Medium-Chain Triglyceride Supplementation in Dogs with Epilepsy

In the literature

Berk BA, Law TH, Packer RMA, et al. A multicenter randomized controlled trial of effect of medium-chain triglyceride dietary supplementation on epilepsy in dogs. J Vet Intern Med. 2020;34(3):1248-1259.

The Research …

Approximately one-third of dogs receiving ≥1 antiseizure drug continue having frequent and potentially refractory seizures.¹ Antiseizure drugs can cause behavior and cognitive problems, which can affect pet owner assessment of quality of life.² Nutrition has become increasingly important both as an alternative and augmentation to traditional seizure control.³ A previous study comparing a medium-chain triglyceride (MCT) diet containing octanoic acid (C8), decanoic acid (C10), and lauric acid (C12) with a standardized placebo diet showed improved seizure control with fewer behavioral adverse effects in dogs with idiopathic epilepsy.³

Using a prospective, randomized, double-blinded, placebo-controlled crossover design, the current study investigated the tolerability and antiseizure effects of a C8/C10 MCT oil supplemented diet as compared with a standardized control oil supplement in dogs with idiopathic epilepsy. Dogs in the study had to meet most of the International Veterinary Epilepsy Task Force Tier II requirements to be diagnosed with idiopathic epilepsy.⁴ Dogs also had to be between 8.8 to 143 lb (4-65 kg), be 6 months to 12 years of age at first seizure occurrence, have experienced ≥3 seizures in the 3 months prior to the study, and be considered resistant to ≥1 antiseizure drug. Twenty-eight of 36 dogs completed the study. Most dogs were given phenobarbital alone or in combination with ≥1 antiseizure drug. Phenobarbital, potassium bromide, and levetiracetam was the most common combination treatment.

Seizure frequency (ie, number of seizures per month) was significantly lower in dogs given an MCT oil supplement (median, 2.51 per month) as compared with the control group (median, 2.67 per month). Two dogs became seizure-free while receiving MCT oil supplementation. Seizure day frequency (ie, number of days in a month in which a seizure occurred) was also significantly lower in dogs given an MCT oil supplement (median, 1.68 per month) as compared with the control group (median, 1.99 per month). In the control group, 61% of dogs had an increase in seizure frequency. Phenobarbital and ALP levels were lower in dogs given an MCT oil supplement, and owners reported better quality of life with less sedation.

… The Takeaways

Key pearls to put into practice:

• A C8/C10 MCT oil is palatable, may lower phenobarbital adverse effects, and may improve seizure control in otherwise healthy epileptic dogs that are refractory to ≥1 antiseizure drug and are eating a consistent diet.

• Although additional evidence is needed, favorable clinical response in this study suggests MCT oil supplementation may be beneficial in clinical practice to a subset of epileptic dogs.

• Patients receiving an MCT oil supplement may show fewer adverse effects typically attributed to phenobarbital (eg, ataxia, lethargy). This may lead to better perceived quality of life, as noted by owners in this study.