What is the pancreas?
The pancreas is an organ located close to the liver, the stomach, and the small intestine. It has two separate and distinct functions: endocrine functions (functions associated with hormone production) and exocrine functions (functions associated with digestive enzyme production).
As an endocrine organ, the pancreas controls blood sugar levels by secreting insulin and glucagon hormones. As an exocrine organ, it aids in digestion by secreting lipase, amylase, and other digestive enzymes.
What pancreatic diseases in dogs can be affected by nutrition?
The pancreas is essential for digestion and nutrient metabolism; the diet is usually adapted based on the disease. Exocrine pancreatic insufficiency (EPI), diabetes mellitus (DM), pancreatitis, and insulinoma are the most common diseases in dogs that can benefit from nutritional changes. Dietary modifications can improve or control the clinical signs, depending on the pancreatic disease and its effects on digestion, nutrient metabolism, or both.
How can nutrition affect dogs with exocrine pancreatic insufficiency (EPI)?
In dogs with EPI, the pancreas does not produce digestive enzymes (pancreatic secretions). Thus, enzyme supplementation is critical for proper treatment. Diet changes can also be necessary, depending on the dog’s response to treatment.
Diet Balance
- It is best to use a high-quality diet that is very digestible. These diets usually contain low fiber, because fiber reduces the digestion and absorption of other nutrients.
- The diet’s fat content must be adjusted based on your dog’s response. After diet changes, your veterinarian will monitor fecal color and consistency with a fecal scoring chart. Yellowish stools can be a sign of fat maldigestion (steatorrhea).
- Fat provides more energy (calories) than protein or carbohydrates, but also requires more time for digestion and absorption, so the diet may be adjusted to address weight gain or fat maldigestion.
- Protein and carbohydrates also require pancreatic secretions but are usually less affected than fat, so less of a concern in the diet.
Nutrient Absorption
The pancreas is also critical for cobalamin absorption (vitamin ). Dogs with EPI require cobalamin supplementation, even when receiving pancreatic enzymes. Oral or injectable cobalamin supplementation are good options. Blood testing is recommended to monitor and adjust the treatment when necessary. For more information about cobalamin, see the handout “Cyanocobalamin (B12 or Cobalamin)”.
Folate (vitamin B9) levels in the blood might be elevated [MY4] [KW5] in dogs with EPI, due to increased production by intestinal bacteria. Bacteria also use cobalamin, so measuring both folate and cobalamin is ideal.
There are no specific diets for dogs with EPI. Low fiber and moderate fat (depending on each dog) is a good initial combination. Your veterinarian will monitor your dog’s response, and may need to make multiple changes and adjustments to the diet type and enzyme supplementation to achieve a good response.
How can nutrition affect dogs with diabetes mellitus (DM)?
Dogs with DM usually require insulin treatment to control blood glucose levels, since the pancreas is not doing it properly. Diet changes can improve glucose levels (glycemia) after meals and thereby lower the amount of insulin the dog requires.
Veterinary diets for dogs with diabetes have specific carbohydrate sources, high fiber, and low fat to control glucose levels after meals.
- Diets for diabetic dogs give more attention to carbohydrates (starch) than protein and fat, because carbohydrates are absorbed as glucose. Protein and fat can produce glucose after absorption in the gastrointestinal tract.
- Carbohydrates in a dog’s diet lead to changes in blood glucose levels after a meal. By adjusting food ingredients and amounts, as well as insulin dose, you can modify glucose absorption, improve glucose levels, and reduce clinical signs of hyperglycemia.
- Diets for diabetic dogs avoid sugars because they are easily digested and can lead to a quick glucose peak. Avoid diets, treats, and “people foods” that contain sugars or sweeteners, such as honey, fruits, and syrups.
- Fibercan modulate glucose levels by delaying gastric emptying and reducing carbohydrate digestion and absorption. Depending on the fibre type, it may also affect intestinal transit time, modulating glucose levels.
As diabetic dogs are predisposed to the development of hyperlipidemia (elevated blood levels of cholesterol or triglycerides), diabetic diets will usually be low in fat and high in fiber to reduce fat absorption. Some dogs may require a specific diet because of another disease or condition (e.g., an underweight dog with diabetes and EPI). It might be more challenging, but achieving adequate glucose control with other diets is possible. In these situations, it is essential to work with your veterinarian to monitor and adjust the diet and insulin dose.
How often should I feed my diabetic dog?
Most dogs adapt well to two meals per day, usually every 12 hours (e.g., 7 a.m. and 7 p.m.). You can offer a snack or smaller meal between the main meals, as long as it is part of the treatment plan. Your veterinarian will monitor and adjust the insulin dose accordingly.
Consistency in the diet and routine is critical for diabetic dogs. It will help prevent daily fluctuations in glucose levels and make insulin adjustments easier.
Any additional foods or treats that your dog receives will likely affect glucose levels. The importance of these extra foods will depend on the nutrient profile and the amount fed.
Big changes in exercise/activity routines should be avoided because they will also affect blood glucose levels.
What should I do if my dog has low glucose levels (hypoglycemia)?
Hypoglycemia can be life threatening. If your dog experiences episodes of hypoglycemia, discuss it with your veterinarian. It is a sign that the treatment, including the diet, should be reviewed.
- If your dog can swallow without difficulty: Offer small amounts of glucose solution, honey, or corn syrup.
- If your dog is not able to swallow appropriately: Rub a small amount of glucose solution, honey, or corn syrup into the gums or under the tongue. Then reach out to your veterinarian or emergency service. Do not offer any liquids by mouth. There is a high risk of the dog breathing in the liquid, which can cause severe respiratory complications.
How can nutrition affect dogs with insulinoma?
Insulinomas are pancreatic tumors that can increase insulin production and cause low blood glucose levels (hypoglycemia). Diets that prevent high peaks in glucose levels (e.g., diabetic diets) can also benefit dogs with insulinoma.
Veterinary diets with high fiber and specific carbohydrate sources and amounts can contribute to the gradual absorption of glucose. Avoiding a high glucose peak will prevent a quick release of insulin and resulting hypoglycemia.
"Avoiding a high glucose peak will prevent a quick release of insulin and resulting hypoglycemia.
Feeding management for insulinoma is essential: smaller and more frequent meals are recommended to decrease the amount of glucose absorbed at each meal, reducing insulin secretion.
If your dog has low blood glucose levels, even with an adequate diet and feeding adjustments, follow the steps outlined above for addressing hypoglycemia.
How can nutrition affect dogs with pancreatitis?
Pancreatitis in dogs has a variety of causes, but often it is not possible to identify the exact trigger. In addition to medical treatment, nutrition can be very important to reduce the clinical signs and the chance of reoccurrence.
A veterinary low-fat diet is usually the best initial option for dogs with pancreatitis. Fat requires more pancreatic secretions to be digested and also delays digestion by reducing gastric emptying.
Once your dog is recovered, the veterinary low-fat diet might not be recommended for the long-term. If the pancreatitis was not caused by the previous diet, it may be possible to return to the previous diet. With any diet change, ensure a slow transition to see if your dog will tolerate the food.
With any diet change, ensure a slow transition to see if your dog will tolerate the food.
If there is no clear reason for pancreatitis, then it is recommended to reduce the amount of fat in the diet. Depending on the previous diet, a veterinary low-fat diet might be the safest option. A low-calorie, over-the-counter diet could also be used, as long as the fat content is significantly lower than the previous diet. See the handout “Deciphering Dog Food Labels” and discuss any over-the counter diet with your veterinarian to ensure a diet is recommended for your dog.
High-quality, low-fibre (residue) diets allow your dog to digest and absorb nutrients more efficiently. Usually, veterinary low-fat diets are low in fibre; over-the-counter low-calorie diets, however, tend to be higher in fibre, which may not be the best diet for your dog.
What should I do if my dog has pancreatitis and is not eating?
Since some pancreatic diseases can lead to pain and vomiting, your dog’s appetite might be reduced. If you notice that your dog is not eating and is losing weight, contact your veterinarian for support.
- Feeding smaller but more frequent meals can help your dog eat the daily amount and tolerate it more easily. This is especially important if changing to a veterinary low fat diet is not possible for your pet as it will reduce the amount of fat per meal.
- Using some low-fat, low-fibre foods as toppers or mixers (e.g., cottage cheese; cooked, skinless chicken breast) can also help with improving your dog’s appetite. However, your dog should not get more than 10% of its calories from these foods, as they may unbalance the diet and lead to nutrient deficiencies.
- Veterinary low-fat canned food is a great option to improve the appetite. Since they are complete and balanced, there is no limit on the amount and they can be used as the only food or in combination with the dry (kibble).
- Adding water or warming the food can also help with food intake. Usually, a temperature close to body temperature is the best. Some dogs also benefit by feeding in different bowls or less stressful environments.
- A board-certified veterinary nutritionist can also formulate a complete and balanced homemade diet, which can be great for picky dogs. Homemade diets can also be a good option if your pet has multiple medical conditions that would not be easily managed with commercial food.
