Levetiracetam (brand: Keppra) is an anti‑seizure (anticonvulsant) medication for cats. It helps the brain be less “trigger‑happy” to reduce seizures. Prescription‑only; in the U.S. it’s approved for people and commonly used extra‑label in cats under a veterinarian’s direction.
Top uses: to help control epilepsy/recurring seizures and to reduce the frequency or severity of cluster seizures; veterinarians may also use an injectable form in‑clinic during seizure emergencies. If a cat is actively seizing, has a seizure that isn’t stopping promptly, or has repeated seizures close together, this is an emergency—direct the owner to the nearest veterinary ER now. Your veterinarian can discuss the treatment plan, monitoring, and what side effects to watch for.
Front desk script: Levetiracetam—also called Keppra—is a prescription anti‑seizure medication for cats. It’s used to help control epilepsy or recurring seizures and may be used alone or with another seizure medication. If your cat is seizing right now or is having repeated seizures, please go to the nearest emergency clinic immediately. For how and when to give it and what to watch for, your veterinarian can review your cat’s specific plan.
Q: What is Keppra and why was it prescribed for my cat?
A: Keppra (levetiracetam) is an anti‑seizure medication veterinarians commonly use to help reduce how often and how severe seizures are in cats. It is a human‑labeled drug used extra‑label in veterinary medicine. Give it exactly as prescribed on a consistent schedule, and do not change or stop it without speaking with your veterinarian. Some tablets are extended‑release and must be swallowed whole; if pills are hard to give, your veterinarian can discuss other forms, such as a compounded liquid. [References: Merck Veterinary Manual; PetMD]
Q: What side effects should I watch for?
A: Most cats tolerate Keppra well. The more common effects are sleepiness, wobbliness/poor balance, drooling, and a decreased appetite—these are usually mild and short‑lived. Because the drug is cleared by the kidneys, tell the care team if your cat has kidney disease. Contact your veterinarian promptly if side effects are persistent, worsening, or you notice concerning signs like repeated vomiting or sudden behavior changes. [References: Merck Veterinary Manual; VCA]
Q: What if I miss a dose or my cat has a seizure?
A: If a dose is missed, give it when you remember unless it’s close to the next scheduled dose—don’t double up. If your cat has a seizure lasting more than 5 minutes (status epilepticus) or has more than one seizure in 24 hours (cluster seizures), seek emergency care immediately. Keep track of when seizures happen and any missed doses so your veterinarian can advise on next steps. [References: PetMD; Merck Veterinary Manual]
Front desk script: Keppra is an anti‑seizure medicine we commonly use in cats. Please give it exactly as the doctor prescribed and don’t crush extended‑release tablets; if pills are difficult, I can ask the veterinarian about other options. If you miss a dose, give it when you remember unless it’s almost time for the next one—don’t double the dose. If a seizure lasts over 5 minutes or your cat has more than one in a day, go to the nearest emergency clinic now and let us know. For any side effects or questions about the plan, your veterinarian can discuss the best next steps.
Owners most often report mild, short‑term sleepiness, wobbly or unsteady walking, drooling, and a decreased appetite after levetiracetam. Occasional vomiting or loose stool and mild behavior changes (quieter or a little agitated) can also occur. These effects are usually mild; your veterinarian can discuss whether they are expected for this pet and how to monitor them.
Call the clinic the same day if side effects are more than mild, are getting worse, or interfere with eating, drinking, walking, or normal behavior; if vomiting happens more than once; if there is sudden or severe behavior change; or if you notice excessive drooling with repeated vomiting. Seek urgent care immediately for signs of an allergic reaction (facial swelling, hives, trouble breathing), extreme lethargy or unresponsiveness, or collapse. Do not change, skip, or stop medication without veterinarian direction—your veterinarian can advise on any adjustments.
If seizures occur, this is not an expected side effect and needs triage: a seizure lasting longer than 5 minutes, repeated seizures without full recovery between them, or two or more seizures within 24 hours are emergencies—direct the owner to the nearest emergency veterinarian now. Let the veterinarian know about any missed doses or new medications, as this can affect seizure control.
Front desk script: Thanks for calling about your cat on Keppra. Common things owners notice are mild sleepiness, a little wobbliness, drooling, or a lower appetite—if these are mild we can note them and update your veterinarian. If your cat is vomiting more than once, not eating, too drowsy to get up, suddenly acting very unlike themselves, or you see swelling or trouble breathing, this needs urgent care—please head to an emergency hospital now. If a seizure lasts over 5 minutes or there are repeated seizures, go to the nearest emergency vet immediately. Please don’t change or stop the medication on your own—our veterinarian can advise next steps.
Forms and basics: Levetiracetam for cats is available as immediate‑release tablets and an oral liquid; some human products are extended‑release (XR/ER). It can be given with or without food; if a cat vomits after a dose on an empty stomach, future doses may be offered with a small meal. Measure liquid doses with a marked oral syringe, and do not crush or split XR/ER tablets. If there is any question about what formulation the client has, ask them to read the label and confirm with the veterinarian.
Administration tips: For tablets, try hiding the pill in a small amount of wet food or a pill‑treat, or use a pill popper. Coating a tablet with a small amount of butter or similar lubricant, and then offering a teaspoon of water or a small bite of food right after, helps it go down and reduces the chance a pill sticks. Some cats may drool or foam from the taste—this can be normal. If a cat consistently refuses tablets or the taste is a problem, your veterinarian can discuss a flavored compounded oral liquid from a licensed pharmacy.
Troubleshooting and escalation: If a cat vomits right after a dose or cannot keep medicine down, do not give an extra dose without veterinary guidance—call for instructions. Persistent vomiting or sudden behavior changes should be reported to the veterinarian the same day. If a seizure lasts more than 5 minutes or there are multiple seizures within 24 hours, instruct the owner to seek emergency veterinary care immediately.
Front desk script: Levetiracetam can be given with or without food; if your cat vomited on an empty stomach, give the next dose with a small meal. Please don’t crush or split any tablet that says XR or ER, and measure liquids with the oral syringe. If your cat drools or spits it out, that’s often taste—our veterinarian can discuss a flavored compounded liquid. If your cat has a seizure lasting over 5 minutes or more than one seizure today, please go to the nearest emergency clinic right now.
Levetiracetam (Keppra) is an Rx‑only anticonvulsant used long‑term to help control seizures in cats. It is not a federally controlled (scheduled) drug in the U.S. Consistent, on‑time dosing is important because this medication is short‑acting; missed or late doses can lead to breakthrough seizures. Extended‑release tablets must not be split, crushed, or chewed. Your veterinarian determines the dose and schedule and should guide any changes.
Refill workflow: confirm pet name/ID, current weight changes, how many doses remain, seizure control since the last visit (any increases, clusters), any side effects, preferred pharmacy, and contact info. Check last exam/monitoring: many veterinarians reassess seizure control and general labs periodically (often every 6–12 months) and may request a recheck before approving refills if the patient is overdue or if there are concerns. Standard turnaround for routine refills is 24–48 business hours; prioritize same‑day review if the pet has ≤2 days of medication remaining. For online pharmacies, verify the pharmacy, note shipping time, and send an e‑prescription or provide a signed written Rx per clinic policy. Defer all dosing/schedule questions to the veterinarian.
Escalation: if the caller reports an active seizure lasting more than 5 minutes, multiple seizures within 24 hours, the pet not returning to normal after a seizure, or first‑ever seizure, direct them to an emergency veterinary hospital immediately and alert the veterinarian. If seizures are worsening, doses were missed, or the pet is nearly out of medication, flag for same‑day veterinarian review.
Front desk script: “I can help with a levetiracetam (Keppra) refill. To get this started, may I confirm your cat’s name, how many doses you have left, any recent seizure changes or side effects, and which pharmacy you prefer? Our normal turnaround is 24–48 business hours, but we prioritize seizure medications—if you’re down to two days or less, I’ll mark this for same‑day review. If your cat has a seizure lasting over five minutes or has three or more in 24 hours, please go to the nearest emergency hospital now. Any dose or schedule changes will be directed by your veterinarian, and we’ll schedule a recheck if your pet is due.”
Escalate immediately if the cat has an active seizure longer than about 5 minutes, has more than one seizure in 24 hours, or has repeated seizures without fully waking up between them. These are medical emergencies. New or rapidly worsening seizures after starting levetiracetam, or any first‑ever seizure, also require urgent veterinary evaluation.
After a levetiracetam dose, watch for severe allergic reactions: sudden facial or muzzle swelling, hives, vomiting or diarrhea, trouble breathing, collapse, or extreme weakness. These are emergencies—get a veterinarian right away.
Possible overdose or serious side effects can include extreme sleepiness, difficulty standing or severe wobbliness (ataxia), heavy drooling, vomiting, or sudden behavior changes. If you suspect the cat got extra doses or chewed tablets, or if vomiting is persistent, escalate now. Bring the medication bottle and be ready to report when the last dose was given; the veterinarian can discuss next steps for medication and monitoring.
Front desk script: What you’re describing needs a veterinarian right now. Please come straight to our hospital or the nearest emergency clinic—I’ll alert the team. Bring the Keppra bottle and tell us the last time any dose was given and any other meds. The veterinarian will assess your cat and advise on medication decisions after the exam.
Levetiracetam (Keppra) has relatively few drug interactions, but phenobarbital can shorten how long levetiracetam stays active in the body. If an owner reports starting, stopping, or changing phenobarbital, flag for veterinarian review, as the care team may need to reassess seizure control and monitoring. Levetiracetam is largely eliminated by the kidneys; use is typically cautioned in pets with kidney disease, so note any new NSAIDs or other medications and hand off to the medical team.
Commonly co-prescribed seizure or behavior/pain medications to listen for: phenobarbital, zonisamide, benzodiazepines used as rescue (e.g., diazepam), and gabapentin. Combining levetiracetam with other central nervous system depressants (benzodiazepines, gabapentin, opioids, trazodone, some antihistamines) may increase drowsiness or wobbliness; document what was given, when, and observed effects, and notify the veterinarian. VCA also lists NSAIDs and phenobarbital as “use with caution” with levetiracetam—capture exact product names and timing and defer to the doctor for guidance.
Common OTC add‑ons owners mention: diphenhydramine (Benadryl) and CBD products. Both can cause sedation and may add to drowsiness when used with levetiracetam or other sedatives—do not advise starting or stopping; instead, record the brand, strength, and dosing schedule and route to a veterinarian. Escalate immediately if a seizure lasts more than 5 minutes, if there are 2 or more seizures within 24 hours, or if the pet is not recovering normally after a seizure; these are emergencies. For notable new or worsening lethargy/ataxia or appetite loss, arrange a same‑day veterinarian callback. Your veterinarian can discuss whether any medication changes or monitoring are needed.
Front desk script: Thanks for telling us—some medicines can affect how Keppra works or increase drowsiness. Can I confirm the exact name, strength, and time of the last dose of the other product (for example phenobarbital, gabapentin, Benadryl, or CBD)? I’ll document this and get our veterinarian to review today. If your cat has a seizure lasting over 5 minutes, has 2 or more seizures in 24 hours, or isn’t returning to normal after a seizure, please go to the nearest emergency hospital right away.
Storage: Keep tablets and the oral liquid at controlled room temperature in the original, tightly closed, child‑resistant container; typical guidance is around 77°F (25°C) with short excursions 59–86°F (15–30°C). Avoid heat, humidity, and direct light (do not store in bathrooms or cars). Do not crush or split extended‑release tablets. Keep all medication and oral syringes out of reach of children and pets. Your veterinarian can discuss any clinic‑specific handling preferences (e.g., how they want oral syringes labeled or stored for pickup).
Shelf life after opening: Many manufacturers of levetiracetam 100 mg/mL oral solution instruct discarding any unused liquid 7 months after first opening; label the bottle with the open date and a discard date. Note that generic or compounded levetiracetam liquids may have different storage needs and shorter beyond‑use dates—follow the dispensing label, and when in doubt, ask the prescribing veterinarian or dispensing pharmacist before promising a timeframe to the owner.
Disposal: Prefer a drug take‑back site or mail‑back program. If no take‑back is available and the medicine is not on the FDA “flush list,” mix unwanted liquid or tablets with something unappealing (used coffee grounds/cat litter), seal in a bag/container, and place in household trash; remove/scratch out personal information on labels. Never pour medications down the sink or flush unless labeling specifically instructs it. If the owner reports new or worsening seizures, seizure clusters, or a seizure lasting more than ~5 minutes, advise immediate veterinary or emergency care.
What to schedule: After levetiracetam is started or the dose is changed, book a doctor recheck in about 1 week to review seizure logs/videos and any side effects. Once stable, plan routine check-ins every 6–12 months, or sooner if the veterinarian requests. Cats with kidney disease or cats taking more than one anti-seizure medicine may need earlier follow-up; the veterinarian will set the exact plan for each patient.
Bloodwork and tests: Routine general bloodwork (including kidney values) is commonly checked every 6–12 months. Blood level testing for levetiracetam is not routine, but the veterinarian may order it if seizures are not well controlled, if side effects increase, or to troubleshoot timing/consistency; if a level is ordered, schedule the blood draw right before the next scheduled dose (a “trough” sample) and follow the veterinarian’s timing instructions.
Escalation to emergency care: If an owner reports a seizure lasting more than 5 minutes, seizures that occur back‑to‑back without full recovery, or multiple seizures within 24 hours, direct them to an emergency hospital immediately. For new severe lethargy, trouble walking, repeated vomiting, or marked behavior change, advise same‑day contact with the clinic. The veterinarian can discuss any additional monitoring that may be needed.
Front desk script: For Keppra, we’ll schedule a quick recheck with the doctor about a week after starting or changing it. After that, routine check‑ins are usually every 6–12 months unless the doctor prefers sooner. If the doctor orders a levetiracetam blood level, we’ll book the blood draw right before the next dose and give you the exact timing. If your cat has a seizure lasting over 5 minutes or several in one day, please go to the nearest emergency hospital now; otherwise call us if you notice concerning side effects. Your veterinarian will tailor the monitoring plan for your cat.
Keppra (levetiracetam) is a seizure-control medication for cats. It is commonly used alone or with other anticonvulsants and is generally well tolerated. In cats, mild effects can include sleepiness, wobbly walking, drooling, or decreased appetite; advise the caller that the veterinarian can discuss what is expected versus concerning and how to proceed. Use in animals is extra-label, and the drug comes in different forms (including extended‑release); only the veterinarian can confirm the correct form for their cat and how it should be given.
If a caller reports an ongoing seizure, one lasting about five minutes or longer, seizures happening back-to-back without full recovery, or more than one seizure in 24 hours, direct them to go to the nearest emergency veterinary hospital immediately. For any questions about dose amounts, timing, missed doses, switching between liquid/tablet/extended‑release, or whether to change the plan, defer to the veterinarian and offer to send a message or schedule a recheck.
Phrases to avoid: “It’s okay to stop or skip doses,” “Go ahead and split or crush the tablet,” “Just increase or decrease the dose,” “Seizures that long are normal,” or “It’s FDA‑approved for cats.” Instead: “Your veterinarian can advise on dosing and formulation for your cat.”
Front desk script: “Thank you for calling [Clinic Name], this is [Your Name]. Keppra, or levetiracetam, helps control seizures in cats; most cats do well, though you may see sleepiness or a little wobbliness. For any questions about how much or how often to give it, missed doses, or switching forms, I’ll check with the veterinarian and call you back. If your cat is seizing now, if a seizure lasts about five minutes, or if there’s more than one in a day, please head to the nearest emergency vet immediately. Would you like me to send a message to your veterinarian or set up a recheck appointment?”