NEW to EPI + DIabetes - 4 month puppy - Food Options?

[dbest11]

Good day!

Our 4 month old mixed breed puppy has been diagnosed with diabetes and EPI. She was hospitalized for diabetic ketoacidosis and pancreatitis for 4 days. She has been home for a week and her Texas AM lab work came back. It reflects the following:

Fasting cTLI: 3.2
Pancreatic Lipase: 391
Cobalamin: >1000
Folate: 16.1
Cortisol: 2

She is getting Vetsulin 2x per day, and I have ordered enzymes from EnzymeDiane.

I am worried and overwhelmed. I will have tons of questions, but my first one is about food.

The internist prescribed Royal Canin GI Low Fat to protect her from another bout of pancreatitis; however, this food is filled with rice, which is not recommended for diabetics dogs. Her glucose was being managed fairly well with a .5 unit in the hospital when she was eating something else. With the Royal Canin food, we are up to 1.5 units, and her glucose barely moves under 400.

I'm looking for food options that will protect her from pancreatitis and spike her glucose less. Are these foods viable options to manage both conditions?

• Ketona Chicken Recipe
  The Honest Kitchen Dehydrated Limited Ingredient Beef
  SquarePet VFS Digestive Support Low Fat Formula Dry Dog Food
  Weruva Cirque De La Mer

Is home made food best given the challenge of managing both conditions? Has anyone worked with a nutritionist successfully to manage both conditions?

[Chance]

Wow, that is a lot for a little puppy, and YOU! It's not often we see pancreatitis and diabetes. But it can happen.

Jill here knows more pancreatitis than I do. She may have more options in terms of foods. Rice is sometimes not tolerated well in dogs with EPI either. It sometimes interferes with the effectiveness of enzymes. Many find it better with grain free diets. And you are also correct that carbs break down into sugars.

I'm not sure if you could find a grain free, low fat diet that is suitable for puppies. Something with lower fiber. I haven't fed kibble in over 15 years, so I'm not really up on the latest options.

Or perhaps you might need to consider fresh homemade food. You control the ingredients, thus can limit fat and carbs. The trick is getting enough ingredients to make sure it is balanced enough. Balance.It is a good site for helping guide with this.

[Olesia711]

oh my... i am so sorry to hear that your very young dog has so much to deal with.

My EPI dogs, Izzy developed Diabetes in her 7th year... it was AWFUL trying to get and keep the Diabetes in good control. lots of carbs in kibble made her blood sugar sky rocket! SHe would spike into the low 700's. And then when we found a better kibble she would flutter in the 400's. Still not ideal.

I used to test her blood sugar at home, the inside of her moth (where i drew the blood ) looked like a meat grinder got at her, but OMG.. i learned SOOOooo much regarding which foods would jack up her blood sugars.

What finally worked for us was to feed her 80% of her diet with all homemade food... so i was able to control her blood sugar... it was amazing how home-feeding immediately kept her #s mostly in the 100's, sometimes up to 250 but that was it.
i also fed 20% Kibble for the density to keep the weight steady. When i tried feeding 100% all home-made.... she lost too much weight. But a combo of 80% home-made and 20% kibble was the perfect mix for us.

The foods you mentioned are touted to be good for Diabetes.... but extremely expensive... i remember trying some and quite honestly, some of the "non-touted food for diabetes" actually worked better.... they were very high protein kibble.. However, this was years ago, and so much has changed... so not sure what to suggest for kibble... jsut make sure you go with one very low in carbs.

For the homemade food part,
i baked and ground chicken breasts (skinned and defatted) 50-80% meat
i baked and mashed sweet potato
i included a cooked green veggie
and sometimes i lightened the meat portion by including lowfat or nofat cottage cheese

Also.... i used the site "fat secret" https://www.fatsecret.com/ to figure out how much calories/protein/fat was in each homemade food item.... and i made sure my dog was getting the right amount of calories in her meals. Nowadays you can also add home-made meal supplements to make sure it is balanced with the right amount of minerals and vitamins. For my current dog, i use ANNAMEAT ENHANCE. with his home-made food.

If you want.... go to this page https://epi4dogs.com/diet-raw-home-prepared-recipes/ .... i have the home-made recipe that i used for my Diabetic dog...

Diet for EPI with Fat Restricted Needs

When my dog developed Diabetes in addition to EPI, i found that i had to revise my home-prepared meal and greatly reduce the fat content in the meal to keep the diabetes blood sugar in control. However, iIf you remove all fat from a diet, you eventually invite additional health concerns. I could not longer even give coconut oil, which my EPI dog used to thrive on, but i did discover that i was able to give fish oil capsules (EFA’s) as Essential Fatty Acids and this supplied the necessary EFAs the body requires. The following is the EPI + Diabetes (low fat) diet that i found success with after much trial an error.

I first make batches of:
(1) baked, de-fatted and skinned chicken breasts and store in refrigerator
(2) i microwave multiple sweet potatoes, then skin, mash and store in container in refrigerator

The EPI + Low Fat diet for a 35 lb dog consists of:
3/4 cup of “Annamaet Lean & Grain Free” kibble http://www.annamaet.com/products/Lean_Formula
1/2 cup of minced de-fatted & skinned chicken breast
1/3 cup baked, skinned & mashed sweet potato.
1/3 cup any brand of “No Fat” cottage cheese
1/2 tsp “UPCO porcine bone meal” (in one meal a day only) https://www.amazon.com/UPCo-Bone-Meal-p ... B00MW8HFJM
1 VetriScience Canine Plus vitamin (in one meal a day only) https://www.vetriscience.com/index.php? ... 9008606090
550mg of EFAs (fish oil+ daily)

*** At the time, i needed to add the Annamaet Lean & Grain Free kibble for additional compressed calories to maintain weight without comparable calories in bulk whole food consequently raising diabetic blood sugar- -adding the Annamaet may or may not be necessary for other dogs- -it will depend on their individual metabolism ***
HOWEVER….. please know that when this recipe was used Annamaet did not include peas in their product. They have since changed the formula and many of our EPI dogs do not do well with too many peas, so this product may or may not work out with your dog… so you might need to use a different low fat kibble (for the diabetes part).


I hope this helps you a little bit!

[dbest11]

Thank you both for all of the information. Cookie and I are grateful. I have had pets will various conditions (PLE, diabetes, pancreatitis, kidney failure, etc.,) but never one with multiple conditions that seem to make management so complicated. I hope I am up to the task.

We know she is underweight, but we have no idea how big she will be full grown, so understanding her caloric needs right now is a challenge. The primary care vet's best guess was maybe 20 pounds full grown when she was about 11 weeks old. One big concern is that she hasn't gained any weight since then. She is still about 5 pounds at 17 weeks. I hope the enzymes will help her put on some weight.

I have gone the homemade route before, so the details are incredibly helpful. If it helps lower costs, that is a bonus because she was diagnosed before her insurance waiting period was complete, so both conditions are pre-existing.

I'm sure I will have more questions. Again, thank you for your kindness and all of the information.

[Olesia711]

you are very welcome. When i did home-made for my EPI + Diabetic dog... they didn't have home-made meal enhancers/supplements back then,so it was a lot trickier.... and i was ALWAYS very concerned about making sure with my home-made food that there was enough bone matter. But nowadays with so much available on the market, it is much easier.

But, since your pup is so young.... bone growth is extremely important...so if you do decide to do the home-made... maybe look into and talk to your vet about not only the home-made meal enhancers, but also UPCO porcine bone meal
https://www.kwikpets.com/products/upco- ... fAQAvD_BwE
.... they use this product for puppies and mamma pups.

[dbest11]

Thank you. I will definitely do that! And I very much appreciate you calling that out for Cookie, specifically, given that she is a pup.

I worry that the internist we are seeing is not amenable to home made or even considering a food other than the Royal Canin one noted above. I did tell her I believe the Royal Canin is making the glucose hard to manage because of the significant rice component. She agreed that was possible, but…..

It may be that we’ll need to find a provider who is more willing to consider alternatives that may be better for her complex case.

[Olesia711]

i typically don't like dealing with nutritionists cuz they simply don't get the EPI digesetive system... BUT.... there was ONE i was impressed with when it came time to making home-made food.... i reached out to one of our other members if she has the contact info to maybe share with you... it might be helpful... or not, but worth looking into.

Unfortunately... although there is a place for prescription foods... they don't always work.

On the home-made diet page... there are other vet approved diets that you might want to look at and possibly make a combo of that would be best suited for Cookie's conditions. if the Royal Canin is jacking up the blood sugar, i would not feed it..

When i was dealing with EPI + Diabetes, the vets couldn't come up with any solutions for my dog Izzy... it took me 2 years and lot of blood testing before i figured out what foods and in what amounts worked for her. The vets were not much help..........

[jilbert57]

Hi. I am so sorry you and little Cookie are having problems. One of my current jacks has bad allergies and had his spleen removed. I sought the help of a canine nutritionist, Hannah Zulueta. She is recommended by Dr. Judy Morgan.
This is Hannahs website. She might be able to help. She is also in TCVM.
https://dailydogfoodrecipes.com/author/ ... perdogmom/

JILL

[Chance]

Just to comment on your issue of not gaining weight. That, is something that does happen. Rylee was 4 months old when she "stopped growing". She weighed less at 6 months than she did at 4 months.

Vet described it as the body going into self preservation mode. Her body's method of best coping with the lack of nutrients was to take the energy from future growth, rather than go straight for eating it's own muscle to survive.

They did say that as long as the nutrient absorption improves before the growth plates fuse, she can start to grow. And she did start growing like a weed again. I think she's still kinda small for a Lab, but she's OK.

[dbest11]

I had similar experiences with vets when my Hurricane Katrina rescue cat was hospitalized for pancreatitis. That is the first time I decided to make homemade food.

I will check out the other recipes and Hannah's site. I am determined to feed her something that is better suited for both conditions. Her sugar is just not responding while eating the RC food. We tried 2 units last night, and still little movement in the glucose readings.

Thanks for the assurance about Cookie's growth.

Her enzymes will be arriving on Monday. If I use an emergency human supplement for the next few days, do I just sprinkle it on her food or should that be incubated in water first?