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EPI and Pancreatitis

août 25, 2022

(Updated from a previous blog)
Note: this blog post will not replace veterinarian advice. Our goal is to help you feed raw to a dog or a cat with pancreas health issues.

How and Why Does My Dog Have Pancreatitis?
If you do not know what a dog going through a pancreatitis attack looks like and are just reading this by interest, know that it is a very worrying experience. The dog may start to get sick after every meal and in between meals there is typically vomiting and diarrhea. Usually, the dog also gets very lethargic and stops eating. In the worst cases, your dog will also show signs of pain when you touch a certain area of their belly. You go to the vet and after a blood test and x-rays or scan, the diagnosis is: pancreatitis. It is typically followed by a hospitalization of a certain number of days that depends on each dog, lots of medication, money spent and a dietary change.

What Causes Pancreatitis?
What you will often hear and read is that a high fat diet is usually the cause of the inflammation. Unfortunately, it is way more complicated than that. Considerably reducing the fat in a diet without any consideration to the type of fat or other nutrients that will replace the fat, shows a lack of understanding of the nutrition physiology.

Pancreatitis: an inflammation of the pancreas often characterized by the over secretion of digestive enzymes, especially lipase, that is used for the diagnosis. This reaction is more often than not caused by a stressor in the dog’s environment such as a major change in their routine, new house, new member of the family or home renovation, etc. The pancreas, compared to other organs, can be extremely sensitive and be the first to react to a negative experience. Often times the pancreas inflammation can be related to the liver and more specifically the secretion of bile acids. The liver, the gallbladder and the pancreas work very closely, and they depend on each other to properly digest and metabolize the food. The bile acid plays a major role in the digestion of many things including breaking down fat in smaller particles. If there is an issue with the bile acid (because of gallstone, for example, or excess fiber), there could be too much pressure put on the pancreas to digest the left-over fat.

Finally, for more sensitive dogs, a too drastic change in their diet, of an indigestion episode can be sufficient enough to provoke an inflammation of the pancreas. In most scenarios, pancreatitis is a single unique attack that will not come back in the future.

Another reason we don’t often hear about, and is probably the most important, is the amount of sugar or more precisely the starch in the diet. For dogs, the pancreas is the only organ able to secrete amylase, the enzymes that break down starch, which makes the glucose available for digestion and absorption. The pancreas is also responsible for releasing hormones related to glucose homeostasis. If a dog is fed a high starch/sugar diet for a long period of time, the amount of pressure that is put on the pancreas could lead to the inflammation of the pancreas, causing the pancreatitis attack, or chronic pancreas inflammation. Since kibble is made of 30% – 60% starch, it is not the favourite target. Fat is a much more convenient culprit.

Finally, genetics can also play a major role in the repetitive inflammation of the pancreas and can even lead to Exocrine Pancreatic Insufficiency (EPI). Older small breed dogs seem to be more prone to pancreatitis with aging. EPI is a condition where the pancreas does not work as it is supposed to, or stops working at all without any influence from the diet. This specific situation needs a very particular and highly digestible diet with added digestive enzymes to replace the ones that the pancreas is supposed to secrete.

Once your dog has suffered from a pancreatic attack, their pancreas will be at a much higher risk to become inflamed again. Therefore, changes need to be made to their diet, at least for a period of time, and raw can still be a solution!

1. Feed Low Carbs
Like said previously, the pancreas is the only organ in dogs that can help digest starch and sugar. If the pancreas in prone to inflammation or not working properly, the carbs content of the diet needs to be lower. If a high carb diet is still offered, not only will the pancreas continue to be stimulated and inflamed, but the unproperly digested starch and sugar will arrive in the small intestine where bacteria will ferment it and cause even more digestive issues.

We want to reduce starch and soluble sugar to 5% or less, 0% being the best option. Since starch and sugar are found in grains, vegetables, and fruits, we want to make sure the amount is the lowest possible. Also, not all fruits and vegetables are equal in a dietary perspective – some being high in fiber and low in sugar. Your dog might benefit from fiber and small amounts of sugar. In that case, green leafy vegetables like spinach and low glycemic fruits such as blueberries are a good option. For dogs with EPI, offering zero vegetables is ideal and is truly the best solution, especially knowing that dogs and cats have no minimum requirements for carbohydrates regarding the Nutrient Requirements of dogs and cats by the NRC. The little needs they have for glucose will be provided by the gluconeogenesis of amino acids – creating of glucose from protein.

2. Feed Moderate Fat
Yes, even if the digestion of fat is not 100% done by the pancreas, lowering the fat content will lower the pressure on the pancreas, even more so if the pancreas inflammation is related to a liver issue, the lipase secretion being stimulated by the amount of fat arriving in the duodenum. In raw feeding, it is almost impossible to go as low as some low-fat kibble diets, which are around 5-6% on a dry matter basis. However, those diets are usually higher in starch which is not really helping the problem as explained earlier. In addition, the amount of food fed on a dry matter basis in raw is lower than kibble, so even if the fat % is a bit higher, the total amount of fat ingested is often similar. Normally a raw diet under 10% fat on an as fed basis will work perfectly fine.

3. Feed Good Fat
However, there are some healthy fats that are beneficial for every inflammatory disease, including pancreatitis, such as omega-3 fatty acids. In addition, it is good to keep in mind that mono and poly-unsaturated fatty acids don’t require as much bile acid and pancreas enzymes to be digested properly, if at all. They are almost all directly absorbed through the blood system. So feeding poly-unsaturated fat will not put any more pressure on the pancreas. Different amounts of unsaturated fat in the diet of healthy dogs does not influence the pancreas to respond (serum or gastrin pancreatic enzymes level.) The fat that we want to reduce and avoid is mainly long-chain saturated fatty acids. Some saturated fats are also an exception like the lauric acid from unrefined coconut oil which does not involve the liver or pancreas enzymes as much as other saturated fats.

Whole fish and fish oil are great ingredient choices that are high in omega-3 fatty acids and other poly-unsaturated fatty acids. They are always a great addition to a diet, but in the situation of an inflammatory disease they are an essential fat source to maintain a healthy metabolism. Healthy fats also play a major role in the health of the skin and coat and improves digestibility of other nutrients compared to a high starch diet. In fact, studies have shown that dogs with EPI might have better nutrient absorption when an enzyme supplement is taken with a high/moderate-fat, high-protein and low-carb diet.

4. Adjust Feeding Schedule and Add Digestive Supplement
Do not over stimulate the digestive system. The liver and the pancreas need to take breaks. Feeding multiple meals per day (which is the most common recommendation) means your dog’s liver and pancreas will never have a break. One to two meals per day is very sufficient – and a fasting period is even recommended when the dog is having a pancreatitis attack. You can start reintroducing food with smaller meals, but you will quickly be able to go back to 1-2 meals per day.

For dogs who have only had one episode of pancreatitis, and once blood test results, stools and everything else are back to normal, it might not be essential to offer your dog digestive enzymes on a daily basis. But if your dog has had multiple attacks or is suffering from EPI, digestive enzymes are your strongest tool to achieve proper digestion. The most holistic way to provide your dog with digestive enzymes is to simply add some pancreas to their diet. Historically, dogs ate the entire digestive tract of their prey including the pancreas, which contains an abundance of naturally occurring digestive enzymes, including amylase, lipase and protease. Depending on the animal, the level of enzyme can differ; pork being higher in lipase than beef for example. That being said, we know that it can be very hard to source and incorporate this into a raw diet. This is why we offer Thrive Freeze-Dried Beef Pancreas and Pork Pancreas supplements!

Here is the list of Big Country Raw meals that typically work great for pets with pancreas health issues, along with the amount of fat and carbs in each:

Meal Type / Fat / Carbs

  • Pure Kangaroo / 4 % / 0,8%
  • Pure Rabbit / 9% / 0,9%
  • Fish Dinner / 2% / 1,8%
  • Game Bird Blend / 6,4% / 1,4%
  • Chicken Dinner / 8% / 2,0%
  • Turkey Dinner / 9% / 1,5%
  • Quail Dinner / 4% / 2,5%
  • Fame Game Line / 6-8% / 1,2-1,9%

Another point to keep in mind in your decision to feed raw to your pet that suffers or has suffered from pancreatitis or other digestive issues, is that raw is actually a food that is alive. Raw is full of natural and healthy bacteria as well as enzymes that will not only feed your pet but also feed their digestive tract. Most commercial pet food is void of live enzymes as the heat used during cooking and the preservatives added to the food destroy all-natural enzymes. This requires your pet’s pancreas and overall digestive system to make an unnatural abundance of the digestive enzymes necessary to digest food.

Many pets thrive on Big Country Raw, even if they suffer from pancreatitis or have EPI, and your pet will be no exception!

References:
Arendt M., F. Tove, K. Lindblad-Toh, E. Axelsson. Amylase Activity is Associated with AMY2B Copy Numbers in Dog: Implications for Dog Domestication, Diet and Diabetes. 2014. Animal Genetics 45(5):716-22. https://pubmed.ncbi.nlm.nih.gov/24975239/

Batt, R.M. Exocrine pancreatic insufficiency. 1993. Veterinary Clinics of North America: Small Animal Practice 23(3) 595-608. https://pubmed.ncbi.nlm.nih.gov/8503162/

James F.E., C.S. Mansfield, J.M. Steiner, D.A. Williams, I.D. Roberston. Pancreatic Response in Healthy Dogs Fed Diets of Various Fat Compositions. 2009. American Journal of Veterinary Research 70(5) 614-618. https://pubmed.ncbi.nlm.nih.gov/19405900/

Kilburn L.R., K. Allenspach, A.E. Jergens, A. Bourgeois-Mochel, J.P. Mochel, M.C. Rossoni Serao. Apparent Total Tract Digestibility, Fecal Characteristics, and Blood Parameters of Healthy adult Dogs Fed High-Fat Diets. 2020. Journal of Animal Science 98(3). https://pubmed.ncbi.nlm.nih.gov/32047902/

National Research Council of the National Academies. Nutrient Requirement for Dogs and Cats. Chapter 5: Fat and Fatty Acids. Animal Nutrition Series. 2006 (2018 edition). P81-104.

Westermarck E., Junttila J.T., M.E. Wiberg. Role of Low Dietary Fat in the Treatment of Dogs with Exocrine Pancreatic Insufficiency. 1995. American Journal of Veterinary Research 56(5) 600-605. https://pubmed.ncbi.nlm.nih.gov/7661454/

Yago M.D., E. Martinez-Victoria, J.R. Huertas, M. Manas. Effects of the Amount and Type of Dietary Fat on Exocrine Pancreatic Secretion in Dogs After Different Periods of Adaptation. 1997. Archives of Physiology and Biochemistry 105(1) 78-85. https://pubmed.ncbi.nlm.nih.gov/9224549/

Xenoulis P.G., J.M. Steiner. Lipid Metabolism and Hyperlipidemia in Dogs. 2010. The Veterinary journal 183 (1) 12-21. https://pubmed.ncbi.nlm.nih.gov/19167915/

Français du Canada
193 --- Cookhouse - Pain de viande de boeuf - 750g ---- 162 ----LOCATION ID>>>>157775<<<<0 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:162 ------ disponible
194 --- Cou de Boeuf 4 à 6 morceaux - 1 lb ---- 0 ----LOCATION ID>>>>157775<<<<0 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:0 ------ Non disponible
197 --- Tripe de boeuf - boite de 4 lb ---- 305 ----LOCATION ID>>>>157775<<<<8 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:313 ------ disponible
198 --- Mélange Campagnard - boite de 4 lb ---- 497 ----LOCATION ID>>>>157775<<<<1097 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:1594 ------ disponible
200 --- Dîner de poulet - Boite de 4 lb ---- 1354 ----LOCATION ID>>>>157775<<<<4265 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:5619 ------ disponible
202 --- Cous de poulet (sans la peau) - 2 lb ---- 0 ----LOCATION ID>>>>157775<<<<1 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:1 ------ disponible
203 --- Slobbers® Huile vierge de noix de coco - 250 ml ---- 0 ----LOCATION ID>>>>157775<<<<598 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:0 ------ disponible
204 --- Hero Dehydrated Beef Liver - 114g ---- 28 ----LOCATION ID>>>>157775<<<<210 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:238 ------ disponible
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