title: Effects of a ketogenic diet on ADHD-like behavior in dogs with idiopathic epilepsy.
abstract: OBJECTIVE
  Epilepsy in humans and rodent models of epilepsy can be associated with behavioral comorbidities including an increased prevalence of attention-deficit/hyperactivity disorder (ADHD). Attention-deficit/hyperactivity disorder symptoms and seizure frequency have been successfully reduced in humans and rodents using a ketogenic diet (KD). The aims of this study were (i) to describe the behavioral profile of dogs with idiopathic epilepsy (IE) while on a standardized nonketogenic placebo diet, to determine whether ADHD-like behaviors are present, and (ii) to examine the effect of a ketogenic medium chain triglyceride diet (MCTD) on the behavioral profile of dogs with idiopathic epilepsy (IE) compared with the standardized placebo control diet, including ADHD-like behaviors.
  
  
  METHODS
  A 6-month prospective, randomized, double-blinded, placebo-controlled, crossover dietary trial comparing the effects of the MCTD with a standardized placebo diet on canine behavior was carried out. Dogs diagnosed with IE, with a seizure frequency of at least 3 seizures in the past 3months (n=21), were fed the MCTD or placebo diet for 3months and were then switched to the alternative diet for 3months. Owners completed a validated behavioral questionnaire to measure 11 defined behavioral factors at the end of each diet period to report their dogs' behavior, with three specific behaviors hypothesized to be related to ADHD: excitability, chasing, and trainability.
  
  
  RESULTS
  The highest scoring behavioral factors in the placebo and MCTD periods were excitability (mean±SE: 1.910±0.127) and chasing (mean±SE: 1.824±0.210). A markedly lower trainability score (mean±SE: 0.437±0.125) than that of previously studied canine populations was observed. The MCTD resulted in a significant improvement in the ADHD-related behavioral factor chasing and a reduction in stranger-directed fear (p<0.05) compared with the placebo diet. The latter effect may be attributed to previously described anxiolytic effects of a KD.
  
  
  CONCLUSIONS
  These data support the supposition that dogs with IE may exhibit behaviors that resemble ADHD symptoms seen in humans and rodent models of epilepsy and that a MCTD may be able to improve some of these behaviors, along with potentially anxiolytic effects.
authors.affiliation: Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK. Electronic address: rpacker@rvc.ac.uk.
authors.forename: Rowena M A
authors.initials: RM
authors.lastname: Packer
authors.affiliation: Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK; Biomolecular Medicine, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK.
authors.forename: Tsz Hong
authors.initials: TH
authors.lastname: Law
authors.affiliation: Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Davies
authors.affiliation: Nestle Purina Research, One Checkerboard Square, 2RS, St Louis, MO 63164, USA.
authors.forename: Brian
authors.initials: B
authors.lastname: Zanghi
authors.affiliation: Nestle Purina Research, One Checkerboard Square, 2RS, St Louis, MO 63164, USA.
authors.forename: Yuanlong
authors.initials: Y
authors.lastname: Pan
authors.affiliation: Department of Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK.
authors.forename: Holger A
authors.initials: HA
authors.lastname: Volk
mesh_terms: D000818:Animals; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001007:Anxiety / Q000178:diet therapy; D001289:Attention Deficit Disorder with Hyperactivity / Q000178:diet therapy* / Q000523:psychology; D001522:Behavior, Animal; D018592:Cross-Over Studies; D055423:Diet, Ketogenic; D004283:Dog Diseases / Q000178:diet therapy* / Q000523:psychology; D004285:Dogs; D004311:Double-Blind Method; D004827:Epilepsy / Q000178:diet therapy* / Q000523:psychology / Q000662:veterinary*; D005239:Fear; D005260:Female; D008297:Male; D009043:Motor Activity; D011446:Prospective Studies; D012640:Seizures / Q000209:etiology; D011795:Surveys and Questionnaires; D014280:Triglycerides / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014280:Triglycerides
keywords: Anxiolytic; Attention-deficit/hyperactivity disorder; Canine; Comorbidity; Ketogenic; Medium chain triglyceride diet