Dog Epilepsy and Diet: Can Seizures Be Controlled Through Food?

Epilepsy is the most common neurological disorder in dogs. Most dogs with epilepsy are thought to have idiopathic epilepsy (IE), which is characterised by recurrent seizures for which there is no identifiable cause.

Although epilepsy can be controlled to some extent by drugs such as phenobarbital, these drugs come with serious side effects which negatively affect overall quality of life and can outweigh their benefits.

As well as reducing quality of life through anti-epileptic drug (AED) side effects and complications, dogs with epilepsy have an increased risk of developing behavioural changes, such as anxiety and attention-deficit hyperactivity disorder.

It has been suggested that approximately 30% of dogs are drug-resistant. If drugs can't help, and if the drugs that do help cause serious side effects, can diet be of any use?

Can diet help control seizures in dogs?

Although certain nutritional strategies are proposed to help control epilepsy, the scientific research supporting them is limited.

Verdoodt et al. (2022) state that the aims of using nutrition in the management of idiopathic epilepsy are:

• Sustenance for adequate brain function
• Halting or decelerating disease progression
• Decreasing the side effects of anti-seizure drugs, and alleviating the behavioural comorbidities of IE

The gut microbiome and seizures

Many diseases, including idiopathic epilepsy, are thought to arise from intestinal dysbiosis — an imbalance between the types of organism in the gut. This gastrointestinal microbiome is affected by nutrition.

A review of the scientific evidence conducted by Mejía-Granados et al. (2021) suggests bidirectional communication between the intestinal microbiota and the central nervous system (CNS). It makes sense that the contribution of the microbiome to the CNS, and vice versa, could play a part in the development of epilepsy.

Diet can serve their functions through many different pathways. One potential pathway includes the microbiota-gut-brain axis, which highlights the relationship between the brain and the intestines. Changing the brain's energy source and a number of dietary sourced anti-inflammatory and neuroprotective factors appears to be the basis for improved outcomes in IE.

Verdoodt et al. (2022)

Keeping the microbiome diverse and healthy is a key component in reducing seizures, and in managing many other conditions.

Prebiotics and probiotics

A study by Mejía-Granados et al. (2018) showed a reduction of up to 50% in seizure frequency in 28.9% of human patients with epilepsy when they were given probiotics to support the health of the microbiome. Studies involving dogs are lacking, but there is some evidence that adding suitable prebiotics and probiotics to a dog's diet may help with the frequency of seizures.

Soluble fibre is an important source of prebiotics. It ferments in the gut and provides food for healthy bacteria. Natural prebiotic sources include:

• Mushrooms
• Chicory root
• Garlic
• Burdock root
• Dandelion greens

Probiotics can be given as pre-made supplements. Natural, homemade probiotic sources include green tripe, sauerkraut, natural yoghurt, kefir and goat milk.

A dog on anti-epileptic drugs would benefit from the addition of prebiotics and probiotics to limit the damage those drugs can do to the microbiome.

Ketogenic diets and MCT oil

The ketogenic diet has been used as a strategy for helping humans control their epilepsy for decades. A ketogenic diet is high in fat, adequate in protein and low in carbohydrate.

Dogs are carnivores with little to no need for carbohydrates, and a species-appropriate diet for a dog is typically low in carbohydrate. It makes sense that such a diet would improve the microbiome and, in turn, have some success in reducing seizures.

Maino et al. (2019) discuss two case studies showing a reduction in seizures when carbohydrates were replaced with protein or fat. When carbohydrates were reintroduced, the dogs began having seizures again.

The diet works by mimicking ketosis, where the body enters starvation mode and burns fat for energy instead of glucose. Although there is significant success with these diets in humans, dogs do not easily become ketotic.

Long-chain triglycerides (LCTs) are used in the traditional ketogenic diet. More recent research has looked at substituting some of these for medium-chain triglycerides (MCTs), on the premise that MCTs are better absorbed by the gastrointestinal tract and produce a more ketogenic effect in dogs.

Carbohydrates are thought to cause over-firing and misfiring of neurons, which leads to increased seizure activity. MCTs may help protect the brain from glucose-based seizure activity. MCTs are found in coconut oil and palm kernel oil, and can also be bought as a supplement.

Foods that promote inflammation

Inflammation is a factor in many diseases and can occur anywhere in the body, including the brain. It makes sense to avoid ingredients that can drive inflammation:

• Foods that trigger allergies, intolerances or sensitivities
• Chemical additives
• Wheat, corn and soy
• Cow's milk products
• Gluten, which is specifically linked to neurological problems including seizures

Foods that cause blood sugar fluctuations

Avoid foods with a high glycaemic index, as these can cause rapid fluctuations in blood sugar. These include ingredients commonly found in commercial dog food:

• Sugars
• White rice
• Wheat and corn
• White potatoes
• Carrots and peas

Foods containing glutamate and aspartate

Glutamate and aspartate are non-essential amino acids, and the most abundant free amino acids in the brain. They are excitatory neurotransmitters synthesised from glucose. Glutamate is the principal excitatory neurotransmitter in the brain and, as such, plays a role in the initiation and spread of seizure activity (Meldrum, 1994).

Micro-dialysis studies show an increase in the extracellular concentration of glutamate and aspartate before or during seizure onset, suggesting that either enhanced amino acid release or impaired uptake contributes to seizure initiation (Chapman, 2000).

Foods high in these amino acids include:

• Grains, especially wheat, barley and oats
• All cow's milk products — goat's milk is much lower
• Beans, especially soy, pinto, lima, black and navy beans, and lentils
• Nuts, especially peanuts, cashews and pistachios
• Seeds, including sunflower and pumpkin
• Anything sweetened with aspartame
• Rabbit and turkey
• Monosodium glutamate (MSG)

Herbs

Rosemary is a common additive in commercial dog food, used as an antioxidant and anti-inflammatory. The data on whether it increases seizures is limited, but rosemary and oregano have both been described as neurotoxic. Neurotoxins act on presynaptic proteins and neurotransmitters and may increase the prevalence of seizures.

Some herbs can lower the seizure threshold, increasing the potential for a seizure. These include kava kava, skullcap, evening primrose oil, borage seed oil, goldenseal, ginkgo, ginseng and wormwood (Becker, 2017).

Vitamins and minerals

Calcium plays an important role in preventing involuntary muscle contractions and the over-stimulation of nerves. Dogs with low blood calcium (hypocalcaemia) can suffer seizures and muscle tremors (Hutchinson et al., 2012). As well as being fed too little calcium, excessive vitamin D can also lead to hypocalcaemia.

Serum levels of manganese, selenium and zinc have been found to be higher in uncontrolled epileptic dogs than in healthy dogs (Vitale et al., 2019). This may be an effect of the seizures rather than a cause, but it does suggest these minerals should be fed at appropriate levels in the diet of a dog suffering seizures.

Thiamine (vitamin B1, found in brewer's yeast, beef, pork, nuts and whole grains) is essential for normal nerve function. Supplementation with betaine hydrochloride, dimethylglycine, taurine (found in meat, especially heart, and in fish, eggs and goat's milk) and proanthocyanidins is also suggested to benefit epileptic dogs.

In summary

It is not clear whether diet can be a cause of idiopathic epilepsy, but there is evidence pointing to a role for it in management. A species-appropriate diet containing higher levels of protein and fat and low levels of carbohydrate, avoiding inflammatory and high-glycaemic foods, and introducing functional foods such as herbs, prebiotics and probiotics, may all have a positive effect on the incidence of seizures. Ensuring vitamins and minerals are given in the correct amounts — not in toxic doses, as with vitamin D, nor in deficient ones, as with thiamine — is essential.

If your dog has been diagnosed with epilepsy and you would like to talk through their diet, get in touch.

Important: This article is for information only and is not a substitute for veterinary advice. Epilepsy is a serious medical condition. Never stop, reduce or change your dog's prescribed medication without speaking to your vet first, and always discuss dietary changes with your veterinary practice, particularly if your dog is receiving anti-epileptic drugs.

References

• Chapman, A.G. (2000) "Glutamate and epilepsy", The Journal of Nutrition, 130(4). doi:10.1093/jn/130.4.1043s
• Han, F.Y. et al. (2021) "Dietary medium chain triglycerides for management of epilepsy: new data from human, dog, and rodent studies", Epilepsia, 62(8), pp. 1790–1806. doi:10.1111/epi.16972
• Hutchinson, D. et al. (2012) "Seizures and severe nutrient deficiencies in a puppy fed a homemade diet", Journal of the American Veterinary Medical Association, 241(4), pp. 477–483. doi:10.2460/javma.241.4.477
• Larsen, J.A., Owens, T.J. and Fascetti, A.J. (2014) "Nutritional management of idiopathic epilepsy in dogs", Journal of the American Veterinary Medical Association, 245(5), pp. 504–508. doi:10.2460/javma.245.5.504
• Mejía-Granados, D.M. et al. (2021) "Gut-microbiota-directed strategies to treat epilepsy: clinical and experimental evidence", Seizure, 90, pp. 80–92. doi:10.1016/j.seizure.2021.03.009
• Meldrum, B.S. (1994) "The role of glutamate in epilepsy and other CNS disorders", Neurology, 44(11 Suppl 8).
• Thomas, W.B. (2000) "Idiopathic epilepsy in dogs", Veterinary Clinics of North America: Small Animal Practice, 30(1), pp. 183–206. doi:10.1016/s0195-5616(00)50009-6
• Thomas, W.B. (2010) "Idiopathic epilepsy in dogs and cats", Veterinary Clinics of North America: Small Animal Practice, 40(1), pp. 161–179. doi:10.1016/j.cvsm.2009.09.004
• Verdoodt, F. et al. (2022) "The role of nutrition in canine idiopathic epilepsy management: fact or fiction?", The Veterinary Journal, 290, p. 105917. doi:10.1016/j.tvjl.2022.105917
• Vitale, S. et al. (2019) "Comparison of serum trace nutrient concentrations in epileptics compared to healthy dogs", Frontiers in Veterinary Science, 6. doi:10.3389/fvets.2019.00467