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.