Key points for recommendations regarding the feeding of a novel medium-chain TAG diet* for the treatment of epileptic seizures in dogs
Canine diets have diversified substantially in recent years and now include many formulations. There are prescription diets, diets formulated for specific niches such as grain-free, joint health, and age, raw diets and many, many others. More recently, research modeled on human medicine has focused on diets designed to promote cognitive health and epilepsy management. Of these diets, a novel medium chain TAG diet was recently studied for its effect on dogs with epilepsy. This article provides some of the key points regarding this study and its outcomes.
While traditional antiepileptic drugs (AED) have improved seizure frequency in many patients, about 30% of dogs fail to respond adequately (persistent seizures, severe side effects, other behavioral changes, etc.). Therefore, alternative treatments for seizure management, including dietary modification, are being explored for dogs. Ketogenic diets (KD) have historically been used in children with encouraging results and may confer the same benefits to dogs, as canine epilepsy can act as a good translational model.
This study’s aim was to determine the antiseizure efficacy of a ketogenic medium-chain TAG diet (MCTD) in dogs with idiopathic epilepsy compared with a standardized placebo control diet (Hong Law, et.al. 2015).
The overall strength of this study was in its design. Prospective research can be challenging, but this study was able to accomplish this along with keeping the process randomized and double-blind. Further there was placebo-control and a cross-over design.
A total of 21 dogs participated in the study. While on the MCTD, 3 dogs were seizure free, 7 received a >50% reduction in seizure frequency, 5 received a <50% reduction in seizure frequency and 6 were unchanged. Based on these numbers, ~30% of patients failed to respond, similar to what is seen with traditional AED therapy.
One limitation of this study is the short duration with which the patients were enrolled. Patients were either fed the MCTD for 3 months and then switched to placebo, or vice versa. Without knowing the individual seizure histories of the patients enrolled, it is difficult to predict what their seizure patterns would be on any given diet. Thus those patients on the MCTD for 3 months, may have naturally experienced fewer seizures during that time.
Another limitation of the study is that a total of 10 dogs (1/3) were not included in the study. 5 were receiving the MCTD and 5 were receiving placebo. Of these 10 dogs, 4 had worsening seizures and 3 had reactions to the diet (2 – MCTD, 1 – placebo).
Reasons for withdraw from study:
- Many dogs will tolerate this diet, some will not
- Some patients may encounter a reduction in seizures, some will not
- Further studies warranted:
- Longer dietary trials
- Greater detail about individual patient seizure frequencies
These key points should be included in your discussions with clients to not only help them understand the potential benefits of a MCTD, but also to set realistic expectations.
*This study was part of the research which Nestlé Purina used to develop NeuroCare ProPlan Veterinary Diet.