Our understanding regarding how best to feed (or not feed) dogs with pancreatitis has undergone significant changes over the last few years. Back when I was in veterinary school in the 1990s, we learned that dogs with pancreatitis should be fasted for 24-48 hours. This protocol was based on a reasonable assumption — food passing through the intestinal tract would stimulate the pancreas to secrete digestive enzymes, thereby increasing pancreatic inflammation.
But now, research in people and dogs is revealing the harmful effects that prolonged fasting can have on the structure and function of the gastrointestinal tract, including its important role in the immune system. The cells that line the intestinal tract depend on absorbing energy and nutrients that pass by after a meal. When a dog does not eat, the lining of the intestinal tract changes: the villi (fingerlike projections that increase the intestine’s absorptive surface) shrink, local immune tissue is reduced, the intestinal wall becomes “leaky,” promoting the absorption of bacteria and toxins, and inflammation increases, both within the digestive tract and systemically. Also, there is some evidence that when the pancreas is inflamed it does not secrete digestive enzymes in response to the presence of food in the same way that a healthy pancreas does, which casts even more doubt on the practice of prolonged fasting.
We don’t have studies in dogs that directly answer the question of when and how to best start feeding dogs with pancreatitis, but many veterinarians are switching to an “as soon as possible” mind set. We should still not be feeding dogs that are actively vomiting (there’s no point if they can’t keep it down), but the effective antiemetic medications that are now available (e.g., maropitant) often allow us to get control of a dog’s vomiting within 24 hours of hospitalization. It is at this time that food should be reintroduced.
In dogs, dietary fat is known to be associated with the development of pancreatitis and can stimulate the secretion of a hormone that induces the pancreas to secrete its digestive hormones. Therefore, low fat foods are recommended. Refeeding should always begin slowly. A common recommendation is to start with one-quarter of the dog’s resting energy requirement divided into four meals throughout the day. In other words, the dog would get four meals consisting of about 1/16 of what it would normally eat spread over 24 hours. As long as the dog continues to improve, the amount of food offered could increase by one-quarter every day so that at the end of four days, the patient is taking in his or her full resting energy requirement.
Because we want dogs with pancreatitis to benefit from as much nutrition as possible even when taking in small amounts of food, a highly digestible diet is preferred. Foods should be low in fiber and made from high-quality ingredients. Several pet food manufacturers make low fat, highly digestible diets for dogs. Most veterinarians carry at least one food like this in their clinics to feed to hospitalized patients and to send home with dogs as they continue to recover. A short-term alternative is to feed a mixture of boiled white meat chicken and white rice, but if a home cooked diet is needed for more than just a few days, a veterinary nutritionist should design a nutritionally complete diet that will meet all of the dog’s needs.
Dr. Jennifer Coates