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Haake J, Meyerhoff N, Meller S, Twele F, Charalambous M, Wilke V, Volk H. Investigating Owner Use of Dietary Supplements in Dogs with Canine Cognitive Dysfunction. Animals (Basel) 2023; 13:3056. [PMID: 37835662 PMCID: PMC10571926 DOI: 10.3390/ani13193056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/10/2023] [Accepted: 09/28/2023] [Indexed: 10/15/2023] Open
Abstract
Canine cognitive dysfunction (CCD) is becoming increasingly recognized in veterinary medicine, as dogs live longer and with CCD being highly prevalent among the elderly dog population. Various studies have shown that diet and dietary supplementation can positively influence the clinical signs of CCD, especially if given at an early stage. The aim of this study was to investigate owner use of dietary supplements (DSs) in dogs with age-related behavioral changes. An observational study based on an online questionnaire for owners of dogs with age-related behavioral changes was performed. Out of a total of 394 owners who completed the survey, after noticing age-related behavioral changes, over half of the dogs received DSs (54%), whereas only 8% reported changing their dog's base diet. The most used DS was fish oil (48%). The use of DSs should be discussed with and monitored by veterinary surgeons since many geriatric patients have multi-morbidities, may have specific nutritional requirements and receive multi-faceted medications.
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Affiliation(s)
- Julia Haake
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (J.H.); (N.M.); (S.M.); (F.T.); (M.C.)
| | - Nina Meyerhoff
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (J.H.); (N.M.); (S.M.); (F.T.); (M.C.)
| | - Sebastian Meller
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (J.H.); (N.M.); (S.M.); (F.T.); (M.C.)
| | - Friederike Twele
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (J.H.); (N.M.); (S.M.); (F.T.); (M.C.)
| | - Marios Charalambous
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (J.H.); (N.M.); (S.M.); (F.T.); (M.C.)
| | - Volker Wilke
- Institute for Animal Nutrition, University of Veterinary Medicine, Foundation, 30173 Hannover, Germany;
| | - Holger Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, 30559 Hannover, Germany; (J.H.); (N.M.); (S.M.); (F.T.); (M.C.)
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Hemida M, Rosendahl S, Jokinen TS, Moore R, Vuori KA, Anturaniemi J, Hielm-Björkman A. Assessing the association between supplemented puppyhood dietary fat sources and owner-reported epilepsy in adulthood, among Finnish companion dogs. Front Vet Sci 2023; 10:1227437. [PMID: 37781290 PMCID: PMC10540444 DOI: 10.3389/fvets.2023.1227437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 08/25/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Epilepsy is a serious and common neurological condition in dogs, despite the wide number of antiepileptic drugs available, in approximately one third of the patients, epilepsy remains unsatisfactorily controlled. We aim to analyze whether feeding dietary fat sources during puppyhood was associated with canine epilepsy in adulthood. Methods A nested case-control study was compiled from the validated DogRisk food frequency questionnaire (DogRisk FFQ). DogRisk FFQ collected feeding, disease, and background data about the dog. The study sample consisted of 108 owner-reported epileptic cases and 397 non-epileptic controls. Each case was matched with up to four controls for the key confounding factors of sex, breed, and age. We analyzed associations between feeding as a puppy and owner-reported epilepsy as an adult dog using Cox regression. We tested 55 different food variables. Results We found that feeding fish fat from dietary sources at least once a week during puppyhood was inversely associated with epilepsy in later life in the unadjusted analysis [OR 0.46 (95% CI 0.25-0.83), p=0.01], while when adjusting for keeping conditions and dog characteristics the association was [OR 0.45 (95% CI 0.23-0.88), p=0.02]. When adjusted for keeping conditions, dog characteristics, and other feeding factors, the association was of similar magnitude but not significance [OR 0.56 (95% CI 0.27-1.15), p=0.12]. Discussion The study indicates possible protective associations of feeding the dog with dietary sources of fish fat against epilepsy, although the result could be confounded by other feeding factors. Findings are compatible with current knowledge regarding the role of omega-3 fatty acids and ketogenic diet, a low carbohydrate, high fat diet as supportive treatments of epilepsy. As our findings are based on observations, we suggest the possibility of causality but do not prove it. Dietary intervention studies should now be conducted to confirm our findings.
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Affiliation(s)
- Manal Hemida
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
- Department of Nutrition and Clinical Nutrition, Faculty of Veterinary Medicine, Beni-Suef University, Beni Suef, Egypt
| | - Sarah Rosendahl
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Tarja S. Jokinen
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Robin Moore
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Kristiina A. Vuori
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Johanna Anturaniemi
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
| | - Anna Hielm-Björkman
- Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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García-Belenguer S, Grasa L, Palacio J, Moral J, Rosado B. Effect of a Ketogenic Medium Chain Triglyceride-Enriched Diet on the Fecal Microbiota in Canine Idiopathic Epilepsy: A Pilot Study. Vet Sci 2023; 10:vetsci10040245. [PMID: 37104400 PMCID: PMC10144861 DOI: 10.3390/vetsci10040245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 03/03/2023] [Accepted: 03/22/2023] [Indexed: 04/28/2023] Open
Abstract
Ketogenic diets have been successfully used in people and dogs with idiopathic epilepsy. This study examined the effect of a ketogenic medium chain triglycerides (MCT)- enriched diet administered for one month on the fecal microbiota of epileptic (n = 11) (six with drug-sensitive epilepsy, DSE; five with drug-refractory epilepsy, DRE) and non-epileptic beagle dogs (n = 12). A significant reduction after diet in the relative abundance of bacteria from the Actinobacteria phylum was observed in all dogs. Epileptic dogs showed a higher relative abundance of Lactobacillus compared with non-epileptic dogs at baseline but these differences disappeared after diet. Epileptic dogs also showed a significantly higher abundance of Negativicutes and Selenomonadales after dietary intervention. Baseline microbiota patterns were similar in non-epileptic beagles and dogs with DSE but significantly different from dogs with DRE. In non-epileptic and DSE groups, the MCT diet decreased the relative abundance of Firmicutes and increased that of Bacteroidetes and Fusobacteria, but the opposite effect was observed in dogs with DRE. These results suggest that the MCT diet effect would depend on individual baseline microbiota patterns and that ketogenic diets could help reduce gut microbiota differences between dogs with DRE and DSE.
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Affiliation(s)
- Sylvia García-Belenguer
- Departamento de Patología Animal, Facultad de Veterinaria, Universidad de Zaragoza, Miguel Servet, 177, 50013 Zaragoza, Spain
| | - Laura Grasa
- Departamento de Farmacología, Fisiología y Medicina Legal y Forense, Facultad de Veterinaria, Universidad de Zaragoza, Miguel Servet, 177, 50013 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS), 50009 Zaragoza, Spain
- Instituto Agroalimentario de Aragón-IA2, Universidad de Zaragoza-CITA, 50009 Zaragoza, Spain
| | - Jorge Palacio
- Departamento de Patología Animal, Facultad de Veterinaria, Universidad de Zaragoza, Miguel Servet, 177, 50013 Zaragoza, Spain
| | - Jon Moral
- Departamento de Patología Animal, Facultad de Veterinaria, Universidad de Zaragoza, Miguel Servet, 177, 50013 Zaragoza, Spain
| | - Belén Rosado
- Departamento de Patología Animal, Facultad de Veterinaria, Universidad de Zaragoza, Miguel Servet, 177, 50013 Zaragoza, Spain
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Corsato Alvarenga I, Panickar KS, Hess H, McGrath S. Scientific Validation of Cannabidiol for Management of Dog and Cat Diseases. Annu Rev Anim Biosci 2023; 11:227-246. [PMID: 36790884 DOI: 10.1146/annurev-animal-081122-070236] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Cannabidiol (CBD) is a non-psychotropic phytocannabinoid of the plant Cannabis sativa L. CBD is increasingly being explored as an alternative to conventional therapies to treat health disorders in dogs and cats. Mechanisms of action of CBD have been investigated mostly in rodents and in vitro and include modulation of CB1, CB2, 5-HT, GPR, and opioid receptors. In companion animals, CBD appears to have good bioavailability and safety profile with few side effects at physiological doses. Some dog studies have found CBD to improve clinical signs associated with osteoarthritis, pruritus, and epilepsy. However, further studies are needed to conclude a therapeutic action of CBD for each of these conditions, as well as for decreasing anxiety and aggression in dogs and cats. Herein, we summarize the available scientific evidence associated with the mechanisms of action of CBD, including pharmacokinetics, safety, regulation, and efficacy in ameliorating various health conditions in dogs and cats.
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Affiliation(s)
- Isabella Corsato Alvarenga
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA;
| | - Kiran S Panickar
- Science & Technology Center, Hill's Pet Nutrition, Inc., Topeka, Kansas, USA
| | - Hannah Hess
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA;
| | - Stephanie McGrath
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA;
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Pergande AE, Belshaw Z, Volk HA, Packer RMA. Owner perspectives on the impact of veterinary surgeons upon their decision making in the management of dogs with idiopathic epilepsy. Vet Rec 2022:e2482. [PMID: 36529783 DOI: 10.1002/vetr.2482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 12/23/2022]
Abstract
BACKGROUND Idiopathic epilepsy is a prevalent canine condition that can be challenging to manage. A positive vet-owner relationship contributes to satisfaction and compliance, but its impact on management is unclear. The aim of this study was to investigate owner perspectives about the impact of veterinary surgeons on decision making and management. METHODS Qualitative methods were utilised, and semi-structured interviews were completed with 21 owners of dogs with epilepsy who lived in England. Transcripts were thematically analysed, and this study discusses the theme 'influences of the veterinary surgeon'. RESULTS Many owners felt that more precise expectations could have improved interactions with their veterinary surgeon(s), and their experiences of caring for their dog. Most owners referred to a specialist reported a positive experience, often due to specialists being perceived to have greater experience or knowledge. Owners who reported predominantly negative experiences were often less trusting of the veterinary profession, and more likely to perform self-directed research. LIMITATIONS These results represent the experiences of a small subset of owners, and larger scale studies are required to support these findings. CONCLUSION Owners appear to value the formation of partnerships of care with their veterinary surgeon, and greater availability of educational resources could further improve owner satisfaction.
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Affiliation(s)
- Amy E Pergande
- Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
| | | | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Rowena M A Packer
- Clinical Science and Services, Royal Veterinary College, Hatfield, Hertfordshire, UK
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Verdoodt F, Watanangura A, Bhatti SFM, Schmidt T, Suchodolski JS, Van Ham L, Meller S, Volk HA, Hesta M. The role of nutrition in canine idiopathic epilepsy management: Fact or fiction? Vet J 2022; 290:105917. [PMID: 36341888 DOI: 10.1016/j.tvjl.2022.105917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 11/05/2022]
Abstract
In the last decade, nutrition has gained interest in the management of canine idiopathic epilepsy (IE) based on growing scientific evidence. Diets can serve their functions through many 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. Selecting a diet with anti-seizure effects and avoiding risks of proconvulsant mediators as well as interference with anti-seizure drugs should all be considered in canine IE. This literature review provides information about preclinical and clinical evidence, including a systematic evaluation of the level of evidence, suggested mechanism of action and interaction with anti-seizure drugs as well as pros and cons of each potential dietary adaptation in canine IE.
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Affiliation(s)
- Fien Verdoodt
- Equine and Companion Animal Nutrition, Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium; Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Antja Watanangura
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany; Center for Systems Neuroscience (ZSN), Hannover, Germany; Veterinary Research and Academic Service, Faculty of Veterinary Medicine, Kasetsart University, Kamphaeng Saen, Nakhon Pathom, Thailand
| | - Sofie F M Bhatti
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Teresa Schmidt
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany; Center for Systems Neuroscience (ZSN), Hannover, Germany
| | - Jan S Suchodolski
- Gastrointestinal Laboratory, Department of Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Luc Van Ham
- Small Animal Department, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - Sebastian Meller
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany; Center for Systems Neuroscience (ZSN), Hannover, Germany
| | - Myriam Hesta
- Equine and Companion Animal Nutrition, Department of Morphology, Imaging, Orthopedics, Rehabilitation and Nutrition, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
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Griffin S, Stabile F, De Risio L. Cross Sectional Survey of Canine Idiopathic Epilepsy Management in Primary Care in the United Kingdom. Front Vet Sci 2022; 9:907313. [PMID: 35795785 PMCID: PMC9251582 DOI: 10.3389/fvets.2022.907313] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/26/2022] [Indexed: 11/13/2022] Open
Abstract
The aims of this study are to gain insight on how primary care veterinarians in the UK diagnose and treat canine idiopathic epilepsy (IE) and what they perceive as challenges in the management of canine IE. Two hundred and thirty-five primary care veterinarians took part in this survey. The questionnaire asked about the type of practice the respondent worked in, any relevant post-graduate qualifications, how many years' experience they had in practice and the participant's canine IE caseload. Participants were asked how they diagnose canine IE, how they select antiseizure drugs (ASDs) and how they assess outcome. The questionnaire also explored which information sources they have access to for deciding on canine IE treatment, challenges that may be faced when managing these cases and areas in which more support can be provided. 94.5% of participants (n = 222/235) managed <10 canine IE cases in a year and 87.8% (n = 206/235) used phenobarbital as their first line ASD. The reported mean initial phenobarbital dose was 2.1 mg/kg (standard deviation = 0.71) every 12 h. When considering how closely participants aligned with IVETF guidelines on the topics of diagnosis, ASD initiation and outcome assessment, on average participants would score around half of the available points. 53.2% (n = 125/235) of respondents recommended neutering in canine IE and 46.8% (n = 110/235) did not. 53.2% (n = 125/235) did not recommend any additional treatments for canine IE beyond use of ASDs. 23.4% recommended Purina Neurocare diet (n = 55/235), 12.8% recommended environmental modification (n = 30/235), and 6.8% (n = 16/235) recommend medium chain triglyceride supplements. In this study participants found managing client expectations to be most challenging alongside canine IE emergency management. The main limitation of this study is the relatively low response rate and therefore the results may not reflect the entire small animal veterinary profession in the UK. However, the results of this study represent a starting point to inform educational resources and support strategies to improve quality care of canine IE in primary care.
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Affiliation(s)
- Sebastian Griffin
- Vet4Life Teddington, Part of Linnaeus Veterinary Limited, Teddington, United Kingdom
- *Correspondence: Sebastian Griffin
| | - Fabio Stabile
- Southfields Veterinary Specialists, Part of Linnaeus Veterinary Limited, Basildon, United Kingdom
| | - Luisa De Risio
- Linnaeus Veterinary Limited, Solihull, United Kingdom
- Nottingham Trent University, Nottingham, United Kingdom
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Booth S, Meller S, Packer RM, Farquhar R, Maddison JE, Volk HA. Owner compliance in canine epilepsy. Vet Rec 2021; 188:e16. [PMID: 34651709 DOI: 10.1002/vetr.16] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/15/2020] [Accepted: 10/30/2020] [Indexed: 11/10/2022]
Abstract
BACKGROUND Poor medication compliance by human epilepsy patients is one of the leading causes of treatment failure and increased seizure frequency. The aim of this cross-sectional study was to analyse owner compliance in pharmacological treatment of canine idiopathic epilepsy and to identify factors associated with poor compliance. METHODS The number of antiseizure drug tablets was recorded to determine if the patient received sufficient tablets to cover the time period between prescriptions and to assess compliant prescription cycles. Additionally, compliance was assessed by an online survey of owners. RESULTS For the prescription monitoring data from 94 cases from three small animal practices in the United Kingdom revealed an overall median compliance of 56%. Thirt-three per cent of owners were >80% compliant, while 21% were 100% compliant. During a non-compliant prescription cycle, a patient missed a median of 6 days (0.11-519 days) of treatment. Patients on polytherapy had higher compliance rates than on monotherapy (p = 0.031). The survey (229 respondents from online canine epilepsy groups) showed that low daily dosing was associated with better compliance (p = 0.049). CONCLUSION Owner compliance was subpar in this study and could represent a significant issue in epilepsy management, which needs to be considered by veterinary surgeons when treating canine epilepsy.
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Affiliation(s)
- Samantha Booth
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Sebastian Meller
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | - Rowena Ma Packer
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | | | - Jill E Maddison
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK
| | - Holger A Volk
- Department of Clinical Science and Services, Royal Veterinary College, Hatfield, UK.,Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
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Jones GMC, Volk HA, Packer RMA. Research priorities for idiopathic epilepsy in dogs: Viewpoints of owners, general practice veterinarians, and neurology specialists. J Vet Intern Med 2021; 35:1466-1479. [PMID: 33960544 PMCID: PMC8162594 DOI: 10.1111/jvim.16144] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/07/2021] [Accepted: 04/19/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Epilepsy is the most common chronic neurological disease in dogs that adversely affects the quality of life (QoL) of affected dogs and their owners. Research on epilepsy in dogs is expanding internationally, but where best to focus limited research time, funds, and expertise to achieve better outcomes for affected dogs and their owners has not been studied. OBJECTIVE To explore idiopathic epilepsy (IE) research priorities of owners of dogs with IE, general practice veterinarians, and veterinary neurologists. METHODS An international online survey was conducted in 2016 and repeated in 2020. Participants rated the absolute importance and relative rank of 18 areas of IE research, which were compared between groups and time points. RESULTS Valid responses were received from 414 respondents in 2016 and 414 respondents in 2020. The development of new anti-seizure drugs (ASD) and improving the existing ASD management were considered the most important research priorities. Areas of research with increasing priority between 2016 and 2020 included non-ASD management, with the greatest potential seen in behavioral and dietary-based interventions. Disagreements in priorities were identified between groups; owners prioritized issues that impacted their and their dog's QoL, for example, adverse effects and comorbidities, whereas general practitioner vets and neurologists prioritized clinical issues and longer-term strategies to manage or prevent IE, respectively. CONCLUSIONS AND CLINICAL IMPORTANCE Ensuring that voices of owners are heard in the planning of future research should be a broader goal of veterinary medicine, to target research efforts toward areas most likely to improve the QoL of the dog-owner dyad.
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Affiliation(s)
| | - Holger Andreas Volk
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHertfordshireUK
- Department of Small Animal Medicine and SurgeryUniversity of Veterinary Medicine HannoverHannoverGermany
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10
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Hobbs SL, Law TH, Volk HA, Younis C, Casey RA, Packer RMA. Impact of canine epilepsy on judgement and attention biases. Sci Rep 2020; 10:17719. [PMID: 33082493 PMCID: PMC7576193 DOI: 10.1038/s41598-020-74777-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/10/2020] [Indexed: 12/19/2022] Open
Abstract
Idiopathic epilepsy (IE) is the most common chronic neurological condition in dogs, characterised by recurrent seizure activity and associated with negative behavioural and cognitive changes. We hypothesised that IE would negatively impact putative affective state, with dogs with IE exhibiting a more pessimistic judgement bias and more negative attention bias than controls. Dogs were tested in a previously-validated spatial judgement bias task, and a novel auditory attention bias task testing attention to sounds with different valence or salience (neutral, novel pre-habituated, threatening). Sixty-eight dogs (IE = 33, Control = 35) were tested, of which n = 37 acquired the spatial discrimination and responses to judgement bias probes were tested (IE = 19, Control = 18), and n = 36 were tested for responses to sounds (IE = 20, Control = 16). Study groups did not significantly differ by age, sex, breed or neuter-status (p > 0.05). Main effects of study group were not significant in judgement bias (F1,102 = 0.20, p = 0.658) or attention bias tasks (F3,102 = 1.64, p = 0.184). In contrast with our hypotheses, there was no evidence that IE altered cognitive biases in this study population; however, dogs with IE were significantly more likely to be unable to learn the spatial discrimination task (p = 0.019), which may reflect IE-related cognitive deficits. Developing methods to test affective state without excluding cognitively impaired individuals is a future challenge for animal welfare science.
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Affiliation(s)
- Sarah L Hobbs
- Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, Hertfordshire, UK
| | - Tsz Hong Law
- Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, Hertfordshire, UK
| | - Holger A Volk
- Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, Hertfordshire, UK.,Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Bünteweg, 30559, Hannover, Germany
| | - Chantal Younis
- Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, Hertfordshire, UK
| | - Rachel A Casey
- Dogs Trust, 17 Wakley Street, The Angel, London, EC1V 7RQ, UK
| | - Rowena M A Packer
- Royal Veterinary College, Hawkshead Lane, Hatfield, AL9 7TA, Hertfordshire, UK.
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11
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Santifort KM, Hamers M, Mandigers P. Epilepsy in veterinary patients: perspectives of Dutch veterinarians in first-line practice. Vet Rec 2020; 187:e44. [PMID: 32727932 DOI: 10.1136/vr.105806] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/27/2020] [Accepted: 06/19/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND This study aims to investigate the perspectives of veterinarians in first-line practice on confidence and satisfaction regarding several important aspects of the description, diagnosis and treatment of canine patients with epilepsy. METHODS A web-based questionnaire was used, focussing on general aspects of canine epilepsy, diagnostic tests, treatment and communication with owners. RESULTS One hundred and two questionnaires were evaluated. No less than 73 per cent of veterinarians had performed euthanasia on one or more patients with epilepsy as the main reason. First-line veterinarians scored confidence on general aspects of epilepsy as 6 or 7 out of 10. Confidence regarding communication with owners was scored 7 or 8 out of 10. CONCLUSIONS This study provides insight into perspectives of Dutch veterinarians in first-line practice regarding canine epilepsy. Several results may provide reasons to adjust (pregraduate or postgraduate) education of veterinarians with regard to management of canine patients with epilepsy. Several factors (such as the importance of diagnostic imaging) may help specialists in the field communicate better with referring veterinarians so that first-line practitioners become better equipped in managing patients with epilepsy. These steps may then positively influence treatment results as well as care-giver burden for the first-line practitioner.
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Affiliation(s)
- Koen Maurits Santifort
- Evidensia Small Animal Hospital Arnhem, Arnhem, The Netherlands.,Evidensia Small Animal Hospital 'Hart van Brabant', Waalwijk, The Netherlands
| | - Maud Hamers
- Department of Clinical Sciences of Companion Animals, Universiteit Utrecht Faculteit Diergeneeskunde, Utrecht, The Netherlands
| | - Paul Mandigers
- Evidensia Small Animal Hospital Arnhem, Arnhem, The Netherlands .,Department of Clinical Sciences of Companion Animals, Universiteit Utrecht Faculteit Diergeneeskunde, Utrecht, The Netherlands
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12
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Molina J, Jean-Philippe C, Conboy L, Añor S, de la Fuente C, Wrzosek MA, Spycher A, Luchsinger E, Wenger-Riggenbach B, Montoliu P, Gandini G, Menchetti M, Ribeiro JC, Varejão A, Ferreira A, Zanghi B, Volk HA. Efficacy of medium chain triglyceride oil dietary supplementation in reducing seizure frequency in dogs with idiopathic epilepsy without cluster seizures: a non-blinded, prospective clinical trial. Vet Rec 2020; 187:356. [PMID: 32532842 PMCID: PMC7799411 DOI: 10.1136/vr.105410] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 03/31/2020] [Accepted: 04/24/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND Despite appropriate antiseizure drug (ASD) treatment, around two-thirds of dogs with idiopathic epilepsy (IE) have seizures long-term and 20-30per cent of affected dogs remain poorly controlled. METHODS The current study aim is to test in a field trial the efficacy and tolerability of a commercially available diet enriched with 6.5per cent medium chain triglyceride (MCT) oil in dogs (n=21) with at least a tier 1 idiopathic epilepsy diagnosis, without cluster seizures, in 10 veterinary practices across Europe. Each dog's quality of life (QoL), ataxia, sedation and frequency and severity of seizures were recorded by owners throughout the study. RESULTS The mean seizure frequency per month, averaged over the entire 84-day study, significantly (P=0.04) decreased 32per cent compared with the baseline monthly seizure frequency recorded during the month immediately before feeding the diet. Similarly, the seizure days rate (days/month) also declined (P<0.001) by 42per cent. QoL was reported as very good to excellent (>8.5/10) in 20 of the 21 dogs before starting the diet and this remained unchanged during the trial. CONCLUSIONS This study demonstrates the use of a diet enriched with MCTs as an adjunct to ASD treatment may have some antiseizure properties for dogs diagnosed with IE, as demonstrated in previous studies.
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Affiliation(s)
- Jenifer Molina
- Technical Communications, Nestlé Purina PetCare EMENA, Barcelona, Spain
| | | | - Lisa Conboy
- Regulatory and Scientific Affairs, Nestlé Purina, Lausanne, Switzerland
| | - Sonia Añor
- Animal Medicine and Surgery, Universitat Autonoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Cristian de la Fuente
- Animal Medicine and Surgery, Universitat Autonoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Marcin Adam Wrzosek
- Department of Internal Diseases, Uniwersytet Przyrodniczy we Wroclawiu, Wroclaw, Poland
| | | | | | | | | | - Gualtiero Gandini
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano Emilia, Italy
| | - Marika Menchetti
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano Emilia, Italy
| | - João Carlos Ribeiro
- Referência Veterinária, Alcabideche, Portugal.,Faculdade de Medicina Veterinaria da Universidada, Lisboa, Portugal
| | - Artur Varejão
- Department of Veterinary Sciences, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal.,Centre for Animal Sciences and Veterinary Studies, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Antonio Ferreira
- Clinics, Faculty of Veterinary Medicine, University of Lisbon, Lisbon, Portugal
| | - Brian Zanghi
- Global Nutrition and Communications, Nestle Purina PetCare, St. Louis, United States
| | - Holger Andreas Volk
- Veterinary Clinical Sciences, Royal Veterinary College, Hatfield, UK.,University of Veterinary Medicine, Hannover, Germany
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13
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Muñana KR, Jacob ME, Callahan BJ. Evaluation of fecal Lactobacillus populations in dogs with idiopathic epilepsy: a pilot study. Anim Microbiome 2020; 2. [PMID: 32747877 PMCID: PMC7398614 DOI: 10.1186/s42523-020-00036-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background Idiopathic epilepsy is a common neurological disorder of dogs characterized by recurrent seizures for which no underlying basis is identified other than a presumed genetic predisposition. The pathogenesis of the disorder remains poorly understood, but environmental factors are presumed to influence the course of disease. Within the growing body of research into the microbiota-gut-brain axis, considerable attention has focused on the protective role of Lactobacilli in the development and progression of neurological disease. Investigations into the association between the gut microbiome and epilepsy are in their infancy, but some preliminary findings support a role for Lactobacilli in drug resistant epilepsy. To date, there are no published studies evaluating the gut microbiome in dogs with epilepsy. This pilot study was undertaken to evaluate fecal Lactobacillus populations in dogs with idiopathic epilepsy compared to healthy dogs. Results Fecal samples were obtained from 13 pairs of dogs, consisting of a drug-naïve epileptic dog and a healthy dog from the same household and maintained on the same diet. Evaluation of large-scale microbial patterns based on 16S rRNA gene amplicon sequencing identified a household effect in the study population. Differential prevalence testing at the 16S rRNA gene sequence variant and genus levels did not identify any statistically significant differences between epileptic and control dogs. Quantitative PCR of Lactobacillus species isolated through culture revealed no statistically significant difference between the epileptic and control dogs (median concentration, 3.8 log10 CFU/g feces and 4.6 log10 CFU/g feces, respectively). Lactobacillus in culture was not killed by exposure to phenobarbital, potassium bromide, zonisamide, or levetiracetam. Conclusions This pilot study did not identify any difference in large-scale microbial patterns or relative or absolute abundance of Lactobacillus species in drug-naïve epileptic dogs compared to healthy dogs. Further studies are warranted to evaluate the role of the gut microbiome in disease progression and treatment response in dogs with epilepsy. Lactobacilli in culture were not killed or inhibited from growing when exposed to phenobarbital, potassium bromide, zonisamide or levetiracetam, suggesting that antiepileptic drug administration is less likely to be a confounding factor in future studies evaluating the role of Lactobacillus in epilepsy.
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Affiliation(s)
- Karen R Muñana
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Veterinary Health Complex Room 2569, 1052 William Moore Drive, Raleigh, NC 27607, USA
| | - Megan E Jacob
- Department of Population Health & Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
| | - Benjamin J Callahan
- Department of Population Health & Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27607, USA
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14
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Berk BA, Law TH, Packer RMA, Wessmann A, Bathen‐Nöthen A, Jokinen TS, Knebel A, Tipold A, Pelligand L, Meads Z, Volk HA. A multicenter randomized controlled trial of medium-chain triglyceride dietary supplementation on epilepsy in dogs. J Vet Intern Med 2020; 34:1248-1259. [PMID: 32293065 PMCID: PMC7255680 DOI: 10.1111/jvim.15756] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 03/12/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Medium-chain triglyceride (MCT) enriched diet has a positive effect on seizure control and behavior in some dogs with idiopathic epilepsy (IE). OBJECTIVE To evaluate the short-term efficacy of MCTs administered as an add-on dietary supplement (DS) to a variable base diet to assess seizure control and antiseizure drug's (ASD) adverse effect profiles. ANIMALS Twenty-eight dogs with International Veterinary Epilepsy Task Force Tier II (IVETF) level diagnosis of treated IE with 3 or more seizures in the last 3 months were used. METHODS A 6-month multicenter, prospective, randomized, double-blinded, placebo-controlled crossover trial was completed, comparing an MCT-DS with a control-DS. A 9% metabolic energy-based amount of MCT or control oil was supplemented to the dogs' diet for 3 months, followed by a control oil or MCT for another 3 months, respectively. Dogs enrolled in this study satisfied most requirements of IE diagnosis stated by the IVETF II level. If they received an oil DS or drugs that could influence the metabolism of the investigated DS or chronic ASD, the chronic ASD medication was adjusted, or other causes of epilepsy were found, the dogs were excluded from the study. RESULTS Seizure frequency (median 2.51/month [0-6.67] versus 2.67/month [0-10.45]; P = .02) and seizure-day frequency were significantly (1.68/month [0-5.60] versus 1.99/month [0-7.42], P = .01) lower when dogs were fed MCT-DS in comparison with the control-DS. Two dogs were free of seizures, 3 had ≥50% and 12 had <50% reductions in seizure frequency, and 11 dogs showed no change or an increase in seizure frequency. CONCLUSIONS AND CLINICAL IMPORTANCE These data show antiseizure properties of an MCT-DS compared to a control oil and support former evidence for the efficacy of MCTs as a nutritive, management option for a subpopulation of drug-resistant dogs with epilepsy.
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Affiliation(s)
- Benjamin A. Berk
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHatfieldUK
- BrainCheck.PetMannheimGermany
| | - Tsz H. Law
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHatfieldUK
| | - Rowena M. A. Packer
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHatfieldUK
| | | | | | - Tarja S. Jokinen
- Faculty of Veterinary Medicine, Department of Equine and Small Animal MedicineHelsinkiFinland
| | - Anna Knebel
- Department of Small Animal Medicine and SurgeryUniversity of Veterinary MedicineHanoverGermany
| | - Andrea Tipold
- Department of Small Animal Medicine and SurgeryUniversity of Veterinary MedicineHanoverGermany
| | - Ludovic Pelligand
- Department of Comparative Biomedical SciencesRoyal Veterinary CollegeHatfieldUK
| | - Zoe Meads
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHatfieldUK
| | - Holger A. Volk
- Department of Clinical Science and ServicesRoyal Veterinary CollegeHatfieldUK
- Department of Small Animal Medicine and SurgeryUniversity of Veterinary MedicineHanoverGermany
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15
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A double-blinded randomised dietary supplement crossover trial design to investigate the short-term influence of medium chain fatty acid (MCT) supplement on canine idiopathic epilepsy: study protocol. BMC Vet Res 2019; 15:181. [PMID: 31146740 PMCID: PMC6543566 DOI: 10.1186/s12917-019-1915-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 05/14/2019] [Indexed: 01/23/2023] Open
Abstract
Background Epilepsy is the most common brain disease in dogs. Recently, diets have been reported to have a positive impact on seizure activity and behaviour in various species including dogs with idiopathic epilepsy (IE). Historically, classic high fat ketogenic diets (KD) and medium chain triglycerides (MCT) KD have been successfully used to manage drug-resistant epilepsy. Similarly, an MCT enriched diet has been shown to improve seizure control and behavioural comorbidities in some dogs with IE. However, it is unknown whether an MCT dietary supplement (DS) may provide similar positive effects. Methods A 6-month prospective, randomised, double-blinded, placebo-controlled, crossover, multicentre dietary trial is designed comparing a 9% metabolic energy based calculated medium-chain triglyceride (MCT) oil supplement to a conventional ‘control’ DS. Only dogs which will have an International Veterinary Epilepsy Task Force Tier II level like diagnosis of IE which satisfied the following inclusion criteria are included: age between 6 months and ≤ 12 years; weighing between 4 and ≤ 65 kg; unremarkable interictal neurological examinations; no clinically significant findings on routine laboratory diagnostics; unremarkable brain MRI scan; have had at least 3 seizures in the previous 3 months prior to enrolment; treated with at least one ASD and being classified as resistant. All dogs are fed initially for 90 ± 2 days with either the control oil or the MCT oil alongside their normal diet, followed by 97 ± 2 days with the other supplement including a 7-day washout period. Overall, the aim is to recruit thirty-six patients at five different centres and to investigate the effect of MCTs as DS on seizure activity, tolerability, behavioural comorbidities and quality of life (QoL). Discussion Dietary interventions are rarely studied in a standardised form in veterinary medicine. The background diet, the cohort of animals and ASD received is standardised in this prospective diet trial to ensure representative data about the potential effect of MCT DS. If the study data confirms former findings, this would provide further evidence for the efficacy of MCTs as a management option for canine epilepsy. This publication should offer a repository of trial conditions and variable description with forecasted statistical analysis. Electronic supplementary material The online version of this article (10.1186/s12917-019-1915-8) contains supplementary material, which is available to authorized users.
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16
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Masino SA, Freedgood NR, Reichert HR, Director CJ, Whittemore VH, Zupec‐Kania B. Dietary intervention for canine epilepsy: Two case reports. Epilepsia Open 2019; 4:193-199. [PMID: 30868131 PMCID: PMC6398089 DOI: 10.1002/epi4.12305] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/01/2019] [Accepted: 01/01/2019] [Indexed: 12/13/2022] Open
Abstract
Epilepsy is a common neurologic disorder in humans and domesticated canines. In both species the etiology is diverse and complex, and even with medication a significant portion of the population does not experience sufficient seizure control and/or has unacceptable side effects. Humans often try alternatives such as dietary therapy or brain surgery, but in dogs, brain surgery is rarely an option and, despite potential benefits, there are no standard recommendations for a dietary approach. Herein we describe 2 retrospective case studies detailing the effects of homemade diets prepared for dogs with uncontrolled epileptic seizures and/or toxic side effects of medication. Basic recipes are provided for each formula-a high-fat "ketogenic" diet and a partial "whole food" diet. Carbohydrate content was reduced or controlled, and in one case this was proven to be essential for seizure control: ingesting carbohydrates would reverse the benefits of the diet and precipitate a seizure. Both dogs experienced fewer seizures and side effects when eating these modified diets compared to when they were administered antiepileptic drugs, including complete cessation of seizures for extended periods. Practical advantages and success of these homemade dietary interventions highlight the potential for diet-based metabolic therapy as a treatment option for seizures not only in humans but also in dogs.
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Affiliation(s)
- Susan A. Masino
- Neuroscience ProgramTrinity CollegeHartfordConnecticut
- Department of PsychologyTrinity CollegeHartfordConnecticut
| | | | | | | | - Vicky H. Whittemore
- National Institute of Neurological Disorders and StrokeNational Institutes of HealthBethesdaMaryland
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17
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Packer RMA, Hobbs SL, Blackwell EJ. Behavioral Interventions as an Adjunctive Treatment for Canine Epilepsy: A Missing Part of the Epilepsy Management Toolkit? Front Vet Sci 2019; 6:3. [PMID: 30746367 PMCID: PMC6360160 DOI: 10.3389/fvets.2019.00003] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 01/09/2019] [Indexed: 12/14/2022] Open
Abstract
Epilepsy is a common, complex and often challenging neurological disorder to treat in the dog, with 20-30% of dogs resistant to conventional medical therapies, and associated with cognitive and behavioral comorbidities and early death. Behavioral interventions are an emerging area of focus in the adjunctive treatment of drug-resistant human epilepsy patients, with studies indicating positive effects of a variety of interventions including relaxation-based techniques and behavioral therapy interventions. Behavioral interventions have the potential not only to improve seizure control, but also improve behavioral comorbidities and general quality of life in this hard to treat patient group. Despite striking similarities between human and canine epilepsy patients, including the recognition of co-morbid anxiety in epilepsy patients, behavioral interventions have yet to be studied in dogs. This is compounded by several licensed psychopharmaceutical agents for dogs being contra-indicated in epilepsy patients. We present evidence from human studies of the efficacy of behavioral interventions to improve seizure control, psychiatric comorbidities and quality of life, and propose that adapting such interventions for canine patients may be a valuable addition to the epilepsy management toolkit. There is a need for multi-center, double-blinded, placebo-controlled trials to confirm the effects of behavioral interventions on seizure frequency in veterinary medicine. In the absence of such evidence to date, the use of established behavioral medicine techniques to reduce stress and improve the mental health of these often sensitive and challenging patients is advocated, with a greater role for behaviorists in the management of epilepsy patients alongside neurologists and general practitioners.
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Affiliation(s)
| | | | - Emily J Blackwell
- Bristol Veterinary School, University of Bristol, Bristol, United Kingdom
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