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A special section to Today's Veterinary Practice | May/June 78 polyphagia, polydipsia, polyuria, restlessness, lethargy, and ataxia, leading veterinarians to walk a narrow line between achieving medication benefits and causing harm. As a result, only 4% of veterinarians surveyed are "totally" or "mostly" satisfied with current treatment options. 1 DIETARY THERAPY: A NEW APPROACH TO MANAGING DOGS WITH EPILEPSY? Traditional ketogenic diets, which are designed to force the body to burn fat instead of carbohydrate and put the body into a state of ketosis, have been used for decades in children whose seizures are not controlled with medication. 10 The rationale is that brain glucose metabolism, which allows for production of adenosine triphosphate (ATP) as well as substrates for the generation of neurotransmitters, 11 is disrupted in epileptic patients, creating a need for alternative sources of brain energy. 11–16 While high-fat, low-carbohydrate diets utilizing long-chain triglycerides have been used and studied in children, this type of diet has yet to be shown to significantly improve seizure control in dogs. 17 In addition, such diets also are unsatisfactory from a nutrient and palatability standpoint for dogs requiring lifelong therapy. Fortunately, dogs can metabolize medium- chain triglycerides (MCTs) to produce ketones, 18 and experts believe that dietary MCTs may also have direct antiseizure effects via blocking the alpha-amino-3- hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA) receptors in the brain. 19 Diets supplemented with MCT oil for dogs can also be formulated with lower amounts of fat and higher proportions of protein and carbohydrates than traditional ketogenic diets—an important factor when a diet needs to be fed for the remainder of a dog's life. EPILEPSY STUDY EXAMINES THE EFFECTS OF TEST DIET WITH MCT OIL ON SEIZURES Neurologic researchers at the Royal Veterinary College (RVC), in partnership with Purina, recently investigated the potential role of diet in the nutritional management of dogs whose seizures were not being well controlled with AEDs. While achieving complete remission was not considered realistic for many patients, the goal was to reduce seizure frequency in epileptic dogs on chronic AED therapy. A total of 21 dogs with idiopathic epilepsy that had experienced at least 3 seizures in the 3 months prior to enrollment completed a 6-month, randomized, placebo-controlled, double-blinded crossover study at the RVC. The study demonstrated for the first time that a test diet with MCT oil can have positive effects on reduction of seizure frequency when fed as an adjunct to veterinary therapy. 18 Dogs in the 2 groups were fed either a test diet containing MCT oil or a placebo diet for a period of 3 months—then switched to the other diet. In the study, the following results were noted: 71% of dogs showed a reduction in seizure frequency 48% of dogs showed a 50% or greater reduction in seizure frequency 14% of dogs achieved complete seizure freedom DIET HELPS NUTRITIONALLY MANAGE DOGS WITH EPILEPSY AS AN ADJUNCT TO VETERINARY THERAPY The results of this study inspired Purina to develop the Purina ® Pro Plan ® Veterinary Diets NC NeuroCare ™ diet, which is formulated with MCT oil to help nutritionally manage dogs with epilepsy that are also being administered AEDs. The diet is enhanced with a unique blend of nutrients—eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), arginine, antioxidants, and B vitamins, as well as MCT oil—to promote cognitive health and help nutritionally manage dogs with cognitive dysfunction syndrome. REFERENCES 1. 2016 Veterinary Landscape Dashboard. 2. Bollinger-Schmitz, K, Kline, K. An overview of canine idiopathic epilepsy for the small animal practitioner. Iowa State University Veterinarian Publication 2000;62(1). 3. Berendt M, Farquhar RG, Mandigers PJJ, et al. International veterinary epilepsy task force consensus report of epilepsy definition, classification and terminology in companion animals. BMC Vet Res 2015;11:182. 4. Skerritt G. Canine epilepsy. In Pract 1988;10:27-30. 5. Packer RMA, Shihab NK, Torres BBJ, et al. Responses to successive anti-epileptic drugs in canine idiopathic epilepsy. Vet Rec 2015;176(8):203. 6. Arrol L, Penderis J, Garosi L, et al. Aetiology and long- term outcome of juvenile epilepsy in 136 dogs. Vet Rec 2012;170:335. 7. Podell M, Fenner W. Bromide therapy in refractory canine idiopathic epilepsy. J Vet Intern Med 1993;7:318-327. 8. Trepanier L, Schwark W, Van Schoick A, et al. Therapeutic serum drug concentrations in epileptic dogs treated with potassium bromide alone or in combination with RESEARCH While the precise cause of canine idiopathic epilepsy is unknown, the effect in the brain has been documented as a rapid, uncontrolled discharge of neurons within the brain's cerebral cortex that leads to seizures.