A randomised trial of a medium-chain TAG diet as treatment for dogs with idiopathic epilepsy

Abstract

Despite appropriate antiepileptic drug treatment, approximately one-third of humans and dogs with epilepsy continue experiencing seizures, emphasising the importance for new treatment strategies to improve the quality of life of people or dogs with epilepsy. A 6-month prospective, randomised, double-blinded, placebo-controlled cross-over dietary trial was designed to compare a ketogenic medium-chain TAG diet (MCTD) with a standardised placebo diet in chronically antiepileptic drug-treated dogs with idiopathic epilepsy. Dogs were fed either MCTD or placebo diet for 3 months followed by a subsequent respective switch of diet for a further 3 months. Seizure frequency, clinical and laboratory data were collected and evaluated for twenty-one dogs completing the study. Seizure frequency was significantly lower when dogs were fed the MCTD (2.31/month, 0-9.89/month) in comparison with the placebo diet (2.67/month, 0.33-22.92/month, P=0.020); three dogs achieved seizure freedom, seven additional dogs had ≥50 % reduction in seizure frequency, five had an overall <50 % reduction in seizures (38.87 %, 35.68-43.27 %) and six showed no response. Seizure day frequency were also significantly lower when dogs were fed the MCTD (1.63/month, 0-7.58/month) in comparison with the placebo diet (1.69/month, 0.33-13.82/month, P=0.022). Consumption of the MCTD also resulted in significant elevation of blood β-hydroxybutyrate concentrations in comparison with placebo diet (0.041 (sd 0.004) v. 0.031 (sd 0.016) mmol/l, P=0.028). There were no significant changes in serum concentrations of glucose (P=0.903), phenobarbital (P=0.422), potassium bromide (P=0.404) and weight (P=0.300) between diet groups. In conclusion, the data show antiepileptic properties associated with ketogenic diets and provide evidence for the efficacy of the MCTD used in this study as a therapeutic option for epilepsy treatment.