Frequently Asked Questions - Diet in Case of Digestive Complaints

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I want to perform an elimination diet trial, should I use a home-prepared diet or a commercially-formulated diet?

Some investigators recommend using a home-prepared diet for such a purpose, because it is easier to keep track of the ingredients and there are no hidden additives. However, such diets are unbalanced and inappropriate for long-term use. They are laborious for the client and the exact composition of the diet may vary from batch to batch. Home-prepared diets are often more expensive than feeding a "prescription diet". The advantage of a commercial diet is that the same diet can be used both for diagnosis and treatment.

I want to perform an elimination diet trial, what is the best diet to use, and for how long should I feed it?

No single diet necessarily suits every patient, and the exact choice should be tailored to the individual. The previous diet of the individual should be used to decide upon the most appropriate ingredients. A traditional elimination diet is composed of single protein and carbohydrate source; available choices for protein include chicken, soy, fish, venison, rabbit, and duck; available choices for carbohydrate include rice, corn [maize], tapioca and potato. Foodstuffs based upon fish protein often make suitable choices for dogs because, unlike cats, this protein is uncommonly used in standard canine diets. Hydrolyzed protein diets are also available, and these are based either on chicken or soy protein. The major advantage of using a hydrolyzed protein diet is that such diets are highly digestible, and it is unlikely for a patient to have previously been exposed to hydrolyzed proteins. The optimum duration for an elimination diet trial is unknown, and many cases require 12 weeks to respond. For dogs with gastrointestinal signs, many investigators recommend an elimination diet trial of 3 - 4 weeks, partly because clinical experience suggests most cases respond rapidly (1 - 2 weeks), and partly because most owners will not tolerate their pet having continued signs of vomiting and diarrhea.

I want to provide fiber-supplementation for a dog with large intestinal diarrhea, how should I go about this?

There are two possible approaches; first, to feed a commercial "high-fiber" diet and second, to add a fiber supplement to the existing diet. Both approaches have their merit, but the latter approach can be tried in clinical cases. In this regard, an elimination diet is tried first, since many cases with large intestinal signs have adverse reactions to food. If response is suboptimal a fiber supplement (e.g., psyllium or Metamucil®), can then be added to gage the effect of additional fiber supplementation.

What is a sacrificial protein, and should I contemplate using this approach?

A sacrificial protein is a novel protein incorporated into a diet fed during the initial treatment phase of a dog with inflammatory bowel disease. A second novel protein is then fed once the inflammation has subsided and used for long-term management. The basis of such an approach is that such patients have ongoing mucosal inflammation, and increased permeability. By feeding a novel protein in the face of such inflammation, there is a theoretical concern that normal mucosal tolerance will be abrogated allowing hypersensitivity to the novel protein. If a single novel protein is used, the potential benefit of using a novel protein diet may be lost; using two diets in series means that a novel hypersensitivity does not develop against the diet intended for long-term control. Whilst there may be theoretical merit, there is no real scientific or clinical basis on which to base this approach, and it is seldom if ever necessary to undertake it. Hypoallergenic diets based on protein hydrolysates may make this practice even less useful (Mandigers & Biourge, 2004).

How much should I feed a dog with severe IBD that has lost 30% of its body weight?

It is important to remember to feed the patient according to its current body weight. The amount fed can then be gradually increased to take account of the individual status of the patient (e.g., activity level, working dog etc.), the effects of malabsorption and to achieve adequate body weight gain. The patient should be weighed regularly and the exact caloric intake tailored to response. If the patient tolerates a moderate fat diet, this may be preferable to a traditional low-fat diet, because the overall volume of diet fed can be reduced.