Can we think about reducing his dose?

So, about three years ago our ten year old (at that time) dog started having seizures. The first one that we know of was massive and my husband was home for it. He had no idea what was going on and rushed to the ER vet. From there we were referred to the neurology vet.

They did a bunch of tests, including a sonogram of his head and found absolutely nothing wrong, and so they said "it's primary epilepsy."

At first we didn't do any daily medication as they had us document a baseline. For about a year he had seizures once a month or so. Then he started having them back to back to back. We started him on daily levetiracetam. He still kept having seizures about once a week, usually at about 3 AM. The vet increased the dose and he was still having seizures. They increased again, still having seizures. We asked for more tests, to try again to see if there was a brain tumor, but they found nothing. They did say that a very small tumor wouldn't show up without an MRI, but they advised against that, saying that if it was a tumor it would have gotten big enough to see on a sonogram by now.

So now we're on the maximum levetiracetam dose. And just like that he stopped having seizures. He has had a few weird moments where we thought he might have one, like he was staring into space and licking his lips, but then he'd just stop and not have the seizure.

He is losing some fur in spots and has some nausea issues that the vet thinks might be side effects of the levetiracetam.

Do you think one year without a grand mal means we might be able to reduce his does and help with the side effects?

He is a 50 pound mixed breed (like really mixed, we had dna and it came back with a list of like 100 breeds) who came from the shelter. He's 13 this year. We are so thankful his seizures are well controlled on this high dose of levetiracetam, so I hate to rock the boat. On the other hand, he isn't feeling that great and he's grumpy with the other dogs and even my husband. The nausea means a lot of accidents in the house. So if we can get him feeling better that would be wonderful.

He's seriously like the best dog ever. I call him Dr. Dog because when he was younger and feeling better he took care of everyone else all the time. We were taking in hospice cases from the shelter, elderly dogs abandoned there who we'd give a little love and comfort in their last days. Dr. Dog took such good care of them, giving them kisses, making sure they were comfortable, and coming to get us if they were having problems.

I know our time is limited. 13 is very old for a 50 pound dog, so maybe it's better to just keep doing what's working. On the other hand, he might feel better if we could reduce the dose.