Pancreatitis
Pancreatitis seems to be more common in dogs than I was aware of. Many people that I talk with that have had dogs become very ill, and in fact hospitalized and on intravenous fluids for the initial treatment, tell me that they have no idea how their dogs got pancreatitis. Canine pancreatitis usually presents with vomiting, anorexia and abdominal pain. The purpose of this writing is not to inform you about canine pancreatitis and its diagnosis but to share what I have learned over 9 months of research, reading, vet visits and searching out those that understand the essential dietary management without using kibble based diets. I am very thankful that my path has led me to continued good health of my border collie who presented with pancreatitis after her rabies immunization.
Learn More About Pancreatitis
To learn more about canine pancreatitis this article by the Whole Dog Journal is very informative:
http://www.whole-dog-journal.com/issues/11_11/features/Canine-Pancreatitis-Symptoms-and-Treatment_16081-1.html
Fortunately my dog that got pancreatitis 9 months ago (May 2015) was not as ill as many dogs are. She had wretching with some minimal vomiting for a few days while we were away at a dog show. I could not adjust her diet or know what was causing this early morning vomiting until I returned and was able to get to my visit our vet and have the SPEC cPL done to confirm pancreatitis. Her value was 365.
I strongly believe that her pancreatitis was due to her Rabies vaccine that was given 7 days prior to the onset of her symptoms. She had been given the homeopathic Vaccinosis to help minimize the effects of the vaccine administration one day prior, day of and 2 days following the Rabies shot. Perhaps this helped minimize the severity of the symptoms presented.
However, there were other factors which perhaps contributed to the perfect storm of a reaction: We were away from home – perhaps adding stress with a dog show. She was eating her raw diet of duck (typically higher in fat); had many more treats for the show and practice prior to the show; and went for a run on a warm day and on Sundays had one marrow bone (very high in fat). All these factors could have contributed to the onset of pancreatitis. However, studies report that even dogs not receiving high fat dies are getting pancreatitis.
In talking with people who say they have no idea how their dogs got ill with pancreatitis, I wonder if they considered that recent vaccinations especially Rabies could have possibly contributed. Any symptoms after a Rabies vaccination especially those presented in the first few weeks should be thought of as possibly a reaction. Consider that the rabies is good for 3 years or more. More and more is being written and reported of delayed reactions to the Rabies vaccine.
Consider reading more about adverse reactions to vaccines by Dr. Jean Dodds who has spent many years researching this topic. Dr. Dodd’s research and writing provide some of the best and more scientific information on this topic: http://www.dogs4dogs.com/blog/2009/08/06/treating-adverse-vaccine-reactions-by-jean-dodds-dvm/
Reports and scientific studies are beginning to emerge linking vaccine damage to pancreatitis. Studies show that the histamine release triggered during vaccination can cause damage to the pancreas.
How I Managed Acute Pancreatitis
We were out of state when my dog started early morning vomiting and wretching. After a day she had no appetite in the morning (she always LOVES food) but would eat starting at noon. When I got back home I made an appointment with my vet who recognized this as possible pancreatitis. People have reported to me that their dogs were so ill that they had to be hospitalized for IV fluids and rest of GI tract.
I was very fortunate that my dog was not this ill. It is possible that by giving her the homeopathic remedy Vaccinosis for helping to reduce the effects of vaccine administration helped to make this a milder case.
Lab Values and Diagnostics
The diagnostic test used for pancreatitis is the SPEC cPL. My dogs SPEC cPL was 369 in the range of positive diagnosis (see chart below for test diagnosis and ranges for interpretation).
The SPEC cPL, launched in 2005 by IDEXX, is the tested and best diagnostic tool to quickly assess pancreatitis.
Visit these web sites to learn more about the SPEC cPL
- IDEXX Labs – SPEC cPL: http://www.idexx.com.au/smallanimal/reference-laboratories/testmenu/innovative-tests/spec-cpl.html
- Values for SPEC cPL from IDEXX LABS: http://www.2ndchance.info/diabetesdog-cPLtest.pdf
201 - 399 ug/L: concentration is questionable range. Possible pancreatitis. Repeat SPEC cPL in 2 weeks
> or = 400 ug/L: concentrations is consistent with pancreatitis
The goal of early treatment after diagnosis is to rest the digestive system. She was placed on 4 small meals of boiled chicken (which is best way to get out all the fat) and sweet potatoes or white rice (white rice is easier to digest than brown rice) which was more highly dilute with water 4:1. Her exercise was curtailed to leash walking for maximum rest.
I also talked with my vet in New York, Dr. Alex Barrientos, that I have mentioned previously in my writings, who is so knowledgeable about supporting animals systems as they heal using supplements. I knew there must be something else we could support my dog with. Dr. Alex recommended:
- Progressive Labs Pan 10X twice a day: PanX is a highly potent sources of pancreatic enzymes
- Pan chelate: twice a day for 30 days: to support the function of the pancreas and normal blood sugar range.
- Also same diet for 2 weeks
AGAIN, I RECOMMEND THAT ANY USE OF THE ABOVE SUPPLEMENTS BE DONE UNDER THE GUIDANCE OF A VETERINARIAN. I worked very closely with Dr Barrientos in New York by phone to determine the dose, frequency and how long to stay on these supplements intermittently depending on lab values for at least 6 months.
My dog did very well with this treatment. Her first week on the low fat diet she had no symptoms but clearly her energy level was much lower and this is so easy to see since she is so high drive and very very active even in the house. One week after her first symptom she started to show her normal Border Collie high energy. I was not able to get the supplements until one week after her first symptoms, but the change in diet greatly helped along with minimal exercise. After one week she started on the Progressive Lab supplements.
2nd Week Report:
No vomiting or symptoms; good energy. Still on very low fat diet of rice and boiled chicken; NO TREATS. Started some off leash activity for 30 minutes where she ran normally and happily. Moved her feedings to three times a day with a slight increase of amount each time. Her treatment was guided by carefully monitoring her energy and any possible symptoms.
Two weeks after her low fat diet started we repeated her SPEC cPL which had dropped from 369 (abnormal) to 30 – a lovely normal range. J
3rd Week:
Due to how well she was doing and her normal SPEC cPL we progressed her diet going into week 3: Added ¼ Cup of Honest Kitchen Base Mix (6% fat and 10.5% Protein). Here is a good place to add guidelines to determine what is going to be considered a safe range of food as we move forward VERY SLOWLY progressing her diet:
- Fat content should always be as low as possible: 6 and 7% is excellent
- Protein content should also be considered with low protein. The combination of fat and protein should NOT EXCEED 20 when looking at the Guaranteed Analysis on the food.
- Diet will now consist of high carbohydrates (potatoes and sweet potatoes) since calories usually come from the fat in a diet.
- NO OMEGA’s (fish oil) now.
To help learn more about diet (fat, protein, carbohydrates; calculation of calories; how much this dog needed; and what I could feed) I purchased 3 excellent books that were recommended to me that I highly recommend:
- Hilary Watson’s Complete and Balanced: 101 Healthy Home-made Meals for Dogs. This is an excellent book that talks about complete and balanced diets; the importance of complete and balanced diet; how to assess the nutrient content in a recipe or ingredient; balancing vitamins and minerals in home-made recipes; and most helpful were her recipes for lo fat diets
- Monica Segal’s first book, K9 Kitchen: Your Dogs’ Diet: The Truth Behind the Hype. Excellent and very informative book on feeding a raw diet, cooked foods; ABCs of food; supplements; individually appropriate diets; blood values and using stools to determine the health of your dogs intestinal track.
- Monica Segal’s, Optimal Nutrition: Raw and Cooked Canine Diets: The Next Level. Excellent book, again adding to my knowledge about a complete and balanced diet AND a chapter and few recipes for pancreatitis and low fat diets.
- Whole Dog Journal, “Healthy Low-Fat Diets for Dogs with Special Dietary needs.” Excellent article to help understand how to read and interpret fat in a diet and a little about homemade low-fat diets and what you need to consider to help make this a balanced nutritional diet.
I must stop here and share my experience trying to get more help from both of these authors who seemed to be the best sources of knowledge on the diet and diet progression for dogs with pancreatitis. I wrote to Hillary Watson with a question on low fat diet from her book and asked if I could do a consultation. She NEVER RESPONDED back to me. I was very very disappointed. My feeling is if someone cares enough to write a book to help others, why would they not take the time to at least acknowledge a correspondence related to their book and work even to say they are sorry but they cannot help or do a consultation.
Monica Segal does consultations for $285 beginning with a very detailed questionnaire on your dog’s history. The wait time is 4 weeks. The process is email contact between the dog owner and Monica for approximately 2 months; no weekend work.
I immediately sent my history with a very detailed questionnaire from Monica and paid for a consultation, hearing back immediately from Monica that she would get back with me at some later time. Of course now I was left with many questions that I could not really find good answers for. Other than Dr. Barrientos in New York, I had no specific resource to help me move forward with dietary planning. When I did finally hear back from Monica she told me that she only worked with people who want to totally do HOME PREPARED DIETS; not partial home prepared. She could not work with me unless this was my intent and my questionnaire indicated that I was willing to home prepare all but the raw meat and bones. This apparently did not fit her protocol so she refunded my money. She was not even willing to do any consultation to help answer my important questions,
- I had a high drive dog that was having trouble keeping weight on and I was not sure how much to feed or how often to feed.
- Since the amount of food had to be increased greatly to make up for the low fat, low protein diet how much was safe to give a dog at a meal especially since I was not sure if increased meals would tax the pancreas and digestive system.
- What should I or could I use for training treats?
I must add that I was very very disappointed in the responses and inability to help from both of these individuals. I realize they are very busy but their lack of either responsiveness or willingness to even do a paid consolation whose treatment is dependent of dietary management (their expertise) is very disheartening.
Progression of Diet – Starting Week 4
I progressed my dog’s diet based repeating the SPEC cPL after 4 weeks to determine how well my dog was doing on her low fat but very restricted diet. I also did a great deal of reading and re-reading the 3 books by Watson and Segal and the reputable Whole Dog Journal articles over and over and researching quality raw food that would be low fat/low protein and again combining both not to exceed a value of 20. I also got basic information from my local vet and much more detailed information and guidelines from Dr. Barrientos in New York per phone consultation.
In researching and reading about the food analysis in different quality meats what I did learn was about low fat meats (rabbit being the lowest; bison very low and some turkey). I learned that when companies add the supplements such as Omega’s and Vitamin E to make their product complete and balanced, that this increases the fat percentage. For example fish oil is 99% fat and cannot be used early in the diet of and perhaps never in dogs that have had pancreatitis. Primal had meat called mixes that had only meat, bones and veggies but no added supplements making their meat low fat. At the end of this article you will see the analysis of several meats that are high quality, yet low fat.
As I mentioned earlier, one of the biggest challenges was I have a very high drive and very very active dog that certainly burns big calories especially on run in the woods days. I had to see what the caloric needs were for a 40 pound dog which I found to be anywhere from 900 – 1200 kcal. At this time I was only reading how many calories were in the raw food for their serving and adding carbohydrates (sweet and white potatoes) and veggies to add more nourishment and calories.
Remember – calories mostly come from fat thus reducing calories in a low fat and now low protein diet.
Below is How I Progressed This Dog’s Diet and Other Considerations – Starting Week 6 After Symptoms
Diet: Boiled chicken (since boiling gets out the most fat) alternating with the lowest fat meat I could find, OC RAW RABBITT (min fat 4%; protein 15&) http://www.ocrawdog.com/products/canine-products/dogs-rabbit.html
Morning: 1/3 Cup Honest Kitchen Preference Base Mix (6% fat; 10.5 % protein): This base mix has as the main ingredient sweet potatoes and veggies. This for me was an excellent way to add calories without the fat in meats. Honest Kitchen has a filter of their foods for low fat: they have 3:
http://www.thehonestkitchen.com/dog-food?nutrients=34
Evening: same meat but with the addition of 1 cup of sweet or white potatoes and a veggie such as squash, ground up carrots, or peas. No Honest Kitchen.
Supplements: On her pancreatitc supplements (Pan Chelate and Pan 10X) under supervisions of Dr. Barrientos. Put back on her supplements of Curriculum, Dogzymes digestive enhancer, and Trixsyn.
Exercise: increased from 30 minutes off leash runs to 1 hour and regular herding and obedience training.
Feeding Schedule: Initially in the first 2 weeks I did 4 very small meals but moved to 3 with the morning and evening being larger since this very active border collie was loosing weight: she lost 3 pounds in 4 weeks.
Treats and Dog Training Treats : very small pieces of boiled chicken and dehydrated sweet potatoes cut into tiny pieces.
Other treats: Honest Kitchen Pecks (buffalo and blueberry) fat content 4% and protein 12.5%. Honest Kitchen’s other treat of a larger size is Smooches (chicken and cranberry) with fat content of 4% and progein of 12%.
HONEST KITCHEN is an excellent company with excellent food and several low fat options.
Repeated SPEC cPL 6 weeks after initial onset of symptoms and now 2 weeks after this diet progression and her SPEC cPL was 35 – again within normal range.
This gave us very important information on if we were doing the right type of diet and treatment since it is very easy, especially early on, for pancreatitis to return. I continued on this same diet for several more months. The OC RAW Rabbitt was expensive but was also the most low fat raw meat I could find. I was very happy to add my carbohydrates (sweet potatoes) and vegetables to this to add calories along with the Honest Kitchen Base Mix once a day.
5 Months After Initial Symptoms
At 5 months we did comprehensive blood work with a super chemistry and SPEC cPL to see how she was doing with all her systems. Her blood work was very good and within normal range and the SPEC cPL was 83. Yes, it was up from the early values of 30 and 35 but she had progressed in her diet.
Since she was doing well and her blood was within low normal, Dr. Barrientos was OK with me finding other low fat/low protein sources of meat since rabbit is very expensive. The 2 other sources that I have found are:
- Darwins Bison: 6% fat; protein 13%
- Primal Turkey Mix: 5% fat; protein 13%
Darwins is an excellent company that delivers to your door. They use high quality natural ingredients: human quality USDA approved free-range meats and organic vegetables. No steroids, hormones or chemical preservatives in any of their meat or meals. No grains, cereals or fillers. I have been using Darwins for over a year with my dogs and find that this is my favorite raw food that my dogs do very very well on including my Puli who has a very sensitive digestive system. No recalls of their food. http://www.darwinspet.com/
Primal is the other company that is excellent and reliable in producing high quality food for dogs. They have had very few if any recalls of their food. Since most of their food has the added supplements the fat and protein was too high except for the mixes. The turkey mix seemed excellent with 5 % and protein 13%
Primal Raw Mixes: http://www.primalpetfoods.com/product/list/c/8
Diet Progression Starting at 6 Months
Since my dog was doing well on this very strict management of her diet (no other food or treats other than what I have mentioned) I progressed her diet and started adding in very small amounts of Omega 3 fish oil. Below is the diet that my border collie is currently on and continues to do well. We will repeat her blood work in 6 months unless any symptoms develop. AND, NO MORE VACCINES including RABIES!!!
I alternate the following meat sources: OC Raw Rabbit or Primal Raw Rabbit (a little higher in fat content); Primal Turkey Mix with MY added supplements; and Darwins Bison – not to exceed 4 days.
Morning:
- Honest Kitchen Base Mix
- 1 paddy (1/2 pound) of one of the above or measured amount of raw meat
- veggie (usually a mix of spinach and kale)
Evening
- 1 Cup sweet potatoes
- 1 paddy (1/2 pound) as in morning
- veggies (squash, peas, ground carrots)
NOTE: carrots are hard to digest and you will see them in the dogs stool undigested unless you cook them OR use a meat grinder to grind them in small pieces.
MY BIGGEST PROBLEM NOW…… WEIGHT
As I mentioned earlier this dog lost weight after starting on this low fat/low protein diet. Previously I know she had kept on weight with all the training treats, one marrow bone a week, and quite early on kibble which I stopped since it was putting on too much weight. Now I was having trouble maintaining a healthy weight. I would look at her to determine if I thought her weight was OK but I had no idea how to increase her weight and no help! This was one question I really had wanted to ask Monica Segal in our consultation.
I decided that I must be much more informed about calorie count of the food she was eating and get a digital scale so I could more carefully monitor her daily weight.
What I found was the following:
- Her calorie count from her current diet put her below what was recommended for a 40 pound dog by about 100-200 calories. Therefore, the first thing I needed to do was find a way to increase calories.
- Looking at the food she ate I looked for ways to increase calories without adding a great deal of volume since I felt her quantity of food each meal seemed quite a lot. I decided to slightly increase her raw meat: I could do this with the Primal Turkey mix by adding a few ounces from 8 oz up to 10 or 11 ozs. I could increase the amount of her morning Honest Kitchen Base Mix slightly from ½ C dehydrated to ¾ since this had good calories. AND most importantly I needed to add a third meal on days that she went for a run and really burned calories. This third meal was not to be big but again 1 C of sweet potatoes and perhaps some meat such as cod fish or some boiled chicken.
I purchased a digital scale which was not expensive but gave me daily feedback on her weight and what was working and what diet she should be on to first gain weight and then to maintain her weight.
In the last few weeks I have been able to put 2 pounds on this border collie and she looks excellent at a weight of 38-39+ pounds. AND now she is on 2 meals a day. I will add a 3rd small meal on days of exercise so we will not loose all we have gained.. But again daily weights have been very very helpful in addition to knowing the calories in the food I feed and how to add more food without adding fat.
A Little About Supplements
I have learned a great deal about the value of and using supplements for dogs early on by reading Dr. Martin Goldstein’s excellent book, The Nature of Animal Healing. A few principles that I believe strongly in and which have been supported by my work with Dr. Barrientos include:
- Disease is the absence of health. Only when our bodies are out of balance are we subject to disease.
- The mechanisms for healing are already built into all individuals including animals.
- A healthy immune system is critical for healing and good health.
- Food, including the necessary vitamins and minerals was intended NOT to improve bur rather to maintain the body.
- Holistic medicine believes that the best way to cure illness is to help the individual/animal cure himself.
- When health has been restored, it can be maintained- if the immune system is sustained.
- There is a connection between poor food and poor health.
- The system should be able to repair itself with the when we send help to repair damaged or diseased cells – thus my believe in the supplements such as we did for the pancrease – Pan 10X and Pan Chealeate.
With these principles I follow the following guidelines for my dogs to help maintain health, wellness, energy and a long life:
- No processed foods including kibble.
- Choosing foods free of hormones, steroids, antibiotics, and pesticides. When ever possible choosing organic or range free animals.
- Adding my own vegetables where I can choose the best. I did try a prepared meal of raw and veggies from a provider in California that did not have the above guaranteed and all my dogs did poorly with loose stools that would not improve. I decided to prepare my own veggies since I could control the quality.
- The daily use of probiotics or digestive enzymes. Many years ago I found the benefit of Dogzymes Digestive Enhancer for my Puli who had no appetite and frequently vomited in the morning. After starting him on Dogzymes Digestive Enhancer he stopped his early morning vomiting and has a great appetite. I feel that digestive enzymes are important for dogs. Knowing what I know about the latest research on the human microbiome and digestive flora in humans I cannot help but think that this does not apply to animals. Monica Segal does write that she believes that digestive enzymes are important for certain chronic gastrointestinal problems and other medical conditions. The enzymes should be sprinkled on the food, and mixed well to allow the mixture to sit for about 10 minutes; allowing the enzyme to break down the food. I use Dogzymes Digestive Enhancer for all my dogs but my dog with the pancreatitis history also has Progressive Formulas Lipo Complex to help with the breakdown of fat and the excellent Plant Enzymes and Probiotics by Animal Essentials of naturally occurring microorganisms for the support of digestive flora and to assist with the breakdown of starches, proteins, triglycerides and fats. We increase the probiotic during travel and times of possible stress to the dogs as recommended by Nature’s Farmacy of Dogzymes https://naturesfarmacy.com/ NOTE: This is an excellent company and they are very responsive and helpful whenever I call with questions for recommendations or help.
- Curcumin twice a day
- Animal Essentials Ocean Omega: half of recommended dose daily except when feeding Bison.
- Joint support supplements
- Low fat diet (rabbit) and increased digestive enhancer when traveling or at dog shows where there could be increased stress levels.
- Additional Supplements for Complete and Balanced: When I am feeding Primal’s turkey mix, there are bones and veggies but NO supplements to help make this complete and balanced. Added to the meals when I use the Primal Turkey Mix is Animal Essential Organic Green Alternative, rich in antioxidants, vitamins and minerals. I also give Animal Essentials Organic OceanKelp from Northwestern Iceland. Kelp is an excellent supplement as long as it is organic and not from ocean areas that could be contaminated with mercury or other chemical pollutants. Kelp is an excellent source of natural vitamins and minerals. If the meat being fed does not include the bones for calcium, Animal Essentials also has a preparation of Seaweed and Calcium.
Check out Animal Essentials: http://animalessentials.com/#company
Animal Essentials is a pioneer company of the holistic pet care industry and is dedicated to producing the finest natural pet care products from only the best ingredients available.
In Summary… The path I have taken and settled on for helping my dog with a low fat diet and weight management is working well for me. I decided early on that I did not want to try to find a good source of meat and have to grind bones and do large preparation. It works well for me having several companies I respect such as Primal and Darwins supply my meat with the guaranteed fat and protein analysis. I do however have time to cook sweet potatoes, dehydrate them for training treats and also prepare squash, carrots, peas, kale, spinach. This does not take me a great deal of prep time and I only do this once a week or less. I am very happy to finally find a way to try to keep my dog healthy, well and able to resume the normal life of a high drive happy and competitive Border Collie.