I would like to discuss diet and diabetes. Diabetes is a huge subject to tackle whether it is in regard to people or to pets. I wanted to start the conversation with the question;
“What should I feed my Diabetic dog?”
Without going into the science of Diabetes which would be a very long and complex conversation let’s just discuss what you can do in regards to your dog’s diet to help them live a longer and healthier life.
I have been dealing with my own diabetes for 28 years now and I worked for a Doctor of Osteopathy as a diabetes educator in her Manhattan, NY office. For the last eight years I have counseled many dog guardians on the subject of canine diabetes. I have seen literally thousands of dogs with every kind of health issue through my work with the non profit FreePlay which educates the public on the benefits of off leash recreation areas and with The Pet Wash a local grooming and retail establishment.
The good news is you can really make a difference in your diabetic dog’s well being through their diet. The bad news is diabetes is an insidious disease that can rob your dog of their sight and their life if left unmanaged.
The Canine Ancestral diet which is approximately 55% protein 25 to 30% fat and 15% carbohydrate or on a calorie weighted basis 50% of calories are from protein, 44% from fat, and only 6% from carbohydrate is a good starting point to consider in trying to help the diabetic dog through diet.
The ancestral diet is so low in carbohydrates that it is tailor made for a diabetic dog. You can prepare this type of diet at home using human grade meats and vegetables which we will discuss in another post or you can try to feed your dog a similar diet using commercial foods. I would recommend starting with a balanced raw diet that does not contain bones and lightly cooking it. I would cook it lightly because a lot of diabetic dogs are not in the best health and their ability to deal with the bacteria and microbes that are in the raw food is probably compromised.
Second choice would be a dehydrated food such as The Honest Kitchen. THK is a quality food that uses only human grade ingredients in all of their formulas. The problem with THK is it is lower in protein that what I would suggest. This can be remedied by adding about 20% lightly cooked meat to each of the recipes. I would stick with similar proteins like fowl for the turkey or chicken formulas, fish for the fish formulas and red meat for the beef formulas.
Next would be a canned food that has no grains or other starches like potatoes. I would look for a canned food that was mostly meats with a little vegetables.
Lastly would be kibble. Kibbles require starch to bind the ingredients. They also are the most processed of all the commercial diets available for dogs. They also are dry and nutrient dense. I would suggest that a diabetic dog be fed a high moisture diet like a fresh food or a dehydrated after it is rehydrated or a canned food. Moisture helps ease the burden of the kidneys which are one of the organs that are affected by diabetes.
If you must feed a kibble for whatever reason then I would look to a kibble like EVO which is only 12 percent carbohydrates. The lowest carb highest protein kibble would be the only kibble I would consider feeding a dog with diabetes. Unfortunately once a dog has diabetes the controlling of this disease would be of paramount importance to me and I would no longer be as concerned with considering all of the qualities of an individual dog food and I would mostly focus on feeding a high protein, low carbohydrate and high moisture diet
- This topic was modified 6 years, 7 months ago by soho.
I was reading the EVO review and the DMB has the carbs listed at 21% and fat at 24% with potato being the 5th ingredient.Potato offers very little nutritional value according to the review.I thought you made a post that you were very interested in purchasing Brothers Complete that is potato free.I don’t know if potato is all that great for feeding a dog with diabetes, but as a person with limited knowledge about the disease I will defer to one of the DFA experts to comment further.My question is what role do potato’s play in a diabetic dogs diet?I agree that fresh non processed food is a clear cut better choice for any dog .
Hi Mike P –
You’re right – potato has a high glycemic index. However what you want to look at is glycemic load – glycemic load measures how the food will impact blood sugar based on the amount of the food eaten. Meaning, just because a food contains an ingredient that is high glycemic doesn’t necessarily mean the food as a whole is high glycemic. For example, Orijen contains white potato (a high glycemic ingredient) however, because they use such a small amount of white potato and such a large volume of meat, the food as a whole is low glycemic (certified low glycemic by the glycemic research institute). Looking at EVO’s protein content (without calling the company) I would assume the food is likely low glycemic. Also, not all of EVO’s formulas contain white potato – the weight management formula (which looks like a wonderful option for dogs with diabetes) is white potato free and has 52% protein and 15% fat, the fish formula is white potato free as well. Now on the flip side, you could use a binder with a lower glycemic index than white potato but if the food is a lot lower in protein/contains much less meat and higher in carbs/contains more binder – that food could actually have a greater impact on blood sugar then a food that contains a large volume of meat and a small amount of a high glycemic binder. White potato and tapioca are both high glycemic but if used in a high quality food with a large volume of meat and only minimum amounts of binders, they shouldn’t affect blood sugar significantly. That’s my understanding (James feel free to correct me if I’m wrong).
So if you “boost” a high quality kibble such as Brothers Complete with maybe fresh meat and eggs,sardines and what not,would that change the playing field?If I kinda try to understand this awful disease more animal protein is a good thing??
Well I’m sure Brother’s doesn’t have a high glycemic index, looking at the protein levels I’d assume there’s a lot of meat and a relatively small amount of tapioca. But definitely, adding fresh meat and eggs would lower the “glycemic” load even more. Starches are a necessary evil in kibble, but by choosing a quality food with minimal starch levels (like in Brother’s) and adding even more fresh meat (high protein, low glycemic) you’re getting the percentages even closer to those in the ancestral diet – what everyone should be aiming for. 🙂
From my understanding Mike S uses a formula to estimate the carbohydrate content of foods. If he had access to the exact percentages of every ingredient in the food he could calculate the carb content more accurately.
On the EVO website they list the carbs in the Guaranteed analysis tab and the foods are as follows:
Turkey and Chicken, Carbohydrates 12% Max
Herring and Salmon, Carbohydrates 18% Max
Red Meat, Carbohydrates 15% Max
So the actual carb content of EVO’s dog foods is between 12% and 18%. At that low level the binder (potatoes) would not affect the blood sugar as much as let’s say a food that was 30% carbs and used lentils as a binder. Let’s not forget that the overall carbohydrate content of a food is very important and that the lower the carbs the better the food is going to be for a diabetic dog.
As far as kibbles go these foods are the lowest in carbs that I know of. If anyone knows of other kibbles this low in Carbohydrates please let me know!
Adding fresh foods like meats or fish to any kibble is going to lower the overall carb content and improve the overall quality of the kibble. As for Brother’s kibbles I don’t think I would classify the 35% dry matter basis carbohydrate content as a minimal binder or a low carbohydrate food. Again the carb content of Brother’s kibbles on DFA is just an estimate and anyone who knows the actual carb content please let me know!
Thank you for the explanations of glycemic load and glycemic index.
As for the effect of different binders on blood sugar I think that the amount of carbs regardless of the glycemic load of those carbs is a very important factor. Whatever the glycemic load of a food is the carbs in that food still must be metabolized by the body. The lower the overall carb content of a food the easier it’s going to be to control those carbs with insulin.
Hey James –
Have you checked out Wysong Epigen? 60% protein/12% fat.
Thank you again. I just quickly looked at the formulas for epigen and epigen 90. Although they both contain 60% protein the regular epigen contains an undetermined amount of vegetable proteins. The epigen 90 is 90% meat and organs with no apparent vegetable proteins.
They both must have a carbohydrate content lower then even EVO! I will look into them more thoroughly and post what I find.
Thanks again HDM
My understanding of how Dr. Mike gets his carb figure is this:
Convert the GA to dry matter basis i.e. mathematically remove the moisture content.
Dry matter carbs%= 100%-dry matter protein%-dry matter fat%-dry matter ash%
Evo’s carb figures probably aren’t dry matter and that is why Dr Mike’s numbers are higher.
Dr Mike also uses 8% as ash although some are higher or lower. That still can’t account for the real fat content or protein content in a food as they are minumums.
And looking for a food solely based on carb content for diabetes can be misleading or detrimental for some. There are some situations where just the lowest carbs are just not healthy for a dog such as a high fat diet or one with a fat-to-protein ratio above 100%. An active/working dog can handle that much better than a sedentary dog. So feeding a high fat but “low carb” food to the sedentary house dog with diabetes can end up with a dog that has both diabetes and pancreatitis.
There’s never a one food fits all or look for one characteristic of a food that will work for all dogs with diabetes. And unfortunately if you don’t make your own food, you will never know the amount your feeding of fat from a commercial food.
The carbohydrate content listed on EVO’s website isn’t on a dry matter basis, however the carbohydrate content Dr. Mike has listed is still way off the mark. EVO lists the carbohydrate content as 12% – converting percents to a dry matter basis for kibble doesn’t alter anything significantly as the moisture content of kibble is so low -and converting to dry matter basis only changes it by 1%, it’s 13% carbohydrates (max) on a dry matter basis. 13% is a big difference from the 21% carbohydrates stated on the EVO review. Like Sandy said, Dr. Mike estimates the ash content, so the carbohydrate contents listed on his reviews are most generally not going to be accurate, they give a good idea but without the actual ash content there’s no way of knowing the actual carbohydrate content. If someone really wanted the actual carbohydrate content of a food they’re better off contacting the company directly.
Hi HDM and Patty
On the EVO website the carbohydrate percentages are listed like this: Carbohydrates NFE (Max) 12.0 %. NFE stands for nitrogen free extract. Nitrogen free extract is what is left after the moisture, protein, fat, fiber, and minerals have been removed from the food.
So it looks like the carbohydrates listed on EVO”s website are based on a dry matter calculation.
Pancreatitis is inflammation and swelling of the pancreas. The causes of pancreatitis in dogs are still not that clear. Certain drugs like corticosteroids increase a dogs chance of getting pancreatitis.. Dogs with Cushing’s disease, diabetes, hypothyroidism, and some forms of hyperlipemia are also at increased risk to develop Pancreatitis. I am by no means an expert on pancreatitis.
So although one of the causes of Pancreatitis may be a diet that is high in fat, the devastation that diabetes can cause to a dog has to be considered very carefully when choosing a diet for the diabetic dog. Choosing a diet based on carbohydrate content as long as the protein levels are adequate is NEVER “misleading” as you stated in your reply. Each dog is different and everything about the dog must be considered whether or not the dog has diabetes. That being said carbohydrates are the single most problematic ingredient for any dog with diabetes.
Not saying what you said is misleading, but in general if I were on the review pages, and asked what food should I give my diabetic dog, and I got a reply of find the lowest carb food without being informed what an ideal low carb food is, how protein and fat are distributed in the ancestral diet and so on, then I only have part of the info I need since diabetes and caring for a dog with diabetes is not simple and then having to look up all different foods because they all have different pro/fat/carbs within each line of dog food can be really daunting for someone. And then learning that the fat listed on most foods is just a minimum can be worrisome. Can really get confusing! That’s why the opening of the forum has been great! Can go in depth about matters and not clog up the reviews.
Not all carbs are created equal.
For some dogs I think the type of starch used could make a huge difference in diabetes irregardless of the overall quantity (although I definitely do agree that carbs need to be at a minimum). Lectins are known to cause type 1 diabetes (the kind most often seen in dogs). They also have research showing lectins can cause lesions on the pancreas. I would assume those lesions could eventually cause diabetes due to the inflammation and necrosis. It is also well established that lectins can cause insulin resistance..
Quality fat has not been linked to the development of pancreatitis… Rancid fats for sure. I would assume that inappropriate types like hydrogenated sunflower oil are problematic too. But, fat doesn’t cause pancreatitis. It simply needs to be reduced when the pancreas is already inflammed. Just like protein doesn’t cause kidney disease but at some point it has to be lowered to help alleviate symptoms. NOT because it is causing the problem. Same with quality fat in pancreatitis.
Here are two segments I found from a paper entitled “Do dietary lectins cause disease?”
The first segment talks about the mechanisms by which lectins cause diabetes.
The second segment explains why everyone who eats lectins does not develop diabetes.
I also found some papers that postulate that lectins may cause insulin resistance.
My point is that I agree that lectins may be an evil force to be reckoned with. It is just that there are many many arguments supporting both sides of the do lectins cause this or that and in who or how many debate and there is know way we can bring this to closure in this forum.
What I do know through my experience with about 50 dogs who had diabetes is that once a dog has diabetes the clock starts ticking and unless the guardian of that dog makes a heroic effort to control that dogs blood sugar the devastation begins! I also know that the amount of carbohydrates that a dog consumes is directly related to rate of devastation.
Injected insulins are most effective at matching the curve of glucose metabolism when used in small amounts. Injected insulins can be plotted along a graph where one axis is time and the other axis is amount of insulin. In order to closely mimic the graph of carbohydrate absorption with the graph of insulin absorption small amounts of each must be used. As you increase the amount of carbs consumed it becomes more and more impossible to match with the use of injected insulin. Therefore the total amount of carbohydrate consumed is the most important factor in controlling diabetes and avoiding the devastation that this disease usually causes
First segment of paper:
Of particular interest is the implication for autoimmune diseases. Lectins stimulate class II HLA antigens on cells that do not normally display them, such as pancreatic islet and thyroid cells.9 The islet cell determinant to which cytotoxic autoantibodies bind in insulin dependent diabetes mellitus is the disaccharide N-acetyl lactosamine,10 which must bind tomato lectin if present and probably also the lectins of wheat, potato, and peanuts. This would result in islet cells expressing both class II HLA antigens and foreign antigen together—a sitting duck for autoimmune attack. Certain foods (wheat, soya) are indeed diabetogenic in genetically susceptible mice.11 Insulin dependent diabetes therefore is another potential lectin disease and could possibly be prevented by prophylactic oligosaccharides.
Second segment of paper:
But if we all eat lectins, why don’t we all get insulin dependent diabetes, rheumatoid arthritis, IgA nephropathy, and peptic ulcers? Partly because of biological variation in the glycoconjugates that coat our cells and partly because these are protected behind a fine screen of sialic acid molecules, attached to the glycoprotein tips.10 We should be safe. But the sialic acid molecules can be stripped off by the enzyme neuraminidase, present in several micro-organisms such as influenzaviruses and streptococci. This may explain why diabetes and rheumatoid arthritis tend to occur as sequelae of infections. This facilitation of lectins by micro-organisms throws a new light on postinfectious diseases and makes the folklore cure of fasting during a fever seem sensible.
I’m not understanding your post? They know lectins cause disease (including diabetes). What they don’t know is to what extent and why one has this issue and one has that. I have a friend whose dog is intolerant of green beans. I know others that have issues with strawberries and cucumbers. I am intolerant of dairy lectins and my husband reacts to pinto bean lectins.
The difference between us and our dogs —- we eat a varied diet while we (many of us) force our dogs to dine on the same cuisine day in and day out. Our dogs are more suseptible to the damages of lectins—if in the diet they are eating day after day..
I’m ALL FOR species appropriate diets by the way.. BEFORE illness sets in especially 🙂 Five of my dogs get raw including my dog born with kidney disease. The foster dogs (which will likely be with us for life) get 5 star kibbles with raw and high protein canned toppers.
To everyone reading these posts on diet and diabetes.
I think if people looked at diabetes a little differently then everyone would understand what I am trying to say. Having diabetes is like having a severe allergy to carbohydrates. This allergy is so severe that anything but the tiniest exposure will cause central nervous system damage, blindness, loss of limbs and death.
I hope that helps!
I am new here and I have a 11 year old Pomeranian who was diagnosed with diabetes in August/September. He was emergency vet for about a week and is now on insulin (canineinsulin (3) 2 times a day) I am having a really difficult time trying to stabilize him. I would love to make his food but dont know where to even start and what ingredients are best for him and what vitamins and how much to add etc.
I also feed him canned food (lil caesars & Mighty dog) however see it is high in fat
I am a single woman on disability and just want to do everything I can to make sure he is getting the best diet and on the best schedule…can someone please help me with resources and links and advice on what to do.
Thank you so much
These recommendations are just my opinion and I am NOT a vet. This is just what I would do if I were in your situation. I would try to find a holistic or integrative vet to be part of your healthcare team in dealing with your dogs diet and his diabetes!
There are many many options for your pom. Since you mentioned you would love to make his food here is one option. Buy ground turkey, ground beef and chicken breasts from your local supermarkets. Buy some frozen vegetables, no onions or starchy veggies like potatoes and no grains. His diet should be at least 80% meat and no more then 20% vegetables.
You can steam the veggies and then mash them up or you can puree them in a blender or food processor without cooking them. The idea is to make the veggies easier to digest since dogs don’t process veggies that well. The meats can be lightly cooked using low heat. I would be cautious about giving raw food to your dog at this point because it is hard for anyone to judge the condition of his immune system and the damage that has been done from the diabetes. A good immune system is necessary to handle the bacteria from raw food.
Since there are no bones in this diet a calcium supplement is necessary. If it is made for dogs it will have the dosages on the label. A multivitamin is also necessary because it is difficult for the home prepared diet to be complete and balanced without adding vitamins and minerals. Again if it is made for dogs the dosage will be on the label. I would also add some digestive enzymes and some sardines for their omega 3 content. The sardines would be part of the 80% meat portion of the diet. additional toppers like green tripe and organ meats can be rotated in the 80% part of the diet. Toppers should be no more then 20% of the total diet.
This is a start and there are many more options than the one I have given. A good book for you to help with your dogs diet would be see spot live longer by Steve Brown.
I wish you and your pomeranian the very best!
I have a diabetic JRT who was diagnosed almost 5 years ago. Search Canine Support Group – it is a forum of very knowledgeable people who have experience with the disease. They helped me so much. One of the biggest challenges is to find a suitable food your dog will willingly eat and follow the same schedule without fail every day. Do you live in the U.S? Canisulin is not an insulin many U.S. vets use anymore because dogs using it are very hard to regulate. It would be great if you could get Novolin NPH or Humulin. You might want to check out a back issue of Whole Dog Journal which had an article about diets for diabetic dogs and all the options.
Hi Guys and Gals
Regretfully not everyone appreciates my posts. This will be my last post on DFA. If anyone has any more questions about diet and diabetes please contact me at [email address removed by the moderator at users request]
Thank you everyone,
James, what happened? I quite liked your post.
I believe he did not like that on another thread, I asked Dr. Mike if it is ok that he advertise the jerky he makes. I believe it is against the rules of both DFA and the forum.
I am new here and have a 12 year old Maltese that has Cushings and was recently diagnosed with diabetes a month and a half ago. He registered at about 550+ (off scale) and I’ve been really struggling to get it down. By his vet’s recommendation he is currently eating Science Diet (mature adult) small bites and Hill’s W/D Diabetic (approx 2 table spoons) but I really have to force him to eat that. He takes 4 units of Humulin ml/cc twice a day and veteroyl 10 mg twice a day but I still have not been able to get him regulated. His vet that he is currently seeing is about an hour away from home and I live in a really small town so our vets here do not have the equipment necessary to monitor all of his conditions and his current vet (who has been wonderful and discovered the diabetes stated he tends to work on horses more so he is not as familiar with dogs). I do travel a lot so will not be able to make homemade meals but am looking to switch his dog food. I have researched quite a bit online and now believe that the science diet is not a good food for him and need to switch but I’m not sure what to. Any information will be helpful..thank you so much in advance!
krist117 – I don’t have experience with Cushings but I have a diabetic JRT who was diagnosed five years ago. I have friends who have dogs with both conditions and I know once you get the Cushings under control, the diabetes will be easier to get regulated. I am worried that your vet admits his lack of experience with dogs – if it is possible, I would find a vet with dog and diabetes experience. If it is not possible, you will have to do the best you can. IMO you need to test your dog’s blood sugar at home. This dog needs to be monitored to determine how his body uses insulin. Buy a human meter(I use the One Touch Ultra) and buy your strips on Amazon or eBay. I test at fasting(before eating), six hours after that and then 6 hours after that at the evening meal. Take your meter with you to your vet and check against his lab. Human blood and canine blood are different but you will get an idea of how to adjust your number based on the difference between your reading and his reading. Testing is vital and don’t waste your time with urine strips – they are not reliable. As for food, I prefer Nutrisca which is low glycemic and my dogs love it. I top it with Nutrisca wet food or Merrrick wet food. I also use Grandma Lucy’s Pure Performance, another low glycemic option to change it up but worry about variety until you have him regulated. I stay away from potatoes and tapioca. Also, remember the most important thing is to find a food your dog will eat willingly. This is not a battle you want to fight – your dog must eat. You can also top the food with boiled chicken or homemade broth(not canned ) to make any dry more appealing.
Thank you so much for your input! I will look around more and see if I can find a more experience vet that has treated dogs similar to my dog’s condition. His cushings is now under better control. We did testing a few weeks ago and confirmed that he is on the correct dosage now for his cushings. I actually purchased a IPET monitor from his vet and it seems to be reliable as the numbers are pretty similar to what his vet was also getting. He will be doing a blood glucose curve test soon so I will verify if there are any differences. I will also look into Nutrisca and see if that is something that he is willing to eat and if that is something that will work for him. I talked to his vet about his unwillingness to eat the W/D and his vet advised me they will do further research to see if G/D or Purina Pro is something he could be on and I will also continue my own research. Thank you once again for your help. This has given me a better idea on what to do!
I would avoid g/d – the ingredients are terrible. I would start looking beyond the vet for food. Has your vet mentioned increasing the insulin dose? Those numbers need to come down before too much damage is done. I wouldn’t increase the insulin dose and food at the same time though. You won’t know which change worked. Most vets in the early stages gradually increase the insulin dosages until the bg comes down to a better level. 550 is a risk of ketoacidosis and organ damage. My 14 lb dog was started at 5 units, increased gradually to 7 units where she stayed for some time. Once I got her settled on a good food that she likes , she is now at 4 units. You will see that as time goes on, their insulin needs change and so regulation is not permanent. I would make the food change first and after 5 – 7 days, explore an insulin change.
Thanks for your input Amy. I have ordered the Nutrisca and it should be here in the following day or so and I can see how he will like it then. I have actually increased his dosage of insulin now and he’s currently at 7 units and he was okay with it… I test him at 3pm daily which is his worst time and he’ll be around 330 so it has gotten a lot better..it’s just frustrating that it’s still so high. I am glad that he’s doing better but still frustrated that he’s not fully regulated after all this time yet :T… I will definitely try the Nutrisca and see how that is for him and see if it helps control his diabetes better.
A lot of dogs seem to be on only one type of insulin and it is usually a medium acting insulin which has a slope like a long in distance, short in height hill. This type of insulin makes it pretty impossible to control diabetes well. A dog must eat at the same times each day and the same amount of food at each meal.
In humans the best control of blood sugars is achieved using a very long acting insulin like lantus combined with a short acting insulin like humulin R. The short acting insulin is taken about 30 to 45 minutes before meals and the long acting insulin is taken once or twice daily to cover the glucose that is constantly being produced by the liver.
This type of insulin regimen requires more daily injections but it allows for several things that are not possible with a more simple insulin regimen:
1)Meals can be eaten at any time of day or night.
2)Meals don’t always have to be the same size and contain the exact same amount of carbs.
3)If your dog is sick or not eating you don’t have to freak out because you are worried that your dog will have low blood sugar because they didn’t eat.
4) You can adjust one of the insulins without also increasing or decreasing the size and content of meals.
5) Your dog will have much better control of his/her diabetes.
With the more intense insulin regimen meals and liver metabolism are handled separately allowing for a more effective control of blood glucose.
I believe that carbs are the enemy of anything (human, dog or otherwise) that has diabetes. I don’t agree with the Glycemic Research Institute that dry foods such as Nutrisca and Orijen are optimal for a dog with diabetes. Nutrisca has an estimated 36% carbs on a dry matter basis. Orijen has 25% carbs as estimated using the NFE (nitrogen free extract) method (this is extremely reliable). I think either % of carbs is waaay too much for a diabetic dog. If there were several foods with let’s say a carb content below 15% then I would look for the one with the lowest glycemic load. But if one food has 35% carbs and another food has 15% carbs it wouldn’t matter to me what the glycemic load of the first food was, I would choose the food with only 15% carbs!!!!
In dry foods (kibbles) the lowest carb content I have found is EVO which ranges from 12 to 18% carbs depending on the variety and Epigen (Thank you Hound Dog Mom) which has only 11% carbs in either of the 2 formulas.
In wet foods maybe you could just add some fresh meat which is in the same family (red, poultry or fish) that you are feeding at any particular meal. You are guaranteed a much higher quality topper if you add your own rather than a canned food.
James – While I agree with some of what you say in theory, it doesn’t always hold true in reality. I think Kristi probably would get better results with a long-acting insulin such as R, but without a vet who is well versed in diabetes, it is a dangerous proposition. Comparing diabetes in humans to diabetes in dogs is helpful in many respects as there are similarities, the flaw with that is dogs can’t communicate in terms we can understand until trouble is there. They can’t say they are feeling bad or shaky and short of checking their sugar many times a day, there is no way to know. If you can stay home non-stop with your dog, then great but most people don’t have that luxury. Also, to say diabetes is impossible to control with nph insulin is just wrong. I have done it for five years now and there are many others out there who have – in fact most dogs are maintained on nph. And just because someone uses a long acting insulin doesn’t mean you throw routine out the window. These dogs are best maintained on the same amount of food at the same time every day. As far as low glycemic foods are concerned, I have found just through my personal experience, that my dog’s blood sugar is just consistently lower and better since she is on Nutrisca. She feels better, looks better and it helps with her allergies. I actually tried Evo when she was first diagnosed and her bg was sky-high on it. The one thing I have found is that diabetic dogs react differently to different food. There was a series in the Whole Dog Journal last year about diabetic diets and the interesting part was there were many different case studies of diabetic dogs and almost all of them were on completely different foods. Some were on commercial diets, home cooked, raw, and even prescription diets but the owners all had great success by finding the food that worked for their dog. You can analyze the numbers and ingredients until your face is blue but if the theoretical “best” food doesn’t give you results, then you have to consider how your dog processes insulin and food.
Kristi, I would find an online forum for dogs with Cushings and/or diabetes so you can talk to people who are going through what you are with their dogs. There are tons of knowledgeable people out there who can really tell you about Cushings and diabetes who live it everyday.
Hey James –
Two other kibbles that just came to mind that I thought you might want to look into – Nature’s Variety Instinct Chicken and Artemis Maximal. Both have 42% protein and 22% fat – so should equate to about 18% carbohydrates.
Thank you HDM
Artemis maximal has lab values for the food and the carbs are 17.8% on a DMB. Here’s the link for the Artemis maximal:
NV Instinct chicken has the same numbers for protein, fat and moisture on the GA as Artemis Maximal so unless I can get the actual carb content or the actual Protein, fat, ash and moisture content your 18% carb estimate is probably correct. I mean you were only 2 tenths of a percent off on your Artemis maximal estimate!
When I do the math for the two epigens the carb content is 5.5% estimated. I will email Wysong and see if I can get some actual numbers.
Protein 60% (min)
Fat 11% (min)
Fiber 3.5% (max)
Moisture 12% (max)
Ash 8% (estimate)
This list will be constantly updated but for right now it looks like the kibbles with the lowest carb content are in order from low to high:
Wysong Epigen 60 and 90, 11% carbs (DFA estimate)
Natura Evo Turkey & chicken 12%, red meat 15% and herring 18% carbs (NFE)
Artemis Maximal 17.8% carbs (actual)
Natures Variety Instinct Chicken 18% (HDM & my estimate)
Thanks again HDM!
James- Although I respect that you are successfully managing your diabetes, dogs are different than humans and I think your suggestions are questionable for someone who doesn’t have a vet well-versed in diabetes. First of all, nph insulin most closely resembles the insulin dogs naturally produce which is different from humans. Most dogs are well maintained on this type of insulin and are not”impossible” to control at all. The short acting insulin(R) is sometimes needed for dogs that have insulin resistance but this dog has not had enough time to be regulated and to determine if resistance is the issue. Regardless of the insulin, diabetic dogs should be fed the same amount at the same time every day. To imply anything else is ridiculous. People who have had long term success managing their dog’s disease live by this principle. As far as food goes, a variety of different diets have been proven to work well for a diabetic dog but with Cushings (or pancreatitis like my dog) , a high fat diet is not recommended. A diet with “cheap” carbs is, of course, not good either. I prefer a food like Nutrisca because there is no potato or tapioca or rice or grain and my dog (dx five years now) thrives on it like no other food. Complex carbs work well with the nph insulin and they are necessary to have stable glucose levels throughout the day. There is an excellent article in the Whole Dog Journal which addresses diabetic diets and includes case studies of many dogs on a wide range of diets- raw, commercial, prescription, home-cooked and the success stories of those dogs. Diabetes is not a one size fits all with dogs and many times, you can analyze foods and labels and ingredients until you are blue in the face but you don’t get the results that you should. Personally, I think there are so many factors – metabolism, age, stress, infection or disease, etc that factor in.
Thanks James and HDM for your input also! Honestly, I’m feeling a little overwhelmed by all this information. I have started to research about Epigen and reading up on others experience on it. There was one review on the Epigen website where the dog did really well having on Epigen having both cushings and diabetes, which is what my dog has, so that is really promising. Today he measured at 407 for his glucose so it’s a stepback. I’m not sure what it is and it’s extremely frustrating. I make sure he gets nothing outside of his normal feeding time and make sure he’s well away from everyone during dinner time so no one feeds him anything at all yet the numbers are still very high. I will definitely look into your suggestions also and will be keeping my fingers crossed. Thank you everyone!
The fact that you have worked with human diabetics and you are a diabetic and have counseled dog guardians(whatever that means) doesn’t really mean alot for this particular person who is facing Cushings and Diabetes with a vet who doesn’t even specialize in dogs. Do not tell me I am unwilling or unable to provide the care my diabetic dog needs – she was diagnosed over five years ago and she is doing great. What are the statistics of the dogs you have worked with? You are making vague statements of your accomplishments but no real hard data to back it up. How many of those dogs had Cushings, and pancreatitis? You recommended high protein and high fat food to these dogs and that worked? If you have this information, share it specifically. This is the danger in this kind of forum and not at all what I thought it was supposed to be. It is one thing to get on and talk food and ingredients but when you make suggestions for people whose dogs are in life-threatening situations and you suggest taking actions that go against everything that is out there from real experts in dog diabetes( not experts in reading labels and studying ingredients), I have to call BS.
Kristi – please find a canine cushings forum to help you with some of your questions. These people are living with your situation every day.
Hi, I am not a vet. All of my advise is based on my experience with both human and canine diabetes. It is exactly what I would do for my own dog with diabetes.
I would like to discuss an insulin regimen for the dog who is not consistent in his or her eating habits. Let’s say you never know how much they are going to eat at any given meal or if they are going to eat at all. This happens a lot to dogs whose health may be declining due to complications from diabetes or any number of other illnesses. It is also very helpful for the finicky eater.
You would still use a long duration insulin like lantus to cover the basal glucose levels which is glucose secreted by the liver and has nothing to do with meals. Lantus begins to work in 2 to 4 hours, has no peak and lasts for about 24 hrs.
For meals (prandial) glucose control you would use a fast acting insulin like Novolog or Humalog which have a duration of 4 to 5 hours. This would cover the glucose metabolism for any given meal without being tied to a certain time or meal size.
For the unpredictable eater you would inject Humalog or Novolog AFTER a meal. This way you could give the right dose for whatever size meal your unpredictable eater consumed or you could give no dose if they did not eat at all.
The most effective glucose control for dog or human is to cover basal glucose and prandial glucose SEPARATELY with 2 different types of insulin, a rapid onset short duration insulin for meals and a slow onset long duration insulin for liver glucose production which remains pretty constant throughout the day.
Here is a graph that shows the curves of different types of insulin:
The basal graph shows the flat blue line which covers the glucose secreted by the liver. The prandial shows the green line which closely matches the glucose from meals. The graph of the NPH insulin doesn’t closely match anything.
James – do you have any research articles/studies that support the use of Lantus in dogs? The link you provided from caninediabetes.org was merely the peaks of certain types of insulin but in the information that followed, it only mentioned the use of Lantus in cats. I am trying to understand where you are coming from with your aversion to using nph for diabetes in dogs and why you make statements about it being “impossible” to regulate a dog with nph – that is absolutely not true. Of course, there are dogs that don’t do well on nph but it is by far the most reliable and most prescribed and that is not just my opinion. I looked for some research on using Lantus and all the information I can find doesn’t give a great endorsement for Lantus use in dogs:
(on page 40, Dr. Nelson states: “My experience with insulin glargine in diabetic dogs has been mixed and somewhat disappointing. I currently only use insulin glargine in poorly-controlled diabetic dogs where NPH and lente insulin are ineffective because of problems with short
duration of insulin effect.”)
http://images4.wikia.nocookie.net/diabetesindogs/images/3/3d/2009_V110Diabetes-Western-2010.pdf (on pg 4, Dr. Scott-Moncrieff states “Long acting insulins such as PZI and Glargine
are quite unpredictable in dogs and are not appropriate for the management of most diabetic dogs.”)
The only reason I am posting this is not to change your mind or to try to prove you wrong or even argue for the sake of arguing – I am deeply concerned about people who have newly diagnosed dogs who are desperate for information who might see what you posted and start having doubts about what their vet is doing. I know how scary, confusing, and overwhelming it is to get that diagnosis. Vets don’t usually do a great job of explaining the process to owners or diabetes for that matter and many don’t encourage their clients to test bgs at home.
Thanks Amy. I will also look at people that are dealing with cushings for their dogs because I was told the cushings is what caused the diabetes to appear in the first place. He actually has quite a bit of issues besides the cushings and diabetes but those are the things that we are trying to get under control first. I do appreciate everyone’s advice. I don’t believe there is anything that is perfect but I hope I will find something that will work for my dog. Today I actually changed his diet because of all the research I’ve done and everyone’s experience that they’ve shared with science diet. I have not received his new food or any of the diets I wanted him on yet so a little bit frustrated with that but I decided to cut half of his science diet food and change half of it to blue buffalo since it appears that is more highly recommended. I’m extremely excited because his glucose read 233 today at 3:00pm! It’s the best reading I’ve had in a while. I still have a ways to go and I will continue to look at other options but I really wanted to do something since it was over 400 yesterday.
The problem with ALL the links you posted and all the quotes about the effectiveness of Lantus (glargine) you supplied is this:
They only used ONE type of insulin in those comparisons. If you were to use only ONE type of insulin I would agree that NPH is marginally better than Lantus. But I have never nor will I ever suggest that you use only ONE type of insulin for a diabetic dog. You will NEVER get the level of glucose control using only ONE type of insulin as you will get with the 2 types of insulin regimen I recommend.
The above link tells you the onset of action and duration of 6 different types of insulin. For each type of insulin there is a graph. Axis y is insulin levels, axis x shows 4 points, Breakfast , lunch, supper and bedtime. The colored line in each graph shows the insulin level in the blood.
The first graph is the basal graph which uses Lantus, the line is flat and stays near the bottom of the graph at the top of the basal level of glucose but below the 3 peaks of breakfast , lunch and dinner. So if you took away the 3 peaks on that graph there would still be a low gray area that traveled from left to right on the graph. That is the basal level of glucose which is constantly being secreted by the liver. The dark blue line of the lantus rides nicely at the top of the basal level of glucose.
The next graph is the prandial graph which uses a rapid acting insulin such as Humalog or Novolog. There are 3 green lines that represent 3 different injections of rapid acting insulin. Each green line almost perfectly covers the 3 glucose peaks of breakfast, lunch and dinner.
So the Lantus perfectly takes care of the basal level of glucose and the rapid acting insulin almost perfectly takes care of the rises in glucose from meals. This is the regimen I suggest. My regimen COMBINES the long acting insulin of the basal graph with the rapid acting insulin of the prandial graph. In this regimen you would only inject the rapid acting insulin once if your dog ate only one meal, twice if your dog ate two meals and not at all if your dog didn’t eat that day.
I used Lantus as an example of an ultra long duration insulin. There is also Ultralente or Levemir. I used Novolog and Humalog as examples of a rapid acting insulin. There is also Apidra.
You suggest using ONLY NPH insulin. The graph of the NPH insulin shows the light blue line of the NPH not covering the basal glucose or the mealtime glucose AT ALL. This regimen is nowhere near as effective at covering the glucose of a dog with diabetes as the 2 insulin regimen I recommend.
I have tried my best to convey to you the superior effectiveness of the 2 insulin regimen I recommend over the use of NPH alone. Everyone is entitled to their own opinions and beliefs. I ask you to please respect my opinions and I will respect yours. I wish you and your dog the best.
Kristi – that is great news. Maybe the higher dose of insulin is making a difference. You might want to do a curve – starting with your morning food/ shot, check the bg every two hours. You will see how your dog is using insulin and the effects of food and activity. Hopefully, your foods will get there soon.
James – I suggest going first with what the vet recommends, which is nph usually. If that doesn’t work, then you go with another insulin, like Levemir or even Lantus but everyone should get this from the vet after monitoring and testing. You were the one who originally posted that a dog on nph was impossible to regulate and as I explained it is wrong to suggest that especially for people who are new to diabetes and looking for info. I have never said a dog should only be on nph. I know from experience that many diabetic dogs require different combinations of insulins and each one will react to the combination of insulin and food. All of the info for Lantus you posted is information for people using Lantus, correct? Dogs don’t process insulin in the same ways as people or even cats(i know you know this) Not only that, my dog’s actual curve doesn’t look exactly like the standard nph curve that the company posts so those graphs don’t mean anything about what is going on in reality.
What to do if your dog in addition to having diabetes also has Hyperlipidemia? Of course our Endocrinologist recommended Hill’s W/D… Actually told us that diet does not make that big of a deal in dogs, only in cats and humans!! I know they are not Dietitians but that just doesnt sit right with me! ??
Hyperlipidemia can be caused by badly controlled Diabetes. It can also be caused by other things.
The first thing I would do if I were you is try to tightly control my dog’s diabetes.
I would fast him or her for 24 hours while I figured out what dose of long acting insulin such as Lantus, Ultralente or Levemir controlled his basal levels of glucose. The basal level of glucose is what the liver constantly produces throughout the day and has nothing to do with meals. You might have to do the fast more than once (with plenty of days in between) until you calculate the correct dosage of long acting insulin. Then you can calculate the mealtime dose of rapid acting insulin such as Novolog, Humalog or Apidra. You would start with a very low dose and slowly increase the dosage until you find the dose of rapid acting insulin that adequately controls the glucose from your dog’s meals.
The beauty of a two insulin regimen is your dogs meals are not tied to any particular time of day and can vary in size. You can give the dose of rapid acting insulin immediately after a meal this way you give the correct dose of insulin for the amount of food your dog actually eats with no worries if he doesn’t finish his whole meal.
You must test your dog’s blood glucose levels a lot in the beginning while you figure everything out!!! I would test upon arising, right before meals, 2 hours after each meal and at bedtime.
The regimen I outlined is not a simple one but it can be done with the help of the right healthcare professional and I believe it pays off in the long run with a happier and healthier dog.
I would never feed my dog Hills W/D. Here are the ingredients:
Whole Grain Corn, Powdered Cellulose, Corn Gluten Meal, Chicken Liver Flavor, Chicken By-Product Meal, Soybean Mill Run, Chicken, Dried Beet Pulp, Soybean Oil, Lactic Acid, Caramel (color), Calcium Sulfate, Potassium Chloride, Flaxseed, L-Lysine, Choline Chloride, vitamins (Vitamin E Supplement, L-Ascorbyl-2-Polyphosphate (source of vitamin C) , Niacin Supplement, Thiamine Mononitrate, Vitamin A Supplement, Calcium Pantothenate, Biotin, Vitamin B12 Supplement, Pyridoxine Hydrochloride, Riboflavin Supplement, Folic Acid, Vitamin D3 Supplement), Calcium Carbonate, Taurine, minerals (Ferrous Sulfate, Zinc Oxide, Copper Sulfate, Manganous Oxide, Calcium Iodate, Sodium Selenite), L-Tryptophan, L-Carnitine, Iodized Salt, Mixed Tocopherols added to retain freshness, Citric Acid added to retain freshness, L-Threonine, Beta-Carotene, Phosphoric Acid, Rosemary Extract.
Dog’s with diabetes are still dogs. They still need a lot of protein. Fat should vary with the individual dog’s health, issues, diseases, etc. The hills W/D diet in my opinion is not fit for any dog to eat. While hills tries to focus on the dog’s diabetes , they completely fail to meet the nutritional needs of ANY canine. Hills addresses the dogs diabetes with high fiber (29.5%), high carbohydrates (51%) , low fat (8.7%) and low protein (18.7%).
As far as diet goes I discuss this in earlier posts in this topic.
Safarisam- You must remove the crap food- I do not care what anyone says about “Dogs evolving” to omnivores. Their bodies can not digest grain and its the dog food we have fed our babies that gave them this human disease. As small as your baby is you can feed a raw or cook a rare-ish diet pretty cheap. Remove all kibble and all commercial dog food period. I have almost killed my dog experimenting with dog food.. Bottom line is ALL dog food is crap if it has fillers of any kind and ash.. There should not be things like “crude analyses” in food of any kind.
Again I can not express enough that unless the dog food is pre-packaged raw, there is NO SAFE DOG FOOD on the market for diabetic dogs – its not safe for non- diabetic dogs but thats another thread.
Feel free to contact me if you want.. I have years experience with this issue and I understand what you are feeling right now. Its so confusing and scary..
Missing from Every Dog Food Label
Carbohydrate content has actually been deliberately omitted from the dog food’s nutrition label.
If feeding your dog a low carbohydrate diet happens to be your goal… and you’re looking for that information on a dog food package… you’re simply out of luck.
But there’s good news.
In less than a minute… you can quickly uncover the hidden percentage of carbohydrates… in virtually any dog food.
How to Quickly Calculate the
Carbohydrate Content of Any Dog Food
Basically, the bulk of all dog foods consist of four major nutrients…
In addition, all these products include something called ash. Ash is the non-combustible mineral residue that’s left over after burning away all the protein, fats and carbohydrates.
Ash content usually measures about five to eight percent of each finished product1 . So, I routinely allow about 8 percent as a benchmark for this important variable.
Together, the protein, fat, ash, carbohydrate and water content must account for roughly 100 percent of the total pre-cooking weight of any dog food.
OK. Now, some simple math…
Fasting a diabetic dog for 24 hours is one of the most dangerous things I have ever heard. There are many different diets out there for diabetic dogs. The trick is finding the one that works with the insulin to keep your dog well maintained. My dog has been diabetic for five years. What works for my dog may not work for the next person. I personally feed Nutrisca with a topper of either Merrick canned or Grandma Lucy’s Pure Performance. I stay away from potatoes and tapioca for my dog. You might google diabetic diets for dogs and find a great article from the Whole Dog Journal. It is quite informative and gives examples of different diets that owners have successfully used to maintain their dogs. If you don’t home test, I would start ASAP.
It looks like you are becoming my own personal stalker!!!
I get it, you don’t like my recommendations. You use an insulin regimen with your dog that was used in humans 25-30 years ago. Yes, NPH was the recommended insulin for treating Diabetes when I became diabetic almost 28 years ago. The current recommended insulin regimens for humans with diabetes has advanced dramatically and the insulin regimen I recommend reflects those advancements.
You on the other hand are using an outdated insulin regimen that is 25 years behind current knowledge about the treatment of diabetes and results in a shorter life expectancy due to complications from Diabetes. You are free to use whatever insulin regimen you like for your dog. Please start your own topic on the treatment of Diabetes. By posting outdated 25 year old insulin regimens on this topic you are potentially hurting the dogs whose guardians might follow your advice.
I have worked with over 50 dogs with diabetes. I have also worked with hundreds of humans with diabetes. One of the things that those dogs and humans have in common is the fact that an insulin regimen like the one I have outlined extended their lives and decreased the amount of complications suffered due to Diabetes.
I am not stalking you but here’s the deal: you have all the suggestions for people who have come here looking for help and answers they aren’t currently getting from their vets. Your suggestions might be great with a knowledgeable vet in a clinical setting where your suggestions could be very tightly controlled. The average person who looks at your suggestions can’t implement them on their own and shouldn’t because they are dangerous for a person who doesn’t possess a great deal of experience. I don’t think all of your ideas are crap – I know lots of lots of people with diabetic dogs who use Levemir or other types of insulin besides nph. You state that the meals when using other types of insulin don’t need to consistent in size and time frame are like nothing I have ever heard. Even my friends who use other insulin keep their dogs on very tight, consistent schedules. Your statements about nph being outdated are ridiculous. It is a widely accepted starting point for most newly diagnosed dogs because it has a track record of most closely resembling their natural insulin. It doesn’t mean every dog will do great on it, though because each dog has different issues and physical makeup.
By the way, I didn’t know that starting a thread here allowed you to say who can or can’t post to it. Do you own the rights to this thread? I have said it before and I will say it again- this isn’t a simple argument about which food is best. You are messing with people whose dogs have just been diagnosed and they are scared and don’t know what to do. You are giving advice to them that can’t be followed without a knowledgeable and willing vet and honestly your ideas have more to do with human diabetes and dogs are not the same. Not only that, you say you are not a vet, but you counsel people whose dogs have diabetes – do you work with a vet or in research? How do you meet these people you counsel? I have read so much research on diabetes and have never seen any protocols published like the ones you are suggesting. So, I guess I will not invade your thread again since you own it but I feel sorry for the people who come here looking for answers. There are some great canine diabetes forums out there administrated by people who know what they are talking about and who actually have diabetic dogs. No crazy advice there.
Good information here; it gives me a lot to think about.
I’m currently feeding 2 cups a day of dry Royal Canin Diabetic kibble and no more than one cup a day of Merrick’s Grain Free 96% Real Chicken canned- he refuses the dry without the canned on top. Urination is becoming more frequent as well as the accidents in the house the last two days. Ketones are normal; blood sugar is close to 600. He’s 34 lbs and consuming as much water as he did before diagnosis of diabetes a month ago. I’m taking him back to the vet this week as his sugar was controlled up until these past two days.
In the interim, has anyone tried feeding their diabetic dog Simply Nourish’s canned grain and gluten free stews? Anakin loved it before he was diagnosed and it seems to be a pretty good food. Low in carbs, high in protein.
Side Note: Im trying to keep his caloric intake around 780/ day. he gets 8 units of Humilin N twice a day after breakfast and dinner. I am not giving insulin with lunch.
Thanks for any feedback you may be able to give and for the OP as well.
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