A Clinical Trial of Medium-Chain Triglyceride Oil for the Treatment of Canine Epilepsy

05/06/2020
Author: Sharon M. Albright, DVM, CCRT

Despite appropriate treatment with anti-seizure medications, one-third of epileptic dogs continue to have seizures. The side effects of anti-seizure medications and the behavioral changes that often accompany canine epilepsy (anxiety and cognitive decline) lead to a decreased quality of life for affected dogs and their owners. For these reasons and more, the AKC Canine Health Foundation (CHF) and its donors are investing in research to explore new treatment options for canine epilepsy.

Eating a high fat, low carbohydrate diet, known as a ‘ketogenic diet,’ has been shown to decrease seizure frequency and severity in children. There is great interest in exploring whether the same positive results can be seen in dogs. One study found an improvement in seizure control and associated behavioral conditions in dogs fed a ketogenic kibble compared to those eating a placebo kibble.1 With funding from CHF Grant 02252: Investigating a Ketogenic Medium-Chain Triglyceride (MCT) Supplement for the Treatment of Drug-Resistant Canine Idiopathic Epilepsy and Its Behavioral Comorbidities, researchers at the Royal Veterinary College, University of London are studying whether supplementation with one component of a ketogenic diet, medium-chain triglycerides, can reduce seizure frequency in dogs.

What are medium-chain triglycerides (MCTs)?
Triglycerides are fats. They are named for their chemical structure containing three fatty acid chains of varied length. Medium-chain triglycerides (MCTs) contain three fatty acids of 6-12 carbon atoms each. This contrasts with long-chain fatty acids which contain 13-21 carbon atoms and short-chain fatty acids which contain less than six carbon atoms.

The Study
Investigators conducted a six month, multicenter, prospective, randomized, double‐blinded, placebo‐controlled crossover trial, comparing an MCT supplement with a control supplement.2 These descriptors are important to demonstrate the scientific validity of this clinical trial:

  • Multicenter – Pet dogs were recruited from multiple veterinary clinics in Germany, Finland, and the United Kingdom.

  • Prospective – Changes were tracked moving forward in time to avoid errors or bias associated with owners remembering what happened in the past.

  • Randomized – Dogs were randomly assigned to their treatment group with no influence from investigators or owners. Eighteen different breeds, including mixed breeds, were represented in this study.

  • Double-blinded – Neither the owners nor the investigators knew when a dog was taking the MCT oil or the placebo oil.

  • Placebo-controlled – In addition to the MCT oil being tested, dogs were also given a ‘sham’ supplement to avoid any placebo effect.

  • Crossover – Each dog that completed the trial received the MCT oil for 90 days and the placebo oil for another 90 days. The crossover design indicates that some dogs started with the MCT oil, while others started with the placebo oil. After 90 days, they ‘crossed over’ to the alternate treatment. 

Dogs continued eating their normal diet during the study. Results were based on a standardized seizure diary completed by each owner. Only grand mal seizures were counted and only data from dogs that had no changes in their anti-seizure medications during the study period were included in the evaluation.

Promising Results
Twenty-eight dogs completed this clinical trial. The MCT oil was well-tolerated and there was a statistically significant improvement in seizure control while dogs were taking the supplement. This was noted as a reduction in the total number of seizures reported each month and a reduction in the number of days each month in which a seizure occurred. Two dogs became seizure-free, three dogs had their seizure frequency reduced by at least 50%, and twelve dogs had an overall reduction in seizure frequency. Owners also reported improvement in medication side effects and quality of life while dogs received the supplement. This data will be published separately.

Results provide additional support for the use of MCT oil supplement as a treatment tool for canine epilepsy. Additional study is needed in a larger group of dogs over a longer period of time, but this is a positive step in the management of canine epilepsy. Since diet and dietary supplements can impact the absorption and efficacy of anti-seizure medications, owners should always consult their veterinarian before making any changes to the care regimen of their epileptic dog. Learn more about this study and others in CHF’s Epilepsy Research Initiative at akcchf.org/epilepsy.

References:

  1. Law T.H., Davies E.S., Pan Y., et al. A randomised trial of a medium‐chain TAG diet as treatment for dogs with idiopathic epilepsy. Br J Nutr. 2015; 114: 1438‐ 1447.
    https://doi.org/10.1017/S000711451500313X

  2. Berk, B. A., Law, T. H., Packer, R. M. A., Wessmann, A., Bathen‐Nöthen, A., Jokinen, T. S., Knebel, A., Tipold, A., Pelligand, L., Meads, Z., & Volk, H. A. (2020). A multicenter randomized controlled trial of effect of medium-chain triglyceride dietary supplementation on epilepsy in dogs. Journal of Veterinary Internal Medicine, 1–2.
    https://doi.org/10.1111/jvim.15756

 

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