Keppra® (Levetiracetam)
Keppra® (Levetiracetam) for Dogs & Cats
Reviewed by Remedy Veterinary Specialists Neurology Team
Dr. Jurney, DVM, DACVIM (Neurology)
Dr. Qahwash, DVM, DACVIM (Neurology)
If your pet has been diagnosed with seizures or another neurologic condition, your veterinarian may have prescribed Keppra®. It’s one of the most commonly used anti-seizure medications in veterinary neurology and is frequently part of both short-term and long-term treatment plans for dogs and cats.
This guide explains how Keppra® works, when neurologists choose it, how it’s given, what side effects to watch for, and what to expect over time.
Why You Can Trust This Guide
This Keppra® guide was written and reviewed by board-certified veterinary neurologists who manage seizure disorders daily. Seizure management is nuanced, individualized, and often evolves over time. Our goal is to give pet parents clear, accurate information without oversimplifying or overstating outcomes.
What Is Keppra® (levetiracetam)?
Keppra® is the brand name for levetiracetam, an anticonvulsant medication used to help control seizures in dogs and cats.
Keppra® may be used:
As a first medication in some seizure patients
Alongside other seizure medications such as phenobarbital or zonisamide
Short-term, during periods of increased seizure activity
Long-term, as part of an ongoing seizure management plan
At Remedy, Keppra® is commonly selected because it’s generally well tolerated and, in most cases, doesn’t require routine blood level monitoring.
How Keppra® Works in the Brain
Keppra® helps stabilize abnormal electrical activity in the brain that leads to seizures. While its exact mechanism is complex, it works differently from many older seizure medications. This is why it is often used in combination with other drugs or when side effects are a concern.
When Keppra® Is the Right Choice (& When It May Not Be)
Keppra® is a valuable tool in seizure management, but it’s not the right medication for every dog or cat.
Neurologists commonly prescribe Keppra® when:
A pet has newly diagnosed seizures and needs immediate control
Seizures are occurring in clusters
Breakthrough seizures are happening despite other medications
Liver-friendly options are preferred
Short-term seizure suppression is needed
Keppra® may not be ideal as the sole long-term medication for some pets with frequent or severe epilepsy. In those cases, it’s often combined with other anticonvulsants for better control.
Choosing the right seizure medication isn’t about one drug being better than another. It’s about matching the medication to the individual pet, seizure pattern, and overall health.
Keppra® & Keppra XR®: What’s the difference?
Regular Keppra®
Typically given every eight hours
Available in tablet or liquid formulations
Commonly used in dogs and cats of all sizes
Keppra XR/ER® (Extended Release)
Typically given every 12 hours
Must be swallowed whole
Cannot be split or crushed
Only appropriate for pets that can reliably swallow pills intact
Extended-release Keppra® is most often used in larger dogs. It’s not appropriate for cats or small dogs unless specifically directed by a neurologist. Our team will help determine which Keppra formulation (regular Keppra® versus Keppra XR/ER®) fits your pet and your daily schedule safely.
Keppra® Dosing & Timing for Dogs & Cats
Keppra is most effective when given on a strict schedule. Even small delays can increase the risk of seizures.
Typical dosing patterns include:
Regular Keppra®: Usually given three times daily (every eight hours)
Keppra XR/ER®: Usually given twice daily with food
Burst therapy: Sometimes started after a seizure and continued every eight hours until the pet has been seizure-free for at least 24 hours
Exact dosing is based on your pet’s weight, seizure history, and overall neurologic plan.
Missed Doses
If you miss a single dose of Keppra®, give it as soon as you remember, even if it’s close to the next scheduled dose.
Do not skip doses or stop Keppra® suddenly. Abrupt changes can trigger seizures, including severe or prolonged episodes.
If dosing changes are needed, contact your veterinary team.
Changing or Stopping Keppra®
Seizure medications usually need to be tapered gradually rather than stopped abruptly. Exceptions may include:
Very short treatment courses
Serious side effects that require immediate adjustment
Never change the dose or stop Keppra® without guidance from your veterinarian or neurologist.
Possible Keppra® Side Effects
Most dogs and cats tolerate Keppra® well. When side effects occur, they’re usually mild and temporary.
Common side effects may include:
Sleepiness or sedation
Wobbliness or unsteadiness
Mild nausea or gastrointestinal upset
Contact your veterinary team if you notice:
Extreme lethargy
Significant behavior changes
Difficulty walking
Vomiting with every dose
What to Expect Over Time
Keppra® can take several weeks to stabilize seizure activity. Some pets respond quickly, while others may require dose adjustments or additional medications.
Over time, neurologists may:
Adjust dosing based on seizure control
Add or remove medications as needed
Reevaluate the treatment plan if seizure patterns change
Every seizure plan is individualized, and there’s no one-size-fits-all approach.
Common Questions & Misconceptions
Does Keppra® stop working over time?
Some pets develop tolerance to Keppra®, while others remain stable long-term. This is why monitoring and follow-up matter.
Is Keppra® safer than other seizure medications?
Keppra® is generally well tolerated, but safety depends on the individual pet and the full treatment plan.
Is Keppra XR/ER® always better?
No. XR formulations are only appropriate for certain pets and situations.
Questions? We're Here to Help
We know seizures and neurologic conditions can feel overwhelming. Whether your pet’s just starting Keppra® or you’re looking to better understand their seizure medications, our neurology team is here to help.
Call us: (415) 967-3303
Learn more: Neurology Services at Remedy Veterinary Specialists