My only comments regarding the paper you cite is that the patient demographic that presents for referral veterinary care for seizures and gets written about is often more severe, more complex cases that people are having difficulty managing. So while studies like this are important, things may be different in that patient set compared to “average” seizure dogs in general practice. You have to critically evaluate study design and see if you think their conclusions are valid and applicable. Their study states that >90% were receiving other AEDs and there’s a whole section about dogs that had even more drugs added in, so I don’t think they’re advocating for monotherapy.