Keppra and phenobarbital be given together?
Yes, and they often are. But phenobarbital speeds up the clearance of Keppra: in one study, peak extended-release Keppra levels were 13.4 versus 33.0 µg/mL in dogs on versus off phenobarbital. Dogs on both may need higher Keppra doses, so ask about checking levels if seizures continue.
What is the Keppra honeymoon effect in dogs?
Some dogs respond well at first and then gradually lose the benefit. In one study, 6 of 9 dogs that responded saw seizures increase again after 4 to 8 months on the same dose. This is one reason vets use pulse dosing for cluster seizures instead of continuous daily dosing in some dogs.
Can you crush Keppra for dogs?
Immediate-release tablets can usually be split or given in food. Extended-release tablets must never be split, crushed or chewed, because that releases the full dose at once. If your dog chews pills, ask your vet for the immediate-release form or a liquid, and confirm any liquid is free of xylitol.
The Short Version
Keppra (levetiracetam) is gentle on the liver, has few side effects and is given every 8 hours (or every 12 with extended-release). It is useful as an add-on, for dogs with liver problems, and as a pulse for clusters. Its placebo-controlled evidence is weak, some dogs lose the effect after months, and phenobarbital cuts its levels substantially. Never split extended-release tablets, don't miss doses, and never stop it suddenly.
For everyday wellness — never a substitute for Keppra or your vet's seizure plan
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Hemp Oil for Dogs → Phenobarbital for Dogs
Dog Seizures · Epilepsy in Dogs · Phenobarbital for Dogs · CBD & Dog Seizures: The Trials · Seizures & End-of-Life Decisions · Cat Seizures · Hemp & Dog Medications
Marc co-founded HempMy Pet in 2016 with his business partner Natalie Mondine, the company's COO. HempMy Pet breeds its own hemp genetics, grows them on its own Colorado farm, and formulates every batch in-house under human-grade standards — seed to sale, nothing sourced overseas. Every batch is third-party tested and the certificates of analysis are published. More about us.
HempMy Pet ran its own 90-day study of 37 dogs with chronic joint discomfort. Of the 32 that completed it, 30 (93%) showed a benefit, and 94% of owners reported their dog's quality of life had improved. It was overseen by Dr. Robin Downing, DVM, MS of the Downing Center for Animal Pain Management, with Lori Kogan, Ph.D. and Peter W. Hellyer, DVM of Colorado State University's College of Veterinary Medicine & Biomedical Sciences, and published in the Journal of the American Holistic Veterinary Medical Association. Read the methodology.
Why Dr. Downing: in 2005 she became only the third veterinarian in the world credentialed as a Diplomate of the American Academy of Pain Management. She founded the International Veterinary Academy of Pain Management, is a Diplomate of the ACVSMR, a Certified Veterinary Pain Practitioner and a Certified Canine Rehabilitation Practitioner, and was the AVMA's 2020 Bustad Companion Animal Veterinarian of the Year. Read the published paper (PDF).
This article is general information for dog owners, not veterinary advice. It is reviewed and updated as new peer-reviewed evidence is published, and where the evidence is thin or negative we say so.
How We Sourced This Article
Every claim above traces to one of these.
- Bhatti SFM, De Risio L, Muñana K, et al. International Veterinary Epilepsy Task Force consensus proposal: medical treatment of canine epilepsy in Europe. BMC Vet Res. 2015;11:176. PubMed.
- Muñana KR, Thomas WB, Inzana KD, et al. Evaluation of levetiracetam as adjunctive treatment for refractory canine epilepsy: a randomized, placebo-controlled, crossover trial. J Vet Intern Med. 2012;26:341–348. PubMed.
- Volk HA, Matiasek LA, Luján Feliu-Pascual A, et al. The efficacy and tolerability of levetiracetam in pharmacoresistant epileptic dogs. Vet J. 2008;176:310–319. PubMed.
- Packer RMA, Nye G, Porter SE, Volk HA. Assessment into the usage of levetiracetam in a canine epilepsy clinic. BMC Vet Res. 2015;11:25. PubMed.
- Gristina BR, Waldron RJ, Nettifee JA, et al. Comparison of caregivers' assessments of clinical outcome in dogs with idiopathic epilepsy administered levetiracetam, zonisamide, or phenobarbital monotherapy. J Am Vet Med Assoc. 2023. PubMed.
- Saint-Maxent G, Juette T, Parent J, et al. Factors influencing serum concentrations of levetiracetam in dogs with epilepsy. J Vet Intern Med. 2024. PubMed. Extended-release with phenobarbital: Muñana KR, et al. J Vet Intern Med 2018, PubMed; Beasley MJ, Boothe DM. J Vet Intern Med 2015, PubMed.
- Charalambous M, Brodbelt D, Volk HA. Treatment in canine epilepsy — a systematic review. BMC Vet Res. 2014;10:257. PubMed. Adverse-effect meta-analysis: Charalambous M, et al. BMC Vet Res 2016, PubMed.
- Mastrocco A, Prittie J, West C. A review of the pharmacology and clinical applications of levetiracetam in dogs and cats. J Vet Emerg Crit Care. 2024. PubMed.
- Peters RK, Schubert T, Clemmons R, Vickroy T. Levetiracetam rectal administration in healthy dogs. J Vet Intern Med. 2014. PubMed. Cagnotti G, et al. BMC Vet Res 2018, PubMed.
- Cagnotti G, Odore R, Bertone I, et al. Open-label clinical trial of rectally administered levetiracetam as supplemental treatment in dogs with cluster seizures. J Vet Intern Med. 2019;33:1714–1718. PubMed.
- Rozental AJ, Weisbeck BG, Corsato Alvarenga I, et al. The efficacy and safety of cannabidiol as adjunct treatment for drug-resistant idiopathic epilepsy in 51 dogs: a double-blinded crossover study. J Vet Intern Med. 2023;37:2291–2300. PubMed.
- Veterinary references. GoodRx, Levetiracetam (Keppra) for dogs (dosing, ER handling, cost) · VCA Animal Hospitals, Levetiracetam.
- Kogan L, Hellyer P, Downing R. The Use of Cannabidiol-Rich Hemp Oil Extract to Treat Canine Osteoarthritis-Related Pain: A Pilot Study. J Am Holist Vet Med Assoc. 2020;58:35–45. Our disclosure: HempMy Pet supplied the hemp extract and reimbursed clinic costs; we had no involvement in any other study cited here.
Spot something that conflicts with your veterinarian's advice? Email support@hempmypet.com and we will correct it.
These statements have not been evaluated by the Food and Drug Administration. Our products are not intended to diagnose, treat, cure, or prevent any disease. This article is general information, not veterinary advice. Levetiracetam is a prescription medication — never start, stop or change your dog's dose without your veterinarian.
