EPI and Diabetes :(

Dog Food Advisor Forums Diet and Health EPI and Diabetes :(

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  • #150683 Report Abuse
    Victoria M
    Participant

    I’m going insane! I don’t know how many dog food labels I’ve read in the past six months. Feel like I’m getting nowhere.

    Bella just turned 13 (GSD x lab). In July she was diagnosed with Lymphoma. After only a few chemo treatments she had a severe bout of pancreatitis. Chemo had to stop.

    Pancreatitis finally cleared up and a milder form of chemo restarted. During a pre-chemo blood panel, she was found to have diabetes. After a few weeks of insulin but continued weight loss, they tested and diagnosed her with EPI. My poor dog!

    I have been on the hunt for food that will help keep both of these diseases at bay. Her vet also does NOT want her on any grain-free or raw food.

    Food has to be:
    Grain-inclusive
    Low-fat
    Low-carbs
    No sugars
    High protein
    No lamb

    Hoping someone can suggest a good food. She’s on Hill’s W/D right now, and it’s not going well so far. 🙁
    Thanks!

    #150700 Report Abuse
    GSDsForever
    Participant

    Victoria,

    You poor thing and your poor dog! That is certainly a lot to be trying to treat at once & in selecting a food.

    Have you thought about feeding a therapeutic homemade diet, via your vet & you doing a consult with a board certified veterinary nutritionist (DACVN)? I wouldn’t recommend them all equally, but there are some good ones.

    Those are some tough dietary parameters to meet all at once, particularly through a commercial kibble/can and from a quality reputable company, and you might have better luck with feeding homemade.

    You might also look into the Vet Support Diets or a custom therapeutic diet from Just Food For Dogs, via their board certified veterinary nutritionists and other vet specialists.

    Bear in mind that with EPI, the diet should also be low fiber, especially insoluble fiber — per veterinary guidelines. The main keys for the EPI part, are the pancreatic enzymes on the food + B 12 supplementing.

    I would strongly encourage you to reach out to EPI4Dogs. Olessia, the lovely owner of that foundation & moderator, in fact has an EPI dog with diabetes that has been well managed on a combination homemade/fresh and Annamaet’s Lean. Dogs with EPI are no longer recommended to to have low fat, but as Olessia’s dog has needed low fat due to the diabetes, she will be able to help. The enzyme preparation that many use there is called Enzyme Diane, which is less costly. Many of the dogs in that group have done very well, and there is a wealth of knowledge and encouragement, hope there.

    I believe most of the EPI dog owners there are feeding grain-free. The issue is with fiber though, as many whole grains found in commercial dog foods are high fiber and much of that fiber is insoluble, which EPI dogs cannot handle. The dogs also notably do not do well with peas, which also happen to be nearly all insoluble fiber. (Ditto for lentils.)

    Among whole grains, a very very small amount of oats (higher in soluble, at ~50%), amaranth, or sorghum would be lowest in both fiber and % insoluble fiber; otherwise, white rice (refined). Lowest fiber grains like brown rice and corn contain almost entirely insoluble fiber. Cassava, white potato, and sweet potato are more balanced in soluble/insoluble fiber than most grains — and the fiber in sweet potatoes reduces to half in canned, vaccuum packed.

    Elizabeth Hershey DVM, DACVIM is an outstanding, nationally known board certified oncologist you might wish to have your local vet reach out to. She is integrative and evidence based, as she is trained in both traditional western medicine and eastern/Traditional Chinese Medicine, includes diet, and typically combines her approaches. She does have success where other oncologists have not.

    If I think of a suitable grain inclusive commercial food from a company that I personally would recommend, I will post it.

    #150707 Report Abuse
    haleycookie
    Member

    You will never find a low carb grain inclusive food sorry to say. See if you can be referred out to a vet nutritionalist to help formulate a low carb low fat homemade either raw or cooked diet. Kibbles HAVE to have a lot of carb to hold them together. Even the highest meat content in a kibble will still have ~30% carb. Might look into canned food options as well but again they will not be grain inclusive if they are low sugar carb fat etc. the closest I can think of are weruva and tiki dog. Usually dog foods that are in shreds of clearly chicken meat are going to be the lowest carb and lowest fat because they are basically just shredded muscle meat.

    #150708 Report Abuse
    GSDsForever
    Participant

    Olessia’s diet for Izzy, with EPI + diabetes, has been *something* like this (check w/her):

    80% homemade/20% Annamaet Lean

    Fresh, cooked homemade portion: Lean Meat/Fish, Sweet Potatoes, 1/3 Raw Egg, Fat Free Cottage Cheese, Fish Oil
    + Vitamins/Minerals and Bone Meal

    Note: Annamaet Lean is a high protein, low fiber, low fat food, grain-free.
    30% Protein/7% Fat (<3.5% Fiber)
    It does have legumes as primary ingredients, along with the meat (chicken, duck, herring meals), + tapioca & potato. It IS an excellent company.
    https://annamaet.com/products/lean-formula/

    You might explore adding a very small amount of grain to this recipe, to be grain inclusive as you & your vet prefer. Using the Annamaet Lean, with its legumes, at 20% of the diet is likely a lower risk (for DCM).

    • This reply was modified 11 months, 4 weeks ago by GSDsForever.
    #150721 Report Abuse
    GSDsForever
    Participant

    These are couple diets some EPI dogs recently have done well on:

    Forza10 Legend Digestion (Actual Fiber ~1.5%)
    https://www.chewy.com/forza10-nutraceutic-legend-digestion/dp/209890

    Sport Dog Herding Dog Elite
    https://www.sportdogfood.com/products/herding-dog#ingredients

    Both are grain-free. You might try adding both lean protein + low fiber veggies (e.g. zucchini, squash, asparagus tips) and a very very small portion of a carefully chosen whole grain, to lower the percentage fat + carbs (while keeping protein high) AND be grain-inclusive. Mushrooms, are also low fiber, high protein per calories, and varieties like Maitake, Shiitake, Reishi, Enoki, and Turkey Tail/Trametes Versicolor are very good for cancer and the immune system.

    #150799 Report Abuse
    Victoria M
    Participant

    Thank you both so much for all that information! It is a LOT to try and balance out and I definitely can’t do it alone.
    Gimme good ol’, reliable cancer any day – at least treatment is pretty specific. 🙁 I’m so exhausted – Bella is doing better than I am at this point!

    She currently is on Enzymediane and weekly B-12 injections. I am feeding her ~90% Hills W/D and 10% cooked food:
    99% lean ground turkey, homemade beef bone broth & riced, frozen broccoli and cauliflower medley. If things ever settle down I plan on upping the amount of fresh food and decreasing the kibble.

    Her vet does not want her on grain-free food. She has a mild heart murmur that he’s afraid might get worse or turn into DCM. He’s also worried about raw food and her compromised immune system. (Can ground pancreas be cooked and still work?)

    I was really hoping there was a simple, decent commercial food that checks at least the major boxes that maybe I missed in my research. I had her on the Annamaet Lean and also tried Nulo, but both had legumes as first three ingredients, and ….eew! Major gas, bloating and horrible blow-out diarrhea resulted.

    I looked around for a veterinary nutritionist, but don’t know who to trust. They all want quite a bit of money for just a consult. I may reach out to the vet that used to do her acupuncture and see if she recommends anyone.
    I’ll also try Just Food For Dogs.

    Thank you again!!
    Victoria & Bella
    New Hampshire, USA

    #150831 Report Abuse
    GSDsForever
    Participant

    Hi Victoria.

    First (so I don’t forget it!), no, you cannot use cooked pancreas for EPI. It *must* be raw for the active enzymes needed. Vets know this — it’s a special exception recommended in otherwise normal, healthy dogs with EPI.

    In your dog’s case, an older dog with cancer, I wouldn’t worry about trying to use pancreas. Just stick with the Enzyme Diane/other prepared enzymes as they are highly effective. For B12, a lot of dogs use WonderLab pills vs the injections.

    I share your vet’s concerns about DCM and the connection to many current grain-free/high legume formulas, your dog’s heart murmur, as well as raw for your dog, and agree with his guidance. (Also, while I am respectful of raw feeding, I prefer gently cooked homemade food as ideal anyway and don’t find a benefit for my dogs in raw.)

    It’s just hard to capture all those criteria — along with low fiber, low insoluble fiber necessary in particular for EPI dogs — in commercial kibbles, especially here in the U.S. at this time.

    Aside from what HaleyCookie pointed out well (Thank you, HaleyCookie!), the starch binding in kibbles, I think companies add to the problem. They just don’t want to spend the money, chance cutting into their profits by including more quality animal protein, which is expensive. Or they don’t think that the public will buy the products at a necessarily higher price — and, here, they might be right.

    I mentioned those particular GF formulas ONLY as something you could potentially do part homemade with, and that other EPI dogs are using with success.

    Another formula currently being re-released and available again, which *might* work for you with some tweaks (you’ll need lower % fiber in an EPI dog; perhaps you can accomplish this diluting it with what you add homemade?):

    Farmina LIGHT Chicken & Pomegranate with Ancestral Grains
    34% Protein/11% Fat (6.4% Fiber)
    https://www.farmina.com/us/dog-food/n&d-ancestral-grain-canine/113-chicken-&-pomegranate-light-medium-&-maxi.html

    I really like Farmina and my German Shepherd is doing very well on their food. I use a different formula, higher in fat and low in fiber (typical of most Farmina formulas).

    A board certified veterinary nutritionist I would recommend is Lisa Weeth, DVM DACVN.
    http://www.weethnutrition.com/about-us.html
    https://weethnutrition.wordpress.com/

    You can work with her long distance, through your vet. She is very supportive of homemade diets and experienced with them, and is also more open minded, fair, unbiased across a variety of commercial diets and brands imo. I think you would get a better diet from her for the money than from some other prominent services/DACVNs.

    You can get a good feel for what she’s like from her nutrition blog, both her blog and Q&A section (click on “comments” at the top), in that 2nd link. You might ask her some questions there, about a commercial kibble or your current homemade additions; she’s pretty gracious and generous in her answers. (Your questions would tie in to her recent blog entries on DCM & diet, also one on grains.)

    I like Susan Wynn, DVM DACVN, also but she left private practice in nutrition in January 2019 to work for Nature’s Variety.

    I think the expensiveness comes from the pre-diet formulation blood tests & work up you’ll need to submit (costs dependent upon your own vet), but I think they need that to ensure that a major health issue is not present so that when they formulate a custom diet for your dog it is safe and appropriate, does not make an underlying health problem worse. And, as you’ve already seen for yourself, multiple health conditions & diet parameters, not only require review of all your medical file, but presents a diet more challenging, complicated to formulate. In your case, if you have any of those blood panels, etc. already done recently, then you’ve already spent that money. Talk to her assistant & ask about costs, what is included, your concerns. (They were very helpful with me.)

    With Just Food For Dogs, the cheapest by far is doing their DIY — where you buy their recipe + balancing supplement. I just don’t know whether any of those would be appropriate for your dog, with her conditions and the diet parameters. They have good customer service (and knowledgeable veterinary staff) if you want to ask them.

    I was encouraged by — and have considered using a couple of their diets myself — an independent review I read from a guy who broke down his total costs for a large breed dog about mine’s weight, showed the receipts and shopped at Whole Foods no less(!), to feed one of the formulas the DIY route. With this diet, you do feed lower total calories because it is fresh whole foods gently cooked, using highest quality ingredients, and is therefore highly digestible. So, his cost was lower than what I would have assumed for a large dog.

    • This reply was modified 11 months, 4 weeks ago by GSDsForever.
    • This reply was modified 11 months, 4 weeks ago by GSDsForever.
    #150834 Report Abuse
    Victoria M
    Participant

    I can’t thank you enough for the info and your time! And for explaining things so well. Can I talk you onto moving to New Hampshire? LOL
    I will look into all your suggestions.

    #150840 Report Abuse
    GSDsForever
    Participant

    Ugh. I edit for one thing & quick post back to you poofs! System glitch.

    You’re welcome. Hoping my disappearing post re-appears.

    #150841 Report Abuse
    GSDsForever
    Participant

    Retry (apologies for duplicates, if they pop up):

    LOL! I just saw your post afterward, as I was sending the last one.

    I would love to live in New Hampshire. What an awesome, beautiful state — and such rich history! My dogs & I would love the seasons and colder weather. Unfortunately, I am stuck for a while elsewhere (lol).

    I got excited when I found the Farmina Light formula, as it’s got to be better than what you’re currently using for dry. Then I compared, and I got more excited for you.

    You’re very welcome. We all need a little help sometimes!

    My own girl is doing really well at this point, but food allergies can make finding foods & selecting them challenging, not to mention this whole DCM-diet concern! I feel like no one can make foods without pulses/legumes anymore, esp. not higher protein ones. So frustrating. And foods aren’t very hypoallergenic, food allergy friendly!

    #150924 Report Abuse
    GSDsForever
    Participant

    Re-Post (Disappeared – System Glitch)

    Comparing the 2 foods, the Farmina Light seems to fit all of your requirements and parameters much better.

    Hill’s W/D Dry, Actual/Typical Analysis
    Meat: Chicken Meal
    Grain-Inclusive: Whole Wheat, Cornmeal, & Oats + Corn Gluten, Cracked Pearled Barley
    +Cellulose, Beet Pulp for Fiber
    Protein: 20.7%
    Fat: 13%
    Fiber: 16%
    Carbs NFE: 45.1%
    Heart Health: Adds Taurine, L-Carnitine
    255 cal/C
    https://www.hillspet.com/dog-food/pd-wd-canine-dry

    Hill’s also helpfully provides this formula’s total dietary fiber and a breakdown of type: 27.6% total, most of which is insoluble at 25.5% (soluble: 1.9%).

    Farmina Light Chicken & Pomegranate w/Ancestral Grains, GA Analysis
    Meat/Animal Protein: Chicken & Herring (both fresh & dehydrated) + Whole Eggs
    Grain-Inclusive: Whole Spelt & Oats
    +Beet Pulp, Psyllium Seed Husks for Fiber
    Protein: 37.4%
    Fat: 12%
    Fiber: 7% (Max)*
    Carbs NFE: 30.9%
    Heart Health: Adds Taurine, L-Carnitine, DL-Methionine (precursor)
    338 cal/C
    https://www.farmina.com/us/dog-food/n&d-ancestral-grain-canine/113-chicken-&-pomegranate-light-medium-&-maxi.html

    *Veterinary standard of care for diets for EPI dogs is low fiber, low insoluble fiber. Usually when looking bag GAs for comparison, you are looking for <4% Crude Fiber. Here it is 6.4% Max, still higher than ideal for EPI, but much lower than Hill’s W/D. (For the actual/typical fiber & fat, you would need to ask Farmina.)

    *Adding a bit of fresh, homemade should bring down that fiber.

    #150925 Report Abuse
    GSDsForever
    Participant

    Hill’s W/D Dry Ingredients:

    Whole Grain Wheat, Powdered Cellulose, Chicken Meal, Whole Grain Corn, Corn Gluten Meal, Chicken Fat, Cracked Pearled Barley, Whole Grain Oats, Chicken Liver Flavor, Dried Beet Pulp, Pork Flavor, Lactic Acid, Soybean Oil, Caramel color, Flaxseed, Choline Chloride, Potassium Chloride, Glyceryl Monostearate, Potassium Citrate, Iodized Salt, L-Lysine, vitamins (Vitamin E Supplement, L-Ascorbyl-2-Polyphosphate (source of Vitamin C), Niacin Supplement, Thiamine Mononitrate, Vitamin A Supplement, Calcium Pantothenate, Riboflavin Supplement, Biotin, Vitamin B12 Supplement, Pyridoxine Hydrochloride, Folic Acid, Vitamin D3 Supplement), L-Tryptophan, Calcium Carbonate, DL-Methionine, minerals (Ferrous Sulfate, Zinc Oxide, Copper Sulfate, Manganous Oxide, Calcium Iodate, Sodium Selenite), Taurine, L-Carnitine, Mixed Tocopherols for freshness, Natural Flavors, Beta-Carotene.

    Farmina Light Chicken & Pomegranate w/Ancestral Grains:

    boneless chicken, dehydrated chicken, whole spelt, whole oats, herring, dehydrated herring, dried whole eggs, dried beet pulp, suncured alfalfa meal, chicken fat, herring oil, dried carrot, inulin, fructooligosaccharide, yeast extract, dried pomegranate, dried apple, dried spinach, psyllium seed husk, dried sweet orange, dried blueberry, salt, brewers dried yeast, turmeric, glucosamine hydrochloride, chondroitin sulfate, vitamin A supplement, vitamin D3 supplement, vitamin E supplement, ascorbic acid, niacin, calcium pantothenate, riboflavin, pyridoxine hydrochloride, thiamine mononitrate, biotin, folic acid, vitamin B12 supplement, choline chloride, beta-carotene, zinc methionine hydroxy analogue chelate, manganese methionine hydroxy analogue chelate, ferrous glycine, copper methionine hydroxy analogue chelate, selenium yeast, DL-Methionine, taurine, L-Carnitine, aloe vera gel concentrate, green tea extract, rosemary extract, mixed tocopherols (a preservative).

    #151029 Report Abuse
    Victoria M
    Participant

    Thank you so much again! Sorry for the late reply, I’ve been sick 🙁

    I ordered and received the Farmina Light. I remember looking at it a couple years ago after the Taste of the Wild food I had her on for a long time decided not to agree with her anymore (I knew it looked different!) But I was trying to steer clear of chicken which I always thought she was sensitive to – if she was back then, it doesn’t seem to bother her now(?)

    I’ll start slooooooooowly adding the Farmina to the W/D food. She never did well on prescription food – with the exception of acute bacterial upsets – and that was canned stuff for only a week or two before it turned on her. There’s a whole lot of carbs and junk in that Hill’s. I have a much better feeling about the Farmina! Hope Bella’s tummy feels the same way 🙂

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