Highlights
- •Attention-deficit/hyperactivity disorder is a common comorbidity of epilepsy.
- •We observed ADHD-like behaviors in dogs with naturally occurring epilepsy.
- •Hyperactivity, excitability, and distractibility were high in these dogs.
- •A medium chain triglyceride diet (MCTD) reduced some ADHD-like behaviors.
- •Stranger-directed fear lowered on the MCTD, a potential anxiolytic effect.
Abstract
Objectives
Epilepsy in humans and rodent models of epilepsy can be associated with behavioral
comorbidities including an increased prevalence of attention-deficit/hyperactivity
disorder (ADHD). Attention-deficit/hyperactivity disorder symptoms and seizure frequency
have been successfully reduced in humans and rodents using a ketogenic diet (KD).
The aims of this study were (i) to describe the behavioral profile of dogs with idiopathic
epilepsy (IE) while on a standardized nonketogenic placebo diet, to determine whether
ADHD-like behaviors are present, and (ii) to examine the effect of a ketogenic medium
chain triglyceride diet (MCTD) on the behavioral profile of dogs with idiopathic epilepsy
(IE) compared with the standardized placebo control diet, including ADHD-like behaviors.
Methods
A 6-month prospective, randomized, double-blinded, placebo-controlled, crossover dietary
trial comparing the effects of the MCTD with a standardized placebo diet on canine
behavior was carried out. Dogs diagnosed with IE, with a seizure frequency of at least
3 seizures in the past 3 months (n = 21), were fed the MCTD or placebo diet for 3 months and were then switched to the alternative diet for 3 months. Owners completed a validated behavioral questionnaire to measure 11 defined
behavioral factors at the end of each diet period to report their dogs' behavior,
with three specific behaviors hypothesized to be related to ADHD: excitability, chasing,
and trainability.
Results
The highest scoring behavioral factors in the placebo and MCTD periods were excitability
(mean ± SE: 1.910 ± 0.127) and chasing (mean ± SE: 1.824 ± 0.210). A markedly lower trainability score (mean ± SE: 0.437 ± 0.125) than that of previously studied canine populations was observed. The MCTD resulted
in a significant improvement in the ADHD-related behavioral factor chasing and a reduction
in stranger-directed fear (p < 0.05) compared with the placebo diet. The latter effect may be attributed to previously
described anxiolytic effects of a KD.
Conclusions
These data support the supposition that dogs with IE may exhibit behaviors that resemble
ADHD symptoms seen in humans and rodent models of epilepsy and that a MCTD may be
able to improve some of these behaviors, along with potentially anxiolytic effects.
Abbreviations:
ADHD (attention-deficit/hyperactivity disorder), AED (antiepileptic drug), AKC (American Kennel Club), BHB (β-hydroxybutyrate), C-BARQ (Canine Behavioral Assessment and Research Questionnaire), CPRS-R (Conners' Parent Rating Scale — Revised), IE (idiopathic epilepsy), KD (ketogenic diet), MCTD (medium chain triglyceride diet), MRI (magnetic resonance imaging), QoL (quality of life)Keywords
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Article info
Publication history
Published online: January 07, 2016
Accepted:
November 14,
2015
Received in revised form:
November 9,
2015
Received:
October 5,
2015
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
