weening cat off of phenobarbital?

My cat was 1 year old and had her first and only "episode" of seizures. She had about 4-5 back to back grand mal seizures before we got to the animal hospital. She was sedated with Valium and received a brain MRI and spinal tap. All results negative and diagnosed with idiopathic epilepsy.

It has been 6 years of being on phenobarbital 15mg 2x daily with no known seizures (no urine puddles discovered either). I would like to ween her off of this medication and wanted to know if that would be wise. I hate seeing her suffer to get her blood checked every 6 months for possible organ failure and feel that drug free is the way to go with an aging cat now 7 yrs old.

What are your thoughts?

I think this is something you should talk to the vet abour

Success discontinuing phenobarb at a gradual rate is patient dependent, with no uniform result for all or most seizure patients.

Starting with a lower dose in the morning, and maintaining the regular evening dose is how most doctors start the slow wean process on anticonvulsants. Consult with your cat's vet about a plan, such as a week period on each reduced dose, until the lowest effective dose is found. If your cat does seize, since you haven't managed a cat with breakthrough or cluster seizures, yet, ask about a plan, such as a rescue dose of intranasal or suppository anticonvulsant to have at home, at the ready, during his dose changes.

Also, after a seizure ends, an additional oral dose of the prescribed phenobarb can be given to a critter with breakthrough seizures if they're not already on the higher end of their phenobarb blood level. Your vet can check the most recent results and let you know if this is a possible rescue management plan while decreasing his dose, to have in place if he seizes, so you're not at home watching him seize after hours, when the vet isn't reachable via phone. 15mg tablets are low doses already, so while decreasing, your vet may be fine with a whole 15mg rescue dose post-seizure, or may want you to try half tablets at a time, for up to 2 or 3 rescue doses, before calling it an emergency in need of intravenous anticonvulsants and neuro monitoring at the hospital.

It's tough when I treat a known epileptic for "emergency" seizures multiple times in a week due to no or insufficient plan in place for them to help their pet while at home, before the stress of a car ride and a vet visit, which can compound seizures once they have already started. Had a dog just last night who could've avoided emergency treatment if the owner knew she could give his oral zonisamide again, after the first seizure, rather than watching the pet have multiple more on the way to us. Even if a patient has had their scheduled dose as recently as 30 minutes before a breakthrough seizure, they can have that rescue repeat dose, especially if their maintenance dose is a low concentration.

That's the best prep you take with doctor before you start reducing the phenobarb. Hope she can achieve a minimal dose. Cats' liver is not as sensitive to steroids and anticonvulsants as dogs. The side effects are much less, and the improved living is worth the low risk. Just reassurance if your girl does need to stay on it. The wicked appetite and preventing obesity is the only consistent side effect to be wary of; ravenous cats in a frustrated hyper temper due to their satiety being affected on phenobarb is a trial, for them and their people.