Investigating Dietary Supplements for the Treatment of Canine Idiopathic Epilepsy

Canine idiopathic epilepsy, defined as recurrent seizures with no identifiable underlying cause, is the most common medical neurologic disease in dogs. Twenty to thirty percent of affected dogs continue to experience seizures despite treatment with currently available anti-epileptic drugs (AEDs).  In addition, side effects from these drugs, such as increased appetite, sedation, restlessness, or anxiety, often decrease quality of life for affected dogs and their owners. For these reasons and more, the AKC Canine Health Foundation (CHF) launched its Epilepsy Research Initiative in January 2017 to focus efforts on this devastating condition and improve the understanding of and treatment for epilepsy in dogs.

As part of the Epilepsy Research Initiative, investigators at the Royal Veterinary College, University of London were awarded CHF Grant 02252: Investigating a Ketogenic Medium-Chain Triglyceride (MCT) Supplement for the Treatment of Drug-Resistant Canine Idiopathic Epilepsy and Its Behavioral Comorbidities. They set out to determine whether supplementation with MCT oil altered the side effects of AEDs, improved the behavioral problems associated with epilepsy, or improved the stress level of epileptic dogs. One aspect of this research was to understand owner use of dietary supplements in dogs with idiopathic epilepsy. Owners completed an online questionnaire about their use of dietary supplements and/or diet change in their epileptic dog.

Results of this research were presented at the 2017 Annual European College of Veterinary Neurology/European Society of Veterinary Neurology Conference and the 2017 AKC CHF National Parent Club Canine Health Conference, as well as published in the peer-reviewed journal Research in Veterinary Science in 2018. Investigators found that two-thirds of owners changed their dog’s diet after being diagnosed with epilepsy, but less than 30% of those did so based on the advice of a veterinarian. Almost half of the owners reported giving dietary supplements to manage their dog’s idiopathic epilepsy. The most common supplements given were coconut oil, fish oil, and milk thistle. Other supplements given included cannabidiol (CBD oil), vitamin B12, homeopathic remedies, glucosamine/chondroitin, taurine, and herbs. Only 17.5% of owners consulted their veterinarian on the use of these supplements, while most owners received guidance from owner support groups or online.

• Coconut oil was the most common supplement given by owners in this study. It was used to provide a source of MCTs, which are known to be ketogenic. Supplementation is hoped to mimic the anti-seizure effects of the ketogenic (high fat and low carbohydrate) diet seen in humans. Ketones may decrease seizure activity through their anti-inflammatory properties, direct inhibition of ion channels, direct inhibition of excitatory neurotransmission, or other mechanisms.
• Fish oil is high in omega three fatty acids, which modulate ion channels and reportedly reduce excitability in the central nervous system. However, little evidence to support this exists in the veterinary literature.
• Milk thistle has antioxidant and anti-inflammatory properties and is used to protect liver cells. However, there is little research on its use in epileptic dogs.
• CBD oil is a non-psychotropic component of the Cannabis sativa plant reported to decrease seizure frequency and severity in humans and some animal models. However, the mechanism of action is unknown and studies on its toxicity and the effects of long-term use in dogs are lacking. CHF is currently funding one of the first scientific studies exploring these topics through Grant 2323: Efficacy of Cannabidiol (CBD) for the Treatment of Canine Epilepsy. Investigators at Colorado State University are completing a randomized, double-blinded, placebo-controlled, crossover clinical trial in dogs with uncontrolled epilepsy. Participating dogs receive standard AED treatment and either CBD or placebo. Then they will receive standard AED treatment and the opposite drug. By monitoring seizure frequency and severity, medication side effects, CBD plasma concentrations, routine physical examinations, and blood work, investigators will have objective information on the efficacy of CBD in the treatment of idiopathic epilepsy in dogs.

Since changes in diet and administration of dietary supplements may affect AED absorption and metabolism, veterinarians and owners should discuss diet and lifestyle in addition to medications when formulating a treatment plan for epileptic dogs. CHF and its donors are committed to supporting research for new and improved treatments for canine idiopathic epilepsy. For dogs that do not respond to currently available AEDs or when the side effects of those AEDs diminish quality of life, new options are needed. Support CHF’s Epilepsy Research Initiative at akcchf.org/epilepsy so that all dogs can live longer, healthier lives.

Learn more about the groundbreaking CHF-funded study on the efficacy of cannabidiol for treating canine epilepsy during the April 10, 2019 webinar “An Update on the Science Behind CBD (Cannabidiol) Use for Pets.” Register at akcchf.org/vetvine.