Can Diet Help With My Dog’s Seizures?
Understanding your dog’s seizures
Having a dog with a seizure disorder can be very overwhelming. Before considering treatment, it is important to work with your veterinarian to uncover any underlying reason for the seizures in your dog. Seizures tell us that there is a problem in the brain, but not the cause. Common causes are metabolic (for example, low blood sugar, liver disease, or toxicity) or primary brain disorders such as tumors or birth defects. When no cause can be found, this is called ‘idiopathic epilepsy.’ However, this can only be decided after all possible causes have been ruled out.
When to consider diet
For dogs with seizures, any diet change should be carefully considered and will likely be different for each dog based on their underlying conditions. If your dog has idiopathic epilepsy, there may be some nutritional changes to consider but let’s look at the evidence and pros and cons behind some different strategies you may hear about.
Ketogenic Diets
Ketogenic diets are typically described as high fat, low to moderate protein, and low to no carbohydrates. This can be challenging to define, though, because there is no official definition of ‘high’ or ‘low’ when it comes to the amount of fat, protein, and carbohydrates beyond the Association of American Feed Control Officials (AAFCO) guidelines for minimum levels of fat and protein required in cat and dog diets. This type of diet is meant to create ‘ketosis’ in the body, which happens when the body doesn’t have enough carbohydrates to burn for energy so it burns fat and makes things called ketones to use for fuel. There have been a few studies looking at ketogenic diets in children with epilepsy that have shown some improvement in seizure control. This doesn’t necessarily translate to dogs, however, because dogs handle ketones differently. In humans, there are also potential side effects of ketogenic diets to consider that can include nutrient deficiencies, digestive issues, nausea, headache, and fatigue. Some of these side effects can also be seen in dogs. Problems I see most often stem from an intolerance to higher fat diets, which can lead to vomiting, diarrhea, pancreatitis, and weight gain if also higher calorie. Without evidence of benefit, and possible negative side effects, I do not recommend ketogenic diets for dogs with idiopathic epilepsy as a first line of defense.
Medium Chain Triglycerides (MCT)
While it is difficult to achieve true ketosis in dogs due to their metabolism, nutrients such as medium chain triglycerides (MCT) in the diet may benefit the brain by providing an energy source that the brain can preferentially utilize instead of other fats. Studies have started looking at potential benefits of pet foods enriched in MCTs, with some dogs having reduced seizure frequency and other dogs having no change. Just having ‘MCT oil’ or ‘coconut oil’ on the label may not be enough, though, as the diets studied had a high amount of calories come from MCTs and we don’t know if less than that would still provide a benefit. More research is needed to better understand if and when MCTs can be used to help with seizure management, but diets with MCTs could be a consideration to discuss with your veterinarian to see if they are right for your dog.
Careful diet transition
Of special note, if your dog receives the seizure medication potassium bromide, it is very important to not make quick changes to your dog’s diet or treats as changes in the chloride levels of different foods can change how the medication works in the body. For healthy dogs, we recommend at least a week to transition to any new food. For dogs on potassium bromide, the amount of time needed for transition will depend on the severity and frequency of their seizure condition and how significant of a change in chloride content there will be between the new and old diet. Always talk to your veterinarian before any diet change.
In summary, for dogs with idiopathic epilepsy, I generally do not recommend ketogenic diets due to lack of evidence for benefit and potential side effects, but consider good quality diets enriched in MCTs a possible adjunct therapy in addition to medical management for some dogs. As always, please make sure you discuss diet with your veterinarian before making any changes!
References:
Vendramini THA, Amaral AR, Rentas MF, Nogueira JPDS, Pedrinelli V, de Oliveira VV, Zafalon RVA, Brunetto MA. Ketogenic diets: A systematic review of current scientific evidence and possible applicability in dogs and cats. J Anim Physiol Anim Nutr (Berl). 2023 Dec 13.
Nakatsuka K, Zanghi B, Hasegawa D. Efficacy evaluation of a commercially available MCT enriched therapeutic diet on dogs with idiopathic epilepsy treated with zonisamide: a prospective, randomized, double-blinded, placebo-controlled, crossover dietary preliminary study. BMC Vet Res. 2023 Sep 6;19(1):145.
Schmidt T, Meller S, Meyerhoff N, Twele F, Zanghi B, Volk HA. A six-month prospective, randomised, double-blinded, placebo-controlled, crossover, dietary trial design to investigate the potential of psychobiotics on seizure semiology and comorbidities in canine epilepsy: study protocol. BMC Vet Res. 2023 Mar 3;19(1):57.
Han FY, Conboy-Schmidt L, Rybachuk G, Volk HA, Zanghi B, Pan Y, Borges K. Dietary medium chain triglycerides for management of epilepsy: New data from human, dog, and rodent studies. Epilepsia. 2021 Aug;62(8):1790-1806.