Informational response provided by Dr. Glenn Olah, DVM, DABVP (Feline) to an inquiry on the use of medium-chain triglycerides and coconut oil in cats:
In regards to medium-chain triglycerides (MCT) use in cats. As you probably surmised, there is not a lot of peer-reviewed research articles regarding their use in cats, and most recommendation are based on dog or human studies or physiological arguments. The paper by Trevisan et al. (2010) was actually supported by Nestlé-Purina Pet Care and the Mark L. Morris Professorship in Clinical Nutrition, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Tex., and only reported as a synopsis in the Winn blog. I apologize for this confusion.
The authors of the paper were quite aware of the previous work pointing out the poor palatability of various MCT oils, and food aversion in cats. The authors used coconut oil that contains ~ 50% MCT and ~ 50% long-chain triglycerides and replaced safflower oil in a balanced feline food. Coconut oil is a blend of MCT oils and not a purified MCT oil as used in earlier studies. And, the concentrations of MCTs were lower than those used in previous studies (MacDonald et al., Physiol Behav. September 1985;35(3):371-375). Find attached below proceeding notes from Dr. Trevizan given at the 2008 ACVIM conference for a little more detail regarding this study.
The question then is whether higher dietary MCT are beneficial to normal cats or cats with diseases like IBD. The answer is – we simply don’t know. The concern with MCT as stated in the BSAVA formulary is not quite correct because coconut oil does contain some essential fatty acids (i.e., ~2% omega-6 and no arachidonic acid), but it is obviously not enough, and, therefore, not balanced for an obligate carnivore like a cat. Plumb’s formulary is better at explaining the adverse effects and contraindications, in particular, why MCT are contraindicated in animals with chronic liver disease, “MCT oil should be used with caution in patients with significant hepatic disease (e.g., portacaval shunts, cirrhosis, etc.). Medium chain triglycerides are rapidly absorbed via the portal vein and if their hepatic clearance is impaired, significantly high systemic blood and CSF levels of medium chain fatty acids can occur. This may precipitate or exacerbate hepatic coma”.
One other point, association between feline hepatic lipidosis (FHL) and MCT is repeatedly stated on VIN and in various proceeding notes, but the original source is never referenced. After searching for this reference, I believe it is MacDonald and Rogers (1984) Annual Review of Nutrition Vol. 4, 52-562 and I have ordered a copy of this paper. The paper by Trevisan et al. (2010) does not mention or reference any paper suggesting the association between FHL and MCT. It is also not clear if this effect/association was direct or indirect (i.e., due simply to poor palatability).
Also, conditions like lymphangiectasia in which MCT supplementation would make physiological sense is actually not common in cats with IBD. They usually have lymphocytic-plasmacytic enteritis or other enteritides. Also, MCT have not been shown to make a difference in lymph flow in dogs with chylothorax; therefore, they are not generally recommended in cats with this condition.
Therefore, I do not think, at this time, that MCT supplementation can be recommended for cats with IBD. More studies would have to be done. With that said, supplementing with a little coconut oil will probably not cause any major problems (maybe flatulence or diarrhea), as long as essential fatty acids are adequate, but whether they help any disease condition in cats is simply not known. I think the reason for BSAVA statement, “Do not use MCT oils in cats” is due to their lack of adequate essential fatty acids and to previous reports of poor palatability in cats. The Plumb formulary is more up-to-date and actually references the Trevisan et al. (2010) paper. (GO, edited for clarity)