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essential nutrition advice for your pet.

Feeding the Starving Dog

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.

Feeding the Starving Dog

October 04, 2013 / (5) comments

I ran across a local canine adoption event a couple of weeks ago. A couple of the dogs had been recently rescued from horrific conditions and were emaciated. We’re talking “skin and bones.” Their caretaker said they looked a lot better than they did when they were first brought in, but they were taking it slow when it came to weight gain.


As contrary as that might sound, this rescue organization was doing exactly the right thing. When dogs that have essentially been starved suddenly have free access to large amounts of food, they can become very sick and even die. This is an especially tough situation because our natural first instinct to seeing an emaciated animal is to give it food … lots and lots of food. In truth, the best thing to do is bring the dog to the veterinarian immediately for an assessment and feeding plan.


The most serious effect associated with reintroducing food to starving dogs goes by the name “refeeding syndrome.” It is well-recognized in people, but less research has been done in dogs. My somewhat limited understanding of refeeding syndrome is that in an attempt to survive starvation, the body’s metabolic pathways undergo some pretty profound shifts. When the body is suddenly “inundated” with food, these new pathways cannot handle the situation, which results in fluid, electrolyte, and vitamin imbalances that have adverse effects on many different organs, including the heart and brain. In extreme cases, organ dysfunction can become severe enough that the dog dies.


A less extreme form of refeeding syndrome results in gastrointestinal problems. The GI tract of a dog who has not been eating much (if anything) for a prolonged period of time simply can’t handle the sudden onslaught of a large amount of food. These dogs develop diarrhea, loss of appetite, and/or vomiting, none of which are helpful when weight gain is the goal.


I was taught to start feeding dogs at risk for refeeding syndrome at one-third of their normal, maintenance caloric requirement and gradually increase the amount they get from there. As far as I can tell, that recommendation is not really based in any scientific research, but is probably the result of a better safe than sorry attitude (not that there’s anything wrong with that).


I suspect the fine details are not all that important, but I still start with several, small meals of high-quality food three or four times a day. The first day, I aim for roughly one-third of what the dog would normally eat and take approximately five days to move the dog up to its normal ration, all the while monitoring the dog closely for any adverse effects. If the dog is otherwise normal but develops diarrhea, I back off a bit on the amount of food offered. Once the dog is eating what would be considered a “normal” amount, free-feeding a diet that is calorically dense (e.g., a puppy food or product designed for working dogs) is appropriate until the dog’s ideal weight has been achieved.



Dr. Jennifer Coates



Image: Susan Schmitz / Shutterstock


Comments  5

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  • Starving Critters
    10/04/2013 09:53pm

    I've always wondered if even small meals of a good quality food might cause stomach upset or intestinal problems just because the food would seem "rich".


  • 10/05/2013 09:54pm

    It's certainly possible.

  • underweight dog w/diarhea
    05/27/2014 07:33pm

    We adopted a 14 month old Husky/German Shepherd who was very thin and is about 25-30 lbs underweight...once we got her home she started having diarrhea..which we figured was due to stress as she hadn't had it as her foster parents. So I switched her to a diet of chicken, sweet potatoes (or pumpkin) and some white rice..she seemed to have harder stools so started putting in some Iams dry food. I think I over did it on the Iams because I felt sorry for her as she seemed always hungry and now she once again has the diarrhea....so we are doing the previous diet again. I've started feeding her 4 times a day but smaller portions. That's been 2 days and the stool seems to at least have a shape again so that's good. I don't want to mess up again so when I start adding her Iam's back in, do I want to add as much as she should be eating if she were only eating the dog food and not the chicken etc or less and when exactly should I start adding the dry food? Should I wait until the stools are hard?

    I want to make sure we do this the right way and not create additional problems. thanks

  • 05/28/2014 03:45pm

    Go very slowly. Once the stools are more or less firm, add in just a tiny bit of the new food removing an equivalent amount of the old. Gradually increase the amount of new/decrease amount of old over the course of a couple of weeks until she is eating only new. If the diarrhea returns, a trip to the veterinarian is in order.

  • brands of dog food
    01/25/2017 12:54am

    we just rescued a lab retriever mix and he's such a sweet dog he's about 3 and supper skinny he eats the kibbles and bits we give him and our other dog but is there a better brand of food we can give him to make him gain weight and to look healthy?