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No idea on the cause and no family history for her, she was from the local rescue. Keto was in the zeitgeist at the time. I had looked at it for weight loss, but in learning about it, found that it has been advocated for epilepsy well before insulin was readily available. I thought I was using a decent cat food before, but it had a bunch of grain in it, which cats obviously wouldn't eat in the wild. So it was essentially a cheap experiment that worked out. I consulted with my vet on it first and they basically said, why not give it a try?