A randomised trial of a medium-chain TAG diet as treatment for dogs with idiopathic epilepsy.
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 (0·071 (sd 0·035) v. 0·053 (sd 0·028) 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.
1Department of Clinical Science and Services,Royal Veterinary College,Hatfield AL9 7TA,UK.
Tsz Hong
TH
Law
1Department of Clinical Science and Services,Royal Veterinary College,Hatfield AL9 7TA,UK.
Emma S S
ES
Davies
3Nestlé Purina Research,St Louis,MO 63164,USA.
Yuanlong
Y
Pan
3Nestlé Purina Research,St Louis,MO 63164,USA.
Brian
B
Zanghi
2Section of Computational and Systems Medicine,Imperial College,London SW7 2AZ,UK.
Elizabeth
E
Want
1Department of Clinical Science and Services,Royal Veterinary College,Hatfield AL9 7TA,UK.
Holger A
0000-0002-7312-638X
HA
Volk
D020155:3-Hydroxybutyric Acid / Q000097:blood; D000818:Animals; D000927:Anticonvulsants / Q000008:administration & dosage; D001786:Blood Glucose / Q000378:metabolism; D001965:Bromides / Q000097:blood; D018592:Cross-Over Studies; D055423:Diet, Ketogenic / Q000662:veterinary*; D004285:Dogs; D004311:Double-Blind Method; D004827:Epilepsy / Q000178:diet therapy* / Q000662:veterinary*; D005260:Female; D008297:Male; D010634:Phenobarbital / Q000097:blood; D017680:Potassium Compounds / Q000097:blood; D011446:Prospective Studies; D011788:Quality of Life; D012640:Seizures / Q000178:diet therapy* / Q000662:veterinary*; D016896:Treatment Outcome; D014280:Triglycerides / Q000008:administration & dosage*
D000927:Anticonvulsants; D001786:Blood Glucose; D001965:Bromides; D017680:Potassium Compounds; D014280:Triglycerides; C039004:potassium bromide; D020155:3-Hydroxybutyric Acid; D010634:Phenobarbital
AED antiepileptic drug; BHB β-hydroxybutyrate; Epilepsy; KBr potassium bromide; KD ketogenic diet; Ketogenic diets; MCT medium-chain TAG; MCTD medium-chain TAG diet; MCTKD medium-chain TAG ketogenic diet; Medium-chain TAG; PB phenobarbital; Seizures