Purina NeuroCare Diet: "Neurological breakthrough" or money making gimic?

Purina NeuroCare:  "A neurological breakthrough"...[insert skeptic emoji here]

March 15 2017

Purina has come out full bore with marketing efforts for their new "epilepsy diet" NeuroCare, and their claims are pretty spectacular. Unfortunately, there remains a lot of skepticism in the Veterinary Neurology community.

I say unfortunately because primary seizure disorders (idiopathic, inherited, etc) remain a very frustrating condition to manage, and we still don't do it very well.  And because we don't do it well, clients are always looking for the magic bullet, that glimmer of hope.  Providing hope (and typically without science to back their merit) are holistic therapies, acupuncture, marijuana products...and now diet (again). And I cannot blame clients for trying anything and everything.  

Years ago, because of some proven benefit  in children with epilepsy, ketogenic diets were suggested and sometimes used in epileptic dogs...they did not work and came with some hazard in dogs, and never took hold as a useful mode of therapy.

Less long ago, researchers looking to ameliorate Canine Cognitive Disorder with diet, noticed that there seemed to be a statistically significant reduction in seizures in epileptic dogs fed there 'senility' diets. And now the Purina funded breakthrough randomized blinded double cross-over study...sounds pretty scientific doesn't it!!  Maybe not...

There has been recent discussion on the Neurology Listserve about the diet and the study they used to support it.  Here are some quotes from some very well known senior vet neurologists:

"In any instance, do statistical details of this report matter? The report claimed that only 22 dogs would be sufficient to show a difference between the two groups. The study included only 21 dogs - doesn't that alone undermine the conclusions?"

"Based on available evidence, my opinion regarding the “Epilepsy Diet” is as follows: 
* Available evidence regarding the “Epilepsy Diet” does not support its use as an adjunct to antiepileptic drugs in the management of canine idiopathic epilepsy. 
* Results of a solitary preliminary efficacy study may support the completion of more extensive efficacy trials, and future effectiveness trials of the “Epilepsy Diet”. However, it is recommended that such additional trials be completed before the “Epilepsy Diet” is marketed to the dog-owning public. 
One of the major conclusions of the solitary study on the "Epilepsy Diet" (Br J Nutrition 2015; 114:1438) is that “further investigations into the effectiveness and efficacy” of the diet are required. Why not complete such studies before marketing the product?  What if “further investigations” demonstrate that the “Epilepsy Diet” is not everything that it is purported to be, based on this single study (that was funded by the manufacturer of the product)?"
So, some skepticism about the study itself and the claims they are making.  Read the study and decide for yourselves.

I am predicting that in the not too distant future, there will be another study that does NOT duplicate their results and conclusions.  Isn't criteria for good study and science the reproducibility of results?  We'll see.

That said, am I going to badmouth the diet and recommend against it?  No...its what clients want...hope.  It appears to be a well balanced diet.  Will it cause harm? Probably not.

My recommendations:
The Purina diet is backed by what many consider to be 'weak science', and science (the British J of Nutrition study) that was funded by Purina themselves.  I don't think the diet can cause harm when used as an adjunct with standard anti-convulsant medications.  I strongly recommend that clients who decide to use the diet, also register on the Seizure Sentry website at www.petepilepsy.com.  This website has been developed and managed by a veterinary neurologist and is a tool used to help manage canine epileptic patients.  One of its most useful features is that it has the ability to track loads of data inputed by the dog owner and/or veterinarian.....medications, doses, geographical info, diet, exposures, etc.  In one consolidated place, thousands of data inputs regarding epileptic dogs can be accumulated and someday analyzed.  It is this kind of data analysis that we need to truly recognize meaningful trends in the successful (or not) management of our epileptic patients. The work done on this website (Seizure Sentry) is the only way we will someday hopefully make meaningful improvements in the way we manage seizure disorders.  So please, along with the discussion about Purina's NeuroCare, urge clients to register on the Seizure Sentry website.  Check it out for yourselves.  A great up to date resource about epilepsy, treatments, etc.  www.petepilepsy.com