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2013年9月21日星期六
Q & A: Best Diet for Dogs with Diabetes Mellitus
I have a 10-year old, male, 4-kg Miniature Pinscher that has been on twice daily NPH insulin injections (0.75 U/kg per injection) for the last 6 months. Because of his diabetes, we have been feeding Hill’s Prescription w/d diet. Overall, the serum glucose curves are quite good, the polyuria and polydipsia have resolved, and the dog seems to feels great. However, despite being well controlled, the dog has been losing weight and has lost over 1.5 kg since diagnosis.
The main problem is that the dog continues to be ravenous and is loosing weight. Despite being well controlled on his blood glucose curved, the dog has lost over 1.5 kg since diagnosis.
Am I feeding the wrong diet? I thought that all diabetic dogs did best when fed a high fiber diet such as Hill’s w/d.
My Response:
First of all, there is not one type of diet that is recommended for all dogs with diabetes. Diabetic dogs can do well when fed a number of diets as long as they are nutritionally complete and balanced, do not contain simple sugars, are fed at consistent times in consistent amounts, and are palatable to ensure a predictable and consistent appetite. As we all know, it’s difficult enough to regulate a diabetic when they are eating consistently well— if they refuse to eat their diet, adequate glucose regulation can become next to impossible.
In many newly diagnosed diabetic dogs, I don’t change their diet at all. Â The most important dietary factor in the diabetic is consistency, so that you can match your insulin dose to the degree of post-prandial hyperglycemia. The owner must understand that the key is to feed the same amount of the same diet at the same time every day!
In general, the goals of dietary therapy in canine diabetes mellitus are four-fold:
- Optimize the dog’s body weight and body condition score (i.e., weight loss versus weight gain, as needed)
- Minimize post-prandial hyperglycemia
- Control hyperlipemia and hypertriglyceridemia
- Modify the diet based any concurrent conditions (e.g., pancreatitis, kidney disease, gastrointestinal disease)
Optimize Body Weight
In diabetic dogs that are obese, I always recommend feeding a reduced calorie diet designed to help the dog lose weight. The high fiber diets are good for this purpose (1-4). No matter what diet is fed, however, it’s also important to limit the amount of fat in the diet when weight loss is the goal. To me, an appropriate weight loss diet should contain restricted amounts of fat — less than 30% on a metabolizable energy (ME) basis, which means <30% of the calories in the diet supplied by fat.
(For more information about how to calculate ME values for fat, protein, and carbohydrates, see Calculating the Metabolizable Energy (ME) Values of a Dog Food, below.)
In underweight dogs with diabetes, the goal of dietary therapy is the complete opposite. In these thin dogs. our priority is to normalize body weight and restore and preserve muscle mass. These dogs may never regain the weight needed if a food with moderate to high amounts of fiber is fed — they may even continue to progressively lose even more weight. Therefore, these thin to emaciated dogs should be fed a high-quality, higher energy diet that can contain a slightly increased fat content to ensure that they regain their lost body weight (3,4).
Minimize Post-prandial Hyperglycemia
Several “older” landmark studies showed that feeding high-fiber diets can improve glycemic control in dogs with diabetes (1,2). The extra dietary fiber slows the digestion and absorption of carbohydrates, and thereby helps to minimize post-prandial hyperglycemia (1-4).
However, there are disadvantages in feeding all diabetic dogs a high-fiber diet. Again, because these diets tend to promote weight loss, they are not suitable for the thin or emaciated dog with diabetes (5). In addition, the high dietary fiber content of the food can result in unwanted side effects, including inappetence, diarrhea, and flatulence in some dogs.
Other more recent studies fail to show a clear-cut clinical benefit of feeding a high-fiber diet over a typical adult maintenance diet with moderate-fiber content to diabetic dogs.  In one study, no significant differences in insulin requirements or glycemic control were found in dogs fed a high-fiber, moderate-carbohydrate, moderate-fat diet versus an adult maintenance diet with moderate fiber, lower carbohydrate, and higher fat (5). As expected, weight loss occurred when the dogs were fed the high-fiber diet, whereas body weights were maintained with the moderate-fiber diet.
For any dog food, the major potential influence on the postprandial glycemic response is the dietary carbohydrate source (6-8). Foods and snacks containing simple sugars which rapidly increased blood glucose should always be avoided, of course. Feeding carbohydrate sources that have a low glycemic index (e.g, sorghum and corn) are preferred for diabetic dogs. Carbohydrates with a higher glycemic index (e.g., rice) are best avoided (6).
Because dogs are omnivores, they can tolerate higher amounts of carbohydrates better than do diabetic cats. Therefore, I recommend a diet that is moderately restricted in carbohydrate content — that is, a diet with <30% metabolizable energy (ME) as carbohydrates— for diabetic dogs to limit their post-prandial glucose load and help control hyperglycemia.
Control Hyperlipemia and Hypertriglyceridemia
A diet containing restricted amounts of fat (again, <30% ME) should be fed to diabetic dogs with concurrent hypertriglyceridemia or hyperlipidemia (4,9).
The presence of hyperlipidemia (i.e., hypertriglyceridemia and, to a lesser degree hypercholesterolemia) has long been associated with pancreatitis in dogs (9). Hyperlipidemia is common in untreated or poorly controlled diabetes mellitus and may contribute to the concurrent pancreatitis that can develop in these diabetic dogs. For my diabetic patients with concurrent pancreatitis, I’ve had good luck with the Royal Canin Veterinary Diet Gastrointestinal Low-Fat LS diet — it contains the lowest amount fat of any of the commercial diets (15% ME for fat), and most dogs find it quite palatable.
However, some dogs with diabetes secondary to chronic pancreatitis also have partial loss of exocrine pancreatic function and can be at risk for excessive weight loss when fed a low fat diet. One approach for the underweight diabetic dog with hypertriglyceridemia is to consider restricting dietary fat intake only after adequate glycemic control has been established. In these dogs, both body weight and serum triglyceride concentrations are followed carefully, and dietary adjustments are made as needed.
High Protein Diets in Canine Diabetes?
The optimal dietary protein for diabetic dogs has not been determined. But it does not appear that the protein requirement for a diabetic dog would be much different than a non-diabetic dog. However, because we frequently aim for either carbohydrate or fat restriction (or both), dietary protein will often provide a substantial source of calories for diabetic dogs (for example, protein >30% ME).
Calculating the Metabolizable Energy (ME) Values of a Dog Food
The most accurate way to evaluate pet foods and their composition is to consider the calories or metabolizable energy (ME) that comes from the protein, fat, and carbohydrate fractions (10). This allows us to compare various diets without worrying about their different fiber, ash, or moisture content.
Remember that the percent carbohydrates, fat, and protein of any diet can be expressed in at least 3 ways — as fed, on a dry matter basis, or on a metabolizable energy (ME) basis. Depending on how the diet composition is expressed, the same food may list a percent carbohydrate value that appears to be very low to rather high (for example, 5% or 25%). As an analogy, if you buy hamburger at the grocery store and the label says it’s 90% lean and 10% fat, you might determine that it is composed mostly of protein and is low in fat. But if you calculate the composition of the hamburger on a caloric or energy basis (ME), the hamburger is actually half fat and only half protein. That’s why the ME basis is the best to really determine what we are actually feeding.
However, unless you are able to obtain the ME values for a diet from the company (always the best way), you may need to estimate the values from the guaranteed analysis (GA) listed for the diet. I like to use the Guaranteed Analysis Converter found on the Balance IT Professional web site to help make this calculation easier (11). The actually calculations are not that difficult but are somewhat cumbersome to perform (10).
The Bottom Line
Dogs should never be fed a high-fiber diet just because they have diabetes. Many dogs do just as well on other maintenance diets containing lower amounts of fiber and carbohydrate and higher amounts of protein. A consistent diet —that is, the type, amount, and time of feeding —is generally much more important in diabetic regulation than any particular fiber content or specific type of diet.
References:
- Nelson R, Duesberg C, Ford S, et al. Effect of dietary insoluble fiber on control of glycemia in dogs with naturally acquired diabetes mellitus. Journal of the American Veterinary Medical Association 1998;212:380–386.Â
- Graham PA, Maskell E, Rawlings L. Influence of a high fibre diet on glycaemic control and quality of life in dogs with diabetes mellitus. Journal of Small Animal Practice 2002;43:67–73.Â
- Rucinsky R, Cook A, Haley S, et al. American Animal Hospital Association.AAHA diabetes management guidelines. Journal of the American Animal Hospital Association 2010; 46:215-224.Â
- Zicker SC, Nelson RW, Kirk CA, et al. Endocrine Disorders. In: Hand MS, Thatcher CD, Remillard RL, Roudebush R, Novotny, BJ (eds), Small Animal Clinical Nutrition. Mark Morris Institute. 2010; 559-584.
- Fleeman LM, Rand JS, Markwell PJ. Lack of advantage of high-fibre, moderate-carbohydrate diets in dogs with stabilised diabetes. Journal of Small Animal Practice 2009;50:604-614.Â
- Rand JS, Farrow HA, Fleeman LM, et al. Diet in the prevention of diabetes and obesity in companion animals. Asia Pacific Journal of Clinical Nutrition 2003;12 Suppl:S6.
- Elliott KF, Rand JS, Fleeman LM, et al. A diet lower in digestible carbohydrate results in lower postprandial glucose concentrations compared with a traditional canine diabetes diet and an adult maintenance diet in healthy dogs. Research in Veterinary Science 2011;96; 288-95.Â
- Nguyen P, Dumon H, Biourge V, Pouteau E. Glycemic and insulinemic responses after ingestion of commercial foods in healthy dogs: influence of food composition. Journal of Nutrition (12 Suppl):2654S-2658S.Â
- Xenoulis PG, Steiner JM. Lipid metabolism and hyperlipidemia in dogs. The Veterinary Journal 2010;183:12-21.Â
- Laflamme DP. Determining metabolizable energy content in commercial pet foods. Journal of Animal Physiolology and Animal Nutrition (Berlin). 2001; 85:222-230.Â
- Balance IT Professional Website. Guaranteed Analysis Converter.Â
2013年9月17日星期二
A VEGETARIAN DIET FOR YOUR DOG
A VEGETARIAN DIET FOR YOUR DOG
In Europe, there are plenty of commercially available, healthy vegetarian diets for pets. There is no reason why vegan / vegetarian pet lovers in our country shouldn’t have the same choice. Moreover, vegetarian diets have been incredibly successful in curing many common ailments that we find nowadays like arthritis, bladder disorders, irritable skin and aggression. Remember that vegetable diets are mostly alkaline in nature compared to other acidic diets – SEE TESTIMONIALS BELOW.
Some may argue that a vegan diet for a dog is unnatural in some way, but its important to note that in nature dogs wouldn’t eat anything like what is commonly found nowadays – in a can or in pellet form. Most commercial pet food is made of very questionable meats, not fit for human consumption that would otherwise be thrown away. These foods are filled with preservatives and other additives that, over time, can detriment the health of your pet.
Fortunately, even though many people would assume that a dog couldn’t possibly be fed a 100% vegetarian diet, nothing could be further from the truth!
Unlike an obligate carnivore, a dog is neither dependent on meat-specific protein nor a very high level of protein in order to fulfill its basic dietary requirements. Dogs are able to healthily digest a variety of foods including vegetables and grains, and in fact dogs can consume a large proportion of these in their diet.
One should be very weary of diets fed to our pets that contain copious amounts of raw meat. Just as raw meat can be dangerous to humans, so it can be so for our pets. There are many reputable veterinarians and researchers who warn of the dangers of raw meat.
Still, in preparing a vegan or vegetable diet for your dog, one should adopt scientific procedures and utilize nutritional data to formulate a recipe that is balanced and nutritious.
Herewith some of the ingredients that we feel are paramount to a basic vegan diet for your dog: brown rice, millet, lentils, peas, barley, wheat germ, rolled oats, beetroot, butternut, sweet potato, carrots and a variety of freshly picked herbs and green veggies. To ensure the perfect balance we also supplement with calcium gluconate, zinc gluconate, taurine, yeast, lecithin, kelp, dandelion and vitamin c.
So, not only is it possible to feed dogs a non-meat diet, it can also be very nutritious and balanced.
TESTIMONIALS:
Just to let you know that I have been feeding my spaniel with the vegan diet since the beginning of Nov 2010 and he has never been so healthy or happy.
Previously, he was diagnosed with bowel disease (NOT IBS!!) at 6 months old and also had bouts of pancreatitis too. He has been on 20mg to 40 mg of steroids (Cortisone) daily ever since to control the disease. He has also been taking buscopan for tummy cramps and allergex. He would normally see the vet at least 2 – 3 x a month with severe pain, distended tummy, inflammation of the bowel. He has been for scopes etc. I was told by my vet that he would have to take steroids for the rest of his life and that he wouldn’t live past about 8 yrs old. He said I had to weigh up “Quality vs Quantity†– meaning that the quality of his life would be better with steroids but he wouldn’t live long. Also, due to the high amounts of cortisone, my spaniel (Harley) is extremely overweight and his thyroid function has been depressed – which means that he will struggle to lose weight even on a “diet.â€
At the age of 4 1/2, I found the Vegan diet online and changed him to that. He has never looked back. No more visits to the vet – only for a vaccination – and the vet was amazed at the change in Harley. His cortisone dosage is down to 2.5mg per day!!! No more buscopan or allergex. No more tummy cramps/severe pain and he has not had a single flare up of pancreatitis either. He is a happy, healthy and content dog now and has lost 3 kg’s.
So, thank you very much for this wonderful vegan food. It is awesome and has changed not only my dog’s life but mine too!
Val
Over the past few years we’ve discovered Vondi’s amazing range of what I like to call Wonder pet food.
Interestingly enough now that I think back at the time we made a decision to move away from a dry pellet food, there we’re several occasions that led us to believe that by changing the diet of our beloved companions to a more nutritious and healthy one, we are going to naturally eradicate many common problems. (Which is what happened J)
In just three weeks we were amazed to see that drastic changes in our two companions once we started feeding just the Vondi’s food … three years later and our companions are just as excited before meals.
Their skin condition is now amazing, their eyes are sparkly, their teeth are spotless, their coats silky soft and shiny, and they have no odour… for the past two years our Vet just wants to know “What is your secret….â€
The only good answer we could think of was, “ You are what you eat!† and this happens to be so true.
All the Best
Thomas
2013年9月14日星期六
Pancreatitis and Low Fiber Diet
I sent this question to Dog Talk’s Official Vet, Dr. Phil:
I just met a woman with aging dog diagnosed with pancreatitis (non acute) and the vet told her to keep it on a LOW FIBER DIET?? I always thought the dietary management was LOW FAT?? Can you clarify this for me so i can pass it along?
Dr Phil Padrid gave me this terrific & detailed explanation:
High dietary fiber is recommended for diabetics because the fiber likely slows the absorption of glucose so it limits any quick rises in blood sugar. Some dogs with pancreatitis develop diabetes (same organ that makes insulin, if grossly inflamed or injured it might limit its ability to produce and release insulin).
For chronic pancreatitis in dogs most recommend what you know, low fat, moderate protein, high carbohydrate, highly digestible food sources, depending on the patient and the case and the expert, may add cobalamin, glutamine etc. Fiber is generally not the key issue in determining diet for most experts, not that it is not important, just that it is not usually the focus of the discussion. The focus is low fat, moderate protein, high carbs and high digestibility.
Fiber is a problem because of digestibility, most dogs with chronic pancreatitis do better on low fiber than high. This is an issue because many commercial diets for intestinal disease are used for dogs with chronic pancreatits, and they have high fiber, and this is felt to be detrimental…
Also, cats are different species of course, low fat diet less helpful (might be harmful), cats don’t make intrinsic factor (involved in vitamin absorption)… so somewhat different dietary recommendations for this species.
Most interestingly, almost all recommendations are based on studies in humans, or experiments that cause acute severe pancreatitis in dogs, or specific experience of specific veterinarians,  almost nothing in the literature that really addresses the question of naturally occurring chronic pancreatitis and results of different dietary strategies, not so different than many other diseases we do our best with.
Talk to you soon
Phil Padrid DVM
Regional Medical Director, VCA
2013年9月13日星期五
Dog Pancreatitis Diet
Dog Pancreatitis Diet
While a mild acute dog pancreatitis diet pancreatitis can be a single event, but chronic pancreatitis can be very painful for your dog and the rest of the family. Chronic cases of pancreatitis can cause serious damage to your dog’s organs and eventually cause lasting damage diet for dog with pancreatitis.
Most cases of dog pancreatitis diet pancreatitis in dogs occur around the holidays, Thanksgiving and Christmas. The reason is because people are more willing to give their pets table scraps are high in fat, causing the pancreas to respond more dog pancreatitis diet. You must dog diet for pancreatitis resist the temptation to feed your dog with foods high in fat in them so diet for dog with pancreatitis you do not have to worry about your pet. If your dog has pancreatitis, depending on the severity, the disease can be treated with a diet low in fat.
The first thing you need to do is take your dog goes through a quick 24-48 hours. After that, you will start feeding on very small amounts of dog food low in fat. Therefore, you will begin to increase the amount dog pancreatitis diet of food that is a little at a time. Be sure to watch for signs of dehydration too. Your veterinarian may suggest intravenously or subcutaneously to ensure that it remains healthy hydration diet for dog with pancreatitis status.
Canine pancreatitis is a dog pancreatitis diet serious problem that all dog owners should bear in mind. If you’re not careful, your dog can actually starve if you have a case of pancreatitis. Make sure you take it to the vet if you notice any changes in your dog pancreatitis diet eating methods becomes lethargic or seems to not want to eat dog diet for pancreatitis something.
Dog Pancreatitis Diet
Dog Diet, Pancreatitis Diet
via DogHealth http://doghealth101.blogspot.com/2013/08/dog-pancreatitis-diet.html
Raw Meat Diet for Dogs With Pancreatitis
Pancreatitis is a painful and sometimes fatal condition that occurs in dogs when the pancreas becomes inflamed. Veterinarians believe that pancreatitis can be caused by poor diet, trauma, kidney disease, diabetes or a combination of these causes. Dogs with pancreatitis must eat a bland diet high in protein and low in fat. A raw meat diet may help some dogs with pancreatitis. However, a poorly formulated raw diet might do more harm than good.
About Pancreatitis In Dogs
The pancreas is an organ that produces insulin and digestive enzymes necessary for the breakdown of food in the intestines. Pancreatitis is inflammation of the pancreas. In severe cases, the pancreas can stop producing any digestive enzymes, or its enzymes can start to digest the pancreas itself and surrounding organs.
Pancreatitis can be either acute or chronic. Acute cases consist of a single episode which leaves no lasting damage, but are often severe and may be fatal if not treated. Chronic pancreatitis is often less severe but causes permanent changes and damage to the pancreas and sometimes to other organs.
Pancreatitis is diagnosed through blood tests that monitor the dog’s levels of pancreatic enzymes. An abdominal ultrasound may also be required to diagnose or rule out the condition. Symptoms include abdominal pain and tenderness, vomiting, irregular appetite and behavioral changes.
Raw Feeding Dogs with Pancreatitis
Most dogs that suffer acute pancreatitis recover completely from the first episode and do not have another episode if dietary changes are made that include giving a high-quality diet high in protein and low in fat. Moderate fiber may also be beneficial. If your dog has suffered acute pancreatitis, a raw diet may prevent the condition from recurring. Dogs with chronic pancreatitis can also benefit from a raw diet, so long as they also regularly see a veterinarian for monitoring of their pancreatic enzyme levels and are treated for any underlying conditions, such as diabetes.
Focus on lean raw meats and cooked vegetables to provide a moderate amount of fiber for dogs with pancreatitis. Skin and fat should be removed from raw meat before it is fed to dogs with a history of pancreatitis. Raw game meats are particularly healthful for dogs with pancreatitis. Elk, wild boar, deer, quail, wild duck, wild goose and moose are all good sources of lean protein.
If you must give farmed meats to a dog with pancreatitis, try to focus on a wide variety of lean red meats with minimal pork and poultry. Emu, goat, mutton, reindeer, farmed elk and bison are ideal for inclusion in a raw diet for dogs with pancreatitis. Avoid fatty cuts of meat and trim any excess fat before feeding your dog. If it is necessary to feed chicken, pork, turkey and beef, buy lean cuts and look for free-range and grass-fed meats. Organic meat is healthful but is not necessarily better for pets with pancreatitis than free-range meat that is not certified organic.
As for fiber, cooked green beans are a raw feeder’s best friend. You can offer a small amount of cooked green beans each day. Cooked pumpkin is also an accessible source of fiber and palatable for most pets. Squash, yams and ancient grains like quinoa are also good sources of fiber for dogs with pancreatitis.
Always consult your veterinarian before making any medical decision for your pet, including feeding a diet intended to treat or manage any medical condition.