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Nutrition Nuggets
 
 
Your dog's nutrition is important for a healthy & happy life. petMD experts help you to know what to feed your dog, how much food to feed, and the differences in dog foods, so your dog gets optimum nutrition.
Nutrition Nuggets is the newest offshoot of petMD's Dog Nutrition Center. Each week Dr. Coates will use her expertise and wisdom to blog about the intricacies of dog nutrition.

New Recommendations for Feeding Dogs with Pancreatitis

August 15, 2014 / (16) comments

Our understanding regarding how best to feed (or not feed) dogs with pancreatitis has undergone significant changes over the last few years. Back when I was in veterinary school in the 1990s, we learned that dogs with pancreatitis should be fasted for 24-48 hours. This protocol was based on a reasonable assumption — food passing through the intestinal tract would stimulate the pancreas to secrete digestive enzymes, thereby increasing pancreatic inflammation.

 

But now, research in people and dogs is revealing the harmful effects that prolonged fasting can have on the structure and function of the gastrointestinal tract, including its important role in the immune system. The cells that line the intestinal tract depend on absorbing energy and nutrients that pass by after a meal. When a dog does not eat, the lining of the intestinal tract changes: the villi (fingerlike projections that increase the intestine’s absorptive surface) shrink, local immune tissue is reduced, the intestinal wall becomes “leaky,” promoting the absorption of bacteria and toxins, and inflammation increases, both within the digestive tract and systemically. Also, there is some evidence that when the pancreas is inflamed it does not secrete digestive enzymes in response to the presence of food in the same way that a healthy pancreas does, which casts even more doubt on the practice of prolonged fasting.

 

We don’t have studies in dogs that directly answer the question of when and how to best start feeding dogs with pancreatitis, but many veterinarians are switching to an “as soon as possible” mind set. We should still not be feeding dogs that are actively vomiting (there’s no point if they can’t keep it down), but the effective antiemetic medications that are now available (e.g., maropitant) often allow us to get control of a dog’s vomiting within 24 hours of hospitalization. It is at this time that food should be reintroduced.

 

In dogs, dietary fat is known to be associated with the development of pancreatitis and can stimulate the secretion of a hormone that induces the pancreas to secrete its digestive hormones. Therefore, low fat foods are recommended. Refeeding should always begin slowly. A common recommendation is to start with one-quarter of the dog’s resting energy requirement divided into four meals throughout the day. In other words, the dog would get four meals consisting of about 1/16 of what it would normally eat spread over 24 hours. As long as the dog continues to improve, the amount of food offered could increase by one-quarter every day so that at the end of four days, the patient is taking in his or her full resting energy requirement.

 

Because we want dogs with pancreatitis to benefit from as much nutrition as possible even when taking in small amounts of food, a highly digestible diet is preferred. Foods should be low in fiber and made from high-quality ingredients. Several pet food manufacturers make low fat, highly digestible diets for dogs. Most veterinarians carry at least one food like this in their clinics to feed to hospitalized patients and to send home with dogs as they continue to recover. A short-term alternative is to feed a mixture of boiled white meat chicken and white rice, but if a home cooked diet is needed for more than just a few days, a veterinary nutritionist should design a nutritionally complete diet that will meet all of the dog’s needs.

 

Dr. Jennifer Coates

 

Image: Michelle D. Milliman / Shutterstock

 

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Comments  16

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  • Makes Sense
    08/15/2014 05:06pm

    This all makes sense.

    Does the intestinal tract of humans, cats and other mammals react the same way with the digestive enzymes?

  • 08/17/2014 10:25pm

    Most dogs with pancreatitis do not go on to develop pancreatic exocrine insufficiency, which is the disease that requires supplementation with pancreatic enzymes.

  • 08/17/2014 10:26pm

    Not exactly, but very similarly in a big picture sort of way.

  • diet and pancreatitis
    08/17/2014 10:39pm

    Hi again,


    Do you have a feeling on the fiber content of the dog food? I have read lower than than 4% and lower than 12% fat for pancreatitris - or is that epi?
    Are there any restictions on protein types or starches?

    Thanks so much!!

    Karen

  • 08/18/2014 11:54am

    One of the commonly used foods for acute pancreatitis in dogs has a fiber content of around 2% and fat content of around 8.5%. This is definitely one of those cases that what works for one dog may not work for another. Also, if a dog has only had one episode of pancreatitis, many veterinarians will not recommend long term feeding of a low fat diet but try to transition them back to a "normal" (but usually not high fat) food.

  • 08/21/2014 08:13pm

    Thank you. We have a 12 year old Bichon who just spent 2 days at the Vet. IV ,pain meds etc. she was released to us on antibiotics and Tramadol. She's been home 10 days and it's a day by day is she ok, is she going to eat. Tramadol wipes her out. She was on metacam and we were wondering if we could use it. We have Purina IM as her food. She seems to be ok and then she seems to be lethargic. She eats very little but eats. Small bits. She is drinking water. She is 13 but just does not seem well. We are done with antibiotics. She seems to be on a roller coaster. We are a little worried. Has any one else had this with the first diagnosis of pancreatitis?

  • 08/22/2014 11:05am

    It can take a while to fully recover from a severe bout of pancreatitis, so your Bichon may just need some more time. Ask your veterinarian whether he or she thinks cutting back or discontinuing the tramadol is appropriate as this medication can affect appetite and energy levels.

  • 08/18/2014 11:55am

    Re. types of proteins and starches - highly digestible is the rule of thumb. Chicken and rice are typical.

  • Pancreatitis scare
    09/01/2014 10:07pm

    Our dog is an eleven year old English Pointer. He has been reluctantly diagnosed with pancreatitis because although nothing in his bloodwork or internal scans indicate pancreatitis, all of his symptoms seem to point to that. He has been hospitalized for a couple of days now and it's been really scary. My husband read a bunch of stuff on the internet that scared him about our dog's chance of survival, but the doctor just said his treatment will take time. Is there anyone out there that has been through this with their dog and can give us some hope?
    Also, at what point is it safe for us to take him out of the hospital and start caring for him at home?
    Thank you.

  • 09/02/2014 09:44pm

    Many dogs with severe pancreatitis dosurvive with appropriate treatment. When it is safe to take him home mostly depends on his ability to keep down food, water, and medications orally. Your veterinarian is in the best position to make this call.

  • 09/06/2014 01:18pm

    Thank you. Augie is not throwing up so we brought him home, but he is in so much discomfort he still will not eat very much. When he does try to eat, he eats very little and then pays for it with severe nausea. So our other concern is that he'll associate his nausea with food.
    We just got a new combination of nausea meds we tried this morning, but so far it does not seem to be improving his appetite. This article really raises my level of concern about his not eating, (which was already high because of his weight loss). The vet says usually the cases she sees are acute cases that get better in a few days, but Augie's condition has been ongoing for two weeks, and was only diagnosed because of his symptoms and not his bloodwork or internal pictures. Is this more common than she thinks?

  • 09/08/2014 03:44pm

    It does sound like Augie's case is somewhat unusual. Unfortunately, it's impossible for me to comment directly on what would be best for him since I don't have the ability to examine him and his records. A second opinion never hurts. Ask your veterinarian whether she thinks a visit to a specialist is reasonable at this point.

  • Pancreatitis or?
    09/29/2014 05:11pm

    I have a 9yr old dachshund that suddenly developed diarrhea in Feb. I did the initial bland diet/ she was put on anti diarrheal and nausea etc../ there was only one vomiting episode. She was always underweight / very thin / she was always in a fish based high quality (instinct or castor & Pollux) never a cheap food. She also got steamed carrots/broccoli/ squash / cauliflower/ for dinner and was getting 1/4 tsp of coconut oil for her skin. And half tsp of pure pumpkin. She never had any health issue until this. Her appetite was always good even when sick. We did blood work and she came back just on edge of pancreatitis (one vet said) the other just said pancreatitis. Her vitamin b12 level was very very very low. We did ultrasound /nothing shown. We could not firm up her poop. Eventually vet said Royak Canin hydrolyzed /hypoallergenic kibble. A soy based protein. And 1/4 tsp Metamucil ea meal. After a while she was regaining weight and her coat looks great. We also did weekly then tapering down vit b12 injections. Her poop firmed up. She started putting on a little to much weight so we tried the same food only moderate calorie. This is interesting because vet wanted HIGH fiber w her and Not high protein and novel protein and LOW fat. I started giving her steamed sweet potato also 1 tbsp per meal. The moderate calorie had more fiber than the reg formula. I've since weaned her off the Metamucil and I would like to get her off this food as I don't think it's the best quality but can't argue it helped her. She looks great. She did not have the typical pancreatits symptoms and the fiber helps her (Metamucil works both ways I guess !). I would love to have another opinion on this as she doesn't fall into a for sure category. I recently started searching for an under 23% protein/ fat below 15% novel protein food. Per her vets directions but what is confusing is the guaranteed Analysis of the RC prescription food was protein min 21.5 fat min 10.5fiber max is 3.1. Brewers rice and hydrolyzed soy protein were first 2 ingredients.
    I would like her on a reg food again- the vet isn't to sure though -
    I dint understand if possibly she was very underweight that could have done this? Or??
    I can provide her blood work details if this isn't enough.

  • 09/30/2014 03:34pm

    I can't make specific recommendations regarding your dog's case but in general if a dog with chronic GI problems is doing well on a particular diet that provides complete and balanced nutrition, I don't recommend making a change. The food your dog is currently eating could be helping control her pancreatitis as well as any other concurrent conditions (e.g., food allergy/intolerance, inflammatory bowel disease) that she might also be suffering from. While the ingredient list might not be what your are looking for and the guaranteed analysis not quite "textbook" for pancreatitis, I don't think you can argue with it's success.

 



ABOUT NUTRITION NUGGETS

JENNIFER COATES, DVM

Photo of Jennifer

... graduated with honors from the Virginia-Maryland Regional College of Veterinary Medicine in 1999. In the years since, she has practiced veterinary medicine in Virginia, Wyoming, and Colorado. She is the author of several books about veterinary medicine and animal care, including the Dictionary of Veterinary Terms, Vet-Speak Deciphered for the Non-Veterinarian .

Jennifer also writes short stories that focus on the strength and importance of the human-animal bond and freelance articles relating to a variety of animal care and veterinary topics. Dr. Coates lives in Fort Collins, Colorado with her husband, daughter, and pets.

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