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Pancreatitis and EPI

July 8, 2021

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.

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 the 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 location 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 diet change.

But what causes pancreatitis? What you will often hear from some veterinarians or read on the internet 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 of 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 is caused by the pancreas secreting way too many digestive enzymes, much more than needed and this is what is provoking the inflammation. This reaction is more often than less, caused by a stressor in the dog’s environment such as a major change in the routine, new house, new member of the family or home renovation, etc. Another reason could be related to the liver and the secretion of bile acids. The bile acid plays a major role in the digestion of many things including fat and if there are not enough bile acids secreted (because of gallstone, for example), there could be too much pressure put on the pancreas. Also, a too drastic change in the diet for some very sensitive dogs could provoke inflammation of the pancreas.

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 it 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. Since kibble is from 30% to 60% made of starch, this information is not something that the industry is willing to investigate and share, fat is a much easier enemy to target.

Finally, genetics can also play a major role in the repetitive inflammation of the pancreas and can even lead to Exocrine Pancreatic Insufficiency (EPI). This means 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. Older small breed dogs seem to be more prone to pancreatitis with aging.

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

Feed Less Carbs: Mainly starch and soluble sugar 5% or less, 0% being the best option. 5% carbs usually means less than 10% fruits and vegetable but not all of them have the same amount of sugar. Your dog might benefit from fiber and small amounts of sugar. In that case green leafy vegetables like spinach and low sugar fruits such as blueberries are a better option. For dogs with EPI having zero vegetables is ideal and truly is the best solution, especially knowing that dogs and cats have no minimum requirements for carbohydrates regarding the Nutrient Requirements for dogs and cats by the NRC. The little needs they have for carbon molecules will be provided by some amino acids (protein) that contains carbon.

Feed Less 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. Therefore, the lipase secretion being stimulated by the amount of fat arriving in the duodenum. In raw 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 raw you can successfully to go a no-starch diet, but you might not be able to go as low in fat. However, with that said, there are some healthy fats that are beneficial for every inflammatory disease such as omega-3 fatty acids. In addition, keep in mind that mono and poly-unsaturated fatty acids don’t require as much bile acid and pancreas enzyme to be digested properly, if none 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, now with that being said normally a raw diet under 10% of fat on a as fed basis will work perfectly fine. Depending on the sensitivity of your dog you might be able to go higher or feed a lower fat diet with a small amount of fruits and vegetables. 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.

Feeding More Often: Giving multiple meals a day will also reduce the pressure on the pancreas. This may help the pancreas work a little bit all day instead of having a high demand once a day.

Digestive Enzymes: Dogs who have only had one episode of pancreatitis and once things have normalized, it might not be essential to offer your dog digestive enzymes. But if your dog has had multiple attacks or is suffering from EPI, digestive enzymes are your strongest tool to achieve proper digestion. The best way to provide your dog with pancreatic enzymes is to 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. That being said, we know that it can be very hard to source and incorporate this to a raw diet. This is why we offer the Thrive freeze-dried bovine pancreas supplement!

Fish and Healthy Fats: Whole fish or fish oil are a top choice ingredient that is 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 which improves digestibility of other nutrients compared to a high starch diet. In fact, 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.

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

Meal Fat Carbs
Pure Kangaroo 3,8% 0,8%
Pure Rabbit 9,1% 0,2%
Fish Dinner 4,5% 1,8%
Game Bird Blend 6,4% 1,4%
Pure Chicken 9,3% 0,1%
Chicken Dinner 8,6% 2,0%
The entire Fame Game line 7-8% 1,4%

If your pet suffers from EPI, avoiding all Dinner formulas would be your best option. For pancreatitis sensitivity low fat Dinners are fine to be fed in moderation. With EPI and after a pancreatitis attack, when digestive enzymes are fed, you do not need to be as strict with the amount of fat in the diet.

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 now 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.

Batt, R.M. Exocrine pancreatic insufficiency. 1993. Veterinary Clinics of North America: Small Animal Practice 23(3) 595-608.

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.

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).

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.

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.

Xenoulis P.G., J.M. Steiner. Lipid Metabolism and Hyperlipidemia in Dogs. 2010. The Veterinary journal 183 (1) 12-21.

English (Canada)
193 --- Cookhouse - Beef Meatloaf - 750g ---- 770 ----LOCATION ID>>>>157775<<<<546 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:1316 ------ In Stock
194 --- Beef Neck Bone 4-6" - 1 lb ---- 0 ----LOCATION ID>>>>157775<<<<0 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:0 ------ Out Of Stock
197 --- Pure Beef Tripe CARTON - 4 lb ---- 44 ----LOCATION ID>>>>157775<<<<118 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:162 ------ In Stock
198 --- Country Blend Carton - 4 lb ---- 494 ----LOCATION ID>>>>157775<<<<1695 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:2189 ------ In Stock
200 --- Chicken Dinner Carton - 4 lb ---- 648 ----LOCATION ID>>>>157775<<<<3625 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:4273 ------ In Stock
202 --- Chicken Necks (Skinless) - 2 lb ---- 0 ----LOCATION ID>>>>157775<<<<1 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:1 ------ In Stock
203 --- Slobbers® Organic Virgin Coconut Oil - 250 ml ---- 0 ----LOCATION ID>>>>157775<<<<598 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:0 ------ In Stock
204 --- Dehydrated Beef Liver - 114g ---- 104 ----LOCATION ID>>>>157775<<<<251 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:355 ------ In Stock
205 --- Dehydrated Beef Lung - 65g ---- 15 ----LOCATION ID>>>>157775<<<<170 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:185 ------ In Stock
207 --- 6" Dehydrated Beef Pizzle Chew ---- 582 ----LOCATION ID>>>>157775<<<<711 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:1293 ------ In Stock
209 --- Dehydrated Chicken Feet - 114g ---- 78 ----LOCATION ID>>>>157775<<<<182 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:260 ------ In Stock
211 --- Duck Dinner Carton - 4 lb ---- 252 ----LOCATION ID>>>>157775<<<<520 ----- LOCATION ID>>>>157773<<<< TOTAL STOCK:772 ------ In Stock