Good Diet and Advice for Dogs with Pancreatitis

Pancreatitis in dogs is life threatening. Dogs that get Pancreatitis can die unless emergency vet care is  started immediately when you see symptoms.

We want you to be fully aware of what you can do to avoid Pancreatitis however some dogs are now thought to be born with the pre-disposition.

CLINICAL SIGNS AND SYMPTOMS:
Typical symptoms include, but are not limited to:  
·         Vomiting;
·         loss of appetite or not eating;
·         abdominal pain
·         The dog, due to abdominal pain, may act restless, pant, cry, shake, stand with an arched  back or lie down with his/her front end down and hind-quarters elevated.

Additional symptoms include:
·         fever;
·         depression
·         diarrhea
·         severe weakness or collapse
·         dehydration or shock.

RISK FACTORS:
Risk factors for developing pancreatitis include a dog being overweight or obese, elevated fats (lipids) in the blood, recent eating of a  high fat meal, and other diseases. Also, some medications are believed to predispose to pancreatitis. These medications can include corticosteroids, Phenobarbital and Potassium or Sodium Bromide. 

DIAGNOSIS:

A diagnosis of pancreatitis is based on several factors. First, your Vet will want to take your dog’s history and do a physical  examination. Procedures for diagnosing pancreatitis commonly include blood work (such as a Complete Blood Count or “CBC”), serum chemistry to measure elevations in the pancreatic enzymes (amylase and lipase), and a urinalysis.  X-rays or ultrasound of the abdomen may also be done to check  the dog’s internal organs, as well as to check the pancreas for inflammation,  abscesses, tumors or other disorders.

Diagnostic blood tests a Vet may conduct include a “cPL test”, which is a specific test for diagnosis of pancreatitis. Other tests used include a trypsin-like-immunoreactivity assay (TLI  assay), and an ELISA test for trypsinogen activation peptide (also known as a  “TAP” test). A TAP test is done to evaluate the levels of trypsin in the  blood.  These blood tests apply more specifically to pancreatic function than tests for amylase and lipase.

TREATMENT: 
Pancreatitis treatment usually requires hospitalization at the Vet’s office or animal  hospital for 3-4 days or more. While in the animal hospital, fluids and  nutrients are given intravenously  (also known as an “I.V.”)  In order to give the pancreas time to “rest” and  heal, food, water and oral medications are not given during this time. In addition, pain medications and antibiotics may be given as well.

Additionally, W. Jean Dodds, DVM, provides the following information regarding blood transfusions in treatment of pancreatitis:

“Pancreatitis can be helped to ‘cool down’ with transfusion of fresh-frozen plasma (3-5 cc per pound given once or twice daily).  A Vet should consider giving plasma as often as is needed to neutralize the excessive trypsin released by the inflamed pancreas. They can even put the plasma directly into the peritoneal cavity to "bathe" the inflamed area to effectively neutralize any trypsin enzyme that has leaked out of the damaged pancreas and is "autodigesting" the tissues it contacts. If this blood product is not readily available where you are, please call my staff at Hemopet and say it’s an emergency need. Fresh-frozen plasma contains alpha-1 anti-trypsin to neutralize the trypsin produced and released by the pancreas, but in the case of pancreatitis, it is released into the surrounding abdominal tissues causing them to be autodigested.”

WHAT IS  PANCREATITIS?
In simple terms, pancreatitis is an inflammation of the pancreas, a gland that produces enzymes that help digest food. When the pancreas becomes inflamed, it produces too much of the digestion enzymes. These “extra” enzymes then damage or destroy the pancreas, intestines and other organs.

Description of Pancreatitis for Vets:  Pancreatitis is an inflammation of the pancreas, a gland that produces enzymes that break down proteins to help with the digestion of food. However, if these enzymes become activated inside the pancreas or leek out of the pancreas into the abdomen, they inflame and digest the pancreas and/or other surrounding tissues, and pancreatitis (or more serious digestion of the bowel) will develop Pancreatitis is a very serious disease that can be life threatening and it requires immediate treatment. If you suspect that your dog may have pancreatitis, immediately take him/her to your Vet or take your pup to your local ER Vet for evaluation.

POST PANCREATITIS CARE AND DIET:
Your Vet will provide instructions regarding medications and a feeding schedule for your pup after an episode of pancreatitis. Be aware that a dog recovering from an episode of pancreatitis should be fed a food that contains no more than 10% fat.

Regarding diet for a dog post-pancreatitis, Dr. W. Jean Dodds states that "the liver cleansing diet would be best — even long term.http://www.canine-epilepsy-guardian-angels.com/liver_diet.htm

For those who cannot cook easily for their dogs, select a diet with not more than 10% fat. Fish and potatoes, fish and rice, chicken and rice, or even vegetarian kibbles are generally OK.  If they only feed canned foods, which are too soft and mostly water, there will likely be a tartar build up problem. There are vegetarian baked dog biscuits, and people can just moisten and season their dog’s kibble and bake it into biscuits — many of our clients do that, if the company that makes the kibble doesn’t have a comparable biscuit."
Dogs that have had an episode of pancreatitis should NEVER be given high fat treats such as rawhides, pig’s ears, pigars and other similar items. In addition, dogs that have suffered a bout of pancreatitis should not be given coconut oil or any other types of supplemental oils or fats.

Finally, your dog’s Anti-Epileptic medications may need to be changed after an episode of  pancreatitis. Dr. Dodds explains “Because of the previous pancreatitis, the risk is much higher that bromide rather than Phenobarbital or other anticonvulsants would trigger another pancreatitis attack.”  Dr.  Dodds also stated "Keppra would be a good alternative to Bromide."

PROGNOSIS:  
Pancreatitis is a serious condition that can be life-threatening. Dogs with a mild case have a better prognosis than those who have a more severe case. If you suspect that your pup may have pancreatitis, take your pup to your Vet or call your local ER Vet as soon as possible for guidance and evaluation.

Diet Factors of Pancreatitis

While fat is often not the initial cause of pancreatitis, it is necessary to reduce the amounts of fat in the diet for a dog recovering from pancreatitis so as not to over stimulate the pancreas. The pancreas is in control of insulin production, which controls blood glucose regulation. Often dogs with diabetes can be prone to pancreatitis, and pancreatitis can lead to diabetes. In cases like these, it would also be a good idea to watch the amount of sugar in the diet. This would include high glycemic vegetables, fruits and honey.

To reduce the work load on the pancreas following an attack of pancreatitis, a low fat diet is recommended, preferably spread over several small meals a day. Smaller, more frequent meals help glucose levels to remain more stable and reduce the load of foods at one serving to decrease the enzyme activity of the pancreas.

In acute cases of pancreatitis, once supportive care is given and the dog recovers fully, they can usually gradually return to their normal diet. In some chronic cases, pancreatin enzymes may need to be given for life so that food can be digested properly.

The diet recommendations I have listed below are for after the dog has recovered from a pancreatic attack, and in most cases are only needed for a few days or weeks. If the dog is prone to chronic pancreatitis, they may well need to be kept on a low fat all their life, and fed several small frequent meals a day. In that event, calcium will need to be added to the home made diets given here, at 800 mg per pound of food served. For short term use (less than two weeks) this is not necessary. Please remember to follow up with your veterinarian for advice on your dog’s recovery and health needs. Periodic check ups and blood panel levels are recommended to monitor health.

50% of the diet should include low fat animal proteins such as:
- White meat chicken (which is lower in fat than dark meat), with skin and excess fat removed.
- Lean or low fat hamburger, and if cooked, drain excess fat (boiling will remove most of the fat).
- Beef heart or roast, with excess fat removed.
- Beef kidney and liver (small amounts).
- Egg whites
- Low fat or nonfat plain yogurt or cottage cheese

25% of the diet should be low glycemic vegetables, such as:
- Broccoli or cauliflower
- Summer squash, such as yellow crookneck or zucchini
- Dark leafy greens, such as romaine lettuce, collard greens, mustard greens, spinach
- Cabbage

These vegetables must be cooked or pureed (in a food processor) in order to be digestible by dogs.

25% of the diet can be higher starch foods such as:

- Sweet potatoes, white potatoes (no skin)
- Oatmeal, rice or barley. These will hopefully add calories lost by feeding a low fat diet.

These foods must be cooked, and grains are more easily digestible if overcooked a little.

To each meal, add digestive enzymes and beneficial bacteria. The Berte’s Digestion Blend is great for this, as it contains a full spectrum of enzymes including pancreatin, acidophilus and l-glutamine which helps fight inflammation in the digestive tract.

Recipe Examples
(for a fifty pound dog, to be fed in three or four portions daily)

Recipe #1:
1-1/2 cups of cooked beef heart chunks, fat drained
1/4 cup steamed or cooked spinach
1/2 cup cooked broccoli
3/4 cup cooked sweet potato
1/2 teaspoon of Berte’s Digestion Blend

Recipe #2
1 cup of cooked chicken breast
1/2 cup of low or nonfat plain yogurt
1/4 cup cooked cabbage
1/2 cup cooked zucchini
3/4 cup white potato
1/2 teaspoon of Berte’s Digestion Blend

Recipe #3
1 cup of boiled lean hamburger, fat drained
1/2 cup cooked beef kidney, fat trimmed
1/4 cup of cooked kale
1/2 cup of yellow crookneck squash
3/4 cup of oatmeal
1/2 teaspoon of Berte’s Digestion Blend

Recipe #4
1 cup cooked stew meat or cut up lean roast, fat drained
1/2 cup low or nonfat cottage cheese
1/2 cup cooked Broccoli
1/4 cup cooked zucchini
3/4 cup cooked barley
1/2 teaspoon of Berte’s Digestion Blend

As your dog improves, you may add vitamin E, vitamin C, a B complex and EPA fish oil. This may take from a few days to a couple of weeks, depending on the severity of the condition. Add EPA fish oil at 1,000 mg per 20 lbs of body weight daily, plus vitamin C, vitamin E and a B complex. A fifty pound dog would get about 500 mg of vitamin C, 400 IU of vitamin E and a B-50 complex.

If these recipes are to be fed longer than 2 weeks, then add 800-1000 mg of calcium per pound of food served (2 cups is approximately one pound). You can use ground eggshell at the rate of 1/2 teaspoon per pound of food, or plain Tums, both of which are calcium carbonate. You should also include liver as part of a long term diet. Give about 1 ounce a day or 2 ounces every other day to a 50 lb dog.

Supplements that B-Naturals carry that are recommended for dogs with pancreatitis include Berte’s Digestion Blend, EPA Fish Oil and Berte’s Daily Blend.

*It is always better to cook real food for your dog (pets) for at least part of their diet.  It is even more important if they are sick.  Most vets will usually suggest cooking chicken and rice or lean meat and rice at bare minimum and will then often suggest some low fat pet food; wet or dry they usually don’t like it much, so cooking for them at least once a day is important and then supplementing with something like Hill’s low fat dry food.

Sources:

Except where noted, primary information was obtained from Carol D. Levin’s book, “Dogs, Diet, & Disease: An Owner’s Guide to Diabetes Mellitus, Pancreatitis, Cushing’s Disease, & More“ and www.vetcentric.com.

Dr. W. Jean Dodds, DVM, reviewed and also contributed to content.

Related:

Pancreatitis in Dogs

Posted by Ask Marion~