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Research Update for Toby's Foundation co-sponsored CHF Grant: Investigating a Ketogenic Medium-Chain
Triglyceride (MCT) Supplement for the Treatment of Drug-Resistant Canine Idiopathic Epilepsy and Its Behavioral Comorbidities
Dr. Holger Volk, DVM, PhD, Royal Veterinary College, University of London
May 2019
We have identified interesting neurotransmitter changes in the urine showing that GABA might play a role in improving seizure control in dogs fed MCT. The untargeted metabonomics did not yield an interesting hit, but we have now just finished a targeted metabonomics run and are analyzing the results.
September 2018
We could show that by supplementing the diet with MCT oil seizure frequency can be reduced significantly. We are currently doing sub-analysis, which we will share shortly. All metabonomics sample are planned to be run and the first analysis should be ready by the end of summer.
May 2017
The ketogenic diet, originally characterized as high in fat and low in carbohydrates, has been a successful treatment in children with epilepsy for several decades, decreasing seizure activity and even leading to seizure freedom in drug-resistant patients. Recent research has identified that a component of the ketogenic diet, a medium-chain fatty acid (MCT) called C10 has directly anti-seizure effects on the brain. This project will investigate whether supplementing the diet of dogs with drug-resistant epilepsy with an MCT oil containing C10 will reduce seizure frequency and/or severity. As epilepsy has multiple impacts on QoL beyond seizure frequency, we will also investigate whether the MCT supplement alters the side effect profile of AEDs the patient is already receiving, improves any behavioral problems associated with epilepsy (e.g. anxiety), cognition and improves the stress levels of the affected dog and their owner. If successful, MCT supplements could be a vital new addition to the tool-kit of epilepsy treatment.
December 2017
Canine epilepsy is a chronic neurological condition, often requiring lifelong medication with anti-epileptic drugs (AEDs). Despite appropriate treatment with available AEDs, seizure freedom may not always be achievable. Indeed, over. There is an urgent need to develop alternative treatments to improve the quality of life (QoL) of drug-resistant patients, who may continue to experience unpleasant AED side- effects despite their lack of success. The project will investigate whether supplementing the diet of dogs with drug-resistant epilepsy with an MCT oil containing C10 will reduce seizure frequency and/or severity. As epilepsy has multiple impacts on QoL beyond seizure frequency, we will also investigate whether the MCT supplement alters the side effect profile of AEDs the patient is already receiving, improves any behavioural problems associated with epilepsy (e.g. anxiety), cognition and improves the stress levels of the affected dog and their owner. We have made good progress after we have identified oils which have a good palatability. We have received full ethical approval, have recruited staff on the trial, have standardised and established all the additional cognitive, behavioural, blood and gait tests in the lab and have currently good case recruitment numbers. As aforementioned we had some delay in recruitment. We have now however finished the recruitment with the last patient finishing the trial in February 2018. We had until now only 8% drop-out rate. This should provide us with sufficient number of dogs finishing the trial and we would hope that until March 2018 we have the analysis for the clinical part of the trial. All metabolomics sample are planned to be run in February and the first analysis should be ready at the end of March 2018.
December 2016
Canine epilepsy is a chronic neurological condition, often requiring lifelong medication with anti-epileptic drugs (AEDs). Despite appropriate treatment with available AEDs, seizure freedom may not always be achievable. Indeed, over two thirds of dogs with epilepsy continue to have seizures long-term and around 20-30% remain poorly controlled on standard AEDs. These hardest to treat dogs are termed 'refractory' or 'drug-resistant' patients. There is an urgent need to develop alternative treatments to improve the quality of life (QoL) of drug-resistant patients, who may continue to experience unpleasant AED side-effects despite their lack of success. The ketogenic diet, originally characterized as high in fat and low in carbohydrates, has been a successful treatment in children with epilepsy for several decades, decreasing seizure activity and even leading to seizure freedom in drug-resistant patients. Recent research has identified that a component of the ketogenic diet, a medium-chain fatty acid (MCT) called C10 has direct anti-seizure effects on the brain. This project investigates whether dietary supplementation with ACT oil containing C10 for dogs with drug-resistant epilepsy will reduce seizure frequency and/or severity. As epilepsy has multiple impacts on QoL beyond seizure frequency, the researchers will also investigate whether the MCT supplement alters the side effect profile of AEDs, improves behavioral problems associated with epilepsy (e.g. anxiety) and cognition, and improves the stress levels of the affected dog. If successful, MCT supplements could provide a new tool for canine epilepsy treatment.