Nutritional Management of Canine Epilepsy

Photo Credit: Susannah Kay

Epilepsy is far and away the most common cause of seizures in dogs. While it is an inherited disease in some breeds, it can occur in dogs of all breeds, shapes, and sizes. Dogs with epilepsy typically experience their first seizure between one and six years of age. Epilepsy is a “rule-out diagnosis”, meaning there is no specific test to define that a dog has it. Rather, the diagnosis is made after ruling out other known causes of seizures.

The mainstay therapy for canine epilepsy consists of anti-seizure medications, using an individual drug or a combination of them. The impact of nutrition on seizure control was discussed in a recent article  appearing in the Journal of the American Veterinary Medical Association. Here are the article highlights.

Ketogenic diets

Diets that cause the body to produce an abundance of ketones (an acetone-like product made when fat is used as the primary energy source) have been used to treat epilepsy in people. These ketogenic diets are very high in fat, low in carbohydrates, and are calorie restricted. Typically, the ratio of fat to combined carbohydrates and protein is 4:1 or 3:1.

It is uncertain exactly how ketogenic diets provide benefit for some people with epilepsy. It is known that, in a state of starvation, ketones are the primary source of energy for the brain. An increased concentration of ketones on a regular basis appears to diminish seizure activity. Additionally, higher levels of omega-3 and omega-6 polyunsaturated fatty acids may subdue seizures by decreasing the excitability of nervous tissue and altering levels of brain chemicals called neurotransmitters.

Approximately two thirds of humans with epilepsy who consume a ketogenic diet experience a reduction in their seizures. These diets do have their drawbacks. Not only are they highly restrictive, creating issues with patient compliance, they can be associated with adverse side effects. For these reasons, ketogenic diets tend to be recommended for people with severe epilepsy who fail to respond to traditional therapy.

Whether or not ketogenic diets benefit dogs with epilepsy has not been adequately studied. Moreso than people, dogs are somewhat resistant to developing ketosis (high blood levels of ketones). Potential complications associated with feeding ketogenic diets to dogs include dietary deficiencies, nutritional imbalances, and issues caused by a high fat diet, such as pancreatitis, gastrointestinal disease, and obesity.

Phenobarbital, a drug commonly used to treat canine epilepsy, notoriously causes increased blood levels of a form of fat called triglycerides. Add to this equation a diet that consists of 80-90% fat, and one may be creating a recipe for disaster.

Effect of body composition

Although not studied in dogs, the authors of this paper suggest that the normal metabolism of anti-seizure medications (how long a drug dose lasts in the body after it is administered) may be altered in dogs who are significantly overweight or underweight. This can result in loss of seizure control because of medication levels in the bloodstream that are too low. Conversely, medication levels in the bloodstream that are too high can cause drug overdose symptoms.

The authors of this article emphasized that maintenance of an ideal and stable body weight is important for dogs with epilepsy. This can be a challenging proposition given that increased appetite is one of the most common side effects for many anti-seizure medications.

Effect of diet and urine pH

The rate at which anti-seizure medications are eliminated via the kidneys can be impacted by the pH of the urine. (The pH defines how acidic or alkaline a substance is.) One study documented that dogs whose urine was alkalinized (pH increased) experienced a more rapid elimination of phenobarbital compared to dogs with more acidic urine.

Dietary components influence the urine pH. Prescription diets used to prevent bladder stones and/or urine crystal formation in dogs do so by significantly altering the pH of the urine. Such diets should be used extremely cautiously in dogs receiving anti-seizure medications. The combination of treatments has the potential to cause loss of seizure control at one extreme and symptoms of drug toxicity at the other.

Dietary considerations with bromide therapy

Potassium bromide is a medication commonly used to treat canine epilepsy. The bromide component is interchangeable with naturally occurring chloride in the body. The key here is that the body maintains a constant sum of bromide and chloride. So, increasing one will cause a decrease in the other. For example, a sudden transition to a high-chloride diet would hasten the elimination of bromide from the body, resulting in lower levels of bromide in the blood stream and potential reduction in seizure control. Conversely, toxic levels of bromide in the bloodstream can occur if chloride intake is significantly reduced.

Sodium chloride- aka salt- is the major source of dietary chloride. Consistency in what is fed, including treats, is of paramount importance for dogs receiving potassium bromide.

Dietary supplements

In recent years there has been much interest in health benefits of the omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). DHA, in particular, has been found to play an important role in brain development. In epileptic rats, DHA and EPA have a protective effect on neurologic tissues, perhaps because of their anti-inflammatory properties. It has been suggested, but not documented, that long-term administration of omega-3 fatty acids may have a similar effect on dogs with epilepsy. Additionally, these fatty acids are known to reduce high blood triglyceride levels, a common side effect of phenobarbital therapy.

Taurine is an amino acid (a component of protein) that has been shown to have possible anti-seizure properties. A study using taurine in a limited number of epileptic cats documented improved seizure control. No such studies have been performed in dogs.

Take home messages

Clearly there is a great deal more to be learned about how nutrition can influence the management of canine epilepsy, including possible effects of raw versus homemade versus processed diets. The limited knowledge available at this supports the following recommendations:

  • Talk with your veterinarian about the role diet may play in managing your dog’s seizures.
  • Strongly consider dietary supplementation with omega-3 fatty acids for your epileptic dog, particularly if phenobarbital is part of the therapy.
  • If your dog is receiving anti-seizure medication(s), do not alter his or her diet before discussing the intended change with your veterinarian.
  • Avoid high-salt treats if your dog receives potassium bromide for seizure control.
  • Do not alter the dosage of your dog’s anti-seizure medication(s) without first consulting with your veterinarian.
  • Do your best to help your dog maintain a healthy body weight.

Have you ever cared for a dog with epilepsy? If so, did you alter his or her diet as part of the treatment plan?

Best wishes,

Nancy Kay, DVM

Diplomate, American College of Veterinary Internal Medicine
Author of Speaking for Spot: Be the Advocate Your Dog Needs to Live a Happy, Healthy, Longer Life
Author of Your Dog’s Best Health: A Dozen Reasonable Things to Expect From Your Vet
Recipient, Leo K. Bustad Companion Animal Veterinarian of the Year Award
Recipient, American Animal Hospital Association Animal Welfare and Humane Ethics Award
Recipient, Dog Writers Association of America Award for Best Blog
Recipient, Eukanuba Canine Health Award
Recipient, AKC Club Publication Excellence Award
Become a Fan of Speaking for Spot on Facebook

Please visit http://www.speakingforspot.com to read excerpts from Speaking for Spot and Your Dog’s Best Health.   There you will also find “Advocacy Aids”- helpful health forms you can download and use for your own dog, and a collection of published articles on advocating for your pet’s health. Speaking for Spot and Your Dog’s Best Health are available at www.speakingforspot.com, Amazon.com, local bookstores, and your favorite online book seller.

Be Sociable, Share!

6 Comments on “Nutritional Management of Canine Epilepsy

  1. Very interesting article and thanks for posting. I have a 7 yo Border Collie with epilepsy since just before he turned 3. He was classified as a borderline ‘difficult to control’ case. He’s on a high quality grain free kibble (also no rosemary extract), he takes Alaskan Salmon oil and Taurine supplements, I’m religious about monitoring the types of treats I give him. In his case, none of that helped as his grand mal seizures continued 2-3 or more times per month. Phenobarbitol didn’t help, but adding Potassium Bromide is what finally helped. He was seizure free and returned to Agility competing at Masters level for 2 years. Maybe the grain free diet/supplements played a role in the long stretch, but seizures returned this past winter – same pattern. NOt sure why they started again as nothing has changed in his environment, food or treats. My Vet added a 3rd drug Zonisamide which seemed to stop them again for over 3 months now. We’re starting to cut back if not entirely the phenobarbitol. We had to stop agility since being on 3 meds is too much for his coordination and lost a little of his Border Collie ‘sharpness’ to keep him safe running at the speeds he runs. Hope we’re able to eliminate Phenobarbitol and keep him seizure free as much as possible to return to what he loves in time. From all the stories I hear and read about, some dogs aren’t as fortunate to be seizure free or relatively so, no matter what changes are made in our control. Awful heartwrenching disease and wouldn’t wish it on anyone or dog.

  2. Hi Fern,

    Thanks for reading my blog and then taking the time to post your comments. To address your question, this blog post was written about a particular article that discussed the nutritional management of epilepsy. It was not my intent to discuss the many different causes of seizures. I hope this helps.

  3. I was just wondering why vaccines were not mention that may play a part in transient seizures as mention by Dr Jean Dodds?

    Adverse Events Associated with Vaccination
    The clinical signs associated with vaccine reactions typically include fever, stiffness, sore joints and abdominal tenderness, susceptibility to infections, neurological disorders and encephalitis, collapse with autoagglutinated red blood cells and icterus (autoimmune hemolytic anemia, AIHA, also called immune-mediated hemolytic anemia, IMHA), or generalized petechiae and ecchymotic hemorrhages (immune-mediated thrombocytopenia , ITP). Hepatic enzymes may be markedly elevated, and liver or kidney failure may occur by itself or accompany bone marrow suppression.
    Furthermore, MLV vaccination has been associated with the development of transient seizures in puppies and adult dogs of breeds or cross-breeds susceptible to immune-mediated diseases especially those involving hematologic or endocrine tissues (e.g. AIHA, ITP, autoimmune thyroiditis). Post-vaccinal polyneuropathy is a recognized entity associated occasionally with the use of distemper, parvovirus, rabies and presumably other vaccines. This can result in various clinical signs including muscular atrophy, inhibition or interruption of neuronal control of tissue and organ function, muscular excitation, incoordination and weakness, as well as seizures.
    http://www.dogs4dogs.com/blog/2009/08/06/treating-adverse-vaccine-reactions-by-jean-dodds-dvm/

  4. I have a wonderful Golden Retriever who suffers from grand mal and petite mal seizures. His first seizure occured at 4 years old when he had a grand mal in the wee hours of the morning. I thought he was dying before my eyes ! The next one came a month later. We put him on phenobarital and watched him closely for months. I decided to wean him off the pheno after I did extensive research on epilepsy for dogs and how raw diet with omega 3 and omega 6’s, like sardines, can help control them. With these changes in his diet as well as holisitic supplements such as protadim his seizures are pretty much under control. I also keep him at a ideal weight which is difficult for a Golden who loves food ! His treats are mainly veggies and fruit.

  5. My Belgian Tervuren presented with his first grand mal seizure at 2 years of age. After 3 such seizures, months apart, I made major dietary changes and he has been seizure free for over 2 years without ever taking medication! These are the thing I eliminated: all grains, all dairy, all soy,and all rosemary (neuroexciter). I added taurine to his diet daily along with wild Alaskan salmon oil. He is fed Horizon Legacy kibble along with a combination of beef, lamb, elk and buffalo He is given Bak-Pak Plus probiotics and MSM daily. . His treats are carefully monitored to contain none of the eliminated ingredients listed aboveb.Healthy and vibrant, this dog is close to completing his AKC Championship and AKC MACH (Master Agility Champion) titles.

  6. Ah, near and dear to my heart. I did care for a Labrador who started having seizures at the age of 2. This was way back in the early 80’s. I waited for 6 months to see how often he would have seizures, timing them, keep thorough notes to tell my vet. He was put on Phenobarbital. After a year, I weaned him off to see how he would do. This is when I began feeding my dogs raw food w/ Taurine which I get from hearts. Charlie remained medication free for the rest of his life and lived to be 13 yrs old. He did have about 5 petite seizures during those 11 yrs, still swimming in the ocean, hiking, camping enjoying a great life with us.
    My brothers dog just suffered a seizure last wknd while out of town. Having never witnessed a seizure in dogs let alone his little baby, I got the call in the wee hrs of the morning. It was a petite seizure, aware of him the entire time. After we ruled out lots of things I asked if he had hit his head recently. The answer was yes the day before. Now, he is waiting and watching to see if there will be recurrences. So far no more.
    Although it’s hard to watch your dog having a seizure it’s always good to get a video (your wonderful idea Dr. K) so you have something to show your vet after you move anything dangerous out of the way.

    Thanks again for bringing these important issues to the forefront.