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Dog food and feeding => Feeding dogs with health problems => Topic started by: Liz47 on Oct 01, 2020, 17:17

Title: Elderly dog diet for Pancreatitis, Bladder Stones & Diabetes?!
Post by: Liz47 on Oct 01, 2020, 17:17
I wonder if anyone can help me. I have a just turned 14 year old neutered dog called Jack. He is a miniature x toy poodle crossed with a German Spitz. Not long after I adopted him 4 years ago he was diagnosed with Struvite and Calcium Oxalate stones, so he was put onto Hills C/D Multicare dry food. We monitored these through regular urine exams and ultrasounds, until it got to a point where he had 2 stones on the brink of merging into one very stone that would cause a blockage so we opted for a Cystotomy. This went well and since he was been regularly scanned/urine tested and it's shown he generally has minimal 'grit'/crystals in the bladder and none visible from the urine exams, although his pH has a tendency to be slightly too alkaline around 7-7.5 mark. I've had no concerns though really and he did well on the diet. At the same time his stones were discovered incidentally we found he also has sludge in his gallbladder (has had a gallbladder mucolele in the past but there was no sign of that in the past year or so on his scans) and his liver has a lesion on it. He is on Destolit daily for these problems, alongside very high ALKP levels on his bloods. He has full bloods, urine exam and ultrasounds every 6 months and for the past few years these have all come back very similar/nothing concerning.

Beginning of last month he became acutely unwell after a suspected fall, he had neck pain but was refusing to eat and vomited as I took him to the vets. The vets suspected pancreatitis (either was building up or caused by the fall ie in pain/a shock/not eating). His bloods showed off the scale Amylase levels, very high Lipase and Pancreatic Enzyme. He was put on treatment for this and pain relief/strict rest for his neck, for the first week I fed him Hills I/D Low Fat Tins and he was only sick twice at home and improved very quickly. I prefer him to have a dry food (he drinks plenty of water from his water fountain) so I moved him onto the dry biscuit version of Hills I/D Low Fat. However, his tummy then began gurgling after he eats, his faeces became loose/wet and he looks uncomfortable after eating and did vomit once. He is very keen to eat, eats all the food and is otherwise moving really well know and back to normal. I decided the Hills I/D might not be right for him so made the change slowly back to his Hills C/D and he has improved.

He was back at the vets yesterday for a recheck and to have his bloods rechecked. His glucose was quite high, and in hindsight had been getting gradually higher for a while. He has also been drinking more so I am handing a urine sample in tomorrow as he may now be diabetic. His PSL and Amylase levels were back down to normal, however his Lipase was still high. His bloods also point to inflammation somewhere and we are suspicious of his gallbladder having gotten worse/a possible tumour somewhere. He is having an ultrasound to further investigate.

In the meantime I am doing lots of research into his diet, he needs a low fat, easily digestible, bladder friendly (low phosphorus, magnesium & calcium), diabetic (possibly!) friendly senior dog food? I have looked at Hills and Royal Canin and they  have a few options.

Hills W/D
Or if we prioritise the other issues over the bladder, Royal Canin Gastrointestinal Low  Fat or Diabetic.

I know these brands aren't actually supposed to be that good, but I think with his health problems I'm scared to chose a different brand but if anyone has any suggestions they would be greatly received.

Thank you
Title: Re: Elderly dog diet for Pancreatitis, Bladder Stones & Diabetes?!
Post by: Dottie on Oct 01, 2020, 21:26
Hello and welcome to the forum. These are complex problems, especially as you are waiting for news about the possibility of diabetes. I can't help you with advice about specific types of dry food because there are so many issues to address. Also, you are under the care of the vet and he or she should be able to advise.  You want a dry food but I am not sure that this is a good choice for a dog as unwell as yours. Dry food dehydrates the dog and that is why they have to drink so much. It also takes longer to digest.  The prescription diets are not high quality  but they can be useful short term.

Cold pressed food is dry but can be soaked very easily and might be worth looking at. They tend to be high in carbs but low in fat. The ones with brown rice might be suitable because it is a complex carbohydrate but again, check with your vet. The two UK companies who have sold this for some time are Gentle and Guru although there are now several manufacturers who have more recently entered into this market. I can't say whether they would meet the criteria regarding the minerals - you would need to discuss this with the manufacturer. These products have good digestibility but with a dog like yours I would be inclined to soak the nuggets so the dog does not become thirsty. 

My choice would be either a good quality wet food or better still, fresh cooked. These are more likely to contain good quality, digestible protein and will also be lower in carbohydrate. Some of the wet foods are high in fat but if you opt for fresh cooked food you can choose the low fat protein sources eg fish. Unfortunately there are very few companies who sell fresh cooked food - the only two that I know of are Butternut Box (https://butternutbox.com/?msclkid=247dcde1b3fd1621adde92978a5ff7d2&utm_source=bing&utm_medium=cpc&utm_campaign=BSN_FIRS_BRND_EXT_Butternut%20Box&utm_term=butternut%20box&utm_content=BB_Pure) and Different Dog. (https://www.differentdog.com/?msclkid=c9171331ae1c114161384c47975a97b0) The latter company has a vet who may be able to advise.  Marleybones (https://marleybones.com/) has just come onto the market and they have simple recipes but we don't yet have the specifics about fat/protein/carbohydrate. Pure Veggi Plus Mixer (https://www.purepetfood.com/recipes-for-dogs/vegi-plus-mixer/) is dehydrated so you could feed that and just add the protein of your choice. Your vet should be able to advise about suitable meats etc.   

If you are able to cook for your dog I would suggest that you get in touch with the
VetChef (https://www.vetchef.co.uk/) for specific recipes.

We have some threads on pancreatitis and on bladder stones. If you put those search terms in the box at the top of the board index you should be able to locate them.  The pancreatitis thread in particular could be helpful to you. 

I hope that you manage to stabilize your dog and that he is able to enjoy some quality of life.
Title: Re: Elderly dog diet for Pancreatitis, Bladder Stones & Diabetes?!
Post by: Liz47 on Oct 01, 2020, 23:28
Thank you very much. Luckily Jack does not act his age at all, and after he recovered from the acute pancreatitis episode he is back to being very playful, enjoying longer walks etc. He is very keen to eat and barks at us to get his food, spins around in excitement etc and clears the bowl. I do use a slow feeder for him as otherwise he would rush his food down, and at the moment he's getting 4 small meals across 24 hours. Shortly afterwards he is uncomfortable though, but after a short time he's back to normal and relaxed again. Thankfully I work at his vets so have lots of support. The vets aren't very familiar with diets though so haven't been able to advise. We spent all afternoon researching, I know he needs a low fat diet (5-10% ideally can go up to 15%), high protein (20-30%) and moderate to high carbs (no more than 60% NFE). We looked at the prescription diabetic food and there wasn't actually anything specific about it.

I do need to find out more from the rest of his investigations, but was confused about what to feed him for now. Since he didn't get on well with the I/D but he needs a more easily digestible low fat food rather than his C/D atm. I did come across Guru and Gentle in my research tonight, and was almost set on Gentle but read a fair amount of peoples dogs passed urine a lot more frequently/had accidents overnight etc?? I just thought as we need to monitor his urine output during the testing/early phases of diabetes management this might not be ideal. I did come across Symply Light and Senior, this fits most of his requirements (I think!) and has the lowest calcium and phosphorus levels I've found so far.
Title: Re: Elderly dog diet for Pancreatitis, Bladder Stones & Diabetes?!
Post by: Dottie on Oct 04, 2020, 16:43
As I mentioned previously, cold pressed food can easily be soaked (not in boiling water). If it is given as a wet food it should not make the dog too thirsty. I fed cold pressed food for a long time and did not experience the problems you describe. Cold pressed food is dense and needs to be fed in the correct quantity. The amount in the bowl looks considerably less than dry extruded foods. It is very easy to overfeed.  I always weighed it. The only way you will know is to try it.  Gentle does meet the criteria for low fat and it is easier to digest than kibble - link. (https://www.youtube.com/watch?v=URQhlOiaDLc)
Title: Re: Elderly dog diet for Pancreatitis, Bladder Stones & Diabetes?!
Post by: Liz47 on Oct 04, 2020, 20:00
Thank you, yeah I did notice the grams of cold pressed food he needs to eat daily is much less than dry extruded options (which is about 120g for his weight). The options that keep coming up do seem to be mostly cold pressed, I keep getting Guru, Gentle or Symply (the only dry extruded). Symply has the lowest calcium and phosphorus levels which would be beneficial for his bladder but cold pressed seem to be better for digestion. The vets can't comment on cold pressed, as they have no experience.

I want to start the change as soon as possible to move away from the prescription diet but couldn't find any Guru or Gentle stockists but did find Symply Senior wet food so for ease I got some and started the change yesterday. His graces haven't been as orange (which was the colour of his prescription diet) and slightly more firm.

I got further test results, he's not clinically diabetic yet which is good. With a good diet and regular checks he hopefully won't need treatment, is likely to have been all the previous damage to his pancreas. I forgot to mention before I got him for 10 years he was fed human food, whatever his elderly owner was eating, so that's likely led to all his problems sadly and he was very overweight.

ETA: I am also going to start feeding him from his treat toys and snuffle mat as he does eat very fast and gobble his food down, he already has a slow feeding bowl but I notice he still tries to gulp.
Title: Re: Elderly dog diet for Pancreatitis, Bladder Stones & Diabetes?!
Post by: Dottie on Oct 04, 2020, 20:20
AFAIK there are only a few shops that sell cold pressed foods. I found only one in the neighbouring city. I usually ordered the food online and paid the delivery charge. Forthglade sell cold pressed food and at one time it was on the shelves in Sainsbury’s. Handily, you could get small bags. I do not know if their products are still in this supermarket but it might be worth checking if interested and if you have a store nearby.
Title: Re: Elderly dog diet for Pancreatitis, Bladder Stones & Diabetes?!
Post by: Liz47 on Oct 04, 2020, 20:50
Thank you, ordering online in the future won't be a problem :) I just wanted something quick since he wasn't getting on with his prescription diet. Already I'm seeing the difference in the Symply wet food, it actually smells nice and you can see the veg in it. The Hills I/D wet was really solid and didn't smell good and he would gag/be uncomfortable after eating. So far so good with the change
Title: Re: Elderly dog diet for Pancreatitis, Bladder Stones & Diabetes?!
Post by: Dottie on Oct 04, 2020, 22:50
That’s great news and I hope that the improvement is maintained. I have heard of Symply dog food but never used it so it is interesting to hear your opinion of their wet food. Just had a look on the Dog Food Directory and it has a nice simple recipe. Carbohydrate is low. Protein and fat are above average so the dog might not need very much quantity wise.
Title: Re: Elderly dog diet for Pancreatitis, Bladder Stones & Diabetes?!
Post by: Liz47 on Oct 05, 2020, 15:30
Thank you, no if he was just on the wet food (Senior Feast version) he wouldn't need much at all. I think I am going to feed a combination of the wet and senior dry version if I decide to stick with this and not try Gentle out. I'm terrible at making decisions and despite working in a vets we really don't delve much intro nutrition, aside from knowing all the prescription diets but this has been an eye opener for me looking at the actual ingredients etc.
Title: Re: Elderly dog diet for Pancreatitis, Bladder Stones & Diabetes?!
Post by: Dottie on Oct 05, 2020, 19:18
I find that when trialling a new food it does take some time to evaluate it properly, particularly for skin conditions. If your dog is tolerating the Symply wet food OK it might be best to stick with that for now.
Title: Re: Elderly dog diet for Pancreatitis, Bladder Stones & Diabetes?!
Post by: Liz47 on Oct 07, 2020, 20:30
Thank you. To update, Jack has had an ultrasound today and his bladder is looking good (no stones), his gallbladder also has no sludge and is looking normal, that's the first time in years! His pancreas is quite damaged, and doesn't look like it can be producing insulin well. He isn't losing glucose in his urine at the moment, he's having this rechecked and a glucose curve done next Wednesday as it's looking like he will need insulin treatment now.

The vet has ok'd his Symply diet and he is doing very well in himself which is good news
Title: Re: Elderly dog diet for Pancreatitis, Bladder Stones & Diabetes?!
Post by: Dottie on Oct 08, 2020, 11:00
Thank you for the update. I am pleased that Symply is helping your dog.