Nutritional Management of Exocrine Pancreatic Diseases

Homemade diet as nutritional support for a dog suffering from chronic pancreatitis and inflammatory bowel disease

“…For the former, a moderate quantity of protein is advised to reduce stimulation (15%-30% DMB). 23,24,28 For the latter, generally ≥25% protein on a dry matter basis is advised to counter increased losses, which were also obvious in this case (Table 1). 21,22 As both chronic enteritis and pancreatitis resulting in exocrine pancreatic insufficiency can lead to dysbiosis, another point of careful consideration is the addition of fibre to the diet.…”

“…The chosen approach by the Institute of Animal Nutrition and Dietetics decreased the protein and fat content of the diet, while simultaneously increasing its digestible carbohydrates. This was based on the rationale that: i. both fat and protein can be considered stimuli for pancreatic excretion in contrast to carbohydrates 23,24,28 ; ii. both reduced digestibility as well as quantity of protein exceeding the digestive capacity of the small intestine can negatively impact the microbiome 49,50 ; iii.…”

“…both fat and protein can be considered stimuli for pancreatic excretion in contrast to carbohydrates 23,24,28 ;…”

“…In this case especially, thiamine deserves special attention as an increased digestible carbohydrate content of the diet also increases the thiamine requirement 38 . In case of fat maldigestion, fat‐soluble vitamins should be provided well above the maintenance requirements 21–24,28,39 . As this appeared to be no issue in this patient, the quantities provided by cod liver oil were deemed sufficient.…”

“…This was done, as it would relieve the patient's digestive tract and would mitigate the pancreatic stimulation. The focus on multiple small meals per day addresses this as well 23,24,28 . The main difference was the inclusion of IBD as a comorbidity in the approach by the Institute of Animal Nutrition and Dietetics.…”