Gastro oesophageal reflux

[Dottie]

Gastro oesophageal reflux (also known as acid reflux) is a condition that occurs in humans and dogs.  It causes an uncontrollable reverse flow of gastric or intestinal fluids from the stomach into the oesophagus.   It can be due to brief relaxation of the sphincter between the oesophagus, a weak or damaged sphincter muscle and chronic vomiting.  It can also occur when dogs have not been properly starved prior to general anaesthetic. The condition is fairly common in dogs and may occur at any age.  The stomach is protected from acid but the oesophagus is not so it can become excoriated, causing pain for the dog.   Commonly this happens after a high fat meal or the dog has simply had too much to eat. 

A while ago one of my dogs began to vomit intermittently in the evening.  It was distinctive in that it was quite sudden with no retching - the food (or some of it) was suddenly expelled.  Another thing I noticed was that she would lick things such as the carpet, clothing etc.  I have since discovered that this can be a sign of an upset stomach.  She is a dog that occasionally brings bile up in the mornings but otherwise was fine in herself.  The vet thought it was diet related - I was giving them a trial of Wainwright's Grain Free.  I therefore put her back on Gentle but it didn't make any difference.

On one particular occasion she vomited several times and was clearly quite poorly and in pain so I took her as an emergency to the vet who advised a low protein diet around 22%. Using the Dog Food Directory of this website I found two grain free products - Fish4Dogs Weight Control and two versions of Wafcol Salmon & Potato. She's had the Fish4Dogs before and was fine on it so I chose that. I soak the kibble and divide it into four meals per day.  She is now symptom free.  I have slowly been able to add in some Superior Adult kibble and she is coping nicely with the added protein and fat.

David, our administrator, gave me some advice:
'......higher protein/higher fat foods are suspected of increasing the likelihood of reflux. The ingestion of protein stimulates stomach acid formation so more protein equals more acid which means more likelihood of a reflux episode in susceptible dogs. Fat is suspected of weakening the sphincter muscle between the stomach and the oesophagus - the muscle that usually keeps the stomach acid in the stomach.
..... as you mention, low protein, grain free foods are very difficult to come by.

Quite often, reflux comes in a bout and then disappears without a trace so in time, you might be able to return her to a food you are more comfortable feeding.'

My dog's previous food was not high in protein or fat but it seems that small amounts can make a difference.  There is more choice of low protein/fat products if grain is acceptable.  If left untreated the oesophagus can become sore and damaged with repeated exposure to stomach acid. As acid reflux is a common problem I am posting just in case it might help someone else who has a dog with this condition.

[Eden Holistic Pet Foods]

This seems overly simplified as an explanation. It take no account of the source or quality of protein or fat (animal v plant) or of the fact that a higher protein percent food can actually have less grammes per day of protein and fat due to reduced feeding amounts.

It is certainly one of the reasons why gradual changes in diet are advised, so the body can adjust to what is being fed.

[Dottie]

Well, I am sorry that you feel that way David but faced with a sick dog I followed the advice of my vet who I trust.  My little dog is now well again. That is all I am bothered about.  Most of the Internet articles regarding reflux give the same advice as my vet and David.  Regarding transitioning to a new food, of course you are correct but in this case it had nothing to do with it because the dog was already established on the food - the reflux did not occur in response to a sudden change of product.   I take your point about the equation of feeding less of a high protein food but for my dog it is not appropriate. That is not to say that your approach might not work for another dog. 

[George]

This seems overly simplified as an explanation. It take no account of the source or quality of protein or fat (animal v plant) or of the fact that a higher protein percent food can actually have less grammes per day of protein and fat due to reduced feeding amounts.

I'm inclined to agree, David.

This article is interesting: http://healthypets.mercola.com/sites/healthypets/archive/2014/12/28/gastroesophageal-reflux-disease.aspx

The article acknowledges that low protein/fat can help, but I note particularly the comment that "many pets with GERD have underlying food sensitivities". This is what I had always assumed to be the case, since I myself suffer from reflux if I eat dairy foods but never otherwise.

The LIttle Cav had reflux, admittedly along with other problems, on many of the foods I used at first but he has none at all on a high protein raw diet. Dottie, I wonder if it is possible that your dog was cured by the new food because it was a different protein source as much as because it was lower protein... a sensitivity to eg chicken can arise at any stage in life.

[Eden Holistic Pet Foods]

I wasn't suggesting that what you have done hasn't worked Dottie, clearly it has, I'm only questioning the reasoning behind why it has worked, and what was the initial trigger.

Certainly as David pointed out, once there has been and episode, the start of a "bout", that in itself will have weakened the sphincter, and treatment is needed to reduce the acid levels to let the sphincter recover... that is why, after recovery that may be aided by a dietary change, you can often go back to the original diet. if that is the case then the change in diet may have aided recovery, but it would seem unlikely that the original diet was the trigger, at least not on its own.

I also notice that you now soak the kibble and serve in four meals, both of those coula also be part of the reason the diet change has helped... soaking will add more water, to help dilute the acid, and the reduced portion in each meal will allow the body to process smaller amonts, and so the tummy will be less full at each meal, leaving more room and so less chance of excess acid coming back up.

What you have don has worked, and that is a fantastic result, but as I said the cause or solution is likely to be far more complex than simply changing protein percentage, and that in itself could be masking the real cause/cure.

[George]

you now soak the kibble and serve in four meals, both of those coula also be part of the reason the diet change has helped... soaking will add more water, to help dilute the acid, and the reduced portion in each meal will allow the body to process smaller amonts, and so the tummy will be less full at each meal, leaving more room and so less chance of excess acid coming back up.

Two excellent points David, and while I would have thought of the latter myself and indeed my first action would be to to feed more frequent smaller meals, the former would never have occurred to me. It does make perfect sense though. It makes me wonder whether wet or raw food is in some ways a better option than dry in these cases, since the food is then already high in moisture...

Wet/raw is usually higher protein of course, but raw in particular tends to contain very high quality protein which is more easily digested by most dogs...

Just pondering.

[Dottie]

Thank you for your interesting comments which add much to the discussion.   I had read about the possibility of intolerance but because of the history I have been able to discount that as a cause.  As far as I can see there is no cause to my dog's problem.  She has the condition and I have to look after her and to try and prevent it from recurring.  Soaking the food and dividing it into four meals has no doubt helped.  Most of the websites advocate wet food but I could find only one that matched the criteria and that was Burns Penlan Farm chicken. 

I apologise if the solution for my dog's problem sounded too simplistic. That was not intended. I am just a pet owner and wanted to share this experience in case it might help someone else. I am not saying that it is the right thing to do - owners need to talk to their vet and should make their own mind up when faced with such problems.  If you feel that this thread is misleading then let me know and I will remove it.   

[George]

I don't think the thread is misleading at all Dottie; it's an interesting discussion that in it's entirety contains a lot of useful information and also gives a lot to think about. Hopefully others will contribute and maybe we can all learn more.

[Sully]

From  a human pov pretty much anything can set off acid reflux for me, even water has aggravated it on occasion  mine is due to a hiatus hernia & is managed by medication that works 98% of the time. It maybe worth your while finding out whether it is a physical thing for your dog as opposed to a dietary thing as at least then you will know to expect the symptoms to occur again

[Dottie]

I am just updating this thread in case it might be useful to somebody.  A few months ago I put two of my dogs back on a prepared raw complete diet. Last time I used raw complete I had a bit of an issue with weight control so this time I used a different product with a lower fat level.  Anyway, this time the weight and both dogs were fine and they enjoy the food. 

I decided to try the one who had the reflux on the same product so I commenced it very slowly, substituting a bit of raw instead of a meal and gradually increasing the amount (not actually mixing kibble and raw).  However, I did stick to the four meals. Eventually she was on all raw except for a small amount of soaked kibble last thing at night.  So far she has been fine so I'm very pleased.  David (admin) said that sometimes this condition comes and goes and I think that this has been the case with my dog.  She is not having any kibble now and I have found a suitable product to give her last thing at night to prevent the early morning acidity/bile reflux. 

All three are on the same food now and I am having no problems with weight control at the moment.  Two of them have had small signs of detoxification (one of them is the dog with reflux).  Some people think this doesn't exist but I am not so sure now.  They have both had small patches of sore, spotty skin.  I've treated it myself and they are healing. 

[Eden Holistic Pet Foods]

That's great news Dottie, well done for persevering.

As far as the "detox" period, I'm not sure how much is is actually detoxification and how much its just a period of adjustment while the body changes its production of the various digestive juices and the gut flora re-balances to digest the new food correctly, This results in a brief period of a few days to a few months when nutrient absorption may not be as good as it should be, and hence you can see some minor issues in the early stages with a small number of dogs.

[chrishordley]

Just looking for such information as my little spaniel/jrt cross shows symptoms. I had changed to cereal free Purizon fish recipe from cold pressed and as a very thin rescue who had not put on weight I had tended to give him more and when feeding him his raw meal have given him more fat. I have the condition myself and responded well to the Monarsh University researchers' FODMAP diet this excludes fructose and fructo olisaccharides which principally means wheat, barley, rye plus legumes like peas and dried fruit. These are often seen as good, fibre sources and can be in some dog food. Onions and garlic are less likely triggers as not included usually. Personally I have also cut out sugar too and take probiotic fermented milk. My problems including asthma and arthritis are significantly reduced as is my weight and risk of type two diabetes. I need a good low fat/protein commercial feed as my dogs will be looked after by elderly parents while I am on holiday.

[Dottie]

Thank you for the interesting and informative post Chris. It sounds as if you have plenty of experience of this condition both canine and human.

 I am afraid in my dog's case I spoke too soon.      Since being on raw, she has only had an occasional episode of bringing bile up first thing in the morning but has not refluxed otherwise. However, this morning she was quite poorly again. She vomitted profusely after breakfast (not bile) and was in a lot of pain. Fortunately I had some medication left over from the last episode so I gave her that and whisked her off to the vet. She seems to have settled now and she will have a light diet for today.  I feel cross with myself  because I should have left things as they were.     I just kept thinking that dogs need protein (which they do) and that I wasn't doing the best for her. 

With regards to your dog's diet whilst you are away on holiday, if it is of any help I found that I could control the problem by mixing Fish4 Dogs Superior weight control and adult 50/50, soaking the kibble. She was doing well on this but I was ( and still am) giving her four small meals a day.  Wainwright's Salmon and Potato Light and Wafcol Salmon and Potato might be worth your consideration.

[Tinyplanets]

Sorry to hear that Dottie, I also have reflux and would agree that peas and beans can be a problem for me. I wonder if the peas in the raw food might not be helping.

[chrishordley]

Peas certainly feature on my helpful FODMAP app as a no and of course in quite a few dog foods recently. After a quick look in my local store I opted for Skinners light version as lowest fat and protein, not a particularly good feed and not what I would have chosen for a year old active boy only just on acceptable weight. He had no incident this morning after four feeds yesterday, one including raw liver. The Skinners had no peas or fructo-olisaccharides and was chicken meal, maize, rice and potato, all of which I can eat myself. I opted for a raw chicken drumstick with skin removed for his breakfast today rather than carcass this morning. Fish4Dogs do a potato and fish biscuit which might make an easy last thing snack. I felt l benefitted from chewing gum to increase my swallowing and salivation which tend to diminish in us older humans but stopped because they all contain xylitol and I didn't want my dogs getting any of it. When they were having a rawhide chew at bedtime we had no problems. This might be an idea worth looking at but I don't like the Chinese origins of the ones in my shop.I had a bad tum myself yesterday and this might have been due to not having lunch until late rather than what I actually ate although first time I have had pineapple for months. It is monitoring all the variables for the individual.