Inflammatory bowel disease and the home-prepared diet

The diagnosis of inflammatory bowel disease (IBD) in your dog can be a challenging diagnosis.  Technically, biopsies of the GI tract are required to confirm that this is indeed the disease process. Veterinarians often use the term chronic enteropathy to describe dogs with chronic GI signs like vomiting or diarrhea. These cases may be further defined by their responses to treatment. For example, a dog may have a food-responsive enteropathy.

In many cases, veterinarians will recommend either a novel protein or a hydrolyzed diet approach as a first line of defense to help ameliorate the clinical signs of the disease.  The idea around a limited ingredient novel protein diet is to help determine if the disease process is food responsive by changing both the protein source and carbohydrate source in the diet on the outside chance that this is just a “food allergy.” 

Suppose your dog does not respond to a dietary change using a commercial dog food from a reputable company. In that case, many vets will suggest a hydrolyzed diet approach, which is often considered the gold standard in treatment. These diets are made with hydrolyzed protein sources where the protein fragments are so small that they should not aggravate the immune system.  Studies have suggested that over half of the dogs on these diets respond positively -- but what about those that don’t?

Home-prepared diets

For many cases that do not respond to either limited ingredient novel proteins or hydrolyzed commercial diet approaches, the next option is a limited ingredient home-prepared diet.  These home-prepared diets are often formulated to be low fat (to address IBD and protein-losing enteropathy [PLE]) that will be nutritionally complete and may garner a response in some dogs. 

Purpose:
  • To provide a convenient resource for home-prepared diets for dogs suspected of having IBD.

  • Because most dogs sent to our service have already been tried on limited ingredient or hydrolyzed diets with limited success.

Limitations:
  • It is not possible to predict which dogs will respond to a home-prepared diet
  • Many IBD cases are not food-responsive and require medical intervention from your veterinarian or a board-certified veterinary internal medicine specialist.
Components:
  • We have provided three dietary plans in this post using either a fish source (tilapia), terrestrial mammal (pork tenderloin), or poultry (99% lean turkey) as the means to try a new source of protein that your dog may not have been exposed to and may garner a response. 
  • The carbohydrate sources in each of these diets will come from rather novel sources and are interchangeable across the diets to provide some options if a dog does not like sweet potato or barley and to provide some flexibility to the diet plans. 
  • Another addition will be a novel vegetable source oil with a mix of essential polyunsaturated fats and an optional amount of fish oil for those that want to provide long-chain omega-three fatty acids in the diet plan. 
  • There is also a choice between two vitamin and mineral mixes that can be purchased and are essential additions to the diet.
Sequence for a smooth transition:
  • Each of these recipes is designed to supply 300 kcals per 5 kg body weight. This will change for dogs of larger size because smaller dogs generally need more calories than larger dogs. Knowing how many calories your dog needs to consume is essential to doing this properly.  Your veterinarian can help calculate your dog’s caloric needs.
    • For example, a 5 kg Havanese will eat about 300-350 kcals a day while a 30 kg Labrador may only eat 1200 kilocalories daily, showing the disparity between weight categories and true caloric needs. 
  • If you plan on using one of these diet plans to start a 6-week trial of home cooking (most dogs respond within 3 weeks), you will need to gradually transition from your current diet to the home-prepared daily diet plans outlined. 
    • This is typically done by starting with the meat, carbohydrate, and oil source without adding the vitamin and mineral mix. 
    • Typically, one would start with about ¼ of the estimated ration needed from the diet plan and ¾ of the old commercial food for about 3 days. 
    • Then if going well, a transition to ½ of the home-prepared ration mixed with ½ of the commercial ration for 3 days. 
    • If continued success is observed, then using the home-prepared ration at about ¾ the daily amount with ¼ of the commercial ration would be used daily for three more days.
    • By day 10 you will be at the full home-prepared amount that should continue to be fed at full ration from day 10 on. 
    • Once on the complete home-prepared ration on day 10, you can start mixing in the vitamin and mineral mix – please mix in well with the food as these vitamin and mineral mixes taste metallic and may throw off the picky eater. Typically, for example, if quadrupling the recipe outlined for a Labrador who only needs 1200 kcals, you would start with a small amount of the vitamin and mineral supplement (1/4 of the total) and work towards the 2 scoops of Annamaet Enhance over 7-10 days to build the complete and balanced ration.
    • Usually, a diet like this is fed by dividing the daily ration into two meals, but it can also be provided over more meals per day depending on medication schedule and GI tolerance. If there is occasional vomiting, decreasing meal size with more frequent feedings may improve passage.

Assessing your dog’s response to the diet transition:
  • The full transition to the new diet will take 2 to 3 weeks. If your dog’s clinical signs have resolved, you have achieved success, and your dog can remain on this diet plan long-term. 
  • If you find that things are generally better but not quite normal, you can try adding a fiber source like psyllium husk to help firm up the stools.  The addition of psyllium husk can be from a generic form, or we often recommend Konsyl 100% psyllium husk powder.
    • To prevent choking, the dry powder needs to be mixed in well with the food along with a little water.
    • As outlined in a per 300 kcal diet, about 1 teaspoon of psyllium husk can improve fecal quality when added to this diet plan. 
    • If feeding more like 4 times this quantity for an average Labrador, it would be 4 teaspoons in addition to the entire diet plan made for the day. 
What if there is no improvement?
  • If this transition does not go smoothly and your dog is not improving, we recommend further work-up by your veterinarian. 
  • If you have been through novel proteins, hydrolyzed diet, and a home-prepared plan of this nature, then it's unlikely that the IBD syndrome your dog is experiencing is likely to be food-responsive. 
  • From here, you are just looking for a highly digestible, possibly lower fat, commercial food that your veterinarian can recommend from one of the many therapeutic enteric and hydrolyzed diet options. Your veterinarian or board-certified internist will provide ways to help manage the problem with medications designed to alter the immune response and treat GI signs symptomatically.  Ask your veterinarian about the available general “enteric diets” to find the best food solution for your dog.
Why not get a consultation with a nutritionist?

Since 2005, we have been doing these fairly straightforward IBD consultations with mixed success, and there is a certain level of frustration on both the owner's part and the nutritionist's part considering the likelihood for success is such a “mixed bag” for each dog. 

Dog owners who are looking for home prepared IBD diet options need this resource because it can be both very successful for some dogs and relatively easy for the owner to provide, and thus the expertise of a boarded veterinary nutritionist is not required to put together a novel protein diet of this nature. Only when there are multiple disease conditions present does this become more difficult and require such expertise. 

In our experience, a dog is either food-responsive or they generally are not, and this is relatively easy to find out using our plans. If they are not responding well to a home-prepared approach within 2-3 weeks, it is necessary to seek further medical interventions from your veterinarian or board-certified internist. 

Three home-prepared diet plans

1. IBD/PLE canine tilapia and sweet potato diet

  • This diet plan is designed to feed an average 5 kg dog. This diet can be multiplied depending on your dog's weight.  For example, a 20 kg dog will need 3-4 times this amount, depending on their activity level.  Knowing your dog’s caloric needs is essential, and your veterinarian may be able to help you find the right amount to feed your dog. 
  • Active dogs may require slightly more, while inactive dogs may require less (up to 40% more or less depending on activity).  Monitor your dog and consult with your veterinarian if there is weight gain or loss – we recommend regular weigh-ins with your vet after starting a home-prepared diet of this nature. 
  • Using a kitchen scale to measure the proportions below properly is ideal for getting the best results. 

Daily diet to consist of (approx. 300 kcals):

3 ounces of baked tilapia (weight after cooking)

6 ounces of baked sweet potato with our without skins

½ teaspoon of hemp seed oil (can find on Amazon –Manitoba harvest)

½ teaspoon of fish oil (Grizzly salmon oil, Nordic Naturals pet, or Welactin)

Added supplements:

½ scoop (2 grams) of Annamaet Enhance or ¾ teaspoon of BalanceIT® Carnivore Blend

This daily portion is usually mixed with the supplements and fed over two or three meals. Please start by feeding the meat, carbohydrate, and oils for 10 days to see if your dog tolerates the new food. Please see the transition instructions in the text above.

If your dog tolerates the ration above by day 10, add one of the supplements listed above, which can be found at:

  1. https://www.heartypet.com/products/annamaet-enhance-dog-supplement
  2. https://shop.balance.it/products/balance-it-original-blends-carnivore-blend-for-dogs-cats 

The supplement you choose can be gradually added over 7 days if your dog tolerates the base ingredients of the diet well. Healthful vitamin and mineral supplements of this nature can alter the taste and acceptability of diets for more picky eaters, and a gradual introduction often prevents food refusal.  

This diet is approximately 32% of energy from protein, 21% from fat, and 47% from carbohydrates. During this diet trial, use of any other commercial treats should not be given, and small pieces of cooked tilapia could be used as treats. Discuss any other treats that you might like to try with your veterinarian.

2. IBD/PLE canine pork and barley diet

  • This diet plan is designed to feed an average 5 kg dog.  This diet can be multiplied depending on your dog’s weight.  For example, a 20 kg dog will need 3-4 times this amount, depending on their activity level.  Knowing your dog’s caloric needs is essential, and your veterinarian may be able to help you find the right amount to feed your dog. 
  • Active dogs may require slightly more, while inactive dogs may require less (up to 40% more or less depending on activity).  Monitor your dog and consult with your veterinarian if there is weight gain or loss – we recommend regular weigh-ins with your vet after starting a home-prepared diet of this nature. 
  • Using a kitchen scale to measure the proportions below properly is ideal for getting the best results.

Daily diet to consist of (approx. 300 kcals):

3 ounces of oven-roasted pork tenderloin (weight after cooking)

4 ounces of stovetop cooked pearled barley

½ teaspoon of hemp seed oil (can find on Amazon –Manitoba harvest)

½ teaspoon of fish oil (Grizzly salmon oil, Nordic Naturals Pet, or Welactin)

Added supplements:

½ scoop (2 grams) of Annamaet Enhance or 1 teaspoon of BalanceIT® Carnivore Blend

This daily portion is usually mixed with the supplements and fed over two or three meals.   Please start by feeding the meat, carbohydrate, and oils for 10 days to see if your dog tolerates the new food. Please see the transition instructions in the text above. If your dog tolerates the ration above by day 10, add one of the supplements listed above, which can be found at:

  1. https://www.heartypet.com/products/annamaet-enhance-dog-supplement
  2. https://shop.balance.it/products/balance-it-original-blends-carnivore-blend-for-dogs-cats

The supplement you choose can be gradually added over 7 days if your dog tolerates the base ingredients of the diet well. Healthful vitamin and mineral supplements of this nature can alter the taste and acceptability of diets for more picky eaters, and a gradual introduction often prevents food refusal.  

This diet is approximately 34% of energy from protein, 24% from fat, and 42% from carbohydrates. During this diet trial, use of any other commercial treats should not be given, and small pieces of cooked pork tenderloin could be used as treats. Discuss any other treats that you might like to try with your veterinarian.

3. IBD/PLE canine turkey and oats diet

  • This diet plan is designed to feed an average 5 kg dog.  This diet can be multiplied depending on your dog's weight.  For example, a 20 kg dog will need 3-4 times this amount, depending on their activity level.  Knowing your dog’s caloric needs is essential, and your veterinarian may be able to help you find the right amount to feed your dog. 
  • Active dogs may require slightly more, while inactive dogs may require less (up to 40% more or less depending on activity).  Monitor your dog and consult with your veterinarian if there is weight gain or loss – we recommend regular weigh-ins with your vet after starting a home-prepared diet of this nature. 
  • Using a kitchen scale to measure the proportions below properly is ideal for getting the best results.

Daily diet to consist of (approx. 330 kcals):

2 ounces pan-cooked 98-99% lean ground turkey

2 ounces of instant quick oats (dry – before rehydration weight)

¼ teaspoon of hemp seed oil (can find on Amazon –Manitoba harvest)

½ teaspoon of fish oil (Grizzly salmon oil, Nordic Naturals Pet, or Welactin)

Added supplements:

½ scoop (2 grams) of Annamaet Enhance or 1 ¼ teaspoon of BalanceIT® Carnivore Blend

This daily portion is usually mixed with the supplements and fed over two or three meals. Please start by feeding the meat, carbohydrate, and oils for 10 days to see if your dog tolerates the new food. Please see the transition instructions in the text above. If your dog tolerates the ration above by day 10, add one of the supplements listed above, which can be found at: 

  1. https://www.heartypet.com/products/annamaet-enhance-dog-supplement
  2. https://shop.balance.it/products/balance-it-original-blends-carnivore-blend-for-dogs-cats

The supplement you choose can be gradually added over 7 days if your dog tolerates the base ingredients of the diet well. Healthful vitamin and mineral supplements of this nature can alter the taste and acceptability of diets for more picky eaters, and a gradual introduction often prevents food refusal.

This diet is approximately 31% of energy from protein, 24% from fat, and 45% from carbohydrates. During this diet trial, use of any other commercial treats should not be given, and small pieces of cooked turkey could be used as treats. Discuss any other treats that you might like to try with your veterinarian.